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Sample records for benign inguinal lump

  1. Dermoid cyst of the spermatic cord: a rare cause of benign inguinal lump

    PubMed Central

    Aslam, Muhammad Z.; Kheradmund, Ferhad; Patel, Nilay S.; Turner, Gareth; Cranston, David

    2009-01-01

    Dermoid cyst of the spermatic cord is an extremely rare pathology seen at the urological clinic. We present the case of a 26-year-old man who presented with a groin lump, thought to be a lipoma or a hydrocoele of the cord. The final histopathological analysis established the diagnosis of a dermoid cyst. PMID:19672433

  2. Causes of breast lumps (image)

    MedlinePlus

    ... breast lumps are benign (non-cancerous), as in fibroadenoma, a condition that mostly affects women under age ... with the menstrual cycle, whereas a lump from fibroadenoma does not. While most breast lumps are benign, ...

  3. An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease.

    PubMed

    Keyzer-Dekker, C M G; van Esch, L; de Vries, J; Ernst, M F; Nieuwenhuijzen, G A P; Roukema, J A; van der Steeg, A F W

    2012-07-01

    Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to women referred after ASM. In addition, the influence of the anxiety as a personality characteristic (trait anxiety) was studied. Between September 2002 and February 2010 we performed a prospective longitudinal study in six Dutch hospitals. Women referred after ASM or with a palpable lump in the breast (PL), who were subsequently diagnosed with BBD, were included. Before diagnosis (at referral) and during follow-up, questionnaires were completed examining trait anxiety (at referral), state anxiety, depressive symptoms (at referral, one, three and 6 months after diagnosis), and QoL (at referral and 12 months). Women referred after ASM (N=363) were compared with women with PL (N=401). A similar state anxiety score was found in both groups, but a lower psychological QoL score at 12 months was seen in the ASM group. In women with not-high trait anxiety those in the ASM group were more anxious with more depressive symptoms at referral, and reported impaired psychological QoL at referral and at 12 months compared with the PL group. No differences were found between ASM and PL in women with high trait anxiety, but this group scored unfavorably on anxiety, depressive symptoms and QoL compared with women with not-high trait anxiety. ASM evokes more anxiety and depressive symptoms and lowered QoL compared with women referred with PL, especially in women who are not prone to anxiety. Women should be fully informed properly about the risks and benefits of breast cancer screening programs. We recommend identifying women at risk of reduced QoL using a psychometric test.

  4. Comparative study of contrast-enhanced ultrasound qualitative and quantitative analysis for identifying benign and malignant breast tumor lumps.

    PubMed

    Liu, Jian; Gao, Yun-Hua; Li, Ding-Dong; Gao, Yan-Chun; Hou, Ling-Mi; Xie, Ting

    2014-01-01

    To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.

  5. Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China.

    PubMed

    Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

    2015-08-28

    There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps.

  6. A Randomized Pilot Study of Inositol in Association with Betaine and Boswellia in the Management of Mastalgia and Benign Breast Lump in Premenopausal Women

    PubMed Central

    Pasta, Vittorio; Dinicola, Simona; Giuliani, Alessandro; Harrath, Abdel Halim; Alwasel, Saleh H.; Tartaglia, Francesco; Cucina, Alessandra; Bizzarri, Mariano

    2016-01-01

    Benign mammary lumps and mastalgia are the most common breast disorders; yet, there is no clear-cut consensus about the best strategy for their treatment. We hypothesized that a combination, including boswellic acid, betaine, and myoinositol, would be beneficial in breast disorders by exerting a pleiotropic effect on multiple pathways. Indeed, myoinositol has already been proven to modulate some factors involved in the genesis of breast diseases, such as fibrosis and metabolic and endocrine cues. In our study, 76 women were randomly assigned to either the experimental or the placebo arm. After six months of treatment, statistically significant differences between the two groups were recorded for pain relief (56% vs 17%) and breast density reduction (60% vs 9%). Furthermore, benign breast mass dimension showed a reduction in the experimental group (40% vs 16%). The combination of boswellic acid, betaine, and myoinositol has been demonstrated to be effective in the treatment of breast pain and radiologically and histologically confirmed benign breast mass and in the reduction of breast density, one of the pivotal risk factors for the development of breast cancer, without any side effects. PMID:27127407

  7. Breast lump

    MedlinePlus

    ... a woman are often caused by fibrocystic changes, fibroadenomas, and cysts. Fibrocystic changes are painful, lumpy breasts. ... period, and then improve after your period starts. Fibroadenomas are noncancerous lumps that feel rubbery. They move ...

  8. Breast Lumps

    MedlinePlus

    ... You might notice: A distinct lump with definite borders A firm, hard area within your breast A ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  9. Neck lump

    MedlinePlus

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  10. Diagnostic yield of a one-stop neck lump clinic.

    PubMed

    Al Hamarneh, Osama; Liew, Lenny; Shortridge, Richard J

    2013-05-01

    Diagnostic clinics for patients with neck lumps were established across the UK in response to NICE guidance on cancer services. The guidance stated that a surgeon and a cytopathologist among its other key recommendations should staff each clinic. The aim of this study was to establish the diagnostic yield of this clinic at Wolverhampton. A prospective cohort study was conducted of patients attending a one-stop neck lump clinic over a period of 30 months. Patients' characteristics, diagnostic tests and outcomes were recorded and the data analysed. Of 333 patients, n = 65 (20 %) had no lump, n = 214 (64 %) had a benign lump and n = 54 (16 %) had a malignant lump. Older age of patients and a history of smoking were found to be significantly higher when a malignant lump was diagnosed when compared with a benign lump. In the benign lump group, freehand FNAC had an accuracy of 87 % (n = 48/55), while USS-guided FNAC had an accuracy of 74 % (n = 32/43). Diagnosis was confirmed on the same day for the majority of patients (n = 178, 84 %). In the malignant lump group, freehand FNAC had an accuracy of 82 % (n = 28/34), while USS-guided FNAC had an accuracy of 81 % (n = 17/21). Diagnosis on the same day was confirmed for 74 % of the patients (n = 40). The clinic in our unit achieved an overall diagnostic yield of 84 %. Outcomes regarding age, sex, smoking, size and site of neck lumps and accuracy of FNAC were in line with published data. The study showed that this one-stop neck lump clinic was better at excluding malignancy than diagnosing it.

  11. Inguinal hernia (image)

    MedlinePlus

    Inguinal hernia is the result of an organ, usually bowel, protruding through a weak point or tear in the thin muscular abdominal wall. Inguinal hernias can restrict blood supply to the bowel herniated ...

  12. Lumping in pharmacokinetics.

    PubMed

    Brochot, Céline; Tóth, János; Bois, Frédéric Y

    2005-12-01

    Pharmacokinetic (PK) models simplify biological complexity by dividing the body into interconnected compartments. The time course of the chemical's amount (or concentration) in each compartment is then expressed as a system of ordinary differential equations. The complexity of the resulting system of equations can rapidly increase if a precise description of the organism is needed. However, difficulties arise when the PK model contains more variables and parameters than comfortable for mathematical and computational treatment. To overcome such difficulties, mathematical lumping methods are new and powerful tools. Such methods aim at reducing a differential system by aggregating several variables into one. Typically, the lumped model is still a differential equation system, whose variables are interpretable in terms of variables of the original system. In practice, the reduced model is usually required to satisfy some constraints. For example, it may be necessary to keep state variables of interest for prediction unlumped. To accommodate such constraints, constrained lumping methods have are also available. After presenting the theory, we study, here, through practical examples, the potential of such methods in toxico/pharmacokinetics. As a tutorial, we first simplify a 2-compartment pharmacokinetic model by symbolic lumping. We then explore the reduction of a 6-compartment physiologically based pharmacokinetic model for 1,3-butadiene with numerical constrained lumping. The lumping methods presented here can be easily automated, and are applicable to first-order ordinary differential equation systems.

  13. Facts for Life: Benign Breast Changes

    MedlinePlus

    ... tests are needed to make a diagnosis. Warning signs of breast cancer See a doctor if you notice any of ... of lump is found, it may be a sign of a benign breast condition or breast cancer. If you find a lump in your breast, ...

  14. Lump wood combustion process

    NASA Astrophysics Data System (ADS)

    Kubesa, Petr; Horák, Jiří; Branc, Michal; Krpec, Kamil; Hopan, František; Koloničný, Jan; Ochodek, Tadeáš; Drastichová, Vendula; Martiník, Lubomír; Malcho, Milan

    2014-08-01

    The article deals with the combustion process for lump wood in low-power fireplaces (units to dozens of kW). Such a combustion process is cyclical in its nature, and what combustion facility users are most interested in is the frequency, at which fuel needs to be stoked to the fireplace. The paper defines the basic terms such as burnout curve and burning rate curve, which are closely related to the stocking frequency. The fuel burning rate is directly dependent on the immediate thermal power of the fireplace. This is also related to the temperature achieved in the fireplace, magnitude of flue gas losses and the ability to generate conditions favouring the full burnout of the fuel's combustible component, which, at once ensures the minimum production of combustible pollutants. Another part of the paper describes experiments conducted in traditional fireplaces with a grate, at which well-dried lump wood was combusted.

  15. Epidermoid cyst at a rare location, as a content of inguinal hernia: A case report with a review of the literature

    PubMed Central

    Meher, Sadananda; Baijal, Manish; Soni, Vandana; Sharma, Anil; Khullar, Rajesh; Chowbey, Pradeep

    2016-01-01

    Epidermoid cysts can occur in a variety of locations including the face, trunk, neck, extremities, and scalp. No case of epidermoid cyst as content of inguinal hernia has been reported so far; however, cases with dermoid, teratoma, lipoma, lymphangioma and leiomyoma as content of inguinal canal have been reported. A 29-year-old female presented with a lump in the left inguinal region that was clinically diagnosed as left inguinal hernia. The patient was planned for laparoscopic inguinal hernia repair after routine investigation. Intraoperatively, a cystic mass was found to be attached to the left round ligament that was excised completely. Histopathological report was consistent with epidermal inclusion cyst. Inguinal epidermoid cyst mimicking inguinal hernia is a rare entity. If such a cyst is encountered during operation, it should be completely excised. PMID:27279405

  16. Benign Breast Problems and Conditions

    MedlinePlus

    ... are benign breast lumps or masses? • What is mastitis? • How is mastitis treated? • What are the signs and symptoms of ... recommended, along with close follow-up. What is mastitis? Mastitis is an infection of the breast tissue. ...

  17. Flux compactifications grow lumps

    NASA Astrophysics Data System (ADS)

    Dahlen, Alex; Zukowski, Claire

    2014-12-01

    The simplest flux compactifications are highly symmetric—a q -form flux is wrapped uniformly around an extra-dimensional q -sphere. In this paper, we investigate solutions that break the internal SO (q +1 ) symmetry down to SO (q )×Z2 ; we find a large number of such lumpy solutions, and show that often at least one of them has lower vacuum energy, larger entropy, and is more stable than the symmetric solution. We construct the phase diagram of lumpy solutions, and provide an interpretation in terms of an effective potential. Finally, we provide evidence that the perturbatively stable vacua have a nonperturbative instability to spontaneously sprout lumps. We give an estimate of the decay rate and argue that generically it is exponentially faster than all other known decays.

  18. Breast lumps: a rare site for rheumatoid nodules

    PubMed Central

    Ali, Hiam; Vidya, Raghavan

    2015-01-01

    Granulomatous mastitis (GM) of the breast is a rare benign inflammatory disease and its presentation closely mimics breast cancer. Its diagnosis is mainly based on histology and there is no consensus agreement regarding its management. We report a case of a 60-year-old woman presenting with a right breast lump associated with a history of rheumatoid arthritis and raised rheumatoid factor. Following triple assessment (history and examination, imaging and biopsy), GM was diagnosed and she was treated conservatively. PMID:25903203

  19. Idiopathic Granulomatous Mastitis: A Clinical Puzzle in Breast Lump Cases.

    PubMed

    Nath, Vivek G; Sahoo, Rakesh; Sahoo, Avinash; Barad, Jithendra Kumar; Arun, K A

    2017-06-01

    Idiopathic granulomatous mastitis (IGM) is a rare benign disease, characterized by chronic inflammation and granulomatous disease process. A middle aged lady with breast lump for six months with equivocal mammographic and ultrasound results underwent lumpectomy and biopsy. Ruling out all other possible granulomatous diseases and malignancy, a diagnosis of IGM was made. IGM becomes clinically significant as it closely mimics carcinoma breast and some inflammatory and infectious pathology.

  20. Round Ligament Leiomyoma Presenting as an Incarcerated Inguinal Hernia: Case Report and Review of the Literature

    PubMed Central

    Mandel, Marc

    2016-01-01

    Leiomyomas are common benign gynecologic tumors occurring in up to 30% of women. Round ligament leiomyomas however are very rare and, if symptomatic, can present as an inguinal hernia. We report the case of a 47-year-old woman who presented with an irreducible inguinal mass consistent with an incarcerated hernia. Intraoperatively, the mass was found to be a round ligament leiomyoma, a diagnosis that was confirmed by histopathology following excision of the mass. Although rare, round ligament leiomyomas should be part of the differential diagnosis of an inguinal hernia in females. PMID:27144048

  1. Recurrent inguinal hernia.

    PubMed Central

    Postlethwait, R W

    1985-01-01

    An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia, incomplete dissection or improper ligation of the sac, failure to narrow the cord, or inadequate reconstruction of the internal ring. No cause for the diffuse direct recurrences was apparent. Of the 241 hernias in Hesselbach's triangle, 144 were small localized defects, usually (112) just lateral to the symphysis. These were considered to be caused by the cutting action of a suture placed under tension. On the basis of these findings, suggestions are made for primary inguinal hernia operations. PMID:4073990

  2. An Uncommon Case of Adolescent Ovarian Teratoma Incarcerated in Inguinal Hernia

    PubMed Central

    Girgenti, Vincenza; Cimador, Marcello; Li Voti, Giuseppe

    2016-01-01

    Mature cystic teratoma is the most frequent benign ovarian neoplastic lesion in adolescents and is generally composed of fully differentiated tissue arising from multipotential three germinal layers. It accounts for approximately 50% of benign ovarian tumors in childhood. Rarely, a bilateral, synchronous, or metachronous presentation can be observed, supporting a conservative approach as the first surgical approach. We report a case of an ovarian mature cystic incarcerated in indirect inguinal hernia in a 15-year-old girl undergoing ovary-sparing surgery. To our knowledge this is the first case of such lesion incarcerated in an inguinal hernia reported in literature. PMID:27525145

  3. An Uncommon Case of Adolescent Ovarian Teratoma Incarcerated in Inguinal Hernia.

    PubMed

    Pensabene, Marco; Girgenti, Vincenza; Cimador, Marcello; Li Voti, Giuseppe; Rodolico, Vito; Siracusa, Fortunato

    2016-01-01

    Mature cystic teratoma is the most frequent benign ovarian neoplastic lesion in adolescents and is generally composed of fully differentiated tissue arising from multipotential three germinal layers. It accounts for approximately 50% of benign ovarian tumors in childhood. Rarely, a bilateral, synchronous, or metachronous presentation can be observed, supporting a conservative approach as the first surgical approach. We report a case of an ovarian mature cystic incarcerated in indirect inguinal hernia in a 15-year-old girl undergoing ovary-sparing surgery. To our knowledge this is the first case of such lesion incarcerated in an inguinal hernia reported in literature.

  4. Lumped transmission line avalanche pulser

    DOEpatents

    Booth, R.

    1995-07-18

    A lumped linear avalanche transistor pulse generator utilizes stacked transistors in parallel within a stage and couples a plurality of said stages, in series with increasing zener diode limited voltages per stage and decreasing balanced capacitance load per stage to yield a high voltage, high and constant current, very short pulse. 8 figs.

  5. Lumped transmission line avalanche pulser

    DOEpatents

    Booth, Rex

    1995-01-01

    A lumped linear avalanche transistor pulse generator utilizes stacked transistors in parallel within a stage and couples a plurality of said stages, in series with increasing zener diode limited voltages per stage and decreasing balanced capacitance load per stage to yield a high voltage, high and constant current, very short pulse.

  6. Breast lumps: a rare site for rheumatoid nodules.

    PubMed

    Iqbal, Fahad Mujtaba; Ali, Hiam; Vidya, Raghavan

    2015-04-22

    Granulomatous mastitis (GM) of the breast is a rare benign inflammatory disease and its presentation closely mimics breast cancer. Its diagnosis is mainly based on histology and there is no consensus agreement regarding its management. We report a case of a 60-year-old woman presenting with a right breast lump associated with a history of rheumatoid arthritis and raised rheumatoid factor. Following triple assessment (history and examination, imaging and biopsy), GM was diagnosed and she was treated conservatively. 2015 BMJ Publishing Group Ltd.

  7. Arterial injuries during inguinal herniorrhaphy.

    PubMed Central

    Shamberger, R C; Ottinger, L W; Malt, R A

    1984-01-01

    In all common forms of inguinal herniorrhaphy, stitches pass either just superficial to the internal iliac artery and vein or through their sheath. Despite the potential for arterial injury, documented cases seem to exist only in the foreign-language literature. We report four cases of arterial injury following inguinal herniorrhaphy in adults. The artery is placed in jeopardy when the transversalis fascia is incorporated in the stitches used to close the medial aspect of the internal inguinal ring. The depth of penetration of the needle and the proximity of the external iliac artery must be accurately judged. Injury can result from direct puncture of the artery or avulsion of one of its branches. Immediate repair of any arterial injury is paramount, and newly subnormal pulses below the inguinal injury are unacceptable. Exposure must be adequate, and division of the floor of the inguinal canal may be necessary for this purpose. Repair may require a simple hemostatic suture, a patch graft, or an interposition graft. PMID:6732332

  8. Calibrating binary lumped parameter models

    NASA Astrophysics Data System (ADS)

    Morgenstern, Uwe; Stewart, Mike

    2017-04-01

    Groundwater at its discharge point is a mixture of water from short and long flowlines, and therefore has a distribution of ages rather than a single age. Various transfer functions describe the distribution of ages within the water sample. Lumped parameter models (LPMs), which are mathematical models of water transport based on simplified aquifer geometry and flow configuration can account for such mixing of groundwater of different age, usually representing the age distribution with two parameters, the mean residence time, and the mixing parameter. Simple lumped parameter models can often match well the measured time varying age tracer concentrations, and therefore are a good representation of the groundwater mixing at these sites. Usually a few tracer data (time series and/or multi-tracer) can constrain both parameters. With the building of larger data sets of age tracer data throughout New Zealand, including tritium, SF6, CFCs, and recently Halon-1301, and time series of these tracers, we realised that for a number of wells the groundwater ages using a simple lumped parameter model were inconsistent between the different tracer methods. Contamination or degradation of individual tracers is unlikely because the different tracers show consistent trends over years and decades. This points toward a more complex mixing of groundwaters with different ages for such wells than represented by the simple lumped parameter models. Binary (or compound) mixing models are able to represent a more complex mixing, with mixing of water of two different age distributions. The problem related to these models is that they usually have 5 parameters which makes them data-hungry and therefore difficult to constrain all parameters. Two or more age tracers with different input functions, with multiple measurements over time, can provide the required information to constrain the parameters of the binary mixing model. We obtained excellent results using tritium time series encompassing

  9. Bilateral Inguinal Hernias Containing Ovaries

    PubMed Central

    Basrur, Gurudutt Bhaskar

    2015-01-01

    Inguinal hernias are rare in females. The authors report a case of bilateral inguinal hernias in a 10-year-old female. On exploration, the patient was found to be having a sliding hernia containing incarcerated ovary as contents on both sides. Peroperatively the contents were reduced, the sac was transfixed at its base and the redundant sac was excised. The repair of this form of hernias is more difficult because of adhesions between the contents and the wall of the sac and risk of damage during dissection. A description of this clinical presentation in the pre operative assessment and operative management are discussed in this report. PMID:25918632

  10. Modified endoscopic left inguinal lymphadenectomy.

    PubMed

    Alvarez-Maestro, M; Rios Gonzalez, E; Martinez-Piñeiro, L; Sanchez Gomez, F J

    2013-01-01

    Endoscopic Inguinal Lymphadenectomy is an evolution of laparoscopic surgery thanks to background in these techniques. This is a new technique and the indications in the field of penile tumors today are expanding. The technique aims at reducing the morbidity of the procedure without compromising the cancer control or reducing the template of the dissection. We present the modified endoscopic inguinal lymphadenectomy in a 70 years-old male patient with penile melanoma and positive sentinel lymph node in left inguinal limb. Intraoperative data, pathology, post operatory evolution and oncological follow-up is described Operative time was 120 min. Nine lymph nodes were retrieved and none of then showed positivity at pathology. There were no complications. The drain was kept for five days. After 12 months of follow up, no signs of disease progression were noted. The endoscopic inguinal lymphadenectomy is feasible in clinical practice. New studies with a greater number of patients and long-term follow-up may confirm the oncological efficacy and possible lower morbidity of these new approach. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  11. Benign Paroxysmal Positional Vertigo

    MedlinePlus

    ... Questionnaire Home Diseases and Conditions Benign Paroxysmal Positional Vertigo (BPPV) Benign Paroxysmal Positional Vertigo (BPPV) Condition Family HealthMenWomen Share Benign Paroxysmal Positional ...

  12. Lumped Element Kinetic Inductance Detectors

    NASA Astrophysics Data System (ADS)

    Doyle, S.; Mauskopf, P.; Naylon, J.; Porch, A.; Duncombe, C.

    2008-04-01

    Kinetic Inductance Detectors (KIDs) provide a promising solution to the problem of producing large format arrays of ultra sensitive detectors for astronomy. Traditionally KIDs have been constructed from superconducting quarter-wave resonant elements capacitively coupled to a co-planar feed line [1]. Photon detection is achieved by measuring the change in quasi-particle density caused by the splitting of Cooper pairs in the superconducting resonant element. This change in quasi-particle density alters the kinetic inductance, and hence the resonant frequency of the resonant element. This arrangement requires the quasi-particles generated by photon absorption to be concentrated at positions of high current density in the resonator. This is usually achieved through antenna coupling or quasi-particle trapping. For these detectors to work at wavelengths shorter than around 500 μm where antenna coupling can introduce a significant loss of efficiency, then a direct absorption method needs to be considered. One solution to this problem is the Lumped Element KID (LEKID), which shows no current variation along its length and can be arranged into a photon absorbing area coupled to free space and therefore requiring no antennas or quasi-particle trapping. This paper outlines the relevant microwave theory of a LEKID, along with theoretical and measured performance for these devices.

  13. Lump of Planetary Stuff Artist Concept

    NASA Image and Video Library

    2009-09-23

    This artist conception shows a lump of material in a swirling, planet- forming disk. Astronomers using NASA Spitzer Space Telescope found evidence that either another star or a planet could be pushing planetary material together, as illustrated here.

  14. Lump and lump-soliton solutions to the (2+1) -dimensional Ito equation

    NASA Astrophysics Data System (ADS)

    Yang, Jin-Yun; Ma, Wen-Xiu; Qin, Zhenyun

    2017-06-01

    Based on the Hirota bilinear form of the (2+1) -dimensional Ito equation, one class of lump solutions and two classes of interaction solutions between lumps and line solitons are generated through analysis and symbolic computations with Maple. Analyticity is naturally guaranteed for the presented lump and interaction solutions, and the interaction solutions reduce to lumps (or line solitons) while the hyperbolic-cosine (or the quadratic function) disappears. Three-dimensional plots and contour plots are made for two specific examples of the resulting interaction solutions.

  15. Uncommon Benign Breast Abnormalities in Adolescents

    PubMed Central

    Warren, Rebekkah; Degnim, Amy C.

    2013-01-01

    The authors discuss benign breast abnormalities in the adolescent breast other than fibroadenoma. Although fibroadenoma is the most common benign abnormality in the adolescent breast, other diagnoses are possible. The majority of adolescents who present with a palpable concern or lump have no discrete abnormality on ultrasound and are diagnosed with clinical fibrocystic change and followed up to ensure clinical stability. Intraductal papilloma and duct ectasia are two benign abnormalities associated with bloody nipple discharge, occurring more rarely in adolescents compared with adult women. Breast infections can occur in adolescents, including both mastitis and/or abscess, and are treated similarly to adults, with drainage and antibiotic coverage for Staphylococcus. When infections are due to nipple piercing, other organisms should be suspected. All surgical procedures in the developing breast should be performed cautiously, as trauma to the undeveloped breast can result in failure of breast development or asymmetry, and surgical disruption of subareolar ducts can impair or preclude future lactation. PMID:24872736

  16. Anatomy essentials for laparoscopic inguinal hernia repair.

    PubMed

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-10-01

    Laparoscopic inguinal hernia repair is performed more and more nowadays. The anatomy of these procedures is totally different from traditional open procedures because they are performed from different direction and in different space. The important anatomy essentials for laparoscopic inguinal hernia repair will be discussed in this article.

  17. Anatomy essentials for laparoscopic inguinal hernia repair

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Laparoscopic inguinal hernia repair is performed more and more nowadays. The anatomy of these procedures is totally different from traditional open procedures because they are performed from different direction and in different space. The important anatomy essentials for laparoscopic inguinal hernia repair will be discussed in this article. PMID:27826575

  18. Testicular atrophy as a risk inguinal hernioplasty.

    PubMed

    Wantz, G E

    1982-04-01

    In my experience, the complication of testicular atrophy after primary hernioplasty occurred only in patients in whom a complete indirect inguinal hernia sac was dissected from the spermatic cord. Avoiding this dissection by leaving the distal part of the sac in place reduces the incidence of the complication. All patients with scrotal inguinal hernias and all patients with recurrent inguinal hernias should have the complications of ischemic orchitis and testicular atrophy explained to them in depth because of the litigious nature of some of the men in whom this condition occurs. Patients who had undergone two or more operations for inguinal hernia should give prior written permission for orchiectomy even though this procedure is rarely necessary. In these patients, the performance of preperitoneal inguinal hernioplasty will permit the surgeon to avoid dissecting previously mobilized spermatic cords and should reduce the incidence of testicular atrophy in men fearful of this complication.

  19. Inflammatory myofibroblastic tumor of inguinal lymph nodes, simulating lymphoma.

    PubMed

    Gandhi, Akansha; Malhotra, Kiran Preet; Sharma, Sonal

    2015-01-01

    Multiple enlarged lymph nodes in an elderly female patient can have varied etiologies as well as histologic pictures. We are presenting the case of a 53-year-old female who presented with inguinal lymphadenopathy with fever, which was clinically misconstrued as lymphoma. Cytology could not exclude a lymphoma. Histology led to the unusual diagnosis of inflammatory myofibroblastic tumor of lymph node in this case. Inflammatory myofibroblastic tumor of the lymph node is a rare, distinctive reactive proliferative pattern in the lymph node which involves proliferation of the connective tissue elements of the lymph node, admixed with lymphocytes, plasma cells, eosinophils, and histiocytes. Multiple etiologic agents have been suggested in existing literature. Despite extensive search, no definite attributable cause could be sought. It is now widely accepted that inflammatory pseudotumor of the lymph node is a non-neoplastic proliferation which has a benign clinical course and excellent prognosis after surgical resection.

  20. Minilaparoscopy For Inguinal Hernia Repair

    PubMed Central

    Malcher, Flavio; Cavazzola, Leandro Totti; Araujo, Guilherme D. E.; Silva, José Antônio Da Cunha E.; Rao, Prashanth; Iglesias, Antonio Carlos

    2016-01-01

    Background and Objectives: Inguinal hernia repair is among the most common procedures performed worldwide and the laparoscopic totally extraperitoneal (TEP) approach is a recognized and effective surgical technique. Although technically advantageous because of the option of no mesh fixation and no need for creation of a peritoneal flap resulting, in less postoperative pain and faster recovery, TEP has not achieved the popularity it deserves, mainly because of its complexity and steep learning curve. Minilaparoscopy was first described in the 1990s and has recently gained significantly from better instrumentation that may increase TEP's effectiveness and acceptance. We performed a prospective study, to analyze the outcomes of minilaparoscopy in pain and operative time when compared to the conventional laparoscopic technique in hernia repair. Methods: Fifty-eight laparoscopic inguinal hernia repairs were performed: 36 by traditional laparoscopic technique and 22 by minilaparoscopic instruments (mini). A study protocol was applied prospectively for data collection. Variables analyzed were early postoperative pain (at hour 6 after procedure), pain at discharge, use of on-demand analgesics, and operative time. Results: The mini group presented reduced early postoperative pain and operative time. The present study also suggests less postoperative pain at discharge with mini procedures, although this difference was not statistically significant. No difference between the groups regarding on-demand use of analgesics was found. Conclusions: This study corroborates findings in previously published papers that have shown the feasibility of minilaparoscopy in laparoscopic TEP hernia repair and its benefits regarding postoperative pain, operative time, and aesthetic outcomes. PMID:27777499

  1. Unusual Finding in the Inguinal Canal: Abdominal Tuberculosis Presenting as Inguinal Hernia

    PubMed Central

    Dhandore, Priya; Hombalkar, Narendra Narayan

    2016-01-01

    Abnormal findings in the inguinal canal during Herniotomy are not very rare for a paediatric surgeon. These abnormal findings may range from opposite gender sex organ (e.g. uterus and fallopian tube during orchidopexy) to unexpected malignancy (e.g. Rhabdomyosarcoma) to the abnormal embryological development (Splenogonadal fusion). Though abdominal tuberculosis is common, abdominal tuberculosis presenting as an inguinal hernia is exceedingly uncommon. We report an unusual case of abdominal tuberculosis presenting as inguinal hernia. PMID:27190886

  2. Benign Breast Conditions

    MedlinePlus

    ... and a lump.Mammograms in women older than 40 if a fine needle biopsy shows a lump is solid. If a cyst can be drained successfully with a fine needle biopsy, no further evaluation of that cyst is needed.If ...

  3. Phase 1 prospective evaluation of the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy in patients with penile carcinoma

    PubMed Central

    Matin, Surena F.; Cormier, Janice N.; Ward, John F.; Pisters, Louis L.; Wood, Christopher G.; Dinney, Colin P. N.; Royal, Richard E.; Huang, Xuelin; Pettaway, Curtis A.

    2012-01-01

    OBJECTIVE To prospectively determine the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy (RAVEIL). PATIENTS AND METHODS Patients with T1-3N0 penile cancer were enrolled into a prospective phase I trial at a tertiary care institution from March 2010 to January 2012. All patients underwent an initial RAVEIL approach. Verification of adequacy of dissection was performed by an independent surgeon via a separate open incision at the conclusion of the RAVEIL procedure. Out of 10 patients, if more than two superficial inguinal fields with ≥ 2 nodes or more than four with ≥ 1 node remained within the superficial dissection field, the study would not proceed to phase II. RESULTS Of 10 enrolled patients two had inguinal metastases and all positive nodes were detected by RAVEIL. The remaining eight patients had no metastases, with a mean of nine (range 5–21) left and nine (range 6–17) right nodes removed. One inguinal field RAVEIL was converted to an open dissection. The verifying surgeon confirmed that 18 of 19 inguinal fields (94.7% in nine patients) had an adequate dissection. Two benign nodes were found just beneath Scarpa’s fascia above the inguinal dissection field. Limitations of the study include an inability to determine decisively what specific wound complications were related to RAVEIL because of the protocol-specified creation of a small inguinal incision for verification of adequate dissection. CONCLUSIONS RAVEIL allowed adequate staging of disease in the inguinal region among patients with penile cancer at risk for inguinal metastases. PMID:23551693

  4. A peculiar variety of indirect inguinal hernia (juxtacordal indirect inguinal hernia)

    PubMed Central

    Alkhateeb, Harith M.; Aljanabi, Thaer J.

    2015-01-01

    Background Indirect inguinal hernias are usually congenital, forming a sac in the core of the spermatic cord covered by the internal spermatic, cremasteric, and external spermatic fasciae1−3. Direct inguinal hernias are acquired; the sac lies beside/behind the cord1−3. A rare third type is a combination of indirect and direct sacs on both sides of inferior epigastric vessels1−3. We describe a rare fourth type, juxtacordal indirect oblique inguinal hernia (Fig. 1), in which the sac emerges through a weakness in the deep inguinal ring, lateral to inferior epigastric vessels, and passes into the inguinal canal beside and in contact with the cord but outside of its covering fasciae. Objective Describes a very rare variety of inguinal hernia. Design Case reports. Setting Tikrit Teaching Hospital/Salahuddin/Iraq. Participants: and presentation The first case; a 5-year-old male with right inguinal hernia, the second case; a 25-year-old man with right inguinal hernia, the third case; a 60-year-old man with right inguinal hernia. Interventions Surgery has been done electively for all. Results and discussion Because the sac emerges through the deep inguinal ring and passes through the inguinal canal, it is an indirect type and because it passes beside the spermatic cord we call it juxtacordal hernia. Because of the thick extraperitoneal fat layer over the sac, we think this hernia is acquired. Conclusions Knowing this type of hernia might reduce the risk of inferior epigastric vessels injury and lower the rate of recurrence. PMID:26052435

  5. 20 CFR 225.26 - Residual Lump-Sum PIA.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Residual Lump-Sum PIA. 225.26 Section 225.26... INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.26 Residual Lump-Sum PIA. The Residual Lump-Sum PIA (RLS PIA) is used to compute...

  6. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the...

  7. 29 CFR 4050.8 - Automatic lump sum.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... determined under § 4050.5(a)(1) (mandatory lump sum) or § 4050.5(a)(2) (de minimis lump sum). (a) General... the deemed distribution date, to the missing participant's estate. (b) De minimis annuity alternative... under § 4050.5(a)(2) (de minimis lump sum) (or the guaranteed benefit form for a beneficiary of such...

  8. 29 CFR 4050.8 - Automatic lump sum.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... determined under § 4050.5(a)(1) (mandatory lump sum) or § 4050.5(a)(2) (de minimis lump sum). (a) General... the deemed distribution date, to the missing participant's estate. (b) De minimis annuity alternative... under § 4050.5(a)(2) (de minimis lump sum) (or the guaranteed benefit form for a beneficiary of such...

  9. 22 CFR 19.13-1 - Lump-sum credit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Lump-sum credit. 19.13-1 Section 19.13-1... THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.13-1 Lump-sum credit. “Lump-sum credit” is the compulsory and special contributions to a participant's or former participant's credit in the Fund...

  10. Obstructive Uropathy Secondary to Uretero-inguinal Hernia

    PubMed Central

    Hong, Lih En; Tan, Chrismin; Li, Jordan

    2015-01-01

    Uretero-inguinal hernia in patients with native kidneys is rare. We report a case of an 84-year-old man who was diagnosed with obstructive uropathy secondary to uretero-inguinal hernia, with no past history of herniorrhaphy or congenital genitourinary malformation. Uretero-inguinal hernias are predominantly indirect inguinal hernias and may be paraperitoneal or extraperitoneal. Computed tomography (CT) is a non-invasive diagnostic tool for uretero-inguinal hernia. Herniorrhaphy is indicated in all cases of uretero-inguinal hernia to prevent obstructive uropathy. PMID:26180656

  11. Lymphoma Diagnosed at Inguinal Hernia Repair

    PubMed Central

    Veal, David R; Hammill, Chet W

    2010-01-01

    Tumors presenting in the inguinal hernia sac are considered to be extremely rare, with the more common neoplasms metastasizing from the gastrointestinal tract, ovary and prostate. We report the case of Mantle cell lymphoma identified in the inguinal hernia sac following hernia repair. While the hernia sac appeared normal to the surgeon, evaluation by the pathologist showed subtle gross irregularities, with subsequent histologic and immunochemical diagnosis of Mantle cell lymphoma. Twelve previous cases of a lymphoma diagnosed during hernia repair have been described in the English literature. This is the first report of Mantle cell lymphoma found in the hernia sac. This case illustrates the value of routine microscopic evaluation of hernia sacs found from inguinal/femoral herniorrhaphies, as it may be the primary presentation of an asymptomatic metastatic lymphoma. Additionally, it underscores the importance of the surgeon's role in screening hernia sacs if the practice of submitting only macroscopically abnormal specimens for microscopic evaluation is adopted. PMID:20358722

  12. Bilateral inguinal hernias: simultaneous or sequential repair?

    PubMed Central

    Stott, M. A.; Sutton, R.; Royle, G. T.

    1988-01-01

    Two hundred and forty four patients underwent either simultaneous bilateral inguinal hernia repair (n = 122) or unilateral inguinal hernia (n = 122) repair at a general hospital between January 1971 and December 1981. The two groups of patients were matched for age and sex. Both groups had a similar overall incidence of post-operative complications and in both groups the duration of post-operative stay and duration of operating time were similar. Chest infections developed in 12 patients after bilateral repair and in 3 patients after unilateral repair (P less than 0.02). All patients were assessed prospectively from 4 to 15 years after operation, when no significant difference in the number of recurrent hernias was found. Our results suggest that simultaneous bilateral inguinal herniorrhaphy is economical in terms of both operating time and duration of hospital stay, and that this economy is not bought at a cost of increased short term morbidity or long-term recurrence rate. PMID:3200778

  13. Colocutaneous Fistula after Open Inguinal Hernia Repair

    PubMed Central

    Kallis, Panayiotis; Koronakis, Nikolaos; Hadjicostas, Panayiotis

    2016-01-01

    The plug-and-patch technique is frequently used for the open repair of inguinal hernias; however, serious complications may arise on rare occasions. We present the case of a 69-year-old patient who presented with a colocutaneous fistula with the sigmoid colon 9 years after the repair of a left sliding inguinal hernia with the plug-and-patch technique. The patient underwent sigmoidectomy and excision of the fistulous track. He was discharged on postoperative day 5 and had an uneventful recovery. Although such complications are reported rarely, the surgeon must be aware of them when deciding upon the method of hernia repair. PMID:27738544

  14. Primary actinomycosis of vulva with inguinal lymphadenopathy

    PubMed Central

    Asia, Anand J; Tapre, Vaibhav N

    2016-01-01

    Actinomycosis is a chronic suppurative granulomatous infection of subcutaneous tissues caused by bacterium Actinomyces israelii. It is a normal commensal of the oral cavity, gastrointestinal tract, respiratory tract, and vagina. Infection is first established locally by breach of mucosal barrier during various procedures, aspiration, trauma, or human bite. Rarely, it may spread through hematogenous and lymphatic system. We present a case of actinomycosis involving the vulva, extending to the inguinal region along with inguinal lymphadenopathy. Involvement of vulva by actinomycosis is uncommon in literature. PMID:27730039

  15. Retroperitoneal vascular malformation mimicking incarcerated inguinal hernia.

    PubMed

    Dubey, Indu Bhushan; Sharma, Anuj; Singh, Ajay Kumar; Mohanty, Debajyoti

    2011-01-01

    A 30-year-old man presented to the Department of Surgery with a painful groin swelling on right side. Exploration revealed a reddish-blue hemangiomatous mass in the scrotum extending through inguinal canal into the retroperitoneum. On further dissection swelling was found to be originating from right external iliac vein. The swelling was excised after ligating all vascular connections. The histopathological examination of excised mass confirmed the diagnosis of venous variety of vascular malformation. This is the first reported case of vascular malformation arising from retroperitoneum and extending into inguinoscrotal region, presenting as incarcerated inguinal hernia.

  16. Inguinal endometriosis attaching to the round ligament.

    PubMed

    Hagiwara, Y; Hatori, M; Moriya, T; Terada, Y; Yaegashi, N; Ehara, S; Kokubun, S

    2007-02-01

    We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location.

  17. Comparative Study of Core Needle Biopsy and Fine Needle Aspiration Cytology in Palpable Breast Lumps: Scenario in Developing Nations.

    PubMed

    Tikku, Gargi; Umap, Pradeep

    2016-01-01

    The purpose of this study was to evaluate the utility of core needle biopsy as a diagnostic tool for palpable breast lumps in developing countries as compared to fine needle aspiration cytology. All patients attending the surgery outpatient department with palpable breast lumps were subjected to fine needle aspiration cytology and core needle biopsy by the same operator in a single session. Fine needle aspiration cytology was performed by the standard technique. Core needle biopsy was done freehand using a 14G manual core biopsy needle. Reporting categories of the two techniques were taken from the standard National Health Service Breast Screening Programme criteria and were compared with the final histopathology results. A total of 107 patients underwent fine needle aspiration cytology and core needle biopsy simultaneously. Histopathology was available for 85 cases. Statistical analysis of fine needle aspiration cytology and core needle biopsy showed no significant difference between the diagnoses offered by core needle biopsy and histopathology while there was a significant difference between fine needle aspiration cytology and histopathology diagnoses. Core needle biopsy detected more breast carcinomas as compared to fine needle aspiration cytology with a sensitivity 95.83% as opposed to 64.58%. Though both the techniques were equally specific (100%), Core needle biopsy was able to correctly categorize borderline / inadequate lesions into definitely benign and malignant categories. We suggest that core needle biopsy should be preferred over fine needle aspiration cytology for the diagnosis of palpable breast lumps with fine needle aspiration cytology being reserved for definitely benign lesions.

  18. Pulsed radiofrequency for chronic inguinal neuralgia.

    PubMed

    Makharita, Mohamed Y; Amr, Yasser M

    2015-01-01

    Chronic inguinal neuralgia has been reported after inguinal herniorrhaphy, caesarean section, appendectomy, and trauma to the lower quadrant of the abdomen or inguinal region. This study was designed to evaluate the efficacy of pulsed radiofrequency in management of chronic inguinal neuralgia. Randomized, double-blind controlled trial. Hospital outpatient setting. Twenty-one patients were allocated into 2 groups. Group 1 received 2 cycles of pulsed radiofrequency (PRF) for each nerve root. In Group 2, after stimulation, we spent the same time to mimic PRF. Both groups received bupivacaine 0.25% +' 4 mg dexamethasone in 2 mL for each nerve root. Visual Analogue Scale (VAS) was assessed. Duration of the first block effective pain relief was reported. Repeated PRF blockade was allowed for any patient who reported a VAS > 30 mm in both groups during the one year follow-up period. The number and duration of blocks were reported and adverse effects were also reported. Significantly longer duration of pain relief was noticed in Group 1 (P = 0.005) after the first block, while the durations of pain relief of the second block were comparable (P = 0.59). In Group 1 the second PRF produced pain relief from the twenty-fourth week until the tenth month while in Group 2, pain relief was reported from the sixteenth week until the eighth month after the use of PRF. All patients in Group 2 received 3 blocks (the first was a sham PRF) during the one year follow-up period. Meanwhile, 2 PRF blocks were sufficient to achieve pain relief for patients in Group 1 except 4 patients who needed a third PRF block. No adverse events were reported. Small sample size. For intractable chronic inguinal pain, PRF for the dorsal root ganglion represents a promising treatment modality.

  19. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.

    PubMed

    Putnis, Soni; Wong, April; Berney, Christophe

    2011-12-01

    During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair. This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly. There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P < 0.001). None of the femoral hernias were clinically detectable preoperatively. Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.

  20. 29 CFR 4050.8 - Automatic lump sum.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Automatic lump sum. 4050.8 Section 4050.8 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.8 Automatic lump sum. This section applies to a missing participant whose designated benefit was...

  1. 29 CFR 4050.8 - Automatic lump sum.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Automatic lump sum. 4050.8 Section 4050.8 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.8 Automatic lump sum. This section applies to a missing participant whose designated benefit was...

  2. 29 CFR 4050.8 - Automatic lump sum.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Automatic lump sum. 4050.8 Section 4050.8 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.8 Automatic lump sum. This section applies to a missing participant whose designated benefit was...

  3. 28 CFR 523.16 - Lump sum awards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Lump sum awards. 523.16 Section 523.16 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER COMPUTATION OF SENTENCE Extra Good Time § 523.16 Lump sum awards. Any staff member may recommend...

  4. Nonlinear, lumped parameter transformer model reduction technique

    SciTech Connect

    Degeneff, R.C.; Gutierrez, M.R.; Vakilian, M.

    1995-04-01

    Utility engineers often need nonlinear transformer models in order to investigate power system transient events. Methods exist to create accurate wideband reduced order linear transformer models, however, to date a method of creating a reduced order wideband nonlinear transformer model has not been presented. This paper describes a technique that starts with a detailed nonlinear transformer model used for insulation design studies and reduces its order so that it can be used conveniently in EMTP. The method is based on linearization of the core`s saturable characteristic during each solution time intervals. The technique uses Kron`s reduction approach in each solution time interval. It can be applied to any nonlinear lumped parameter network which uses electric parameter analogies (i.e., FEM networks). This paper outlines the nonlinear reduction technique. An illustrative example is given using the transient voltage response during saturation for a 785/345/34.5kV, YYD 500 MVA single phase auto transformer.

  5. Ureteral inguinal hernia: an uncommon trap for general surgeons

    PubMed Central

    Yahya, Zarif; Al-habbal, Yahya; Hassen, Sayed

    2017-01-01

    Inguinal hernias involving the ureter, a retroperitoneal structure, is an uncommon phenomenon. It can occur with or without obstructive uropathy, the latter posing a trap for the unassuming general surgeon performing a routine inguinal hernia repair. Ureteral inguinal hernia should be included as a differential when a clinical inguinal hernia is diagnosed concurrently with unexplained hydronephrosis, renal failure or urinary tract infection particularly in a male. The present case describes a patient with a known ureteroinguinal hernia who proceeded to having a planned hernia repair and ureteric protection. The case is a reminder that when faced with an unexpected finding such an indirect sliding inguinal hernia, extreme care should be taken to ensure that no structures are inadvertently damaged and that a rare possibility is the entrapment of the ureter in the inguinal canal. PMID:28275027

  6. lumpGEM: Systematic generation of subnetworks and elementally balanced lumped reactions for the biosynthesis of target metabolites

    PubMed Central

    Ataman, Meric

    2017-01-01

    In the post-genomic era, Genome-scale metabolic networks (GEMs) have emerged as invaluable tools to understand metabolic capabilities of organisms. Different parts of these metabolic networks are defined as subsystems/pathways, which are sets of functional roles to implement a specific biological process or structural complex, such as glycolysis and TCA cycle. Subsystem/pathway definition is also employed to delineate the biosynthetic routes that produce biomass building blocks. In databases, such as MetaCyc and SEED, these representations are composed of linear routes from precursors to target biomass building blocks. However, this approach cannot capture the nested, complex nature of GEMs. Here we implemented an algorithm, lumpGEM, which generates biosynthetic subnetworks composed of reactions that can synthesize a target metabolite from a set of defined core precursor metabolites. lumpGEM captures balanced subnetworks, which account for the fate of all metabolites along the synthesis routes, thus encapsulating reactions from various subsystems/pathways to balance these metabolites in the metabolic network. Moreover, lumpGEM collapses these subnetworks into elementally balanced lumped reactions that specify the cost of all precursor metabolites and cofactors. It also generates alternative subnetworks and lumped reactions for the same metabolite, accounting for the flexibility of organisms. lumpGEM is applicable to any GEM and any target metabolite defined in the network. Lumped reactions generated by lumpGEM can be also used to generate properly balanced reduced core metabolic models. PMID:28727789

  7. Inguinal herniation with hydrometra/mucometra in a poodle bitch

    PubMed Central

    Sontas, B. Hasan; Toydemir, F.T. Seval; Erdogan, Özge; Şennazli, Gülbin; Ekici, Hayri

    2013-01-01

    A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus. PMID:24155486

  8. Noninvasive Inguinal Approach for Cryptorchidectomy in Thirty-eight Stallions

    PubMed Central

    Arighi, Mimi; Horney, J. Donald; Bosu, William T. K.

    1988-01-01

    We describe the results of the noninvasive inguinal approach in 38 cases of cryptorchidism. Whether the retained testis was intra-abdominal or in the inguinal canal, this technique was found to be an easy, reliable method of locating abdominal and inguinal testes through a normal body opening. No postoperative complications were recorded in this series of cases and the postoperative rest period was minimal. PMID:17423023

  9. Inguinal herniation with hydrometra/mucometra in a poodle bitch.

    PubMed

    Sontas, B Hasan; Toydemir, F T Seval; Erdogan, Ozge; Sennazli, Gülbin; Ekici, Hayri

    2013-09-01

    A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus.

  10. Jack in the box: inguinal endometriosis

    PubMed Central

    Pandey, Deeksha; Coondoo, Ambika; Shetty, Jyothi; Mathew, Stanley

    2015-01-01

    A 39-year-old woman with a left-sided inguinal swelling was referred to us with a diagnosis of inguinal hernia. On asking leading questions, the patient gave a typical history of cyclical pain and increased swelling during menstruation. Fine-needle aspiration biopsy revealed endometrial glands. Preoperatively, the extent of the endometriotic lesion was delineated using MRI. The lesion was approached through the patient's caesarean scar for cosmetic reasons and excised in toto. Final diagnosis was round ligament endometriosis. The patient was asymptomatic at 3, 6 and 12 months’ follow-up. This case re-emphasises the fact that endometriosis is an enigmatic disease and can be found anywhere in the body. Thus, a woman of reproductive age presenting with any cyclical symptom should be asked about its relation to her menstrual cycle. PMID:25827916

  11. Pain control following inguinal herniorrhaphy: current perspectives

    PubMed Central

    Bjurstrom, Martin F; Nicol, Andrea L; Amid, Parviz K; Chen, David C

    2014-01-01

    Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed. PMID:24920934

  12. A Lip Lump: An Unexpected Histological Diagnosis of a Lip Schwannoma

    PubMed Central

    Glore, John Raad; Gouldesbrough, David; Wong, Winson

    2017-01-01

    Schwannomas are benign nerve sheath tumours arising from Schwann cells. They comprise 1% of all benign tumours. In the 2016 World Health Organisation Classification of Central Nervous System, they are classified as a tumour of the cranial and paraspinal nerves, Schwannoma 9560/0. A 23-year-old Caucasian lady presented with a seven-month history of a painless right upper lip lump. Examination revealed a small cystic 0.5 cm diameter lesion within the right upper lip. The clinical impression was that of a mucocele. Excision of the lip lesion was performed under local anaesthetic. Histological examination of the excised lesion demonstrated a circumscribed nodule consisting of spindle cells mixed with vascular spaces containing red blood cells and fibrin. Immunohistochemistry for S100 was strongly positive. The findings were consistent with that of a small benign schwannoma. The current consensus is for surgical excision of a conservative nature with no need for margins. If recurrence does occur one needs to consider whether complete enucleation was achieved or whether malignant transformation has occurred. PMID:28270941

  13. Chronic pain after open inguinal hernia repair.

    PubMed

    Nikkolo, Ceith; Lepner, Urmas

    2016-01-01

    Following the widespread use of mesh repairs, recurrence rates after inguinal hernia surgery have become acceptable and focus has shifted from recurrence to chronic pain. Although pain can be controlled with analgesics, chronic postsurgical pain is a major clinical problem, which can significantly influence the patient's quality of life. The rate of chronic pain after inguinal hernia mesh repair can reach 51.6%. The reasons for posthernioplasty chronic pain are often unclear. It has been linked to nerve injury and nerve entrapment, but there is also association between the rate of chronic pain and the type of mesh used for hernia repair. As there are >160 meshes available in the market, it is difficult to choose a mesh whose usage would result in the best outcome. Different mesh characteristics have been studied, among them weight of mesh has probably gained the most attention. The choice of adequate therapy for chronic groin pain after inguinal hernia repair is controversial. The European Hernia Society recommends that a multidisciplinary approach at a pain clinic should be considered for the treatment of chronic postoperative pain. Although surgical treatment of chronic posthernioplasty pain is limited because of the lack of relevant research data, resection of entrapped nerves, mesh removal in the case of mesh related pain or removal of fixation sutures can be beneficial for the patient with severe pain after inguinal hernia surgery. One drawback of published studies is the lack of consensus over definition of chronic pain, which makes it complicated to compare the results of different studies and to conduct meta-analyses and systematic reviews. Therefore, a uniform definition of chronic pain and its best assessment methods should be developed in order to conduct top quality multicenter randomized trials. Further research to develop meshes with optimal parameters is of vital importance and should be encouraged.

  14. Laparoscopic repair of inguinal hernia in adults

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. The procedures include intraperitoneal onlay mesh (IPOM) repair, transabdominal preperitoneal (TAPP) repair and total extraperitoneal (TEP) repair. These procedures have totally different anatomic point of view, process and technical key points from open operations. The technical details of these operations are discussed in this article, also the strategies of treatment for some special conditions. PMID:27867954

  15. Outcomes of Lichtenstein hernioplasty for primary and recurrent inguinal hernia.

    PubMed

    Beltrán, Marcelo A; Cruces, Karina S

    2006-12-01

    The Lichtenstein hernioplasty for the repair of primary inguinal hernia in male patients is well established and constitutes the current gold standard. However a gold standard technique for the repair of recurrent inguinal hernia has not been established. The aim of this study was to analyze the outcomes of Lichtenstein hernioplasty for the repair of primary inguinal hernia and recurrent inguinal hernia, applying for that purpose the Qualitative and Quantitative Measurement Instrument (QQMI). We studied 75 recurrent inguinal hernia patients and 287 primary inguinal hernia patients with a follow-up period ranging from 60 to 107 months. The final QQMI score demonstrated that most patients in both groups reached scores between 8 and 11 points, with a significant difference in the maximum score (11 points) favoring primary hernia patients. All evaluated parameters showed better outcomes in primary hernia patients. Applying the QQMI, we have demonstrated that the outcomes of Lichtenstein hernioplasty are not similar between primary and recurrent inguinal hernia; there is a tendency toward better outcomes for primary inguinal hernia patients, although the Lichtenstein hernioplasty stands as a safe option for repair of recurrent inguinal hernias.

  16. Ruptured abdominal aneurysm disguised as an incarcerated inguinal hernia.

    PubMed

    Colpaert, J; Willaert, B; Van Molhem, Y

    2017-01-31

    An incarcerated inguinal hernia is a textbook example of a basic and straightforward diagnosis. In rare cases, an incarcerated hernia may be a symptom of more complex underlying pathology. In this case report a patient with a ruptured abdominal aortic aneurysm presented with an incarcerated left inguinal hernia. Only two other cases have been reported with a stable patient at initial presentation. The diagnosis was suspected when blood seeping next to the internal inguinal ring was detected, and an urgent ultrasound in the operating room confirmed the diagnosis. Whether or not patients with an inguinal hernia are more at risk for an AAA remains unclear.

  17. Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias.

    PubMed

    Hoshino, M; Sugito, K; Kawashima, H; Goto, S; Kaneda, H; Furuya, T; Hosoda, T; Masuko, T; Ohashi, K; Inoue, M; Ikeda, T; Tomita, R; Koshinaga, T

    2014-06-01

    Previously, we established a pre-operative risk scoring system to predict contralateral inguinal hernia in children with unilateral inguinal hernias. The current study aimed to verify the usefulness of our pre-operative scoring system. This was a prospective study of patients undergoing unilateral inguinal hernia repair from 2006 to 2009 at a single institution. Gender, age at initial operation, birth weight, initial operation side, and the pre-operative risk score were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of our pre-operative risk scoring system. The follow-up period was 36 months. We used forward multiple logistic regression analysis to predict contralateral hernia. Of the 372 patients who underwent unilateral hernia repair, 357 (96.0 %) were completely followed-up for 36 months, and 23 patients (6.4 %) developed a contralateral hernia. Left-sided hernia (OR = 5.5, 95 %, CI = 1.3-24.3, p = 0.023) was associated with an increased risk of contralateral hernia. The following covariates were not associated with contralateral hernia development: gender (p = 0.702), age (p = 0.215), and birth weight (p = 0.301). The pre-operative risk score (cut-off point = 4.5) of the patients with a contralateral hernia was significantly higher, compared with the patients without a contralateral hernia using the area under the receiver operating characteristic curve (p = 0.024). Using multivariate analysis, we confirmed usefulness of our pre-operative scoring system and initial side of the inguinal hernia, together, for the prediction of contralateral inguinal hernia in children.

  18. A Clinicopathological Study of Benign Phyllodes Tumour of Breast with Emphasis on Unusual Features

    PubMed Central

    Naik, Reena

    2016-01-01

    Introduction Benign Phyllodes Tumours (PTs) are rare fibroepithelial neoplasms that resemble fibroadenoma. But unlike fibroadenoma, benign PT can recur and both stromal & epithelial components can progress to malignancy. Contrary to earlier belief that benign PT is a stromal neoplasm and possibly arises from fibroadenoma, more recent molecular studies have suggested that both stroma and epithelium can become neoplastic. Sometimes, benign PT can occur synchronously with fibroadenoma. Here histomorphologic analysis of eleven cases of benign PT are presented including some unusual features. Materials and Methods Eleven cases of benign PT diagnosed between Dec 2014 and Jan 2016 in the Department of Pathology were studied. The demographic and clinicopathological features were analysed. Results The most common age group affected was 20-30 years (range: 13-45). Clinical features included pain, lump and bleeding from nipple. The tumour size varied from 2.5-18 cm in diameter. H&E stained sections showed secondary changes (haemorrhage, myxoid, change, cystic degeneration), epithelial hyperplasia (8), squamous & columnar metaplasia (1), benign tubular adenoma like areas (1), Ductal Carcinoma In Situ (DCIS) (1), Invasive Ductal Carcinoma (IDC) (1), Pseudoangiomatous Stromal Hyperplasia (PASH) (1), histologic infarction (2), tumour necrosis (1) and synchronous fibroadenoma (1). Unusual histologic features included atypical ductal hyperplasia, DCIS, IDC, synchronous fibroadenoma and tubular adenoma like areas arising within benign PT. Conclusion This study shows a spectrum of hyperplastic, metaplastic, dysplastic, benign, in-situ-malignancy and even invasive ductal malignancy occurring in benign PT. Therefore adequate and extensive sampling is recommended for accurate diagnosis. PMID:27630851

  19. Lump Solution of (2+1)-Dimensional Boussinesq Equation

    NASA Astrophysics Data System (ADS)

    Ma, Hong-Cai; Deng, Ai-Ping

    2016-05-01

    A class of lump solutions of (2+1)-dimensional Boussinesq equation are obtained with the help of Maple by using Hirota bilinear method. Some contour plots with different determinant values are sequentially made to show that the corresponding lump solution tends to zero when the determinant approaches zero. The particular lump solutions with specific values of the involved parameters are plotted, as illustrative examples. Supported by the National Natural Science Foundation of China under Grant No. 10647112 and the Fund of Science and Technology Commission of Shanghai Municipality under Grant No. ZX201307000014

  20. Lump solutions to the BKP equation by symbolic computation

    NASA Astrophysics Data System (ADS)

    Yang, Jing-Yun; Ma, Wen-Xiu

    2016-09-01

    Lump solutions are rationally localized in all directions in the space. A general class of lump solutions to the (2+1)-dimensional B-Kadomtsev-Petviashvili (BKP) equation is presented through symbolic computation with Maple. The Hirota bilinear form of the equation is the starting point in the computation process. Like the KP equation, the resulting lump solutions contain six arbitrary parameters. Two of the parameters are due to the translation invariances of the BKP equation with the independent variables, and the other four need to satisfy a nonzero determinant condition and the positivity condition, which guarantee analyticity and rational localization of the solutions.

  1. Nonlinearly Coupled Superconducting Lumped Element Resonators

    NASA Astrophysics Data System (ADS)

    Collodo, Michele C.; Potočnik, Anton; Rubio Abadal, Antonio; Mondal, Mintu; Oppliger, Markus; Wallraff, Andreas

    We study SQUID-mediated tunable coupling between two superconducting on-chip resonators in the microwave frequency range. In this circuit QED implementation, we employ lumped-element type resonators, which consist of Nb thin film structured into interdigitated finger shunt capacitors and meander inductors. A SQUID, functioning as flux dependent and intrinsically nonlinear inductor, is placed as a coupling element together with an interdigitated capacitor between the two resonators (cf. A. Baust et al., Phys Rev. B 91 014515 (2015)). We perform a spectroscopic measurement in a dilution refrigerator and find the linear photon hopping rate between the resonators to be widely tunable as well as suppressible for an appropriate choice of parameters, which is made possible due to the interplay of inductively and capacitively mediated coupling. Vanishing linear coupling promotes nonlinear effects ranging from onsite- to cross-Kerr interaction. A dominating cross-Kerr interaction related to this configuration is notable, as it induces a unique quantum state. In the course of analog quantum simulations, such elementary building blocks can serve as a precursor for more complex geometries and thus pave the way to a number of novel quantum phases of light

  2. Retroperitoneal approach for recurrent benign multicystic peritoneal mesothelioma.

    PubMed

    Bakhshi, Girish D; Wankhede, Kishor R; Tayade, Mukund B; Bhandarwar, Ajay H; Gore, Sandeep T; Choure, Dayanand D

    2013-01-25

    Benign multicystic peritoneal mesothelioma (BMPM) is an uncommon lesion. It presents as a lump in abdomen or a finding seen on imaging modalities. Surgery is the primary modality of treatment. However, it has a high recurrence rate; this results in adhesions and subsequent surgeries difficult. We present a case of recurrent BMPM in a female operated twice earlier in a rural centre. Imaging modalities showed majority of the lesion in paracolic and retroperitoneal region. Hence, retroperitoneal approach for surgery was taken. This avoided previous surgical adhesions. A brief case report on this novel approach and review of literature is presented.

  3. Retroperitoneal Approach for Recurrent Benign Multicystic Peritoneal Mesothelioma

    PubMed Central

    Bakhshi, Girish D.; Wankhede, Kishor R; Tayade, Mukund B.; Bhandarwar, Ajay H.; Gore, Sandeep T.; Choure, Dayanand D.

    2013-01-01

    Benign multicystic peritoneal mesothelioma (BMPM) is an uncommon lesion. It presents as a lump in abdomen or a finding seen on imaging modalities. Surgery is the primary modality of treatment. However, it has a high recurrence rate; this results in adhesions and subsequent surgeries difficult. We present a case of recurrent BMPM in a female operated twice earlier in a rural centre. Imaging modalities showed majority of the lesion in paracolic and retroperitoneal region. Hence, retroperitoneal approach for surgery was taken. This avoided previous surgical adhesions. A brief case report on this novel approach and review of literature is presented. PMID:24765496

  4. Robotic benign esophageal procedures.

    PubMed

    Hanna, Jennifer M; Onaitis, Mark W

    2014-05-01

    Robotic master-slave devices can assist surgeons to perform minimally invasive esophageal operations with approaches that have already been demonstrated using laparoscopy and thoracoscopy. Robotic-assisted surgery for benign esophageal disease is described for the treatment of achalasia, epiphrenic diverticula, refractory reflux, paraesophageal hernias, duplication cysts, and benign esophageal masses, such as leiomyomas. Indications and contraindications for robotic surgery in benign esophageal disease should closely approximate the indications for laparoscopic and thoracoscopic procedures. Given the early application of the technology and paucity of clinical evidence, there are currently no procedures for which robotic esophageal surgery is the clinically proven preferred approach. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Benign prostate hyperplasia (BPH) - resources

    MedlinePlus

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... organizations provide information on benign prostatic hyperplasia ( prostate enlargement ): National Kidney and Urologic Diseases Information Clearinghouse -- www. ...

  6. Lumped Parameter Model (LPM) for Light-Duty Vehicles

    EPA Pesticide Factsheets

    EPA’s Lumped Parameter Model (LPM) is a free, desktop computer application that estimates the effectiveness (CO2 Reduction) of various technology combinations or “packages,” in a manner that accounts for synergies between technologies.

  7. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number of...

  8. 7 CFR 1726.205 - Multiparty lump sum quotations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Procurement Procedures § 1726.205 Multiparty lump sum quotations. The borrower or its engineer must contact a sufficient number of...

  9. Are there any predictive factors of metachronous inguinal hernias in children with unilateral inguinal hernia?

    PubMed

    Jallouli, M; Yaich, S; Dhaou, M B; Yengui, H; Trigui, D; Damak, J; Mhiri, R

    2009-12-01

    This study was done to identify risk factors for metachronous manifestation of contralateral inguinal hernia in children with unilateral inguinal hernia. This is a retrospective study of 565 patients with inguinal hernia during a nine-year period at a single institution. Age, sex, and side of the hernia at presentation were recorded. The incidence of metachronous inguinal hernia and its risk factors were analyzed. Of 565 children, 62 (11%) were presented with synchronous bilateral hernias. Of the remaining 503, a metachronous contralateral hernia developed in 22 (4.4%). The age at hernia repair of the patients with contralateral manifestation (18 ± 3.67 months; mean ± SD), was significantly younger than observed in the control patients (34 ± 1.34 months; p = 0.000). There was no significant difference between the groups in other factors such as the age at hernia presentation, the initial side of the hernia, birth weight. and the percentage of patients who had experienced incarceration. We believe that the incidence is still too low to recommend routine contralateral exploration. Therefore, infants younger than 18 months appear to be a higher-risk subpopulation and should receive closer follow-up over this time period.

  10. Ultrasound Prenatal Diagnosis of Inguinal Scrotal Hernia and Contralateral Hydrocele

    PubMed Central

    Massaro, G.; Sglavo, G.; Cavallaro, A.; Pastore, G.; Nappi, C.; Di Carlo, C.

    2013-01-01

    Fetal inguinal scrotal hernia is a rare condition resulting in an abnormal embryonic process of the tunica vaginalis. We report a case of ultrasound prenatal diagnosis of inguinal scrotal hernia associated with contralateral hydrocele in a woman at 37 weeks of gestation, referred to our clinic for a scrotal mass. Differential diagnosis includes hydrocele, teratoma, hemangiomas, solid tumours of testis, bowel herniation, and testicular torsion. Bowel peristalsis is an important ultrasound sign and it allowed us to make diagnosis of inguinal scrotal hernia. Diagnosis was confirmed at birth and a laparoscopic hernia repair was performed without complications on day 10. During surgery, a bilateral defect of canal inguinal was seen and considered as the cause of scrotal inguinal hernia and contralateral hydrocele observed in utero. PMID:24455356

  11. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937 Act...

  12. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937 Act...

  13. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937 Act...

  14. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937 Act...

  15. 20 CFR 234.12 - 1937 Act lump-sum death payment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false 1937 Act lump-sum death payment. 234.12 Section 234.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.12 1937 Act lump-sum death payment. (a) The 1937 Act...

  16. Benign positional vertigo - aftercare

    MedlinePlus

    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare; Dizziness - positional vertigo ... Your health care provider may have treated your vertigo with the Epley maneuver . These are head movements ...

  17. Benign positional vertigo

    MedlinePlus

    ... Clinical practice guideline: Benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg . 2008;139(5 Suppl 4):S47-S81. ... BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015: ...

  18. The Benign Hamburger.

    ERIC Educational Resources Information Center

    Peaslee, Graham; Lantz, Juliette M.; Walczak, Mary M.

    1998-01-01

    Uses a case study of food poisoning from hamburgers at the fictitious Jill-at-the-Grill to teach the nuclear science behind food irradiation. Includes case teaching notes on the benign hamburger. (ASK)

  19. [Differential diagnostic value of real-time tissue elastography and three dimensional ultrasound imaging in breast lumps].

    PubMed

    Li, M H; Liu, Y; Liu, L S; Li, P X; Chen, Q

    2016-05-24

    To investigate the real-time tissue elastography and 3D contrast-enhanced ultrasonography(CEUS) in breast lumps differential diagnostic value. A total of 126 patients (180 lumps) with breast mass were retrospectively analyzed from December 2012 to December 2014 in Tumor Hospital Affiliated To Xinjiang Medical University.All patients were divided into three groups by using stratified random method.Each group was detected by real-time tissue elastography, 3D CEUS and two joint inspection.Each group of 42 cases (60 lumps) was confirmed by the pathological results as gold standard.Diagnostic sensitivity, specificity and coincidence rate of different methods were compared. The benign masses of ultrasound contrast showed the punctate, linear and nodular enhancement, and the border of enhancement was smooth.The malignant tumors were mainly dominated by uneven and high enhancement. There was no statistical difference in sensitivity, specificity and coincidence rate between elastography group and 3D CEUS group (64.7% vs 73.5%, 69.2% vs 76.9%, 66.7% vs 75.0%, all P>0.05). The sensitivity, specificity and coincidence rate of two joint inspection group were higher than those of elastography group and 3D CEUS group, the differences were statistically significant (97.1%, 92.3% and 98.3% , all P<0.05). 3D CEUS combined with real-time tissue elastography is of high value in the diagnosis of breast masses.

  20. Benign cystic peritoneal mesothelioma.

    PubMed Central

    Bhandarkar, D S; Smith, V J; Evans, D A; Taylor, T V

    1993-01-01

    The well defined but rare entity of benign cystic mesothelioma is reported. The aetiology of this neoplasm remains obscure. The presenting features make a precise preoperative diagnosis difficult; information provided by computed tomography and cytology may help. A firm diagnosis can only come from electron microscopic or immunohistochemical examination of the tumour. Diagnostic accuracy and diligent follow up are essential because, although the tumour is considered benign, it does tend towards local recurrence. Images PMID:8227441

  1. Aqueduct stenosis-?Benign.

    PubMed

    Allan, Rodney; Chaseling, Raymond; Graf, Nicole; Dexter, Mark

    2005-02-01

    'Benign' aqueduct stenosis is a common cause of hydrocephalus in the paediatric population and is frequently treated by endoscopic third ventriculostomy. Occasionally, aqueduct stenosis can be a prelude to the development of other pathology, as is seen in these two cases of pineal tumours developing in patients whose hydrocephalus was successfully treated with endoscopic third ventriculostomy. The case histories are presented, along with the recommendation for increased radiological screening of patients with this usually 'benign' presentation.

  2. Persistent benign pleural effusion.

    PubMed

    Porcel, J M

    In this narrative review we describe the main aetiologies, clinical characteristics and treatment for patients with benign pleural effusion that characteristically persists over time: chylothorax and cholesterol effusions, nonexpansible lung, rheumatoid pleural effusion, tuberculous empyema, benign asbestos pleural effusion and yellow nail syndrome. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  3. ROBOTIC ASSISTED SINGLE SITE FOR BILATERAL INGUINAL HERNIA REPAIR.

    PubMed

    Bosi, Henrique Rasia; Guimarães, José Ricardo; Cavazzola, Leandro Totti

    2016-01-01

    The inguinal hernia is one of the most frequent surgical diseases, being frequent procedure and surgeon´s everyday practice. To present technical details in making hernioplasty using robotic equipment on bilateral inguinal hernia repair with single port and preliminary results with the method. The bilateral inguinal hernia repair was performed by using the Single-Site(c) Da Vinci Surgical Access Platform to the abdominal cavity and the placement of clamps. This technique proved to be effective for inguinal hernia and have more aesthetic result when compared to other techniques. Inguinal hernia repair robot-assisted with single-trocar is feasible and effective. However, still has higher costs needing surgical team special training. A hérnia inguinal é uma das doenças cirúrgicas mais frequentes, tornando-a procedimento frequente e do cotidiano do cirurgião. Apresentar detalhes da técnica da hernioplastia inguinal bilateral robótica por single-site e resultados preliminares com o método. Foi realizada hernioplastia inguinal bilateral assistida por robô, utilizando-se da Vinci Single-Site(c) Surgical Platform para acesso a cavidade abdominal e colocação das pinças. Esta técnica demonstrou-se efetiva para correção da hérnia inguinal, além de apresentar melhor resultado estético quando comparado às outras técnicas. A hernioplastia inguinal assistida por robô com trocarte único é viável e eficaz. Contudo, ainda apresenta custos mais elevados e necessidade de treinamento especial por parte da equipe cirúrgica.

  4. Inguinal Lymph Node Anthracosis: A Case Report

    PubMed Central

    Soto, Carlos Alberto

    2016-01-01

    Summary: Anthracosis is defined as black, dense pigments in tissues, usually carbon deposits. We, as surgeons, have to make decisions during surgery to the best of our knowledge and based on what the literature provides us. We present the case of a 30-year-old female patient who underwent abdominoplasty. During surgery, bilateral inguinal pigmented and enlarged lymph nodes were seen. Biopsy of the nodes was done to rule out any malignancy. The results showed tattoo pigments on all lymph nodes. We present this case as tattoo pigment migration, which has been rarely described. PMID:27536493

  5. Simulation and study of the geometric parameters in the inguinal area and the genesis of inguinal hernias.

    PubMed

    Fortuny, Gerard; López-Cano, Manuel; Susín, Antonio; Herrera, Blas

    2012-01-01

    We are interested in studying the genesis of a very common pathology: the human inguinal hernia. How the human inguinal hernia appears is not definitively clear, but it is accepted that it is caused by a combination of mechanical and biochemical alterations, and that muscular simulation plays an important role in this. This study proposes a model to explain how some physical parameters affect the ability to simulate the region dynamically and how these parameters are involved in generating inguinal hernias. We are particularly interested in understanding the mechanical alterations in the inguinal region because little is known about them or how they behave dynamically. Our model corroborates the most important theories regarding the generation of inguinal hernias and is an initial approach to numerically evaluating this affection.

  6. Symposium on the management of inguinal hernias: 4. The Shouldice technique: a canon in hernia repair

    PubMed Central

    Bendavid, Robert

    1997-01-01

    Controversy exists on the merits of the various approaches to inguinal repair. Evolution of the classic open repair has culminated in the Shouldice repair. Challenges from newcomers, namely, tension-free repair and laparoscopy, are being examined. These two techniques have a number of disadvantages: the presence of foreign bodies (prostheses) and their implication in cases of infection; the cost of prosthetic material, which is no longer negligible (particularly with expanded polytetrafluoroethylene); and problems of safety in that the laparoscopic approach is no longer a dependable asset except in the hands of a highly specialized and dextrous operator. Still, complications occur with laparoscopic repair that should not be associated with a surgical procedure that is considered benign, safe and cost-effective. Surgeons must recognize the pertinent facts and decide according to their conscience which method of repair to use. PMID:9194781

  7. Direct inguinal hernias and anterior surgical approach are risk factors for female inguinal hernia recurrences.

    PubMed

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian; Bisgaard, Thue; Rosenberg, Jacob

    2014-01-01

    The purpose of this study was to establish the risk of recurrence after direct and indirect inguinal hernia operation in a large-scale female population and to establish the relationship between the type of hernia at the primary and recurrent procedure. Using data from the Danish Hernia Database (DHDB), a cohort was generated: all females operated on electively for a primary inguinal hernia by either Lichtenstein’s technique or laparoscopy from 1998 to 2012. Within this prospectively collected cohort, the hernia type at the primary procedure (direct inguinal hernia (DIH), indirect inguinal hernia (IIH), combination hernia), the hernia type at the recurrent procedure (DIH, IIH, combination hernia, femoral hernia), anesthesia type, and time from primary procedure to reoperation were registered. A total of 5,893 females with primary elective inguinal hernia operation on in the study period (61 % IIH, 37 % DIH, 2 % combined hernias) were included with a median follow-up time of 72 months (range 0 to 169). A total of 305 operations for suspected recurrences were registered (61 % inguinal recurrences, 38 % femoral recurrences, 1 % no hernias), which corresponded to an overall reoperation rate of 5.2 %. All femoral recurrences occurred after a previous open anterior operation. The crude reoperation rate after primary DIH operation was 11.0 %, 3.0 % after primary IIH operation and 0.007 % after combined hernia operation (p < 0.001). The multivariate adjusted analysis found that DIH at primary operation was a substantial risk factor for recurrence with a hazard ratio of 3.1 (CI 95 % 2.4–3.9) compared with IIH at primary operation (p < 0.001), and that laparoscopic operation gave a lower risk of recurrence with a hazard ratio of 0.57 (CI 95 % 0.43–0.75) compared with Lichtenstein’s technique (p < 0.001). The risk of femoral recurrence was correlated to operation for DIH with a hazard ratio of 2.4 (CI 95 % 1.7–3.5) compared with operation for IIH. In a

  8. Benign breast disease: when to treat, when to reassure, when to refer.

    PubMed

    Vaidyanathan, Lakshmi; Barnard, Karen; Elnicki, D Michael

    2002-05-01

    Many women have breast symptoms-swelling and tenderness, nodularity, pain, palpable lumps, nipple discharge, or breast infections and inflammation. Fortunately, relatively few have breast cancer. Physicians must distinguish benign breast conditions from malignant ones, and know when to refer the patient to a specialist. We have included some of the newer diagnostic techniques and the approach to patients with nonpalpable lesions detected on a screening mammogram.

  9. [Is the presence of an asymptomatic inguinal hernia enough to justify repair?].

    PubMed

    Metzger, Jürg

    2015-11-11

    The risk of strangulation in case of a inguinal hernia is low. Patients with a symptomatic inguinal hernia should undergo an operation. Morbidity and mortality in inguinal hernia surgery are very rare. There is also non-conservative treatment of inguinal hernias. Trusses should no longer be recommended. Watchful waiting is an option for men with minimally symptomatic or asymptomatic inguinal hernias. But patients must be informed that there is a high risk of becoming symptomatic.

  10. Laparoscopic inguinal hernia repair: is the enthusiasm justified?

    PubMed

    Cooper, S S; McAlhany, J C

    1997-01-01

    One surgeon repaired 72 inguinal hernias in 61 patients by a transabdominal preperitoneal laparoscopic placement of prosthetic mesh. There were 58 male and 3 female patients; the mean age was 47.9 years. Thirty-six unilateral inguinal hernias (either direct or indirect), 11 bilateral inguinal hernias, 12 recurrent inguinal hernias, and 2 unilateral pantaloon inguinal hernias were repaired. There were no operative mortalities. The mean follow-up was 21 months, with a range of 6 to 42 months. Ten hernia recurrences (13.8%) were documented 3 to 24 months postoperatively (mean, 12 months). There were six direct hernia recurrences, two indirect hernia recurrences, and two recurrences of recurrent hernia repairs. Thirteen patients (21.3%) experienced morbidity: seromas in eight, a hematoma in one, an ileus in one, hematuria in one, and neuropathy in two. In our opinion, the significant morbidity and early recurrence rate of a laparoscopic inguinal hernia repair are unacceptable. Enthusiasm for laparoscopic technique to repair inguinal hernias is not justified if similar morbidity and recurrence rates are documented within the surgical community.

  11. Developmental Venous Anomaly: Benign or Not Benign.

    PubMed

    Aoki, Rie; Srivatanakul, Kittipong

    2016-09-15

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes.

  12. Developmental Venous Anomaly: Benign or Not Benign

    PubMed Central

    AOKI, Rie; SRIVATANAKUL, Kittipong

    2016-01-01

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes. PMID:27250700

  13. Evaluating conservative treatment for acute appendicitis with lump formation

    PubMed Central

    Malik, Ajaz Ahmad; Wani, Mohd Lateef; Wani, Shadab Nabi; Parray, Fazl Qadir; Nayeem-Ul-Hassan; Irshad, Ifat

    2012-01-01

    Background: Interval appendectomy after acute appendicitis with lump formation (phlegmon) remains controversial. We conducted this study to determine the risk of recurrent appendicitis following initial non-operative treatment for appendicitis, and evaluate factors associated with recurrence. Secondarily, we evaluate the efficacy of interval appendectomy versus no appendectomy. Materials and Methods: Patients who received conservative treatment for appendicitis with lump formation were prospectively studied from June 2006 to June 2008. These patients were followed for recurrence of appendicitis. Results: Of 763 patients with acute appendicitis some 220 patients had lump formation (28.8%). Median age was 28 years. Conservative treatment was successful in 213 (96.8%) patients. The rate of recurrence was 13.1%, all occurring within six months after the index admission. Mean follow-up was 26±18 months. Conclusion: Conservative treatment of appendicitis with lump formation is efficient and the recurrence rate is low. Routine interval appendectomy after initial conservative treatment for lump formation is not a cost-effective intervention and not recommended. PMID:22416152

  14. Inguinal endometriosis or irreducible hernia? A difficult preoperative diagnosis.

    PubMed

    Miranda, L; Settembre, A; Capasso, P; Piccolboni, D; De Rosa, N; Corcione, F

    2001-03-01

    Two cases of endometriosis infiltrating the round ligament and associated with an inguinal hernia are presented. The initial diagnosis was irreducible hernia, since this rare association often causes unusual preoperative symptoms and diagnostic problems. Diagnosis is frequently made by histologic examination. Surgery is the treatment of choice both for hernia and for endometriosis, and is locally curative. However, in a fertile woman with a painful mass in the inguinal region the possibility of endometriosis should be considered, and if suspected at inguinal exploration a laparoscopy should be made to rule out the presence of intraperitoneal endometriosis.

  15. Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia.

    PubMed

    Sejben, István; Rácz, András; Svébis, Mihály; Patyi, Márta; Cserni, Gábor

    2012-08-01

    Chronic granulomatous inflammation may develop after injecting foreign oily substances into the penis. The disorder affects mainly the site of administration, but regional lymphadenopathy or even systemic disease can occur. We present a 39-year-old man with petroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopathologic findings of these nodes were consistent with mineral oil granuloma. Paraffinoma of the male genitalia can cause various clinical features posing a differential diagnostic dilemma. Regional lymphadenitis may be the main clinical characteristic. Patient's history, physical and histopathological examination are required to establish the diagnosis.

  16. Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia

    PubMed Central

    Sejben, István; Rácz, András; Svébis, Mihály; Patyi, Márta; Cserni, Gábor

    2012-01-01

    Chronic granulomatous inflammation may develop after injecting foreign oily substances into the penis. The disorder affects mainly the site of administration, but regional lymphadenopathy or even systemic disease can occur. We present a 39-year-old man with petroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopathologic findings of these nodes were consistent with mineral oil granuloma. Paraffinoma of the male genitalia can cause various clinical features posing a differential diagnostic dilemma. Regional lymphadenitis may be the main clinical characteristic. Patient’s history, physical and histopathological examination are required to establish the diagnosis. PMID:23093564

  17. Primary hepatic benign schwannoma

    PubMed Central

    Hayashi, Michihiro; Takeshita, Atsushi; Yamamoto, Kazuhiro; Tanigawa, Nobuhiko

    2012-01-01

    Schwannoma is predominantly a benign neoplasm of the Schwann cells in the neural sheath of the peripheral nerves. Occurrence of schwannoma in parenchymatous organs, such as liver, is extremely rare. A 64-year-old man without neurofibromatosis was observed to have a space-occupying lesion of 23mm diameter in the liver during follow-up examination for a previously resected gastrointestinal stromal tumor (GIST) in the small intestine. He underwent lateral segmentectomy of the liver under a provisional diagnosis of hepatic metastatic recurrence of the GIST. Histological examination confirmed the diagnosis of a benign schwannoma, confirmed by characteristic pathological findings and positive immunoreactions with the neurogenic marker S-100 protein, but negative for c-kit, or CD34. The tumor was the smallest among the reported cases. When the primary hepatic schwannoma is small in size, preoperative clinical diagnosis is difficult. Therefore, this disease should be listed as differential diagnosis for liver tumor with clinically benign characteristics. PMID:22530081

  18. Benign cutaneous Degos disease.

    PubMed

    Zamiri, Mozheh; Jarrett, Paul; Snow, John

    2005-08-01

    A 24-year-old woman presented with an 8-year history of a recurrent asymptomatic rash characterized by small erythematous papules which evolved to form atrophic porcelain white scars with a telangectatic rim. She had never had gastrointestinal or neurological symptoms. A short trial of aspirin did not alter the behavior of the disease. Histology confirmed the clinical diagnosis of Degos disease. Degos disease is a rare disorder that has been classified into the benign or malignant variety. The malignant type has a poor prognosis. Gastrointestinal involvement is the most frequent cause of death. The existence of patients with a prolonged, purely cutaneous or benign form has been increasingly recognized. It may be impossible to classify a patient at the time of initial presentation. Her progress is consistent with the benign form.

  19. [Benign chronic pain].

    PubMed

    Serrie, A; Thurel, C

    1994-09-15

    Recent data indicate that 25 to 30% of the population in industrialized countries suffers from benign chronic pain. Among these patients, 50 to 75% are professionally incapable for varied lengths of time, from a few days to some weeks or months, or even definitively. The aetiology and clinical presentation of chronic benign pain are enormously varied because this definition includes such different pathologies as headache, pain of rheumatologic, postsurgical, organic, and post-zoster origin, lombalgia, radiculalgia, post-amputation pain, neuropathologic pain, causalgia, algoneurodystrophic pain, psychosomatic and idiopathic pain. Since these syndromes and causes of pain could not be discussed individually, they have been grouped according to their neurophysiology and pathophysiology.

  20. Multiple lumps in the breast due to Mycobacterium fortuitum.

    PubMed

    Chandanwale, Shirish S; Gulati, Ishita; Baravkar, Dadaso S; Shinde, Sumedha P; Mishra, Neha

    2016-04-01

    Although breast tissue is the most resistant to tuberculosis, its incidence is increasing worldwide. High incidence of breast tuberculosis is presumed in India. The rapidly growing nontubercular mycobacteria, such as Mycobacterium fortuitum and Mycobacterium chelonae, are of increasing clinical importance because infections due to these organisms are often hospital acquired. The true incidence of M. fortuitum is unknown but it has been estimated to be between 4 and 6 cases per one million people. It causes skin or soft tissue infections following trauma or surgery. Breast infection with M. fortuitum is very uncommon. The most common clinical presentation of breast tuberculosis is a painless lump. Multiple lumps are rarely reported. The culture and molecular studies are the keystone for differentiation of various mycobacterium species. We report one such case of a 25-year-old female presenting with multiple painless lumps due to M. fortuitum infection in the left breast.

  1. Lumped mass modelling for the dynamic analysis of aircraft structures

    NASA Technical Reports Server (NTRS)

    Abu-Saba, Elias G.; Shen, Ji Yao; Mcginley, William M.; Montgomery, Raymond C.

    1992-01-01

    Aircraft structures may be modelled by lumping the masses at particular strategic points and the flexibility or stiffness of the structure is obtained with reference to these points. Equivalent moments of inertia for the section at these positions are determined. The lumped masses are calculated based on the assumption that each point will represent the mass spread on one half of the space on each side. Then these parameters are used in the differential equation of motion and the eigen characteristics are determined. A comparison is made with results obtained by other established methods. The lumped mass approach in the dynamic analysis of complicated structures provides an easier means of predicting the dynamic characteristics of these structures. It involves less computer time and avoids computational errors that are inherent in the numerical solution of complicated systems.

  2. Application of Mass Lumped Higher Order Finite Elements

    SciTech Connect

    Chen, J.; Strauss, H. R.; Jardin, S. C.; Park, W.; Sugiyama, L. E.; G. Fu; Breslau, J.

    2005-11-01

    There are many interesting phenomena in extended-MHD such as anisotropic transport, mhd, 2-fluid effects stellarator and hot particles. Any one of them challenges numerical analysts, and researchers are seeking for higher order methods, such as higher order finite difference, higher order finite elements and hp/spectral elements. It is true that these methods give more accurate solution than their linear counterparts. However, numerically they are prohibitively expensive. Here we give a successful solution of this conflict by applying mass lumped higher order finite elements. This type of elements not only keep second/third order accuracy but also scale closely to linear elements by doing mass lumping. This is especially true for second order lump elements. Full M3D and anisotropic transport models are studied.

  3. Electrical Lumped Model Examination for Load Variation of Circulation System

    NASA Astrophysics Data System (ADS)

    Koya, Yoshiharu; Ito, Mitsuyo; Mizoshiri, Isao

    Modeling and analysis of the circulation system enables the characteristic decision of circulation system in the body to be made. So, many models of circulation system have been proposed. But, they are complicated because the models include a lot of elements. Therefore, we proposed a complete circulation model as a lumped electrical circuit, which is comparatively simple. In this paper, we examine the effectiveness of the complete circulation model as a lumped electrical circuit. We use normal, angina pectoris, dilated cardiomyopathy and myocardial infarction for evaluation of the ventricular contraction function.

  4. Benign multicystic peritoneal mesothelioma.

    PubMed

    Uzüm, Nüket; Ozçay, Necdet; Ataoğlu, Omür

    2009-06-01

    Benign multicystic peritoneal mesothelioma is a rare tumor that occurs mainly in women in their reproductive age. It is characterized by the formation of multiple, thin-walled, multilocular cysts that frequently produce large, intra-abdominal masses. The short follow-ups and possible etiologies based on the published reports make it difficult to draw any firm conclusions.

  5. Hospital costs associated with laparoscopic and open inguinal herniorrhaphy.

    PubMed

    Spencer Netto, Fernando; Quereshy, Fayez; Camilotti, Bruna G; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

    2014-01-01

    The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operating room (OR) and total hospital costs. Two hundred eleven patients underwent elective unilateral inguinal herniorrhaphy (117 open and 94 laparoscopic), and 33 patients underwent elective bilateral inguinal herniorrhaphy (9 open and 24 laparoscopic). OR and total hospital costs for open unilateral inguinal hernia repair were significantly lower than for the laparoscopic approach (median total cost, $3207.15 vs $3723.66; P < .001). OR and total hospital costs for repair of elective bilateral inguinal hernias were similar between the open and laparoscopic approaches (median total cost, $4574.02 vs $4662.89; P = .827). In the setting of a Canadian academic hospital, when considering the repair of an elective unilateral inguinal hernia, the OR and total hospital costs of open surgery were significantly lower than for the laparoscopic techniques. There was no statistical difference between OR and total hospital costs when comparing open surgery and laparoscopic techniques for the repair of bilateral inguinal hernias. Given the perioperative benefits of laparoscopy, further studies incorporating hernia-specific outcomes are necessary to determine the cost-effectiveness of each approach and to define the optimal treatment strategy.

  6. Hospital Costs Associated With Laparoscopic and Open Inguinal Herniorrhaphy

    PubMed Central

    Quereshy, Fayez; Camilotti, Bruna G.; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

    2014-01-01

    Purpose: The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. Methods: A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operating room (OR) and total hospital costs. Results: Two hundred eleven patients underwent elective unilateral inguinal herniorrhaphy (117 open and 94 laparoscopic), and 33 patients underwent elective bilateral inguinal herniorrhaphy (9 open and 24 laparoscopic). OR and total hospital costs for open unilateral inguinal hernia repair were significantly lower than for the laparoscopic approach (median total cost, $3207.15 vs $3723.66; P < .001). OR and total hospital costs for repair of elective bilateral inguinal hernias were similar between the open and laparoscopic approaches (median total cost, $4574.02 vs $4662.89; P = .827). Conclusions: In the setting of a Canadian academic hospital, when considering the repair of an elective unilateral inguinal hernia, the OR and total hospital costs of open surgery were significantly lower than for the laparoscopic techniques. There was no statistical difference between OR and total hospital costs when comparing open surgery and laparoscopic techniques for the repair of bilateral inguinal hernias. Given the perioperative benefits of laparoscopy, further studies incorporating hernia-specific outcomes are necessary to determine the cost-effectiveness of each approach and to define the optimal treatment strategy. PMID:25392677

  7. Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

    PubMed Central

    Tekin, Recep; Ceylan Tekin, Rojbin; Ceylan Cevik, Figen; Cevik, Remzi

    2015-01-01

    Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition. PMID:25973280

  8. Transmission block to simplify combined pelvic and inguinal radiation therapy.

    PubMed

    Kalnicki, S; Zide, A; Maleki, N; DeWyngaert, J K; Lipsztein, R; Dalton, J F; Bloomer, W D

    1987-08-01

    A homogeneous dose distribution of radiation to inguinal lymph nodes and deep pelvic structures can be achieved with use of a transmission block over the central portion of a large anterior pelvic-inguinal portal, together with a smaller posterior field. This relatively simple technique permits individualization of isodose distributions and eliminates the problems of matching abutting portals. Reproducibility of daily setup and optimization of machine utilization are both improved.

  9. Pain and compression neuropathy in primary inguinal hernia.

    PubMed

    Wright, R; Born, D E; D'Souza, N; Hurd, L; Gill, R; Wright, D

    2017-08-17

    Enlargement of the ilioinguinal nerve at the external inguinal ring is observed in 34% of patients undergoing primary open inguinal herniorrhaphy; in 88% of patients it occurs at the fascial edge where the hernia mushrooms with abdominal pressure. Compression neuropathy occurs near many anatomical nerve constriction sites and is associated with enlargement of the peripheral nerve accompanied by sensory changes. In this prospective study, Carolina Comfort Scale (CCS) questionnaire data was collected for 35 primary hernia repairs. Each patient underwent primary inguinal herniorrhaphy that included ilioinguinal neurectomy. All nerves were sampled proximal to the external inguinal ring. Any nerves with grossly increased overall diameter to any degree distal to the external ring were additionally sampled in the thickened portions. A neuropathologist performed histologic evaluation of the H&E-stained cross sections. Paired comparison of proximal and distal nerves revealed a greater overall diameter and greater measured nerve-specific diameter in distal nerve segments. Nerves with increased overall diameter were also found to have a statistically significant positive correlation with four of eight pain measures. Additionally, increased nerve-specific diameter correlates with increased pain on four of eight pain values, but age effect on nerve diameter blunts this finding. Increased preoperative CCS pain values in primary open inguinal hernia are significantly correlated with gross enlargement of the overall diameter and nerve-specific diameter of the ilioinguinal nerve beyond the external inguinal ring. This is consistent with a compression neuropathy.

  10. A retrospective study of inguinal hernia in 35 dogs.

    PubMed

    Waters, D J; Roy, R G; Stone, E A

    1993-01-01

    Inguinal hernia was associated with trauma in five dogs and was considered nontraumatic in 30 dogs. There were 11 males, 13 intact females, and six spayed females with nontraumatic inguinal hernia. Six dogs had bilateral hernias. Five dogs were younger than 4 months at the time of diagnosis. In 11 older dogs with nontraumatic inguinal hernia, the hernias were identified less than 7 days before surgical repair; in 14 older dogs, the hernias had been recognized for 1 to 60 months. Clinical signs in dogs without small intestinal incarceration were usually limited to a visible or palpable mass without pain or systemic illness. Herniorrhaphy approaches included inguinal, midline with contralateral ring evaluation, and celiotomy with or without inguinal exposure. Fat and omentum were the most common hernial contents. Small intestine was within the hernias of 12 dogs. Six dogs had nonviable small intestine. Postoperative complications included two incisional infections, one incisional dehiscence, two cases of peritonitis and sepsis associated with bowel leakage after intestinal resection and anastomosis, and one hernia recurrence. The overall prevalence of postoperative complications was 17%, and the mortality rate was 3%. Vomiting for 2 to 6 days was predictive of nonviable small intestine. Dogs younger than 2 years were at 11 times greater risk for nonviable small intestine than dogs older than 2 years. Four of five dogs with nontraumatic inguinal hernia and nonviable small intestine were intact males, whereas none of 13 intact females were affected. Only one of 14 dogs with longstanding hernias had nonviable small intestine.

  11. Benign Paroxysmal Positional Vertigo (BPPV)

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Benign Paroxysmal Positional Vertigo (BPPV) BPPV is the most common vestibular disorder. Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of ...

  12. Application of Biologically-Based Lumping To Investigate the ...

    EPA Pesticide Factsheets

    People are often exposed to complex mixtures of environmental chemicals such as gasoline, tobacco smoke, water contaminants, or food additives. However, investigators have often considered complex mixtures as one lumped entity. Valuable information can be obtained from these experiments, though this simplification provides little insight into the impact of a mixture's chemical composition on toxicologically-relevant metabolic interactions that may occur among its constituents. We developed an approach that applies chemical lumping methods to complex mixtures, in this case gasoline, based on biologically relevant parameters used in physiologically-based pharmacokinetic (PBPK) modeling. Inhalation exposures were performed with rats to evaluate performance of our PBPK model. There were 109 chemicals identified and quantified in the vapor in the chamber. The time-course kinetic profiles of 10 target chemicals were also determined from blood samples collected during and following the in vivo experiments. A general PBPK model was used to compare the experimental data to the simulated values of blood concentration for the 10 target chemicals with various numbers of lumps, iteratively increasing from 0 to 99. Large reductions in simulation error were gained by incorporating enzymatic chemical interactions, in comparison to simulating the individual chemicals separately. The error was further reduced by lumping the 99 non-target chemicals. Application of this biologic

  13. WATGIS: A GIS-Based Lumped Parameter Water Quality Model

    Treesearch

    Glenn P. Fernandez; George M. Chescheir; R. Wayne Skaggs; Devendra M. Amatya

    2002-01-01

    A Geographic Information System (GIS)­based, lumped parameter water quality model was developed to estimate the spatial and temporal nitrogen­loading patterns for lower coastal plain watersheds in eastern North Carolina. The model uses a spatially distributed delivery ratio (DR) parameter to account for nitrogen retention or loss along a drainage network. Delivery...

  14. Leaks, Lumps, and Lines: Stigma and Women's Bodies

    ERIC Educational Resources Information Center

    Chrisler, Joan C.

    2011-01-01

    Women's bodies have often been positioned in art and popular culture as monstrous or defiled and women's bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women's bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those…

  15. Leaks, Lumps, and Lines: Stigma and Women's Bodies

    ERIC Educational Resources Information Center

    Chrisler, Joan C.

    2011-01-01

    Women's bodies have often been positioned in art and popular culture as monstrous or defiled and women's bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women's bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those…

  16. Dynamics of neutrino lumps in growing neutrino quintessence

    NASA Astrophysics Data System (ADS)

    Casas, Santiago; Pettorino, Valeria; Wetterich, Christof

    2016-11-01

    We investigate the formation and dissipation of large-scale neutrino structures in cosmologies where the time evolution of dynamical dark energy is stopped by a growing neutrino mass. In models where the coupling between neutrinos and dark energy grows with the value of the scalar cosmon field, the evolution of neutrino lumps depends on the neutrino mass. For small masses the lumps form and dissolve periodically, leaving only a small backreaction of the neutrino structures on the cosmic evolution. This process heats the neutrinos to temperatures far above the photon temperature, such that neutrinos acquire again an almost relativistic equation of state. The present equation of state of the combined cosmon-neutrino fluid is very close to -1 . By contrast, for larger neutrino masses, the lumps become stable. The highly concentrated neutrino structures entail a large backreaction similar to the case of a constant neutrino-cosmon coupling. A present average neutrino mass of around 0.5 eV seems to be compatible with observations so far. For masses lower than this value, neutrino-induced gravitational potentials remain small, making the lumps difficult to detect.

  17. 29 CFR 4044.75 - Other lump sum benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... sum benefits. The value of a lump sum benefit which is not covered under § 4044.73 or § 4044.74 is equal to— (a) The value under the qualifying bid, if an insurer provides the benefit; or (b) The present value of the benefit as of the date of distribution, determined using reasonable actuarial...

  18. Reduction in thermal conductivity of BiSbTe lump

    NASA Astrophysics Data System (ADS)

    Ahmad, Kaleem; Wan, C.; Al-Eshaikh, M. A.; Kadachi, A. N.

    2017-03-01

    In this work, systematic investigations on the thermal conductivities of BiSbTe lump, microstructured pristine BiSbTe bulk and single wall carbon nanotubes (SWCNTs)/BiSbTe bulk nanocomposites were performed. BiSbTe lumps were crushed to form a coarse powder (200 µm) and effect of particle size reduction on the effective thermal conductivity of BiSbTe (200 µm) bulk were analyzed. For further reduction in the conductivity, a two pronged strategy has been employed. First, additional refinement of BiSbTe (200 µm) were performed through ball milling in an inert environment. Second, SWCNTs in 0.75, and 1.0 vol% were distributed uniformly in the fine BiSbTe ball milled powder. The results showed that the effective thermal conductivities decrease with the reduction in the particle size from lump to BiSbTe (200 µm) bulk as well as with the addition of SWCNTs accompanied by further refinement of BiSbTe particles. The significant reduction in thermal conductivities of the lump was achieved for pure BiSbTe (200 µm) bulk and 0.75 vol% of SWCNTs/BiSbTe composite. This can be ascribed to the enhanced phonon scattering by the grain boundaries between the nanostructured BiSbTe particles as well as the interfaces between BiSbTe and the low dimensional carbon nanotubes.

  19. Experimental realization of optical lumped nanocircuits at infrared wavelengths.

    PubMed

    Sun, Yong; Edwards, Brian; Alù, Andrea; Engheta, Nader

    2012-01-29

    The integration of radiofrequency electronic methodologies on micro- as well as nanoscale platforms is crucial for information processing and data-storage technologies. In electronics, radiofrequency signals are controlled and manipulated by 'lumped' circuit elements, such as resistors, inductors and capacitors. In earlier work, we theoretically proposed that optical nanostructures, when properly designed and judiciously arranged, could behave as nanoscale lumped circuit elements--but at optical frequencies. Here, for the first time we experimentally demonstrate a two-dimensional optical nanocircuit at mid-infrared wavelengths. With the guidance of circuit theory, we design and fabricate arrays of Si3N4 nanorods with specific deep subwavelength cross-sections, quantitatively evaluate their equivalent impedance as lumped circuit elements in the mid-infrared regime, and by Fourier transform infrared spectroscopy show that these nanostructures can indeed function as two-dimensional optical lumped circuit elements. We further show that the connections among nanocircuit elements, in particular whether they are in series or in parallel combination, can be controlled by the polarization of impinging optical signals, realizing the notion of 'stereo-circuitry' in metatronics-metamaterials-inspired optical circuitry.

  20. Characterization of an air jet haptic lump display.

    PubMed

    Bianchi, Matteo; Gwilliam, James C; Degirmenci, Alperen; Okamura, Allison M

    2011-01-01

    During manual palpation, clinicians rely on distributed tactile information to identify and localize hard lumps embedded in soft tissue. The development of tactile feedback systems to enhance palpation using robot-assisted minimally invasive surgery (RMIS) systems is challenging due to size and weight constraints, motivating a pneumatic actuation strategy. Recently, an air jet approach has been proposed for generating a lump percept. We use this technique to direct a thin stream of air through an aperture directly on the finger pad, which indents the skin in a hemispherical manner, producing a compelling lump percept. We hypothesize that the perceived parameters of the lump (e.g. size and stiffness) can be controlled by jointly adjusting air pressure and the aperture size through which air escapes. In this work, we investigate how these control variables interact to affect perceived pressure on the finger pad. First, we used a capacitive tactile sensor array to measure the effect of aperture size on output pressure, and found that peak output pressure increases with aperture size. Second, we performed a psychophysical experiment for each aperture size to determine the just noticeable difference (JND) of air pressure on the finger pad. Subject-averaged pressure JND values ranged from 19.4-24.7 kPa, with no statistical differences observed between aperture sizes. The aperture-pressure relationship and the pressure JND values will be fundamental for future display control.

  1. Benign notochordal cell tumors.

    PubMed

    Martínez Gamarra, C; Bernabéu Taboada, D; Pozo Kreilinger, J J; Tapia Viñé, M

    2017-08-01

    Benign notochordal cell tumors (TBCN) are lesions with notochordal differentiation which affect the axial skeleton. They are characterized by asymptomatic or non-specific symptomatology and are radiologically unnoticed because of their small size, or because they are mistaken with other benign bone lesions, such as vertebral hemangiomas. When they are large, or symptomatic, can be differential diagnosis with metastases, primary bone tumors and chordomas. We present a case of a TBCN in a 50-year-old woman, with a sacral lesion seen in MRI. A CT-guided biopsy was scheduled to analyze the lesion, finding that the tumor was not clearly recognizable on CT, so the anatomical references of MRI were used to select the appropriate plane. The planning of the approach and the radio-pathological correlation were determinant to reach the definitive diagnosis. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. [Large benign prostatic hiperplasia].

    PubMed

    Soria-Fernández, Guillermo René; Jungfermann-Guzman, José René; Lomelín-Ramos, José Pedro; Jaspersen-Gastelum, Jorge; Rosas-Nava, Jesús Emmanuel

    2012-01-01

    the term prostatic hyperplasia is most frequently used to describe the benign prostatic growth, this being a widely prevalent disorder associated with age that affects most men as they age. The association between prostate growth and urinary obstruction in older adults is well documented. large benign prostatic hyperplasia is rare and few cases have been published and should be taken into account during the study of tumors of the pelvic cavity. we report the case of an 81-year-old who had significant symptoms relating to storage and bladder emptying, with no significant elevation of prostate specific antigen. this is a rare condition but it is still important to diagnose and treat as it may be related to severe obstructive uropathy and chronic renal failure. In our institution, cases of large prostatic hyperplasia that are solved by suprapubic adenomectomy are less than 3%.

  3. Benign cutaneous Degos' disease.

    PubMed

    Ojeda Cuchillero, R M; Sánchez Regaña, M; Umbert Millet, P

    2003-03-01

    Malignant atrophic papulosis is a rare systemic vaso-occlusive disorder characterized by thrombosis of vessels of the dermis, gastrointestinal tract, central nervous system and, occasionally, other organs. Cutaneous lesions consist of erythematous, dome-shaped papules that develop a central area of necrosis to leave a porcelain-like scar. The most accepted theory of pathogenesis is based on endothelial cell damage. There is no effective treatment of the disease. We describe a 26-year-old man with Degos' disease, a diagnosis based on the clinical and histologic pattern of skin lesions. The good response to antiplatelet therapy and the absence of systemic involvement over 8 years' follow-up is noteworthy. We believe that this case represents the benign form of the disease, typically referred to as benign cutaneous Degos' disease.

  4. [Benign vocal fold lesions].

    PubMed

    Pickhard, A; Reiter, R

    2013-05-01

    Benign vocal fold lesions are grouped in lesions arising from the epithelium like papillomas, lesions affecting the Reinke's space (nodules, polyps, cysts, Reinkes's edema as a form of chronic laryngitis) and lesions affecting the arytenoid (granulomas). A multifactorial genesis is assumed. Main symptoms are dysphonia and hyperfunctional vocal behavior that might also be a cause of these lesions. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Environmentally Benign Pyrotechnic Delays

    DTIC Science & Technology

    2012-06-01

    jay.poret@us.army.mil † School of Mechanical Engineering, Purdue University, West Lafayette, Indiana, USA ABSTRACT Pyrotechnic delays are used in...benign formulations are described. The delay time of the new system is easily tunable. These compositions will consistently function in aluminum ...tunable. These compositions will consistently function in aluminum housings which is generally difficult for delay compositions due to extreme thermal

  6. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Annuity or elective lump sum-living missing participant... CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.9 Annuity or elective lump sum—living missing... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of...

  7. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Annuity or elective lump sum-living missing participant... CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.9 Annuity or elective lump sum—living missing... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of...

  8. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Annuity or elective lump sum-living missing participant... CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.9 Annuity or elective lump sum—living missing... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of...

  9. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Annuity or elective lump sum-living missing participant... CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.9 Annuity or elective lump sum—living missing... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of...

  10. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Annuity or elective lump sum-living missing participant... CORPORATION PLAN TERMINATIONS MISSING PARTICIPANTS § 4050.9 Annuity or elective lump sum—living missing... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of...

  11. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation of...

  12. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation of...

  13. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation of...

  14. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation of...

  15. 20 CFR 234.11 - 1974 Act lump-sum death payment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true 1974 Act lump-sum death payment. 234.11... LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.11 1974 Act lump-sum death payment. (a) The total amount... household” as the employee at the time of the employee's death. (Refer to § 234.21 for an explanation of...

  16. Benign familial hyperphosphatasemia

    SciTech Connect

    Siraganian, P.A.; Mulvihill, J.J.; Mulivor, R.A.; Miller, R.W. )

    1989-03-03

    Elevated alkaline phosphatase activity in serum suggests bone or liver disease or a neoplasm but can also indicate pregnancy or another benign condition. A family with benign hyperphosphatasemia was studied to elucidate the genetics and enzyme defect. Serum total alkaline phosphatase activity was greater than the population mean in all six family members, and more than 7 SDs above the mean in two of four offspring. Monoclonal antibodies to three alkaline phosphatase isoenzymes, intestinal, placental, and tissue nonspecific demonstrated markedly increased intestinal alkaline phosphatase levels in all family members and significantly elevated liver/bone/kidney activity in the two offspring. Guanidine hydrochloride denaturation of the liver/bone/kidney component showed high alkaline phosphatase activity from liver in both siblings and from bone in one. The mode of inheritance in this family is obscure, but a complex regulation of the products of two different alkaline phosphatase genes seems likely. Steps toward diagnosis are suggested. Early recognition of this benign biochemical abnormality should help to avoid unnecessary diagnostic tests.

  17. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    PubMed Central

    Tatar, Cihad; Tüzün, İshak Sefa; Karşıdağ, Tamer; Kızılkaya, Mehmet Celal; Yılmaz, Erdem

    2016-01-01

    Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of non-complicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3), and the other consisting of patients not undergoing bowel resection (Group 4). Results: In Group 1, it was observed that eight (7.14%) of the patients had wound infections, while two (1.78%) had hematomas, four (3.57%) had seromas, and one (0.89%) had relapse. In Group 2, one (2.56%) of the patients had a wound infection, while three (7.69%) had hematomas, one (2.56%) had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection, seroma

  18. Shouldice is superior to Bassini inguinal herniorrhaphy.

    PubMed

    Kux, M; Fuchsjäger, N; Schemper, M

    1994-07-01

    The original Bassini and Shouldice methods for inguinal herniorrhaphy were tested against each other and against their respective variants that avoid permanent suturing of the internal oblique muscle. Seven hundred fifty inguinal hernia repairs were prospectively allocated to 1 of 4 groups: group A: Bassini with absorbable sutures (polyglycolic acid); group B: Bassini with nonabsorbable sutures (polyester); group C: Shouldice with four rows of polypropylene sutures; and group D: Shouldice with two rows of polypropylene sutures. Outcome was correlated to prospectively defined types and risk factors such as direct hernia, repair for recurrent hernia, hernial sac diameter greater than 8 cm, age greater than 70 years, overweight, and chronic bronchitis. Actual (not actuarial) recurrence rates were determined through clinical examination by hospital staff surgeons (not through information by letter or phone) for 93.6% of surviving patients. Local complications exclusive of recurrence, but including the redoubtable and litigious sequelae of testicular atrophy and chronic ilioinguinal pain, were significantly reduced from 6.3% (group B and C) to 2.3% by omitting permanent muscle sutures (groups A and D; P < 0.05). However, the use of slowly absorbable suture material resulted in a disproportionately high recurrence rate of 12.8% in the modified Bassini group A. The original Bassini method, ie, division of the transversalis fascia and repair with nonabsorbable sutures, as was used in group B, had an actual 2-year recurrence rate of 8.7%, still a highly significant difference compared with 3.6% and 2.3% for Shouldice groups C and D, respectively (P = 0.012). For repair of recurrent hernia, the superiority of the Shouldice technique was not statistically significant: re-recurrence rate 7.6% versus 13.5% for the original Bassini group B. Repair of recurrent hernia was the only patient-related risk factor of equal significance as the method of repair. The Shouldice technique

  19. Open inguinal herniotomy: Analysis of variations

    PubMed Central

    Ibrahim, Musa; Ladan, Mu’azu Adamu; Abdussalam, Umar Sharif; Getso, Kabiru Ibrahim; Mohammad, Mohammad Aminu; Chukwuemeka, Anyanwu Lofty-John; Owolabi, Femi Luqman; Akhparov, Nurlan Nurkenovich; Aipov, Rassulbek Rakhmanberdievich

    2015-01-01

    Background: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. Materials and Methods: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). Results: A total of 458 repairs were done. Patients’ age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 ± 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 ± 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 ± 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 ± 4.19 (median, 4). Operation time per repair was 26.50 ± 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 ± 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 ± 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 ± 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 ± 1.43, 2.94 ± 0.81, 2.18 ± 0.69, 1.87 ± 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. Conclusion: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers

  20. Bilateral painful parotid lumps and a lump in the groin: An uncommon presentation of common Kikuchi's disease

    PubMed Central

    Mirgh, Sumeet Prakash; Satiya, Jinendra; Sorabjee, Jehangir Soli

    2016-01-01

    Kikuchi-Fujimoto disease (KFD) is an under-recognized disease most commonly presenting with cervical lymphadenopathy, fever, and cytopenias in young females. Bilateral parotid enlargement is usually caused by infections (e.g., mumps) and autoimmune conditions (e.g., Sjogren syndrome). Parotid enlargement, inguinal lymphadenopathy, and pyrexia of unknown origin are uncommon presenting features of KFD and should be suspected in the appropriate setting. PMID:27843864

  1. The government and the inguinal hernia.

    PubMed

    Friedman, D; Schwartzbard, A; Velcek, F T; Klotz, D H; Kottmeier, P K

    1979-06-01

    Our review of the incidence of inguinal hernias in children based on socioeconomic differences and their risk of incarceration with its subsequent complications, was prompted by a governmental decision to disallow elective herniorrhaphy in children over 1 yr of age. The review showed the following: The risk of incarceration, the failure of preoperative reduction and the potential gonadal injury is more than three times as high in the poor child, usually covered by Medicaid. Since operative and postoperative complications increase proportional to the incidence of incarcertain, the denial of an elective herniorrhaphy endangers the life of a child. Since the increased hospitalization after incarceration also increases the financial expenditure, this rule is not only medically but also economically unsound. This review suggests that unilateral governmental health care decisions, especially those aimed at cost containment, should be carefully scrutinized to determine what price not only the society, but the patient has to pay for the "cost containment". We feel that the price of the denial of a herniorrhaphy is too high.

  2. Inguinal hernia recurrence: Classification and approach

    PubMed Central

    Campanelli, Giampiero; Pettinari, Diego; Cavalli, Marta; Avesani, Ettore Contessini

    2006-01-01

    The authors reviewed the records of 2,468 operations of groin hernia in 2,350 patients, including 277 recurrent hernias updated to January 2005. The data obtained - evaluating technique, results and complications - were used to propose a simple anatomo-clinical classification into three types which could be used to plan the surgical strategy: Type R1: first recurrence ‘high,’ oblique external, reducible hernia with small (<2 cm) defect in non-obese patients, after pure tissue or mesh repairType R2: first recurrence ‘low,’ direct, reducible hernia with small (<2 cm) defect in non-obese patients, after pure tissue or mesh repairType R3: all the other recurrences - including femoral recurrences; recurrent groin hernia with big defect (inguinal eventration); multirecurrent hernias; nonreducible, linked with a controlateral primitive or recurrent hernia; and situations compromised from aggravating factors (for example obesity) or anyway not easily included in R1 or R2, after pure tissue or mesh repair. PMID:21187986

  3. Profile of benign breast diseases in western Saudi Arabia

    PubMed Central

    Albasri, Abdulkader M.

    2014-01-01

    Objectives: To describe the histopathological patterns of benign breast diseases (BBD) among Saudi patients. Methods: This is a retrospective review of BBD reports of Saudi patients of both genders and all age groups seen between January 2006 and December 2013 at King Fahad Hospital, Madinah, Kingdom of Saudi Arabia. Results: Out of the total 1005 breast biopsies, 603 cases (60%) were BBD. The female to male ratio was 30.7:1. The overall mean age for BBD was 27.5 years, with an age range of 14-80 years. The most common lesion was fibroadenoma (FA) accounting for 44.3% of cases (mean age: 23.5 years), followed by 23.4% fibrocystic change (FCC) (mean age: 37.1 years). Both lesions had a peak occurrence in the third decade. Inflammatory lesions constituted 13.9% of cases. Most common were granulomatous mastitis (3.5%), chronic mastitis (3.3%), and acute mastitis with abscess (3.1%). Other major lesions encountered were fibroadenomatoid hyperplasia (3.1%), intraductal papilloma (2.8%), and benign phylloides tumor (2.6%). All benign diagnoses in male patients were gynecomastia and most patients (68.4%) were under 40 years. Conclusion: In this study, BBD constituted 60% of breast lumps, and were mostly FA and FCC. The BBD peaked at the 20-29 year age range. PMID:25491220

  4. Repeated in vivo inguinal measurements to estimate a single optimal mesh size for inguinal herniorrhaphy

    PubMed Central

    2012-01-01

    Background Inguinal hernia is a common condition and its repair (herniorrhaphy) is one of the most commonly performed procedures in general surgery. The Lichtenstein herniorrhaphy technique is a widely used and effective surgery that uses mesh to reinforce the area of weakness. Although a wide range of mesh sizes are available for use in hernia repair, in low-resource health care settings the provision of multiple products may not be supportable and it may be necessary for the provision and use of a single mesh size. This study aimed to determine whether the recommended 7.0 cm x 15.0 cm size is an appropriate single mesh size. Methods In order to determine the optimal mesh size according to recommended surgical practices, in vivo measurements of key dimensions of the inguinal floor were taken in patients undergoing herniorrhaphy. Results Measurements were taken in 43 patients: 40 men and 3 women, mean age 43 years (SD 13.6); 39 with indirect hernias, 4 with direct. Allowing for recommended mesh overlaps, the optimal mesh size for provision to be appropriate for the majority of patients was determined to be 8.5 cm x 14.0 cm, 21% wider than the mesh size currently recommended for use in Lichtenstein herniorrhaphy. Conclusions An appropriate size for routine provision in low-resource settings, or other settings where the provision of several mesh sizes is not supportable, may be 8.5 cm x 14.0 cm. PMID:23031606

  5. [Azoospermia and a history of inguinal hernia repair in adult].

    PubMed

    Khodari, M; Ouzzane, A; Marcelli, F; Yakoubi, R; Mitchell, V; Zerbib, P; Rigot, J-M

    2015-10-01

    Inguinal hernia repair is one of the most performed surgeries in the world. It is recognized that any surgery of the pelvic floor may represent a risk factor of male infertility. Retrospective study of patients with azoospermia and a history of adult inguinal hernia repair surgery and referred to our center between January 1990 and January 2011 for infertility. Among 69 azoospermia patients with history of adult inguinal hernia repair surgery, 60 patients underwent surgical extraction of sperm that was successful in 75% (45/60). Positive extraction rate decreases in the subgroup of patients with risk factors for infertility (61.4%) as well as in the group with bilateral inguinal hernia (67.9%). There was no statistically significant difference in the positive rate of sperm retrieval according to surgical technique or according to the use of polypropylene mesh (P>0.05). The obstruction of the vas deferens due to an inguinal hernia repair was a potential iatrogenic cause of male infertility that was rare and underestimated. The influence of using a polypropylene mesh was not clearly demonstrated. The management of these patients is based on prevention in order to identify patients with risk factors of infertility in order to propose a presurgery cryopreservation of sperm. 5. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. [Clinical use of a new method of inguinal hernia repair].

    PubMed

    Shkvarkovskiy, I V; Moskaliuk, O P; Grebeniuk, V I; Yakobchuk, S A; Rusak, O B

    2015-02-01

    Surgery is the only treatment for inguinal hernias. The use of allografts has reduced the number recurrences of hernias to 3-14%. However, in any form of alloplasty around implantat develops tissue reaction that causes a number of specific complications. At present, researchers found that in 45-59% of cases of inguinal allogernioplasty leads to a significant disruption of spermatogenic and hormonal functions of the testicle. On the basis of the Surgical Department № 1 (Chernivtsi Emergency Hospital) 61 patients (main group) underwent surgery according to the proposed method (patent of Ukraine for useful model № 81728). The control group included 63 male patients from 19 to 61 years old who underwent inguinal hernia repair by I.L. Lichtenstein. Postoperative recovery periods examined basal activity and disability, pain intensity, the presence of specific complications, length of postoperative hospital stay days, recurrences of hernias. In order to assess reproductive disorders studied the state of blood circulation to the testicular arteries, testicular volume and the level of sex hormones. The prevention of polymeric implant to contact with the components of the spermatic cord reduces the inflammatory response to the structure of the inguinal canal, and the reproductive organs, which leads to a reduction of pain. Also accelerated social and labor rehabilitation of patients, blood circulation is preserved in the testicle and male hormones in the postoperative period. The proposed method prevents the development of recurrences of hernias through the elimination of the deep inguinal ring as one of the weaknesses of the anterior abdominal wall.

  7. Inguinal hernias associated with a single strenuous event.

    PubMed

    Williamson, J S; Jones, H G; Radwan, R R; Rasheed, A

    2016-10-01

    There is debate regarding the role of physical activity and, in particular, a single strenuous event (SSE) in the development of inguinal hernia. This study aims to identify the incidence and associated features of hernias perceived to be due to a single strenuous event and to compare their features with published guidelines. All consecutive patients surgically treated for primary inguinal hernia at a single NHS trust between April 2010 and April 2011 were identified and contacted to participate in a questionnaire. Clinical details from operative records and case notes were compared with patients' responses to identify features of their presentation attributable to a single strenuous event according to previously published guidelines. Three hundred and thirty five eligible patients were contacted with a response rate of 292 (87 %). 41/292 (14 %) of patients reported an SSE associated with the onset of their hernia. Only 2 of 41 (5 %) patients reporting a hernia associated with SSE met published criteria for association of the hernia with SSE, and this represented less than 1 % of all patients treated for inguinal hernia at a single centre in a 1-year period. The relationship between physical activity and development of inguinal hernia is under debate; however, we find that inguinal hernia that can be attributed to SSE is a rare event, despite the fact that many patients present with acute symptoms. Updated guidelines for the assessment of 'cause' in industrial claims for the association of hernia with workplace activity are required.

  8. Pyometra in an inguinal hernia in a bitch.

    PubMed

    Gogny, A; Bruyas, J-F; Fiéni, F

    2010-12-01

    Pyometra in an inguinal hernia was diagnosed in a 10-year-old intact cross-bred bitch which had had dysorexia, depression and inguinal distension. The hernia contained caudal portions of the two uterine horns, uterine cervix and cranial part of the vagina. As the organs were enlarged and full of pus, manual attempt to push back the uterine horns and the vagina in the abdominal cavity through the inguinal canal was unsuccessful. Herniated uterine horns were ligated and cut in their median portion, so it became possible to remove the cervix and the caudal portion of the horns through the hernial orifice, and the ovaries and the cranial part of the horns through a peritoneal midline incision. This bitch was not intended for breeding purposes and, given the presence of a huge pyometra associated with an inguinal hernia, an ovario-hysterectomy was recommended. Uterine herniation should be considered as a differential diagnosis of a caudal lateral inguinal mass. When pushing the uterus back in the abdominal cavity is impossible, a surgical procedure should be performed to detect ischemia–reperfusion injury and/or a septic risk.

  9. Preoperative sonography of nonreducible inguinal masses in girls.

    PubMed

    Narci, Adnan; Korkmaz, Mevlit; Albayrak, Ramazan; Sözübir, Selami; Güvenç, Bekir Haluk; Köken, Reşit; Demir, Tevfik; Doğru, Omer

    2008-09-01

    Inguinal hernia is one of the most common surgical pathologies in childhood. Any of the abdominal organs can slide into the hernial sac and become incarcerated there. In girls, the fallopian tubes, ovaries, uterus, and-rarely-ovarian cysts can form the sliding component of an inguinal hernia. The aim of this study was to investigate the diagnostic value of preoperative sonographic examination in girls with nonreducible inguinal masses. Nine girls ranging in age from 2 months to 8 years who were admitted to our clinic with nonreducible inguinal masses were included in the study. All patients underwent sonographic examination followed by surgery on the day of admission. A definitive diagnosis was obtained in 6 patients on preoperative sonographic evaluation, whereas 3 patients were misdiagnosed. One patient was diagnosed sonographically as having lymphadenopathy, but surgery revealed an ovarian cyst sliding into the hernial sac. A second patient was found to have an infected lymph node at surgery instead of a strangulated bowel loop as diagnosed on sonographic examination. In the third patient, the preoperative sonographic diagnosis was an ovarian cyst in the hernia sac, but surgery revealed a cyst of the canal of Nuck. Inguinal masses in young girls must be carefully evaluated, because the sonographic preoperative diagnosis may be misleading. (c) 2008 Wiley Periodicals, Inc.

  10. Inguinal sentinel lymph node biopsy for staging anal cancer.

    PubMed

    Péley, G; Farkas, E; Sinkovics, I; Kovács, T; Keresztes, S; Orosz, Z; Köves, I

    2002-01-01

    The optimal treatment of clinically negative inguinal lymph nodes in patients with primary anal cancer has not yet been clearly defined. The presence of metastases in the inguinal lymph nodes is an adverse prognostic factor for anal cancer. In the present study the feasibility of sentinel lymph node biopsy (SLNB) for staging anal cancer was investigated. From September 1999 to March 2002, 8 patients with biopsy proven primary anal cancer underwent lymphoscintigraphy and dual-agent guided inguinal SLNB for nodal staging before starting multimodality treatment. Inguinal SLNB was successful in all 8 patients (13 groins). A total of 20 hot and blue SLNs (mean 1,5 (1-2) per groins) were removed. In 2 patients (25%) the SLN was positive for metastasis. Lymphoscintigraphy followed by dual-agent guided inguinal SLNB is technically feasible for staging patients with primary anal cancer. The detection of metastases in the removed sentinel lymph node(s) may alter the treatment and thus may improve the locoregional control and overall survival of these patients.

  11. Lump Solutions for the (3+1)-Dimensional Kadomtsev-Petviashvili Equation

    NASA Astrophysics Data System (ADS)

    Liu, De-Yin; Tian, Bo; Xie, Xi-Yang

    2016-12-01

    In this article, we investigate the lump solutions for the Kadomtsev-Petviashvili equation in (3+1) dimensions that describe the dynamics of plasmas or fluids. Via the symbolic computation, lump solutions for the (3+1)-dimensional Kadomtsev-Petviashvili equation are derived based on the bilinear forms. The conditions to guarantee analyticity and rational localisation of the lump solutions are presented. The lump solutions contain eight parameters, two of which are totally free, and the other six of which need to satisfy the presented conditions. Plots with particular choices of the involved parameters are made to show the lump solutions and their energy distributions.

  12. Benign paroxysmal positional vertigo.

    PubMed

    von Brevern, Michael

    2013-07-01

    Benign paroxysmal positional vertigo (BPPV) is the most common and the most effectively treated vestibular disorder. The prevailing pathomechanism is canalolithiasis, which is otoconia falling in one of the semicircular canals where they move in response to changes of the head position, triggering excitation of the vestibular receptors of the affected canal. In the majority of patients with BPPV, the posterior canal is affected by canalolithiasis and there are two highly effective therapeutic maneuvers for treatment. About 20% of patients present with lithiasis of the horizontal or anterior canal. The author focuses on recent advances in diagnosis and treatment of the more rare variants of BPPV.

  13. RCS reduction of a microstrip patch using lumped loads

    NASA Astrophysics Data System (ADS)

    Volakis, John L.; Alexanian, Angelos

    1992-01-01

    In this report we consider the radar cross section (RCS) of a single rectangular patch antenna in a recessed cavity. Using a previously developed finite element-boundary integral method code, a study is performed on the patch's RCS as a function of frequency. To reduce the RCS of the patch at the resonant frequency, lumped (resistive) loads are placed at the edges of the patch. The effects of the lumped loads on the patch's RCS and gain are examined and it is observed that the RCS and gain are reduced as the as the load value decreases, whereas the antenna's bandwidth is increased. At resonance, the usual relations between the RCS and gain is observed, but it is shown that this relation no longer holds at frequencies away from resonance.

  14. Sensitivity of Lumped Constraints Using the Adjoint Method

    NASA Technical Reports Server (NTRS)

    Akgun, Mehmet A.; Haftka, Raphael T.; Wu, K. Chauncey; Walsh, Joanne L.

    1999-01-01

    Adjoint sensitivity calculation of stress, buckling and displacement constraints may be much less expensive than direct sensitivity calculation when the number of load cases is large. Adjoint stress and displacement sensitivities are available in the literature. Expressions for local buckling sensitivity of isotropic plate elements are derived in this study. Computational efficiency of the adjoint method is sensitive to the number of constraints and, therefore, the method benefits from constraint lumping. A continuum version of the Kreisselmeier-Steinhauser (KS) function is chosen to lump constraints. The adjoint and direct methods are compared for three examples: a truss structure, a simple HSCT wing model, and a large HSCT model. These sensitivity derivatives are then used in optimization.

  15. A novel approach for inguinal lymph node dissection without inguinal skin incision for invasive extramammary Paget disease.

    PubMed

    Sato, Sayuri; Nakamura, Yasuhiro; Teramoto, Yukiko; Yeh, Yu-Wen; Maruyama, Hiroshi; Nakamura, Yoshiyuki; Fujisawa, Yasuhiro; Fujimoto, Manabu; Yamamoto, Akifumi

    2015-01-01

    Inguinal lymph node dissection (ILND) for skin cancer is associated with a high incidence of wound complications. The traditional skin approaches are associated with a high risk of wound/flap necrosis of the inguinal skin, which leads to wound dehiscence and wound infection. We report a novel approach for ILND without inguinal skin incision for patients with invasive extramammary Paget disease (EMPD) to minimize the wound complications inherent in conventional ILND. We totally performed this procedure in 3 patients with invasive EMPD with inguinal nodal metastases. No patient had complications, including flap necrosis, wound dehiscence, or wound infection. Our novel surgical approach would retain the vascular supply because there was no inguinal skin incision, preventing postoperative wound complications. In addition, ILND was easily performed with satisfactory exposure of the surgical field. However, the number of patients was small and the follow-up period was short. Further evaluation of a larger case series with longer follow-up is essential to investigate the effect, safety, and indications for this novel approach.

  16. Lumped Node Thermal Modeling of EMA with FEA Validation (PREPRINT)

    DTIC Science & Technology

    2010-11-01

    minor heat path. For forced convection, the Nusselt number for a cylinder is determined from[6], ⁄ (3) where and are based on the Reynold’s...of information if it does not display a currently valid OMB control number . PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE...SUBTITLE LUMPED NODE THERMAL MODELING OF EMA WITH FEA VALIDATION (PREPRINT) 5a. CONTRACT NUMBER FA8650-09-2-2940 5b. GRANT NUMBER 5c. PROGRAM

  17. Tumescent local anesthetic technique for inguinal hernia repairs

    PubMed Central

    Chyung, Ju Won; Kwon, Yujin; Cho, Dong Hui; Lee, Kyung Bok; Park, Sang Soo; Yoon, Jin; Jang, Yong Seog

    2014-01-01

    Purpose We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs. Methods The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed. Results The mean operation time (±standard deviation) and hospital stay were 64.5 ± 17.6 minutes and 2.7 ± 1.5 days. The postoperative complication rate was 17.8%. There were four cases of recurrences (2.5%) at a mean follow-up of 24 ± 14 months. Conclusion Our results suggest that local anesthesia with the tumescent technique is an effective and safe modality for inguinal hernia repairs. PMID:25485241

  18. Benign follicular tumors*

    PubMed Central

    Tellechea, Oscar; Cardoso, José Carlos; Reis, José Pedro; Ramos, Leonor; Gameiro, Ana Rita; Coutinho, Inês; Baptista, António Poiares

    2015-01-01

    Benign follicular tumors comprise a large and heterogeneous group of neoplasms that share a common histogenesis and display morphological features resembling one or several portions of the normal hair follicle, or recapitulate part of its embryological development. Most cases present it as clinically nondescript single lesions and essentially of dermatological relevance. Occasionally, however, these lesions be multiple and represent a cutaneous marker of complex syndromes associated with an increased risk of visceral neoplasms. In this article, the authors present the microscopic structure of the normal hair follicle as a basis to understand the type and level of differentiation of the various follicular tumors. The main clinicopathological features and differential diagnosis of benign follicular tumors are then discussed, including dilated pore of Winer, pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma, proliferating trichilemmal cyst/tumor, trichoblastoma and its variants, pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and trichofolliculoma. In addition, the main syndromes presenting with multiple follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the diagnosis of follicular tumors relies on histological examination, we highlight the importance of their knowledge for the clinician, especially when in presence of patients with multiple lesions that may be the cutaneous marker of a cancer-prone syndrome. The dermatologist is therefore in a privileged position to recognize these lesions, which is extremely important to provide further propedeutic, appropriate referral and genetic counseling for these patients. PMID:26734858

  19. Lumped parametric model of the human ear for sound transmission.

    PubMed

    Feng, Bin; Gan, Rong Z

    2004-09-01

    A lumped parametric model of the human auditoria peripherals consisting of six masses suspended with six springs and ten dashpots was proposed. This model will provide the quantitative basis for the construction of a physical model of the human middle ear. The lumped model parameters were first identified using published anatomical data, and then determined through a parameter optimization process. The transfer function of the middle ear obtained from human temporal bone experiments with laser Doppler interferometers was used for creating the target function during the optimization process. It was found that, among 14 spring and dashpot parameters, there were five parameters which had pronounced effects on the dynamic behaviors of the model. The detailed discussion on the sensitivity of those parameters was provided with appropriate applications for sound transmission in the ear. We expect that the methods for characterizing the lumped model of the human ear and the model parameters will be useful for theoretical modeling of the ear function and construction of the ear physical model.

  20. Experimental realization of optical lumped nanocircuits at infrared wavelengths

    NASA Astrophysics Data System (ADS)

    Sun, Yong; Edwards, Brian; Alù, Andrea; Engheta, Nader

    2012-03-01

    The integration of radiofrequency electronic methodologies on micro- as well as nanoscale platforms is crucial for information processing and data-storage technologies. In electronics, radiofrequency signals are controlled and manipulated by ‘lumped’ circuit elements, such as resistors, inductors and capacitors. In earlier work, we theoretically proposed that optical nanostructures, when properly designed and judiciously arranged, could behave as nanoscale lumped circuit elements—but at optical frequencies. Here, for the first time we experimentally demonstrate a two-dimensional optical nanocircuit at mid-infrared wavelengths. With the guidance of circuit theory, we design and fabricate arrays of Si3N4 nanorods with specific deep subwavelength cross-sections, quantitatively evaluate their equivalent impedance as lumped circuit elements in the mid-infrared regime, and by Fourier transform infrared spectroscopy show that these nanostructures can indeed function as two-dimensional optical lumped circuit elements. We further show that the connections among nanocircuit elements, in particular whether they are in series or in parallel combination, can be controlled by the polarization of impinging optical signals, realizing the notion of ‘stereo-circuitry’ in metatronics—metamaterials-inspired optical circuitry.

  1. The pitfalls of inguinal herniorrhaphy: Surgeon volume matters.

    PubMed

    Aquina, Christopher T; Probst, Christian P; Kelly, Kristin N; Iannuzzi, James C; Noyes, Katia; Fleming, Fergal J; Monson, John R T

    2015-09-01

    There is currently little information regarding the impact of procedure volume on outcomes after open inguinal hernia repair in the United States. Our hypothesis was that increasing procedure volume is associated with lesser rates of reoperation and resource use. The database of the Statewide Planning and Research Cooperative System was queried for elective open initial inguinal hernia repairs performed in New York State from 2001 to 2008 via the use of International Classification of Diseases, 9th Revision and Current Procedural Terminology codes. Surgeon and hospital procedure volumes were grouped into tertiles based on the number of open inguinal hernia repairs performed per year. Bivariate, hierarchical mixed effects Cox proportional-hazards, and negative binomial regression analyses were performed assessing for factors associated with reoperation for recurrence, procedure time, and downstream total charges. Among 151,322 patients who underwent open inguinal hernia repair, the overall rate of reoperation for recurrence within 5 years was 1.7% with a median time to reoperation of 1.9 years. An inverse relationship was seen between surgeon volume and reoperation rate, procedure time, and health care costs (P < .001). After we controlled for surgeon, facility, operative and patient characteristics, low-volume surgeons (<25 repairs/year) had greater rates of reoperation (hazard ratio 1.23,95% confidence interval [95% CI] 1.11-1.36), longer procedure times (incidence rate ratio 1.22, 95% CI 1.21-1.24), and greater downstream costs (incidence rate ratio 1.13,95% CI 1.10-1.17) than high-volume surgeons (≥25 repairs/year). Surgeon volume <25 cases per year for open inguinal hernia repair was independently associated with greater rates of reoperation for recurrence, worse operative efficiency, and greater health care costs. Referral to surgeons who perform ≥25 inguinal hernia repairs per year should be considered to decrease reoperation rates and resource use

  2. Poorly recognized age-related downward deviation of the inguinal ligament

    PubMed Central

    Nawaz, Yassir; Barvalia, Mihir; Rana, Gurinder; Khakwani, M Zain; Azim, Khizr; Patel, Rahul; Idrees, Sohira; Baker, Gail; Cohen, Marc; Wasty, Najam

    2016-01-01

    Objective: To determine factors affecting actual inguinal ligament course in live human subjects. Introduction and hypothesis: Although the expected inguinal ligament course is supposedly a straight line extending from anterior superior iliac spine to pubic tubercle, the actual inguinal ligament course is frequently depicted a priori by a downward bowing dotted line. There are no studies in a live subject supporting this assumption. We hypothesized this assumption is indeed valid and is related to among other factors a lifelong effect of gravity and lax abdominal musculature on the inguinal ligament course. Methods: We retrospectively reviewed 54 consecutive computed tomography scans of the abdomen and pelvis randomly distributed across all age groups. Actual inguinal ligament course was visualized by reconstructing images using Terracon software. Vertical distance from the lowest point of actual inguinal ligament course to the expected inguinal ligament course was measured. We used multiple linear regression analysis to study the correlation between degree of inguinal ligament deviation and several variables. Results: Actual inguinal ligament course was below the expected inguinal ligament course in 52 of 54 patients. The mean deviation was 8.2 ± 5.9 mm. Advanced age was significantly associated with greater downward bowing of the inguinal ligament (p = 0.001). Conclusion: Actual inguinal ligament course is often well below the expected inguinal ligament course; this downward bowing of the inguinal ligament is especially pronounced with advancing age. Operators need to be mindful as this downward bowing can lead to supra-inguinal sticks causing vascular complications. PMID:27826446

  3. Surprises in operations on the inguinal area in young children.

    PubMed

    MARKS, R M

    1962-08-01

    In surgical operations in the inguinal area in infants and children many unusual pathologic states were observed that were at first thought to be simple hernia. Among the conditions observed, in addition to complicated hernias and other anomalies of the processus vaginalis, were male pseudo-hermaphroditism, ectopic spleen, ectopic adrenal with neuroblastoma, diverticulum of the bladder, inguinal adenitis and suppurative iliac adenitis. In light of the sometimes surprising contents of the hernia sac, good exposure and careful identification of all anatomic structures is mandatory.

  4. Giant Inguinal Herniae Managed by Primary Repair: A Case Series

    PubMed Central

    Anand, Madhur; Naku, Narang; Hajong, Debobratta; Singh, K Lenish

    2017-01-01

    Giant inguinal hernia are usually found in developing countries due to delay in seeking medical attention. The management of such hernias may sometimes require procedures to increase the intra-peritoneal capacity prior to the repair of the giant hernia. Otherwise patients may develop abdominal compartment syndrome leading to various unwanted complications. Primary repair of giant hernias are possible in some cases without having significant post-operative complications. In this present case series, we have managed a total of four patients of giant inguinal hernia by primary repair without much post-operative complications. PMID:28384934

  5. Primary inguinal hernia repair: how audit changed a surgeon's practice.

    PubMed Central

    Drew, P J; Hartley, J E; Qureshi, A; Lee, P W

    1998-01-01

    Over 10 years one senior consultant surgeon performed 114 standard plication darn herniorraphies on 92 patients with primary inguinal hernias. These patients were contacted and were reviewed if there was any suspicion of recurrence. Four recurrences were detected, giving an overall recurrence rate of about 3.5%. According to actuarial life-table analysis the risks of recurrence at 1 year, 5 years and 10 years were 0.94%, 3.02% and 9%. This level of recurrence is unacceptable in modern practice and, as a result of the audit, the surgeon changed his technique of primary inguinal hernia repair. PMID:10325875

  6. [A case of ascending colon carcinoma metastasized to an inguinal hernia sac].

    PubMed

    Miyake, Yasuhiro; Kato, Takeshi; Katayama, Kinzo; Doi, Takashi; Oshima, Kazuteru; Handa, Rio; Hoshi, Minako; Makari, Yoichi; Oshima, Satoshi; Iijima, Shohei; Kurokawa, Eiji; Kikkawa, Nobuteru

    2007-11-01

    While inguinal hernia is one of the most common diseases, metastatic cancer of an inguinal hernia sac is rare. We report a case of ascending colon cancer metastasized to an inguinal hernia sac. A 60-year-old man, who was undergone a right hemicolectomy for an ascending colon cancer, was pointed out a palpable inguinal mass at one year and eight months after the operation. He was diagnosed as inguinal hernia, and herniorrhaphy was performed. In the operation, a tumor of the inguinal hernia sac, which invaded to spermatic cord, could be found and was removed with right testis. Bassini's method was performed after the resection of the inguinal tumor. Histological examination revealed that the tumor was metastasis of colon carcinoma. Examination of the entire body showed no other metastasis. As for the advanced colon cancer, we need to mention the possibility of metastatic saccular tumor.

  7. [Benign myoepithelioma of the lung].

    PubMed

    El Mezni, F; Zeddini, A; Hamzaoui, A; Ismail, O; Ghrairi, H; Ben Miled, K; Smati, B; Kilani, T

    2004-11-01

    Benign myoepithelioma of the lung is a benign tumor caused by proliferating myoepithelial cells with no ductal component. These tumors are exceptional: only three cases have been reported in the literature. We report a fourth case in a 37-year-old woman at 8 months gestation. Pathological proof of diagnosis was obtained.

  8. A new accurate method of physical examination for differentiation of inguinal hernia types.

    PubMed

    Tromp, Wouter G; van den Heuvel, Baukje; Dwars, Boudewijn J

    2014-05-01

    It is generally stated that preoperative differentiation between indirect and direct inguinal hernias by physical examination is inaccurate and irrelevant. With the expansion of the laparoscopic technique, new relevance has emerged. Laparoscopic correction of an indirect hernia is more challenging and time consuming than laparoscopic correction of a direct hernia. Preoperative knowledge concerning the type of hernia informs the laparoscopic surgeon about the required expertise and the expected operative time, and this knowledge is useful for training programs and management. The authors therefore developed a new accurate and easy method of physical examination to differentiate types of inguinal hernia. A prospective study was conducted to determine the accuracy of this new method that combines physical examination with a hand-held Doppler device (not ultrasound) to differentiate types of inguinal hernia. This prospective diagnostics study consisted of two consecutive parts. Each part included 100 consecutive patients presenting with an inguinal hernia. The inguinal occlusion test was used to differentiate the types of inguinal hernia during physical examination in the first part of the study. A hand-held Doppler device was used for adequate localization of the epigastric vessels in addition to the occlusion test in the second part of the study. Preoperative remarks were compared with findings during laparoscopic inguinal hernia repair. The McNemar symmetry χ (2) test was used for statistical evaluation The first part of the study showed a preoperative accuracy of 35 % for direct inguinal hernias and 86 % for indirect inguinal hernias (p < 0.001). The second part of the study showed a preoperative accuracy of 79 % for direct inguinal hernias and 93 % for indirect inguinal hernias (p < 0.001) CONCLUSION: The inguinal occlusion test combined with the use of a handheld Doppler device is accurate in distinguishing direct and indirect inguinal hernias and provides

  9. Inguinal Hernia and Airport Scanners: An Emerging Indication for Repair?

    PubMed Central

    Cawich, Shamir O.; Maharaj, Ravi; Dan, Dilip

    2013-01-01

    The use of advanced imaging technology at international airports is increasing in popularity as a corollary to heightened security concerns across the globe. Operators of airport scanners should be educated about common medical disorders such as inguinal herniae in order to avoid unnecessary harassment of travelers since they will encounter these with increasing frequency. PMID:24368923

  10. A Rare Emergency: Testicular Torsion in the Inguinal Canal

    PubMed Central

    Şener, Nevzat Can; Bas, Okan; Yesil, Suleyman; Zengin, Kursad; Imamoglu, Abdurrahim

    2015-01-01

    Objectives. To report our experience and present the largest series of testicular torsion cases in the inguinal canal. Material and Methods. The clinical data of 13 patients with testicular torsion in the inguinal canal treated between 2005 and 2013 were reviewed. Recorded patient age, whether the testes were palpable or not, side of the affected testes, the presence of hernia, ischemia time, and operation outcomes were assessed. Results. Patient age ranged from 8 to 70 months (29.15 ± 20.22). Mean ischemia time was 16.5 ± 21.3 hours. Accompanying inguinal hernia was present in 92% of the cases (12/13). Four of the thirteen patients (30.8%) were treated by orchiectomy because the necrosis was present after prolonged ischemia time. Nine patients (69.2%) were treated by single session orchidopexy. Conclusion. Torsion of testes in the inguinal canal is a rare disease, but with rapid diagnosis, affected testes can be salvaged, but the key factor is to keep this condition in mind. PMID:25654093

  11. The Burnia: Laparoscopic Sutureless Inguinal Hernia Repair in Girls.

    PubMed

    Novotny, Nathan M; Puentes, Maria C; Leopold, Rodrigo; Ortega, Mabel; Godoy-Lenz, Jorge

    2017-04-01

    Laparoscopic inguinal hernia repair in children is in evolution. Multiple methods of passing the suture around the peritoneum at the level of the internal inguinal ring exist. Cauterization of the peritoneum at the internal ring is thought to increase scarring and decrease recurrence. We have employed a sutureless, cautery only, laparoscopic single port repair of inguinal hernias and patent processus vaginalis (PPV) in girls. After institutional ethical review was obtained, a retrospective review of sutureless laparoscopic inguinal hernia repairs in girls by 4 surgeons at separate institutions was performed. Patient demographics, intraoperative findings, and postoperative outcomes were recorded and analyzed. The technique involves an umbilical 30° camera and either a separate 3 mm stab incision in the midclavicular line or a 3 mm Maryland grasper placed next to the camera, and the distal most portion of the hernia sac is grasped and pulled into the abdomen and cauterized obliterating the sac. Eighty inguinal hernias were repaired using this technique in 67 girls between July 2009 and September 2015. The ages and weights ranged from 1 month to 16 years and from 2 to 69 kg, respectively. There was one conversion to open approach because an incarcerated ovary was too close to the ring. A single umbilical incision was utilized in 85%. Fifty-seven percent patients had hernias on the right whereas 42% had hernias on the left. Of the patients with presumed unilateral hernias, 22 patients were found to have PPV and were treated through the same incisions, 17/22 were found during a contralateral hernia surgery and 5/22 were found incidentally during appendectomy. Average operative time for unilateral and bilateral hernias was 22 minutes (5-38 minutes) and 31 minutes (11-65 minutes), respectively. No patient required a hospital stay because of the hernia repair. At an average of 25 months follow-up (1.6-75 months), there were no recurrences. The only complication was

  12. Inguinodynia in patients submitted to conventional inguinal hernioplasty.

    PubMed

    Dias, Bruno Garcia; Santos, Marcelo Protásio Dos; Chaves, Ana Barbara DE Jesus; Willis, Mariana; Gomes, Marcio Couto; Andrade, Fernandes Tavares; Melo, Valdinaldo Aragão DE; Santos, Paulo Vicente Dos

    2017-01-01

    to evaluate the incidence of chronic pain and its impact on the quality of life of patients submitted to inguinal hernioplasty using the Lichtenstein technique. this was a descriptive, cross-sectional study of patients operated under spinal anesthesia from February 2013 to February 2015 and who had already completed six postoperative months. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. out of 158 patients submitted to the procedure, we identified 7.6% as having inguinodynia. Of these, there was an impact on the quality of life in 25%. the incidence of inguinodynia after hernioplasty with repercussion in quality of life was similar to the one of found in the world literature. avaliar a incidência de dor crônica e o seu impacto na qualidade de vida de pacientes submetidos à hernioplastia inguinal pela técnica de Lichtenstein. trata-se de estudo transversal descritivo, de pacientes operados de hérnia inguinal pela técnica de Lichtenstein sob anestesia raquidiana, no período de fevereiro de 2013 a fevereiro de 2015, e que já haviam completado seis meses de pós-operatório. Os pacientes foram questionados sobre a presença de dor inguinal crônica e, caso confirmada, convidados a uma consulta na qual foi feita análise da qualidade da dor e seu impacto na qualidade de vida. do total de 158 pacientes submetidos ao procedimento, 7,6% foram identificados como portadores de inguinodinia. Destes, houve impacto na qualidade de vida em 25%. observou-se incidência de inguinodinia pós-hernioplastia com repercussão na qualidade de vida semelhante à literatura mundial.

  13. Random effects of fissile lumps in molten salt reactors

    SciTech Connect

    Dulla, S.; Ravetto, P.; Prinja, A. K.

    2013-07-01

    The problem of the effect of fissile lumps spatially appearing in a random fashion inside a fluid fuel reactor is addressed. The effect on reactivity is evaluated by means of first-order perturbation theory. The analysis is carried out in diffusion theory with the presence of delayed neutron emissions in one dimensional plane geometry. The estimation of the mean value and standard deviation of the reactivity inserted is performed by Monte Carlo simulations and a deterministic quadrature approach, to compare the methods in terms of computational effort and the accuracy of the results. The results presented show that the effects constitute an important issue in the assessment of these innovative systems. (authors)

  14. Lump-type solutions for the (4+1)-dimensional Fokas equation via symbolic computations

    NASA Astrophysics Data System (ADS)

    Cheng, Li; Zhang, Yi

    2017-09-01

    Based on the Hirota bilinear form, two classes of lump-type solutions of the (4+1)-dimensional nonlinear Fokas equation, rationally localized in almost all directions in the space are obtained through a direct symbolic computation with Maple. The resulting lump-type solutions contain free parameters. To guarantee the analyticity and rational localization of the solutions, the involved parameters need to satisfy certain constraints. A few particular lump-type solutions with special choices of the involved parameters are given.

  15. Benign prostatic hyperplasia

    PubMed Central

    2006-01-01

    Introduction Symptomatic benign prostatic hyperplasia (BPH) may affect up to 30% of men in their early 70s, causing urinary symptoms of bladder outlet obstruction. Symptoms can improve without treatment, but the usual course is a slow progression of symptoms, with acute urinary retention occurring in 1-2% of men with BPH per year. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical, surgical, and herbal treatments? We searched: Medline, Embase, The Cochrane Library and other important databases up to May 2005 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 43 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, alpha-blockers, beta-sitosterol plant extract, less-invasive surgical techniques, pygeum africanum, rye grass pollen extract, saw palmetto plant extracts, transurethral microwave thermotherapy, transurethral needle ablation, and transurethral resection.

  16. Laparoscopic inguinal hernia repair by the hook method in emergency setting in children presenting with incarcerated inguinal hernia.

    PubMed

    Chan, Kin Wai Edwin; Lee, Kim Hung; Tam, Yuk Him; Sihoe, Jennifer Dart Yin; Cheung, Sing Tak; Mou, Jennifer Wai Cheung

    2011-10-01

    The development of laparoscopic hernia repair has provided an alternative approach to the management of incarcerated inguinal hernia in children. Different laparoscopic techniques for hernia repair have been described. However, we hereby review the role of laparoscopic hernia repair using the hook method in the emergency setting for incarcerated inguinal hernias in children. A retrospective review was conducted of all children who presented with incarcerated inguinal hernia and underwent laparoscopic hernia repair using the hook method in emergency setting between 2004 and 2010. There were a total of 15 boys and 1 girl with a mean age of 30 ± 36 months (range, 4 months to 12 years). The hernia was successfully reduced after sedation in 7 children and after general anesthesia in 4 children. In 5 children, the hernia was reduced by a combined manual and laparoscopic-assisted approach. Emergency laparoscopic inguinal hernia repair using the hook method was performed after reduction of the hernia. The presence of preperitoneal fluid secondary to recent incarceration facilitated the dissection of the preperitoneal space by the hernia hook. All children underwent successful reduction and hernia repair. The median operative time was 37 minutes. There was no postoperative complication. The median hospital stay was 3 days. At a median follow-up of 40 months, there was no recurrence of the hernia or testicular atrophy. Emergency laparoscopic inguinal hernia repair by the hook method is safe and feasible. Easier preperitoneal dissection was experienced, and repair of the contralateral patent processus vaginalis can be performed in the same setting. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Double Hole-Lump Interaction between Halogen Atoms.

    PubMed

    Duarte, Darío J R; Peruchena, Nélida M; Alkorta, Ibon

    2015-04-23

    In this paper a theoretical study has been carried out to investigate the nature of the unusual halogen-halogen contacts in the complexes R-X···X-R (with R = -H, -Cl, -F and X = Cl, Br, I). AIM, NBO, and MEP analyses have been used to characterize X···X interactions. Formation of the unusual X···X interactions leads to a significant increase of electron charge density in the bonding region between the two halogen atoms. The geometry and stability of these complexes is mainly due to electrostatic interactions lump(X1) → hole(X2) and lump(X2) → hole(X1) [or equivalently [VS,min(X1) → VS,max(X2) and VS,min(X2) → VS,max(X1)] and the charge transfers LP(X1) → σ*(R-X2) and LP(X2) → σ*(R-X1). In other words, these findings suggest that the electrostatic interactions and the charge transfer play a substantial role in determining the optimal geometry of these complexes, as in conventional halogen bonds, even though the dispersion term is the most important attractive term for all the complexes studied here, save one.

  18. Effects of lump characteristics on plutonium self absorption correction methods

    SciTech Connect

    Curtis, D. C.; Wormald, M. R.; Croft, S.

    2007-07-01

    An evaluation study has been undertaken to assess the robustness of several published Pu self-absorption correction methods against variation in size, shape, density etc. for use in the gamma assay of nuclear waste. The correction methods studied are a numerical plutonium self absorption correction (PuSAC) technique, the Fleissner 2-line, Fleissner 3-line and Infinite Energy Extrapolation methods with both linear and polynomial extrapolation to 1/E=0. The performance of these methods has been compared for a limited set of measured encapsulated PuO{sub 2} sources plus a range of modelled unencapsulated Pu lumps. An indication of the magnitude of the uncertainties of the numerical PuSAC method has been determined for cases of blind assays where the Pu material, shape and distribution are unknown with the aim of ultimately applying it to real waste. The importance of the range of Pu lumps used in the baseline modelled dataset has been examined. Data are presented to illustrate how the uncertainties in the method are affected by the shape, composition, density, number and mass distribution of Pu particles in a sample for a given modelled base dataset. (authors)

  19. A Lumped Computational Model for Sodium Sulfur Battery Analysis

    NASA Astrophysics Data System (ADS)

    Wu, Fan

    Due to the cost of materials and time consuming testing procedures, development of new batteries is a slow and expensive practice. The purpose of this study is to develop a computational model and assess the capabilities of such a model designed to aid in the design process and control of sodium sulfur batteries. To this end, a transient lumped computational model derived from an integral analysis of the transport of species, energy and charge throughout the battery has been developed. The computation processes are coupled with the use of Faraday's law, and solutions for the species concentrations, electrical potential and current are produced in a time marching fashion. Properties required for solving the governing equations are calculated and updated as a function of time based on the composition of each control volume. The proposed model is validated against multi- dimensional simulations and experimental results from literatures, and simulation results using the proposed model is presented and analyzed. The computational model and electrochemical model used to solve the equations for the lumped model are compared with similar ones found in the literature. The results obtained from the current model compare favorably with those from experiments and other models.

  20. [Modified Rives technic in the treatment of recurrent inguinal hernia].

    PubMed

    Zuvela, M; Milićević, M; Galun, D; Bulajić, P; Raznatović, Z; Lekić, N; Basarić, D; Palibrk, I; Petrović, M

    2003-01-01

    After the introduction of prosthetic material in hernia surgery the fundamental changes in operative strategy occurred. This is because the coverage of myopectineal orifitium with non-absorbable prosthesis decreases the incidence of recurrences. Because of the appearance of lateral re-recurrences after the classical Rives procedure, we modified the operative technique. The modified Rives technique consists of the following: always polypropilen mesh 15x10 cm; creation of the new internal inguinal ring between Poupart's ligament and mesh; no lateral notching the mesh and anchoring mesh 2-3 cm from the medial, inferior, lateral and superior edge. During the period January 2001-December 2003, 34 cases of recurrent hernias were operated on 7th dept. of I Surgical Clinic of CCS. The recurrences were managed by classical (10/34) or modified Rives technique through direct inguinal approach (22/34), less frequently Lichtenstein procedure (1/34) and McVay (1/34) technique. Among 10 patients with recurrent inguinal hernias managed by classical Rives technique 2 re-recurrences appeared (indirect and interstitial) and 2 cases of infection (immediately after the operation or 7 months after the operation), and in the group of 22 cases with recurrent inguinal hernias managed by modified Rives technique the aim complications didn't appear. Using the modified Rives technique we managed the primary hernias in 56 cases without recurrences and infections. The modified Rives technique, because of the way of mesh fixation (all around), no lateral notching of mesh and remaining hem in all directions secures abdominal wall protection 2-3 cm from the line of fixation and prevents any movement of the mesh. This procedure enables management of all inguinal hernias regardless to their size and full protection of the medial, femoral and lateral inguinal triangle. The modified Rives technique is the technique of choice for big multiple defects (giant inguino-scrotal and re

  1. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    PubMed

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Image-detected 'probably benign' breast lesions: a significant reason for referral from primary care.

    PubMed

    Brennan, M E; Houssami, N

    2006-10-01

    In Australia, and many health care provider systems, primary care physicians are the first to see women with breast symptoms and are responsible for making decisions on whether to investigate and when to refer to specialist teams. We present an audit of new patient referrals from primary care triaged to a 'low-risk' (low likelihood of cancer) clinic on the basis of benign findings. The most common reason for referral was 'breast lump' (38%) followed by 'image-detected' abnormality (26%.) We have identified that (outside of population screening services) many women are being referred from primary care to specialist clinics for management of screen-detected lesions considered benign on imaging. Further research is needed to identify the reasons for such referrals and to develop appropriate educational strategies and clinical policy, both for the primary care and the specialist breast practitioner.

  3. Lumps, Bumps, and Things that Go Itch in Your Office!

    ERIC Educational Resources Information Center

    McLeod, Renee P.

    2003-01-01

    This article presents a short dermatological case presentation involving a 12-year-old white male who has Pityriasis rosea. Pityriasis rosea is an acute, benign, self-limiting disorder that affects males and females equally. It rarely occurs in children younger than 5 years of age but can occur in children as young as 1 year. It is most commonly…

  4. A rare case of persistent muellerian duct syndrome presenting as inguinal hernia.

    PubMed

    Chattopadhyay, Shankar Das; Karmakar, Nisith Chandra; Sengupta, Ritankar; Sengupta, Tamal Kanti; Biswas, Ravi Shankar; Mukherjee, Rina

    2011-10-01

    Irreducible inguinal hernia is a very common emergency surgical problem. In most of the cases the content is either bowel or omentum. Testis, as a content of hernial sac is also found in undescended testis presenting as obstructed or irreducible congenital inguinal hernia. Here a case is reported of a phenotypically normal looking male presenting with irreducible left sided inguinal hernia which on exploration revealed uterus, fallopian tubes and testis. The case is presented because of its rarity of presentation.

  5. [Multiple recurrent eccrine porocarcinoma with inguinal metastasis. A case report].

    PubMed

    Acosta-Arencibia, Aida; Abrante-Expósito, Begoña; Ramos-Gordillo, Matilde

    2016-01-01

    Eccrine porocarcinoma, first described in 1963, is a rare malignant lesion arising from the eccrine sweat glands. It is usually a primary tumour, or even more common, a malignant degeneration of an eccrine poroma. It usually affects older persons and is located most commonly on the lower extremities. About 20% of eccrine porocarcinoma will recur after treatment. The treatment is wide local excision of the primary lesion. This uncommon skin tumour has a locally aggressive behaviour and a high recurrence rate. An 82 year-old man presenting with multiple recurrent eccrine porocarcinoma with inguinal metastasis. The treatment was a radical excision and inguinal lymphadenectomy. There were no postoperative complications, but there was local recurrence after six months. Early diagnosis and wide excision is the best way to achieve a good prognosis, due to the aggressiveness of this tumour. Copyright © 2015. Published by Masson Doyma México S.A.

  6. Inguinal hernia repair: anaesthesia, pain and convalescence.

    PubMed

    Callesen, Torben

    2003-08-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (< 1%), although intraoperative pain is quite common. The generally low rate of serious complications does not allow firm conclusions, but the rate of less serious complications is lower by local anaesthesia, compared to other anaesthetic techniques. Of special interest is, that the rate of urinary retention can be eliminated by the use of local anaesthesia. Local anaesthesia results, in comparative studies, in a higher degree of patient satisfaction than other anaesthetic techniques. Local anaesthesia also facilitates faster mobilisation and earlier discharge/fulfilment of discharge criteria from post anaesthetic care units than other anaesthetic techniques. Pain after hernia repair is more pronounced at mobilisation or coughing than during rest, and younger patients seem to have more pain than older patients. The pain ceases over time, and it is most pronounced the day after surgery, where two thirds have moderate or severe pain during activity, while one third still have moderate or severe pain after one week, and approximately 10% after 4 weeks. Pain after laparoscopic surgery is less pronounced than after open surgery, while different open repair techniques do not exhibit significant differences. Postoperative

  7. Laparoscopic inguinal hernia repair: a prospective evaluation at Eastern Nepal

    PubMed Central

    Shakya, Vikal Chandra; Sood, Shasank; Bhattarai, Bal Krishna; Agrawal, Chandra Shekhar; Adhikary, Shailesh

    2014-01-01

    Introduction Inguinal hernias have been treated traditionally with open methods of herniorrhaphy or hernioplasty. But the trends have changed in the last decade with the introduction of minimal access surgery. Methods This study was a prospective descriptive study in patients presenting to Surgery Department of B. P. Koirala Institute of Health Sciences, Dharan, Nepal with reducible inguinal hernias from January 2011 to June 2012. All patients >18 years of age presenting with inguinal hernias were given the choice of laparoscopic repair or open repair. Those who opted for laparoscopic repair were included in the study. Results There were 50 patients, age ranged from 18 to 71 years with 34 being median age at presentation. In 41 patients, totally extraperitoneal repair was attempted. Of these, 2 (4%) repairs were converted to transabdominal repair and 2 to open mesh repair (4%). In 9 patients, transabdominal repair was done. The median total hospital stay was 4 days (range 3-32 days), the mean postoperative stay was 3.38±3.14 days (range 2-23 days), average time taken for full ambulation postoperatively was 2.05±1.39 days (range 1-10 days), and median time taken to return for normal activity was 5 days (range 2-50 days). One patient developed recurrence (2%). None of the patients who had laparoscopic repair completed complained of neuralgias in the follow-up. Conclusion Laparoscopic repair of inguinal hernias could be contemplated safely both via totally extra peritoneal as well as transperitoneal route even in our setup of a developing country with modifications. PMID:25170385

  8. Inguinal hernia as a presentation of testicular feminization.

    PubMed

    Gibor, Udit; Ohana, Eric; Elena, Dubilet; Kirshtein, Boris

    2015-08-01

    We present a case of a 20-year-old female who was admitted to our department for an elective inguinal hernia repair. An oval-shaped mass was found in the hernia sac during the surgery that was suspected to be an ovary. Histological examination revealed testicular tissue. Further evaluation confirmed testicular feminization. She underwent laparoscopic orchiectomy and hernia repair from the contralateral side 3 months later.

  9. Herniorrhaphy With Polypropylene Mesh Causing Inguinal Vasal Obstruction

    PubMed Central

    Shin, David; Lipshultz, Larry I.; Goldstein, Marc; Barmé, Gregory A.; Fuchs, Eugene F.; Nagler, Harris M.; McCallum, Stewart W.; Niederberger, Craig S.; Schoor, Richard A.; Brugh, Victor M.; Honig, Stanton C.

    2005-01-01

    Objective: To report a multiinstitutional experience of men presenting with infertility secondary to inguinal hernia repair using polypropylene mesh. Summary Background Data: An estimated 80% of inguinal hernia operations involve placement of a knitted polypropylene mesh to form a “tension-free” herniorrhaphy. The prosthetic mesh induces a chronic foreign-body fibroblastic response creating scar tissue that imparts strength to the floor and leads to fewer recurrences. However, little is known about the long-term effects of the polypropylene mesh on the vas deferens, especially with regard to fertility. Methods: Eight institutions in the United States reported a total of 14 cases of azoospermia secondary to inguinal vasal obstruction related to previous polypropylene mesh herniorrhaphy. Patient characteristics and operative findings were forwarded to 1 center for tabulation of data. Results: Mean patient age was 35.5 years with an average duration of infertility of 1.8 years. Mean number of years between urologic evaluation and herniorrhaphy was 6.3 years. Types of inguinal hernia repair previously performed were: open (10), laparoscopic (2), or both (2). Nine patients had bilateral obstruction and 5 patients had unilateral obstruction with contralateral testicular atrophy or epididymal obstruction. Surgical exploration revealed a dense fibroblastic response encompassing the polypropylene mesh with either trapped or obliterated vas in all patients. Surgical reconstruction was performed in 8 of 14 men (57%). Conclusion: Reconstruction to restore fertility can be difficult secondary to fibrotic reaction. Before undergoing polypropylene mesh herniorrhaphy, men, especially of young reproductive age or with a solitary testicle, need to be carefully advised of potential obstruction and compromise to future fertility. PMID:15798455

  10. Cost-effectiveness of inguinal hernia surgery in northwestern Ecuador.

    PubMed

    Shillcutt, Samuel D; Sanders, David L; Teresa Butrón-Vila, M; Kingsnorth, Andrew N

    2013-01-01

    Cost-effectiveness of tension-free inguinal hernia repair at a private 20-bed rural hospital in Esmeraldas Province, Ecuador, was calculated relative to no treatment. Lichtenstein repair using mosquito net or polypropylene commercial mesh was provided to patients with inguinal hernia by surgeons from Europe and North America. Prospective data were collected from provider, patient, and societal perspectives, with component costs collected on site and from local supply companies or published literature. Patient outcomes were forecasted using disability adjusted life years (DALYs) averted. Uncertainty in patient-level data was evaluated with Monte-Carlo simulation. Surgery was provided to 102 patients with inguinal hernias of various sizes. Local anesthesia was used for 80 % of operations during the first mission, and spinal anesthesia was used for 89 % in the second mission. Few complications were observed. An average 6.39 DALYs (3,0) were averted per patient (95 % confidence interval: 6.22-6.84). The average cost per patient was US$499.33 (95 % CI: US$490.19-$526.03) from a provider perspective, US$118.79 (95 % CI: US$110.28-$143.72) from a patient perspective, and US$615.46 (95 % CI: US$603.39-$650.40) from a societal perspective. Mean cost-effectiveness from a provider perspective was US$78.18/DALY averted (95 % CI: US$75.86-$85.78) according to DALYs (3,0) averted using the West Life Table level 26, well below the Ecuadorian per-capita Gross National Income (US$3,850). Results were robust to all sensitivity analyses. Inguinal hernia repair was cost-effective in western Ecuador through international collaboration.

  11. Inguinal hernia repair in overweight and obese patients

    PubMed Central

    Park, Chan Yong; Kim, Jung Chul; Kim, Shin Kon

    2011-01-01

    Purpose To describe the clinical characteristics and outcomes after inguinal hernia repair in overweight and obese patients. Methods We retrospectively reviewed the medical records of 636 adult patients who underwent mesh plug inguinal hernia repair performed by one surgeon from November 2001 to January 2009.The clinical characteristics and surgical outcomes of the patients were analyzed. According to the body mass index, patients higher than 23 were defined as overweight and obese patient group (O group) and patients between 18.5 and 23 were defined as normal weight patient group (N group). Seventeen underweight patients were excluded in this study. Results Of 619 cases, the number for O group was 344 (55.6%) and for N group was 275 (44.4%). The mean age was significantly higher in N group (62.2 ± 12.6 vs. 64.4 ± 14.8, P = 0.048). Underlying diseases were present in 226 (65.7%) of the O group and 191 (69.5%) of the N group (P = 0.322). Anesthesia method, operative time and postoperative hospital stay had no significant difference between the two groups. Postoperative complications developed in 41 (11.9%) of the O group and in 28 (10.2%) of the N group, respectively, and no major complications developed in either group. Conclusion Adult inguinal hernias developed at a relatively younger age in overweight and obese patients than in normal weight patients. There were no specific differences in other clinical characteristics and outcomes between the two groups. Therefore inguinal hernia repair in overweight and obese patients is a safe procedure as in normal weight patients. PMID:22066122

  12. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and cold-molded...

  13. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 5 2012-10-01 2012-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and cold-molded...

  14. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and cold-molded...

  15. 46 CFR 148.245 - Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Direct reduced iron (DRI); lumps, pellets, and cold-molded briquettes. 148.245 Section 148.245 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Requirements for Certain Materials § 148.245 Direct reduced iron (DRI); lumps, pellets, and cold-molded...

  16. DEVELOPMENT OF A LUMPED-PARAMETER MODEL OF INDOOR RADON CONCENTRATIONS

    EPA Science Inventory

    The report describes a simplified, lumped-parameter model to characterize indoor radon concentrations from data that are more readily available than those required for existing mathematical models. he lumped-parameter model was developed from numerous sensitivity analyses with th...

  17. 5 CFR 847.702 - Lump-sum payments and refunds.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Lump-sum payments and refunds. 847.702... payments and refunds. (a) Employee contributions with interest which are transferred to the Fund under subpart E of this part are included in any lump-sum credit or unexpended balance payable to the...

  18. 5 CFR 838.1010 - Court orders or decrees preventing payment of lump sums.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  19. 5 CFR 550.1206 - Refunding a lump-sum payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... section. (c) An employee who is reemployed in a position that has no leave system to which annual leave... ADMINISTRATION (GENERAL) Lump-Sum Payment for Accumulated and Accrued Annual Leave § 550.1206 Refunding a lump... leave under 5 U.S.C. 5551 is reemployed in the Federal service prior to the end of the period covered...

  20. 5 CFR 837.602 - Lump-sum payment of retirement deductions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Lump-sum payment of retirement deductions... retirement deductions. If an annuitant reemployed subject to the provisions of this part dies while so... retirement deductions withheld during the period of reemployment will be paid in a lump sum to the...

  1. 5 CFR 831.2003 - Eligibility for lump-sum payment upon death or retirement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... death or retirement. 831.2003 Section 831.2003 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2003 Eligibility for lump-sum payment upon death or retirement. (a) If there is no survivor who is entitled to...

  2. 5 CFR 837.602 - Lump-sum payment of retirement deductions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Lump-sum payment of retirement deductions... retirement deductions. If an annuitant reemployed subject to the provisions of this part dies while so... retirement deductions withheld during the period of reemployment will be paid in a lump sum to the...

  3. 5 CFR 837.602 - Lump-sum payment of retirement deductions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Lump-sum payment of retirement deductions... retirement deductions. If an annuitant reemployed subject to the provisions of this part dies while so... retirement deductions withheld during the period of reemployment will be paid in a lump sum to the...

  4. 5 CFR 837.602 - Lump-sum payment of retirement deductions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Lump-sum payment of retirement deductions... retirement deductions. If an annuitant reemployed subject to the provisions of this part dies while so... retirement deductions withheld during the period of reemployment will be paid in a lump sum to the...

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Lump-sum payment of retirement deductions... retirement deductions. If an annuitant reemployed subject to the provisions of this part dies while so... retirement deductions withheld during the period of reemployment will be paid in a lump sum to the...

  6. Diagnosis of inguinal hernia by prone- vs. supine-position computed tomography.

    PubMed

    Miyaki, A; Yamaguchi, K; Kishibe, S; Ida, A; Miyauchi, T; Naritaka, Y

    2017-08-10

    The aim of this study was to investigate the efficacy of prone-position computed tomography (CT) for detecting and classifying inguinal hernia relative to supine-position CT before laparoscopic inguinal hernia repair. Seventy-nine patients who underwent laparoscopic transabdominal preperitoneal repair of inguinal hernia were enrolled in this prospective study. Patients diagnosed with inguinal hernia by physical examination underwent abdominal CT in the supine and prone positions for preoperative assessment. The anatomy of the right and left inguinal regions was confirmed during the surgery and compared with the preoperative CT findings. The 79 cases included 87 operated lesions and 71 non-operated contralateral inguinal sites. Of the 84 clinical hernias, inguinal hernia was detected significantly more frequently on prone-position CT images (84, 100%) than on supine-position CT images (55, 65.5%). In addition, the inguinal hernia type was determined with significantly greater accuracy on prone-position CT images (96.4%) than on supine-position CT images (58.3%). Twenty-two occult hernias were detected by laparoscopy. The detection rate and accuracy for determining the type of occult hernia were significantly greater when using prone-position CT images [19 of 22 lesions (86.4%) and 77.3%, respectively] than when using supine-position CT images [8 of 22 lesions (36.4%) and 27.3%, respectively]. Prone-position CT is adequate for detecting and classifying inguinal hernia and for evaluating occult hernia.

  7. Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.

    PubMed

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten; Jorgensen, Lars N

    2013-02-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery. In the nationwide Danish Hernia Database, a cohort of 92,457 patients operated on for inguinal hernias was recorded from January 1998 until June 2010. Eight-hundred forty-three (0.91 %) of these patients underwent a ventral hernia operation between January 2007 and June 2010. A multivariate logistic regression analysis was applied to assess an association between inguinal and ventral hernia repair. Direct (Odds Ratio [OR] = 1.28 [95 % CI, 1.08-1.51]) and recurrent (OR = 1.76, [95 % CI, 1.39-2.23]) inguinal hernias were significantly associated with ventral hernia repair after adjustment for age, gender, and surgical approach (open or laparoscopic). Patients with direct and recurrent inguinal herniation are more prone to ventral hernia repair than patients with indirect inguinal herniation. This is the first study to show that herniogenesis is associated with type of inguinal hernia.

  8. Does inguinal hernia repair have an effect on sexual functions?

    PubMed Central

    Sonbahar, Bilgehan Çağdaş; Bora, Gül; Özalp, Necdet; Kara, Cengiz

    2016-01-01

    Introduction The aim of this study is to evaluate sexual functions which are affected by inguinal hernias and may change after hernia repair surgery. Material and methods A total of 47 patients who underwent Lichtenstein tension-free anterior repair and inguinal hernia surgery were evaluated in terms of erectile function, intercourse function, sexual desire, overall satisfaction and orgasm satisfaction using the International Index of Erectile function questionnaire (IIEF) scoring system before surgery and in the first and sixth months after surgery. Parameters evaluated with the IIEF score before the surgery and in the first and sixth months after surgery were compared statistically using the Wilcoxon test. Results The average age of patients was 46.2 ±11.2 years (range: 22–67). It was determined that all scores, apart from sexual desire (p = 0.08), significantly increased in the postoperative first and sixth months compared to the preoperative period. It was measured that the preoperative sexual desire score increased significantly in the postoperative sixth month (p <0.001). A significant score was also detected when all scores in the postoperative sixth month were compared to the postoperative first month. Conclusions Inguinal hernia surgery positively affects sexual functions compared to the preoperative period. The improvement in sexual parameters in addition to the benefits of hernia removal and presence of no significant postoperative complications indicates that this surgery is useful and safe. PMID:27551560

  9. Inguinal lymph node metastases from germ cell testicular tumors.

    PubMed

    Klein, F A; Whitmore, W F; Sogani, P C; Batata, M; Fisher, H; Herr, H W

    1984-03-01

    Between 1948 and 1982, 22 patients were seen with metastasis to the inguinal nodes from testicular germ cell tumors: 8 had a history of unilateral or bilateral orchiopexy with or without herniorrhaphy, 4 had nonsurgically corrected or uncorrected cryptorchidism, 9 had a history of herniorrhaphy, hydrocelectomy or transscrotal orchiectomy and 1 had no history of scrotal, iliac or inguinal surgery, or of tunica vaginalis or scrotal wall involvement by tumor. The histological type was pure seminoma in 5 patients, embryonal carcinoma in 7 and mixed tumor in 10. Treatment was individualized for tumor type and mode of presentation, and varied during the years according to the modalities available. At the time of this report 8 of 22 patients (36 per cent) are alive without evidence of disease from 2 to 29.5 years, 3 (16 per cent) have died without evidence of disease 10 to 17 years after treatment, 10 (45 per cent) have died of metastases 10 months to 6 years after treatment and 1 has been lost to followup. The over-all incidence of groin metastases from testicular carcinoma is low, even with a history of scrotal or inguinal surgery.

  10. Transabdominal preperitoneal laparoscopic approach for incarcerated inguinal hernia repair

    PubMed Central

    Yang, Shuo; Zhang, Guangyong; Jin, Cuihong; Cao, Jinxin; Zhu, Yilin; Shen, Yingmo; Wang, Minggang

    2016-01-01

    Abstract To investigate the efficacy, key technical points, and complication management of the transabdominal preperitoneal (TAPP) approach for incarcerated inguinal hernia repair. Seventy-three patients with incarcerated inguinal hernias underwent TAPP surgery in our department between Jan 2010 and Dec 2015. A retrospective review was performed by analyzing the perioperative data from these patients. The operation was successfully completed in all 73 patients. Operation time was 54.0 ± 18.8 minutes (range, 35–100 minutes). Length of stay was 3.9 ± 1.1 days (range, 3–9 days). There was 1 case of incisional infection, 32 cases of seroma, and 3 cases of postoperative pain during follow-up. All patients recovered after the appropriate treatment. No recurrence or fistula was observed. The TAPP approach represents a safe and effective technique for incarcerated inguinal hernia repair because of its potential in assessment of hernia content and decreasing incisional infection rate. However, it requires experienced surgeons to ensure safety with special attention paid to the key technical points as well as complication management. PMID:28033260

  11. Meshless treatment of open inguinal hernia repair: a prospective study

    PubMed Central

    Kassab, Paulo; Franciulli, Ettore Ferrari; Wroclawski, Carolina Kassab; Ilias, Elias Jirjoss; Castro, Osvaldo Antônio Prado; Malheiros, Carlos Alberto

    2013-01-01

    ABSTRACT Objective: To evaluate two types of meshless open inguinal repair and to evaluate the recurrence rate. Methods: We operated on sequentially 98 men and 15 women with 144 unilateral or bilateral inguinal hernias between December 1988 and April 2007. The surgeries were performed by two experienced surgeons and divided into two groups: Bassini or McVay reconstructive surgery techniques. Bassini type reinforcements were employed for Nyhus II and IIIB with minor destruction of the posterior wall. Patients with Nyhus type IIIA, type IIIB with major destruction of the fascia transversalis, and type IIIC were subjected to the McVay technique. Results: Seventy-five hernias were corrected using the McVay technique. Only two recurrences (2.67%) were observed in this group. For group Bassini, two recurrences for 69 hernias (2.89%) were observed (p=0.658). Mean age for the recurrent group was 56 years. No differences were observed between the ages of males and females (52 years). Conclusions: Non-mesh repair in inguinal hernia can be safely used if performed by experienced surgeons. PMID:23843059

  12. Lumped element kinetic inductance detectors for space applications

    NASA Astrophysics Data System (ADS)

    Monfardini, Alessandro; Baselmans, Jochem; Benoit, Alain; Bideaud, Aurelien; Bourrion, Olivier; Catalano, Andrea; Calvo, Martino; D'Addabbo, Antonio; Doyle, Simon; Goupy, Johannes; Le Sueur, Helene; Macias-Perez, Juan

    2016-07-01

    Kinetic Inductance Detectors (KID) are now routinely used in ground-based telescopes. Large arrays, deployed in formats up to kilopixels, exhibit state-of-the-art performance at millimeter (e.g. 120-300 GHz, NIKA and NIKA2 on the IRAM 30-meters) and sub-millimeter (e.g. 350-850 GHz AMKID on APEX) wavelengths. In view of future utilizations above the atmosphere, we have studied in detail the interaction of ionizing particles with LEKID (Lumped Element KID) arrays. We have constructed a dedicated cryogenic setup that allows to reproduce the typical observing conditions of a space-borne observatory. We will report the details and conclusions from a number of measurements. We give a brief description of our short term project, consisting in flying LEKID on a stratospheric balloon named B-SIDE. Keywords: cryogenics detectors, millimeter-wave, superconducting resonators.

  13. Granulocytic Sarcoma Presenting as a Palpable Breast Lump

    PubMed Central

    Fernandes Vieira, Victor; Vo, Quoc Duy; Bouquet de la Jolinière, Jean; Khomsi, Fathi; Feki, Anis; Hoogewoud, Henri-Marcel

    2017-01-01

    We report the case of a 45-year-old woman who palpated a voluminous painless lump in the superior outer quadrant of her left breast. Her past medical history revealed an acute myeloid leukemia (AML) treated and considered in remission 1 month prior to this discovery. Imaging work-up by mammogram, US, and MRI showed multiples masses suspect of malignancy in both breasts. US-guided needle biopsy was performed in the palpable mass and in one of the multiple lesions located in the right breast. Histologic findings were compatible with a granulocytic sarcoma in both breasts, which was considered as a relapse of the AML treated a few months earlier. PMID:28168190

  14. Modeling of cerebral aneurysm using equivalent electrical circuit (Lumped Model).

    PubMed

    Abdi, M; Karimi, A; Navidbakhsh, M; Hassani, K; Faghihi, S

    2014-03-01

    The circle of Willis (CoW) is a key asset in brain performance as it supports adequate blood supply to the brain. The lumped method (electrical equivalent circuits) is a useful model to simulate the process of the human cardiovascular system. In this study, the whole cardiovascular system is modeled, using an equivalent electrical circuit to investigate an aneurysm in an artery. The cerebrovascular system consists of 29 compartments, which includes the CoW. Each vessel is modeled by a resistor, a capacitor and an inductor. Using MATLAB Simulink, the left and right ventricles are modeled by controlled voltage sources and diodes. The effects of the left internal carotid artery aneurysm (Fusiform) on the pressure of the efferent arteries in the circle of Willis are studied. The modeling results are entirely in agreement with the available clinical observations. The results of the present study may have clinical implications for modeling different cardiovascular diseases, such as arterial stiffness and atherosclerosis.

  15. Lumped mass formulations for modeling flexible body systems

    NASA Technical Reports Server (NTRS)

    Rampalli, Rajiv

    1989-01-01

    The efforts of Mechanical Dynamics, Inc. in obtaining a general formulation for flexible bodies in a multibody setting are discussed. The efforts being supported by MDI, both in house and externally are summarized. The feasibility of using lumped mass approaches to modeling flexibility in a multibody dynamics context is examined. The kinematics and kinetics for a simple system consisting of two rigid bodies connected together by an elastic beam are developed in detail. Accuracy, efficiency and ease of use using this approach are some of the issues that are then looked at. The formulation is then generalized to a superelement containing several nodes and connecting several bodies. Superelement kinematics and kinetics equations are developed. The feasibility and effectiveness of the method is illustrated by the use of some examples illustrating phenomena common in the context of spacecraft motions.

  16. Recursive modular modelling methodology for lumped-parameter dynamic systems.

    PubMed

    Orsino, Renato Maia Matarazzo

    2017-08-01

    This paper proposes a novel approach to the modelling of lumped-parameter dynamic systems, based on representing them by hierarchies of mathematical models of increasing complexity instead of a single (complex) model. Exploring the multilevel modularity that these systems typically exhibit, a general recursive modelling methodology is proposed, in order to conciliate the use of the already existing modelling techniques. The general algorithm is based on a fundamental theorem that states the conditions for computing projection operators recursively. Three procedures for these computations are discussed: orthonormalization, use of orthogonal complements and use of generalized inverses. The novel methodology is also applied for the development of a recursive algorithm based on the Udwadia-Kalaba equation, which proves to be identical to the one of a Kalman filter for estimating the state of a static process, given a sequence of noiseless measurements representing the constraints that must be satisfied by the system.

  17. Breast lump detection: who is more accurate, patients or their GPs?

    PubMed

    Donnelly, J

    2010-03-01

    A breast lump is the most commonly presenting complaint given by GPs when making a referral to the local breast unit. This does not necessarily mean that this was the breast symptom for which the woman consulted her GP. This study aimed to assess the accuracy of women and their GPs in detecting true breast lumps. Between October 2008 and March 2009, the patients' symptoms, the signs elicited by the GP and the examination findings of the specialist breast clinician (BC) were recorded and compared for every consecutive new referral to the symptomatic breast clinic. A true lump was considered to present if it was detectable by the BC. Of the 282 referrals, 228 (81%) were for a lump. Women were 95% sensitive and 59% specific in detecting a true lump. GPs were 98% sensitive and 34% specific. Forty-six patients were referred by their GP with a lump but denied that one was present in themselves. Cancer was diagnosed in four of these women, three of whom suffered from dementia. Patients' and GPs' breast assessments are highly sensitive in detecting breast lumps. The specificity of GPs' assessments is low. The results reflect the high level of awareness that breast cancer usually presents as a lump and the priority given to not missing cancer. In the subgroup of cognitively unimpaired women referred with a lump, but who themselves deny that one is present, the patient will be correct and the GP incorrect in their assessment in 96% and 95% of patients respectively. If a woman consults her GP with breast symptoms, but has not found a lump, it is safe for her GP not to find one either. Such patients can be reassured and reviewed after a month with a view to referral, if symptoms persist.

  18. Cholesterol and Benign Prostate Disease

    PubMed Central

    Freeman, Michael R.; Solomon, Keith R.

    2014-01-01

    The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association bet ween BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemi, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept. PMID:21862201

  19. Pharmacotherapy for benign prostatic hyperplasia.

    PubMed Central

    Narayan, P; Indudhara, R

    1994-01-01

    Benign prostatic hyperplasia is a benign neoplasm of the prostate seen in men of advancing age. Microscopic evidence of the disorder is seen in about 70% of men by 70 years of age, whereas symptoms requiring some form of surgical intervention occur in 30% of men during their lifetime. Although the exact cause of benign prostatic hyperplasia is not clear, it is well recognized that high levels of intraprostatic androgens are required for the maintenance of prostatic growth. In recent years, extensive surveys of patients undergoing transurethral resection of the prostate reveal an 18% incidence of morbidity that has essentially not changed in the past 30 years. This procedure is also the second highest reimbursed surgical therapy under Medicare. These findings have resulted in an intensive search for alternative therapies for prostatic hyperplasia. An alternative that has now been well defined is the use of alpha-adrenergic blockers to relax the prostatic urethra. This is based on findings that a major component of benign prostatic hyperplasia symptoms is spasm of the prostatic urethra and bladder neck, which is mediated by the alpha-adrenergic nerves. A second approach is to block androgens involved in maintaining prostate growth. Several such drugs are now available for clinical use, and we discuss their side effects and use. We also include the newer recommendations on evaluating benign prostatic hyperplasia that are cost-effective yet comprehensive. Images PMID:7528957

  20. Cholesterol and benign prostate disease.

    PubMed

    Freeman, Michael R; Solomon, Keith R

    2011-01-01

    The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association between BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemia, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept.

  1. LUMPED: a Visual Basic code of lumped-parameter models for mean residence time analyses of groundwater systems

    NASA Astrophysics Data System (ADS)

    Ozyurt, N. N.; Bayari, C. S.

    2003-02-01

    A Microsoft ® Visual Basic 6.0 (Microsoft Corporation, 1987-1998) code of 15 lumped-parameter models is presented for the analysis of mean residence time in aquifers. Groundwater flow systems obeying plug and exponential flow models and their combinations of parallel or serial connection can be simulated by these steady-state models which may include complications such as bypass flow and dead volume. Each model accepts tritium, krypton-85, chlorofluorocarbons (CFC-11, CFC-12 and CFC-113) and sulfur hexafluoride (SF 6) as environmental tracer. Retardation of gas tracers in the unsaturated zone and their degradation in the flow system may also be accounted for. The executable code has been tested to run under Windows 95 or higher operating systems. The results of comparisons between other comparable codes are discussed and the limitations are indicated.

  2. 20 CFR 234.18 - Payment of a deferred lump-sum to a widow(er).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Payment of a deferred lump-sum to a widow(er). 234.18 Section 234.18 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT LUMP-SUM PAYMENTS Lump-Sum Death Payment § 234.18 Payment of a deferred lump-sum to a widow(er). In certain cases, a deferred LSDP ma...

  3. Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair.

    PubMed

    Nishihara, Yuichi; Isobe, Yoh; Kitagawa, Yuko

    2017-06-07

    A realistic simulator for transabdominal preperitoneal (TAPP) inguinal hernia repair would enhance surgeons' training experience before they enter the operating theater. The purpose of this study was to create a novel physical simulator for TAPP inguinal hernia repair and obtain surgeons' opinions regarding its efficacy. Our novel TAPP inguinal hernia repair simulator consists of a physical laparoscopy simulator and a handmade organ replica model. The physical laparoscopy simulator was created by three-dimensional (3D) printing technology, and it represents the trunk of the human body and the bendability of the abdominal wall under pneumoperitoneal pressure. The organ replica model was manually created by assembling materials. The TAPP inguinal hernia repair simulator allows for the performance of all procedures required in TAPP inguinal hernia repair. Fifteen general surgeons performed TAPP inguinal hernia repair using our simulator. Their opinions were scored on a 5-point Likert scale. All participants strongly agreed that the 3D-printed physical simulator and organ replica model were highly useful for TAPP inguinal hernia repair training (median, 5 points) and TAPP inguinal hernia repair education (median, 5 points). They felt that the simulator would be effective for TAPP inguinal hernia repair training before entering the operating theater. All surgeons considered that this simulator should be introduced in the residency curriculum. We successfully created a physical simulator for TAPP inguinal hernia repair training using 3D printing technology and a handmade organ replica model created with inexpensive, readily accessible materials. Preoperative TAPP inguinal hernia repair training using this simulator and organ replica model may be of benefit in the training of all surgeons. All general surgeons involved in the present study felt that this simulator and organ replica model should be used in their residency curriculum.

  4. Environmentally Benign Stab Detonators

    SciTech Connect

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CSRS lump-sum payments. 831.2011 Section 831.2011 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011... amount of the lump-sum payment from any back pay to which the employee is entitled as required by 5 CFR...

  6. 5 CFR 831.2011 - Effect of part 772 of this chapter on CSRS lump-sum payments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... CSRS lump-sum payments. 831.2011 Section 831.2011 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011... amount of the lump-sum payment from any back pay to which the employee is entitled as required by 5 CFR...

  7. 5 CFR 831.2011 - Effect of part 772 of this chapter on CSRS lump-sum payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... CSRS lump-sum payments. 831.2011 Section 831.2011 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011... amount of the lump-sum payment from any back pay to which the employee is entitled as required by 5 CFR...

  8. 5 CFR 831.2011 - Effect of part 772 of this chapter on CSRS lump-sum payments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CSRS lump-sum payments. 831.2011 Section 831.2011 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011... amount of the lump-sum payment from any back pay to which the employee is entitled as required by 5 CFR...

  9. 5 CFR 831.2002 - Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions (SF 2802). 831.2002 Section 831.2002...) RETIREMENT Payment of Lump Sums § 831.2002 Eligibility for lump-sum payment upon filing an Application for...

  10. 5 CFR 831.2002 - Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions (SF 2802). 831.2002 Section 831.2002...) RETIREMENT Payment of Lump Sums § 831.2002 Eligibility for lump-sum payment upon filing an Application for...

  11. 5 CFR 831.2002 - Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions (SF 2802). 831.2002 Section 831.2002...) RETIREMENT Payment of Lump Sums § 831.2002 Eligibility for lump-sum payment upon filing an Application for...

  12. 5 CFR 831.2002 - Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions (SF 2802). 831.2002 Section 831.2002...) RETIREMENT Payment of Lump Sums § 831.2002 Eligibility for lump-sum payment upon filing an Application for...

  13. Multicystic Benign Mesothelioma Complicating Pregnancy.

    PubMed

    Tamhankar, V A

    2015-01-01

    Multicystic benign mesothelioma (MBM) is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section.

  14. Multicystic Benign Mesothelioma Complicating Pregnancy

    PubMed Central

    Tamhankar, V. A.

    2015-01-01

    Multicystic benign mesothelioma (MBM) is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section. PMID:26345310

  15. [Benign stenosis of the esophagus].

    PubMed

    Salis, G; Lazaroni, F; Chiocca, J C; Mazure, P A; Sferco, A

    1978-09-01

    In the present study 39 patients with benign esphageal stenosis were studied (average age 59,9 years). The most common etiology was refux esofagitis, and the most common associated pathology was esophageal hiatus hernia. Thirty one patients received medical treatment (diet. antireflux drugs and dilatations.) Twenty four were dilated with the slow continuous method, six with metalic bougies. One patient was not dilated. Seven patients were not treated since the stenosis was due to extrinsec compression. One patient was surgically treated from the onset. Seventy percent of the patients had goods results with esophageal dilatation. We propose that patients with benign esophageal stenosis should be treated by the slow continuous dilatation method.

  16. Radiotherapy of unusual benign disease

    SciTech Connect

    Aristizabel, S.A.; Runyon, T.D.

    1981-10-01

    Four different case reports are presented with a review of the literature in which radiation therapy was used for the treatment of four rare benign diseases: pyogenic granuloma of the middle ear, juvenile xanthogranuloma of the iris, a fourth ventricle choroid plexus papilloma, and an ovarian lymphangioma associated with peritoneal lymphangiomatosis. A trial of radiation therapy was given in each case, because of extenuating circumstances. We hope that the information presented here will contribute to current guidelines used in weighting patient benefits versus potential risks of therapy when ionizing radiation is considered as a mode of therapy for benign disorders.

  17. Benign paroxysmal torticollis of infancy.

    PubMed

    Drigo, P; Carli, G; Laverda, A M

    2000-05-01

    Benign paroxysmal torticollis is an episodic functional disorder of unknown etiology that occurs in the early months of life in healthy individuals. The child's head tilts to one side for a few hours or days, usually without any associated symptoms. The disorder, which disappears within the first few years of life, is often misinterpreted and the patient pointlessly undergoes numerous tests. We present our series of 22 patients observed at the pediatric neurology outpatients clinic in Padova with a view to refreshing the pediatrician's memory on this frequent, benign pathology.

  18. Benign Prostatic Hyperplasia: An Overview

    PubMed Central

    Roehrborn, Claus G

    2005-01-01

    Despite the deceptively simple description of benign prostatic hyperplasia (BPH), the actual relationship between BPH, lower urinary tract symptoms (LUTS), benign prostatic enlargement, and bladder outlet obstruction is complex and requires a solid understanding of the definitional issues involved. The etiology of BPH and LUTS is still poorly understood, but the hormonal hypothesis has many arguments in its favor. There are many medical and minimally invasive treatment options available for affected patients. In the intermediate and long term, minimally invasive treatment options are superior to medical therapy in terms of symptom and flow rate improvement; tissue ablative surgical treatment options are superior to both minimally invasive and medical therapy. PMID:16985902

  19. Neonatal perforated appendicitis in incarcerated inguinal hernia in the differential diagnosis of testis torsion.

    PubMed

    Erginel, Basak; Soysal, Feryal Gun; Celik, Alaaddin; Salman, Tansu

    2017-07-01

    Appendicitis in newborns is uncommon and difficult to diagnose. Reports on neonatal appendicitis subsequent to inguinal hernia incarceration are exceptionally rare. We present the case of a 26-day-old infant with perforated appendicitis due to incarceration of a right inguinal hernia, mimicking right testicular torsion. © 2017 Japan Pediatric Society.

  20. Effect of ambient temperature on species lumping for total organic gases in gasoline exhaust emissions

    NASA Astrophysics Data System (ADS)

    Roy, Anirban; Choi, Yunsoo

    2017-03-01

    Volatile organic compound (VOCs) emissions from sources often need to be compressed or "lumped" into species classes for use in emissions inventories intended for air quality modeling. This needs to be done to ensure computational efficiency. The lumped profiles are usually reported for one value of ambient temperature. However, temperature-specific detailed profiles have been constructed in the recent past - the current study investigates how the lumping of species from those profiles into different atmospheric chemistry mechanisms is affected by temperature, considering three temperatures (-18 °C, -7 °C and 24 °C). The mechanisms considered differed on the assumptions used for lumping: CB05 (carbon bond type), SAPRC (ozone formation potential) and RACM2 (molecular surrogate and reactivity weighting). In this space, four sub-mechanisms for SAPRC were considered. Scaling factors were developed for each lumped model species and mechanism in terms of moles of lumped species per unit mass. Species which showed a direct one-to-one mapping (SAPRC/RACM2) reported scaling factors that were unchanged across mechanisms. However, CB05 showed different trends since one compound often is mapped onto multiple model species, out of which the paraffinic double bond (PAR) is predominant. Temperature-dependent parameterizations for emission factors pertaining to each lumped species class and mechanism were developed as part of the study. Here, the same kind of model species showed varying lumping parameters across the different mechanisms. These differences could be attributed to differing approaches in lumping. The scaling factors and temperature-dependent parameterizations could be used to update emissions inventories such as MOVES or SMOKE for use in chemical transport modeling.

  1. Parotid glands tumours: overview of a 10-year experience with 282 patients, focusing on 231 benign epithelial neoplasms.

    PubMed

    Ungari, C; Paparo, F; Colangeli, W; Iannetti, G

    2008-01-01

    Salivary gland tumours are uncommon, representing less than 6% of head and neck neoplasm. Pleomorphic adenoma is the most common benign epithelial salivary gland neoplasm, comprising 50%-74% of all parotid tumours. It is followed by Warthin's tumour (4-14%). The authors retrospectively reviewed 282 eligible patients surgically treated for parotid gland tumours in the last 10 years, focusing on 231 benign epithelial neoplasms. Clinical and diagnostic findings, surgical treatment and surgical outcome were discussed. The diagnosis of a parotid gland neoplasm must be considered in any patient presenting with a lump near the mandible. Smoking habit is important in Warthin's tumour pathogenesis. Fine needle aspiration citology (FNAC) can't lead alone to histological diagnosis. Only surgery can give histological certainty of benignity, thus preventing malignant degeneration, lump infection or risk of size-dependent surgical complications. Conservative formal parotidectomy appears to be the treatment of choice. Tumour pseudopodia and capsule ruptures are recognised factors involved in pleomorphic adenoma recurrences but also tumour multicentricity might play an important role.

  2. Benign Breast Problems and Conditions

    MedlinePlus

    ... fluid. Fibroadenoma: A type of solid, benign breast mass. Hormone: A substance made in the body by cells or organs that controls the function ... breast are used to detect breast cancer. The image that is created is called a ... mass containing normal cells. Obstetrician–Gynecologist (Ob-Gyn): A ...

  3. Benign ear cyst or tumor

    MedlinePlus

    ... Bony tumor of the ear canal Images Ear anatomy References Nicolai P, Castelnuovo P. Benign tumors of the sinonasal tract. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; ...

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

    NASA Technical Reports Server (NTRS)

    1973-01-01

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

  5. Is Postoperative Wound Infection Following Simple Inguinal Herniorrhaphy a Predisposing Cause of Recurrent Hernia?

    PubMed Central

    Glassow, Frank

    1964-01-01

    The significance of postoperative wound infection in simple inguinal herniorrhaphy was studied in a series of almost 26,000 simple inguinal herniorrhaphies. There was a recurrence rate of about 1% in uninfected cases and 4% in infected cases. The wound infection rate was 1.8%. Of about 2500 patients with recurrent inguinal hernia admitted to the Shouldice Hospital, Toronto, following an initial operation of elsewhere, about 4% gave a history of postoperative wound infection. Postoperative wound infection after simple inguinal herniorrhaphy increased the risk of a subsequent recurrent hernia about four times. However, in more than 95% of cases other etiological factors were responsible for the recurrence. No relation between infection and type of recurrent inguinal hernia subsequently developing was demonstrable. PMID:14217253

  6. The inguinal ligament and its lateral attachments: correcting an anatomical error.

    PubMed

    Acland, Robert D

    2008-01-01

    The inguinal portions of the internal oblique and transversus abdominis muscles are generally described as arising from the inguinal ligament. Previous authors have shown that this description is incorrect. A new dissection study in 15 lightly embalmed cadavers confirms that in reality the inguinal portions of these muscles arise from a thickened strip of ilipsoas fascia that forms the superolateral part of the ilio-pectineal arch. Details are given of a new dissection technique that fully exposes the deep aspect of the inguinal ligament, without disrupting its continuity. The historical background of the persistent textbook error is explored. It originated at a time when there was widespread descriptive and semantic confusion regarding the structure now known as the inguinal ligament.

  7. Outpatient repair for inguinal hernia in elderly patients: still a challenge?

    PubMed

    Palumbo, Piergaspare; Amatucci, Chiara; Perotti, Bruno; Zullino, Antonio; Dezzi, Claudia; Illuminati, Giulio; Vietri, Francesco

    2014-01-01

    Elective inguinal hernia repair as a day case is a safe and suitable procedure, with well-recognized feasibility. The increasing number of elderly patients requiring inguinal hernia repair leads clinicians to admit a growing number of outpatients. The aim of the current study was to analyze the outcomes (feasibility and safety) of day case treatment in elderly patients. Eighty patients >80 years of age and 80 patients ≤55 years of age underwent elective inguinal hernia repairs under local anesthesia. There were no mortalities or major complications in the elderly undergoing inguinal herniorraphies as outpatients, and only one unanticipated admission occurred in the younger age group. Elective inguinal hernia repair in the elderly has a good outcome, and age alone should not be a drawback to day case treatment. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  8. The laparoscopic approach for repair of indirect inguinal hernias in infants and children

    PubMed Central

    Juang, David; Fraser, Jason D.

    2016-01-01

    Repair of an indirect inguinal hernia is one of the most common operations performed around the world by pediatric surgeons. Until the last 15 years, most inguinal hernia repairs were performed using an inguinal crease incision and extraperitoneal ligation of the patent processes vaginalis. However, since 2000, the laparoscopic approach has gained popularity and there have been increasing descriptions about various techniques for laparoscopic hernia (LH) repair. At our institution, we have transitioned the majority of inguinal hernia repairs to the laparoscopic approach. In this article, we will describe the technique that is utilized at Children’s Mercy Hospital in Kansas City, Missouri (USA) and express our thoughts on the current debate regarding laparoscopic versus open inguinal hernia repair in infants and children. PMID:27867843

  9. The epidemiology and risk factors for recurrence after inguinal hernia surgery.

    PubMed

    Burcharth, Jakob

    2014-05-01

    Recurrence after inguinal hernia surgery is a considerable clinical problem, and several risk factors of recurrence such as surgical technique, re-recurrence, and family history have been identified. Non-technical patient related factors that influence the risk of recurrence after inguinal hernia surgery are sparsely studied. The purpose of the studies included in this PhD thesis, was to describe the epidemiologic characteristics of inguinal hernia occurrence and recurrence, as well as investigating the patient related risk factors leading to recurrence after inguinal hernia surgery. Four studies were included in this thesis. Study 1: The study was a nationwide register-based study combining the Civil Registration System and the Danish National Hospital Register during a five-year period. We included a total of 46,717 persons operated for a groin hernia from the population of 5,639,885 people (2,799,105 males, 2,008,780 females). We found that 97% of all groin hernia repairs were inguinal hernias and 3% femoral hernias. Data showed that inguinal hernia surgery peaked during childhood and old age, whereas femoral hernia surgery increased throughout life. Study 2: Using data from the Danish Hernia Database (DHDB), we included all male patients operated for elective primary inguinal hernia during a 15-year period (n = 85,314). The overall inguinal hernia reoperation rate was 3.8%, and subdivided into indirect inguinal hernias and direct inguinal hernias, the reoperation rates were 2.7% and 5.2%, respectively (p <0.001, chi-square). In the multivariate Cox proportional hazards analysis of factors predicting reoperation, we found that a direct inguinal hernia at primary operation was a substantial risk factor for recurrence with a Hazard ratio of 1,90 (CI 95% 1.77-2.04) compared with an indirect inguinal hernia at primary operation (p < 0.001). We found that there was a significant relationship between the type of hernia at the primary operation and reoperation, when

  10. Renal cell carcinoma: Atypical metastasis to inguinal lymph nodes

    PubMed Central

    Chaudhry, Qamar Saeed; Bhatty, Tanweer Ahmed Naveed; Khan, Ziauddin; Osman, Elsawi Medani

    2017-01-01

    Renal cell carcinoma (RCC) is a common tumor of the urinary tract. It is known to have variable presentations due to the extremely vascular nature of the organ. RCC are known to metastasize to lungs, bone, and brain commonly but atypical metastasis to various sites are reported in literature but as very rare pathology. We report a case of a 60-year-old female who presented with multiple inguinal and axillary lymph node enlargements which on excision biopsy showed metastatic RCC. RCC can present with synchronous metastatic deposits in the various organs. RCC can metastasize to some atypical sites as well such as thyroid, orbit, and neck as mentioned earlier in literature. The patient presenting with extra-regional lymph nodes like inguinal and axillary is extremely rare, and so far only one clinical case could be found from India in 2008. A 61-year-old female presented in the emergency department with left flank pain and hematuria. Imaging showed left swollen kidney but multiple lymph nodes in retroperitoneum, left inguinal and axillary region. Excisional biopsy confirmed metastatic renal clear cell carcinoma. The case was referred to an oncologist after left radical nephrectomy for further treatment. Renal cancer is quite common aggressive disease. Due to its vascular nature, it may present quite atypically as evident from literature. Although treatment of metastatic carcinoma is still controversial surgery is the mainstay of treatment and guidelines consider metastasectomy and cytoreductive nephrectomy as valid option followed by targeted systemic therapies. RCC has quite a high potential to metastasize in the versatile pattern, in our case, it is evident that valid management is still surgery but needs support from the multidisciplinary team. PMID:28216937

  11. A simplified technique for giant inguinal hernia repair in infants.

    PubMed

    Banieghbal, B

    2008-06-01

    Repair of giant inguino-scrotal hernia (GISH) in male infants is a difficult operation, even in experienced hands. It requires an immaculate technique to avoid known complications such as tearing of the sac, injury to delicate testicular vessels and dividing of vas deferens. Moreover, a recurrence rate of 9% is noted in a number of reports. This article describes a new surgical maneuver to simplify the procedure. All GISH repaired by the author, over a 5-year period (October 2001-September 2006), were reviewed retrospectively. In total, 89 infants with 106 GISH underwent uni- or bilateral herniotomies. A standard inguinal incision is made and Scarpa's fascia is sharply opened; the external inguinal ring and the cord is identified. By gentle manipulation and blunt dissection, the spermatic cord together with the testis is exteriorized. The assistant applies gentle traction to the cord, which allows for easy identification of the inguinal sac and its subsequent separation from vas and vessels. Testis is replaced in the scrotum, hernial sac suture ligated at its base and the wound closed in layers. All cases were managed with the above approach. The average length of the procedure was 11 min for unilateral and 19 min for bilateral cases. Except for minimal scrotal swelling post-operatively, no other surgery-related complications were noted during or immediately after the operation. Testicular atrophy or iatrogenic undescended testes were not encountered in the follow-up period. Ipsilateral recurrent hernia was noted in one infant after 6 months which required re-operation with the same technique. In cases of GISH; dislocating the testis into the wound and applying a gentle stretch on the cord allows for a safe dissection of the hernial sac and subsequent herniotomy. This maneuver converts a difficult procedure into a relatively simple one.

  12. Open tension free repair of inguinal hernias; the Lichtenstein technique

    PubMed Central

    Sakorafas, George H; Halikias, Ioannis; Nissotakis, Christos; Kotsifopoulos, Nikolaos; Stavrou, Alexios; Antonopoulos, Constantinos; Kassaras, George A

    2001-01-01

    Background Recurrences have been a significant problem following hernia repair. Prosthetic materials have been increasingly used in hernia repair to prevent recurrences. Their use has been associated with several advantages, such as less postoperative pain, rapid recovery, low recurrence rates. Methods In this retrospective study, 540 tension-free inguinal hernia repairs were performed between August 1994 and December 1999 in 510 patients, using a polypropylene mesh (Lichtenstein technique). The main outcome measure was early and late morbidity and especially recurrence. Results Inguinal hernia was indirect in 55 % of cases (297 patients), direct in 30 % (162 patients) and of the pantaloon (mixed) type in 15 % (81 patients). Mean patient age was 53.7 years (range, 18 – 85). Follow-up was completed in 407 patients (80 %) by clinical examination or phone call. The median follow-up period was 3.8 years (range, 1 – 6 years). Seroma and hematoma formation requiring drainage was observed in 6 and 2 patients, respectively, while transient testicular swelling occurred in 5 patients. We have not observed acute infection or abscess formation related to the presence of the foreign body (mesh). In two patients, however, a delayed rejection of the mesh occurred 10 months and 4 years following surgery. There was one recurrence of the hernia (in one of these patients with late mesh rejection) (recurrence rate = 0.2 %). Postoperative neuralgia was observed in 5 patients (1 %). Conclusion Lichtenstein tension-free mesh inguinal hernia repair is a simple, safe, comfortable, effective method, with extremely low early and late morbidity and remarkably low recurrence rate and therefore it is our preferred method for hernia repair since 1994. PMID:11696246

  13. Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique – own experience

    PubMed Central

    Patkowski, Dariusz

    2014-01-01

    Introduction Percutaneous internal ring suturing (PIRS) is a method of laparoscopic herniorrhaphy, i.e. percutaneous closure of the internal inguinal ring under the control of a telescope placed in the umbilicus. Aim To evaluate the usefulness of the PIRS technique. Material and methods Fifty-five children (39 girls and 16 boys) underwent surgery using this method in our institution between 2008 and 2010. Results In 10 cases the presence of an open inguinal canal on the opposite side was also noted during surgery, and umbilical hernia was recognized in 2 patients. In 5 cases it was necessary to convert to the open surgery because of the inability to continue the laparoscopic procedure. In 1 case, male pseudohermaphroditism was diagnosed during surgery. Recurrent inguinal hernia required a conventional method of surgery in 1 child. Other children did not exhibit the characteristics of hernia recurrence. The inguinal canals were followed up with postoperative ultrasound examination in 29 children. In 23 children, the ultrasound examination showed no dilatation of the inguinal canal. In the other 6 children dilatation of the inguinal canal or the presence of fluid within the inguinal canal was observed during ultrasound. In 6 children symptoms such as swelling and soreness around the inguinal canal developed within 3 to 6 months after surgery. Conclusions Inguinal hernia surgery using the PIRS procedure is an alternative, effective, minimally invasive method of surgery. Visualization of the peritoneal cavity allows for detection of other abnormalities, as well as for performing other procedures during the same session (such as closing the contralateral inguinal canal or umbilical hernia surgery). PMID:24729810

  14. Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana.

    PubMed

    Ohene-Yeboah, Michael; Beard, Jessica H; Frimpong-Twumasi, Benjamin; Koranteng, Adofo; Mensah, Samuel

    2016-04-01

    Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings. Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment. A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8 % (95 % CI 8.0, 13.6 %), and 2.2 % (95 % CI 0, 5.4 %) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0 % (95 % CI 10.2, 15.7 %). Prevalence of inguinal hernia increased with age; 35.4 % (95 % CI 23.6, 47.2 %) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socio-economic status. Of those with inguinal hernia, 52.4 % did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2 %). Although inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society and could be adapted for use in other low-resource settings.

  15. Inguinal hernia: preperitoneal placement of a memory-ring patch by anterior approach. Preliminary experience.

    PubMed

    Pélissier, E P

    2006-06-01

    The aim of this prospective study was to set up and evaluate a technique allowing, by the mean of a memory ring, easy placement of the patch in the preperitoneal space (PPS), directly via the hernia orifice, so as to associate the advantages of the preperitoneal patch, anterior approach and minimally invasive surgery. The memory-ring patch was made by basting a PDS cord around a 14 x 7.5 cm oval shaped polypropylene mesh. The hernia sac was dissected, blunt dissection of the PPS was carried out through the hernia orifice and the patch was introduced in the PPS via the orifice. Spreading of the patch in the PPS was facilitated by the memory-ring. One hundred and twenty nine hernias, classified as Nyhus Type IIIa, IIIb and IV, were operated on 126 patients; 11 were big pantaloon or sliding hernias. The anesthesia was spinal in 116 cases and local in 10 cases. There were three benign postoperative complications (2.3%) related to the hernia repair. Ninety six percent of the patients were evaluated with a mean follow up of 24.5 months (12-42). Two recurrences (1.6%) occurred, 7 patients (5.6%) felt some degree of light pain, but not any case of disabling pain was observed. This technique offers many advantages. It is tension-free and almost sutureless. The patch is placed in the PPS through the hernia orifice without any remote opening in the abdominal wall. The patch applied directly to the deep surface of the fascia reinforces the weak inguinal area by restoring the normal anatomic disposition. The good preliminary results are encouraging and justify further randomized evaluation.

  16. Finding and Testing Network Communities by Lumped Markov Chains

    PubMed Central

    Piccardi, Carlo

    2011-01-01

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

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

    SciTech Connect

    Kodah, Z.H.

    1982-01-01

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

  18. Testicular atrophy as a consequence of inguinal hernia repair.

    PubMed

    Reid, I; Devlin, H B

    1994-01-01

    Testicular atrophy is an uncommon but well recognized complication of inguinal hernia repair and one that frequently results in litigation. A series of ten cases of testicular atrophy occurring after hernia repair in nine patients is presented. Identifiable risk factors were present in eight instances. Surgeons should make careful enquiries as to previous groin or scrotal surgery and, when indicated, warn the patient before surgery of the increased risk of testicular atrophy. Overzealous dissection of a distal hernia sac, dislocation of the testis from the scrotum into the wound and concomitant scrotal surgery should all be avoided.

  19. Current options in inguinal hernia repair in adult patients

    PubMed Central

    Kulacoglu, H

    2011-01-01

    Inguinal hernia is a very common problem. Surgical repair is the current approach, whereas asymptomatic or minimally symptomatic hernias may be good candidate for watchful waiting. Prophylactic antibiotics can be used in centers with high rate of wound infection. Local anesthesia is a suitable and economic option for open repairs, and should be popularized in day-case setting. Numerous repair methods have been described to date. Mesh repairs are superior to "nonmesh" tissue-suture repairs. Lichtenstein repair and endoscopic/laparoscopic techniques have similar efficacy. Standard polypropylene mesh is still the choice, whereas use of partially absorbable lightweight meshes seems to have some advantages. PMID:22435019

  20. Mesh erosion into urinary bladder following laparoscopic inguinal hernia repair

    PubMed Central

    Sandhu, Arjun Singh; Kumar, Ameet; Kumar, Bharath N.

    2017-01-01

    Along with advantages, evolving surgical techniques bring unique complications. A young male developed urinary symptoms a few months after undergoing laparoscopic inguinal hernia repair. On evaluation, mesh erosion into the urinary bladder was found. Removal of mesh with repair of bladder was done. A vesico-cutaneous fistula resulted which was managed with repeat surgery. We review all such cases reported in literature; discuss the etiopathogenesis, presentation, management and possible preventive measures. To the best of our knowledge, this is only the 12th case being reported. PMID:28281479

  1. Performance Prediction of Two-Phase Geothermal Reservoir using Lumped Parameter Model

    NASA Astrophysics Data System (ADS)

    Nurlaela, F.; Sutopo

    2016-09-01

    Many studies have been conducted to simulate performance of low-temperature geothermal reservoirs using lumped parameter method. Limited work had been done on applying non-isothermal lumped parameter models to higher temperature geothermal reservoirs. In this study, the lumped parameter method was applied to high-temperature two phase geothermal reservoirs. The model couples both energy and mass balance equations thus can predict temperature, pressure and fluid saturation changes in the reservoir as a result of production, reinjection of water, and/or natural recharge. This method was validated using reservoir simulation results of TOUGH2. As the results, the two phase lumped parameter model simulation without recharge shows good matching, however reservoir model with recharge condition show quite good conformity.

  2. 5 CFR 838.235 - Payment of lump-sum awards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REGULATIONS (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Procedures for Processing Court Orders Affecting Employee Annuities Payment Procedures § 838.235 Payment of lump-sum awards. If a court order...

  3. 5 CFR 838.235 - Payment of lump-sum awards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REGULATIONS (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Procedures for Processing Court Orders Affecting Employee Annuities Payment Procedures § 838.235 Payment of lump-sum awards. If a court order...

  4. 5 CFR 838.235 - Payment of lump-sum awards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REGULATIONS (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Procedures for Processing Court Orders Affecting Employee Annuities Payment Procedures § 838.235 Payment of lump-sum awards. If a court order...

  5. Application of Biologically-Based Lumping To Investigate the Toxicological Interactions of a Complex Gasoline Mixture

    EPA Science Inventory

    People are often exposed to complex mixtures of environmental chemicals such as gasoline, tobacco smoke, water contaminants, or food additives. However, investigators have often considered complex mixtures as one lumped entity. Valuable information can be obtained from these exp...

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

    NASA Astrophysics Data System (ADS)

    Zhao, Jingcheng; Cheng, Yongzhi

    2016-10-01

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

  7. Application of Biologically-Based Lumping To Investigate the Toxicological Interactions of a Complex Gasoline Mixture

    EPA Science Inventory

    People are often exposed to complex mixtures of environmental chemicals such as gasoline, tobacco smoke, water contaminants, or food additives. However, investigators have often considered complex mixtures as one lumped entity. Valuable information can be obtained from these exp...

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

    NASA Technical Reports Server (NTRS)

    Hays, J. R.

    1969-01-01

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

  9. Lumped modeling with circuit elements for nonreciprocal magnetoelectric tunable band-pass filter

    NASA Astrophysics Data System (ADS)

    Li, Xiao-Hong; Zhou, Hao-Miao; Zhang, Qiu-shi; Hu, Wen-Wen

    2016-11-01

    This paper presents a lumped equivalent circuit model of the nonreciprocal magnetoelectric tunable microwave band-pass filter. The reciprocal coupled-line circuit is based on the converse magnetoelectric effect of magnetoelectric composites, includes the electrical tunable equivalent factor of the piezoelectric layer, and is established by the introduced lumped elements, such as radiation capacitance, radiation inductance, and coupling inductance, according to the transmission characteristics of the electromagnetic wave and magnetostatic wave in an inverted-L-shaped microstrip line and ferrite slab. The nonreciprocal transmission property of the filter is described by the introduced T-shaped circuit containing controlled sources. Finally, the lumped equivalent circuit of a nonreciprocal magnetoelectric tunable microwave band-pass filter is given and the lumped parameters are also expressed. When the deviation angles of the ferrite slab are respectively 0° and 45°, the corresponding magnetoelectric devices are respectively a reciprocal device and a nonreciprocal device. The curves of S parameter obtained by the lumped equivalent circuit model and electromagnetic simulation are in good agreement with the experimental results. When the deviation angle is between 0° and 45°, the maximum value of the S parameter predicted by the lumped equivalent circuit model is in good agreement with the experimental result. The comparison results of the paper show that the lumped equivalent circuit model is valid. Further, the effect of some key material parameters on the performance of devices is predicted by the lumped equivalent circuit model. The research can provide the theoretical basis for the design and application of nonreciprocal magnetoelectric tunable devices. Project supported by the National Natural Science Foundation of China (Grant Nos. 11172285, 11472259, and 11302217) and the Natural Science Foundation of Zhejiang Province, China (Grant No. LR13A020002).

  10. 29 CFR Appendix B to Part 4022 - Lump Sum Interest Rates for PBGC Payments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for PBGC Payments B Appendix B to... 4022—Lump Sum Interest Rates for PBGC Payments Rate set For plans with avaluation date On or after Before Immediate annuity rate (percent) Deferred annuities (percent) i1 i2 i3 n1 n2 1 11-1-93 12-1-93 4...

  11. 29 CFR Appendix C to Part 4022 - Lump Sum Interest Rates for Private-Sector Payments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for Private-Sector Payments C... Appendix C to Part 4022—Lump Sum Interest Rates for Private-Sector Payments [In using this table: (1) For... (where y is an integer and 0 n 1 + n 2), interest rate i 3 shall apply from the valuation date for a...

  12. Otitis media and a neck lump--current diagnostic challenges for Paragonimus-like trematode infections.

    PubMed

    Schuster, H; Agada, F O; Anderson, A R; Jackson, R S; Blair, D; McGann, H; Kelly, G

    2007-02-01

    A 29 year-old Nigerian studying in the UK presented with a neck lump and otitis media. Paragonimus-like trematode eggs were found in the neck lump aspirate. Morphologically these eggs resembled Paragonimus uterobilateralis or Achillurbainia congolensis. We favoured the diagnosis of achillurbainiasis over extrapulmonary paragonimiasis on the basis of clinical features and because we could not amplify DNA sequences using PCR primers specific for Paragonimus species. We discuss current diagnostic challenges for this rare parasitic infection.

  13. Lump-type solutions to nonlinear differential equations derived from generalized bilinear equations

    NASA Astrophysics Data System (ADS)

    Ma, Wen-Xiu; Zhou, Yuan; Dougherty, Rachael

    2016-08-01

    Lump-type solutions, rationally localized in many directions in the space, are analyzed for nonlinear differential equations derived from generalized bilinear differential equations. By symbolic computations with Maple, positive quadratic and quartic polynomial solutions to two classes of generalized bilinear differential equations on f are computed, and thus, lump-type solutions are presented to the corresponding nonlinear differential equations on u, generated from taking a transformation of dependent variables u = 2(ln f)x.

  14. Risk factors for early recurrence after inguinal hernia repair

    PubMed Central

    2009-01-01

    Background Family history, male gender and age are significant risk factors for inguinal hernia disease. Family history provides evidence for a genetic trait and could explain early recurrence after inguinal hernia repair despite technical advance at least in a subgroup of patients. This study evaluates if age and family history can be identified as risk factors for early recurrence after primary hernia repair. Methods We performed an observational cohort study for 75 patients having at least two recurrent hernias. The impact of age, gender and family history on the onset of primary hernias, age at first recurrence and recurrence rates was investigated. Results 44% (33/75) of recurrent hernia patients had a family history and primary as well as recurrent hernias occurred significantly earlier in this group (p = 0.04). The older the patients were at onset the earlier they got a recurrent hernia. Smoking could be identified as on additional risk factor for early onset of hernia disease but not for hernia recurrence. Conclusion Our data reveal an increased incidence of family history for recurrent hernia patients when compared with primary hernia patients. Patients with a family history have their primary hernias as well as their recurrence at younger age then patients without a family history. Though recurrent hernia has to be regarded as a disease caused by multiple factors, a family history may be considered as a criterion to identify the risk for recurrence before the primary operation. PMID:20003183

  15. On the interaction of gravity-capillary lumps in deep water

    NASA Astrophysics Data System (ADS)

    Masnadi, Naeem; Duncan, James

    2016-11-01

    The nonlinear response of a water surface to a pressure source moving at a speed just below the minimum phase speed of linear gravity-capillary waves in deep water (cmin = 23 . 1 cm/s) consists of periodic generation of pairs of three-dimensional solitary waves (lumps) in a V-shaped pattern downstream of the source. In the reference frame of the laboratory, these unsteady lumps propagate in a direction oblique to the motion of the source and are damped by viscosity. In the current study, the interaction of lumps generated by two equal strength pressure sources moving side by side in parallel straight lines is investigated experimentally via photography-based techniques. The first lump generated by each source, collides with the lump from the other source in the center-plane of the two sources. It is observed that a steep depression is formed during the collision. Soon after the collision, this depression radiates energy in the form of small-amplitude radial waves. After the radiation, a quasi-stable pattern is formed with several rows of localized depressions that are qualitatively similar to lumps but exhibit periodic oscillations in depth, similar to a "breather". The shape of the wave pattern and the period of oscillations depend strongly on the distance between the soures.

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

    SciTech Connect

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

    2013-07-01

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

  17. [Benign pleural pathology of asbestos].

    PubMed

    Chailleux, E; Rembeaux, A; de Lajartre, A Y; Delumeau, J

    1988-01-01

    The most frequent benign lesions of the pleura created by asbestos are fibro-hyaline plaques, i.e. thick areas of collagen located on the parietal pleura and gradually becoming calcified. Less common is benign pleural effusion the cause of which is not always easy to determine. To these must be added an extensive pleural fibrosis with functional repercussions that are not negligible, and round pseudotumoral atelectasias. These pleural asbestos-induced lesions are often observed after a low intensity exposure, but they appear as a rule after more than 20 years of latency. While they betray a previous exposure to asbestos, they also raise the problem of possible asbestos-induced lung cancer and mesothelioma.

  18. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Patient reported outcomes in benign multiple sclerosis.

    PubMed

    Hviid, Line E; Healy, Brian C; Rintell, David J; Chitnis, Tanuja; Weiner, Howard L; Glanz, Bonnie I

    2011-07-01

    Benign MS patients have a mild course of disease and show no or minimal accumulation of disability over time. Little is known about the patient reported outcomes (PROs) in benign MS. The objective of the study was to compare PROs in benign MS patients and patients with similar disease duration or disability status, and to investigate how the definition of benign MS affected this outcome. Two groups of Benign MS patients (disease duration ≥15 years, Expanded Disability Status Scale [EDSS] score ≤1.5 [Benign-1.5], or ≤3.0 [Benign-3]) were compared with four other MS groups: disease duration ≥15 years, EDSS score >3.0 (Late-MS); disease duration <15 years, and EDSS score ≤1.5 (Low-EDSS-1.5), or ≤3.0 (Low-EDSS-3); disease duration ≤5 years (Early-MS). PROs included measures of QOL, fatigue, depression, and social support. Cognitive function was also assessed. Both benign groups had better PROs than Late MS patients on all measures (p < 0.05). QOL, depression, and fatigue were significantly different between Benign-1.5 and Early-MS groups (p < 0.01). Benign-1.5 had higher mental health QOL than Low EDSS-1.5, but was otherwise similar. Benign-3 patients had worse depression than Early-MS (p < 0.01), and worse cognition compared with Low-EDSS-3 (p = 0.033). Benign-1.5 had higher QOL and lower fatigue (p < 0.005) than Benign-2-3, and showed a marginally significant difference in cognitive functioning (p = 0.055). Patients with benign MS had better PROs than other groups of MS patients, suggesting that both disease duration and disability influence PROs. The study also showed a difference in PROs based on the way benign MS was defined.

  20. Lumping and splitting: the health policy agenda in India.

    PubMed

    Peters, David H; Rao, K Sujatha; Fryatt, Robert

    2003-09-01

    India's health system was designed in a different era, when expectations of the public and private sectors were quite different. India's population is also undergoing transitions in the demographic, epidemiologic and social aspects of health. Disparities in life expectancy, disease, access to health care and protection from financial risks have increased. These factors are challenging the health system to respond in new ways. The old approach to national health policies and programmes is increasingly inappropriate. By analyzing inter- and intra-state differences in contexts and processes, we argue that the content of national health policy needs to be more diverse and accommodating to specific states and districts. More 'splitting' of India's health policy at the state level would better address their health problems, and would open the way to innovation and local accountability. States further along the health transition would be able to develop policies to deal with the emerging epidemic of non-communicable diseases and more appropriate health financing systems. States early in the transition would need to focus on improving the quality and access of essential public health services, and empowering communities to take more ownership. Better 'lumping' of policy issues at the central level is also needed, but not in ways that have been done in the past. The central government needs to focus on overcoming the large inequalities in health outcomes across India, tackle growing challenges to health such as the HIV epidemic, and provide the much needed leadership on systemic issues such as the development of systems for quality assurance and regulation of the private sector. It also needs to support and facilitate states and districts to develop critical capacities rather than directly manage programmes. As India develops a more diverse set of state health policies, there will be more opportunities to learn what works in different policy environments.

  1. A Nonlinear Lumped Model for Ultrasound Systems Using CMUT Arrays

    PubMed Central

    Satir, Sarp; Degertekin, F. Levent

    2015-01-01

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

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

    PubMed

    Satir, Sarp; Degertekin, F Levent

    2015-10-01

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

  3. A 10-year experience of totally extraperitoneal endoscopic repair for adult inguinal hernia.

    PubMed

    Toma, Hiroki; Eguchi, Toru; Toyoda, Shuichi; Okabe, Yasuhiro; Kobarai, Tomonari; Naritomi, Gen; Ogawa, Takahiro; Hirota, Ichio

    2015-11-01

    Laparoscopic surgery is fast becoming the treatment of choice for inguinal hernia. By reviewing our 10-year experience of performing totally extraperitoneal repair (TEP), we sought to establish its clinical significance in the treatment of adult inguinal hernia. We reviewed retrospectively the clinical records of patients who underwent TEP for adult inguinal hernia between January 2003 and December 2012. None of the 303 patients with adult primary or recurrent inguinal hernia in our study needed TEP converted to other procedures or suffered serious complications during the procedure. A significant difference was noted in the operation time between direct (n = 32) vs indirect (n = 128) hernias in the primary unilateral inguinal hernia group (91 ± 27 vs 80 ± 32 min, p = 0.033) and between direct/direct (n = 31) vs indirect/indirect (n = 24) hernias (136 ± 58 vs 89 ± 24 min, p = 0.01) in the primary bilateral inguinal hernia group. The only postoperative complications recorded were four cases of hernia recurrence (1.3 %) and one case of chronic pain (0.3 %). The results obtained for TEP over 10 years support this as a promising procedure for the treatment of adult inguinal hernia.

  4. Preliminary experience with laparoscopic repair of associated inguinal and umbilical hernias in children.

    PubMed

    Bertozzi, M; Magrini, E; Appignani, A

    2015-08-01

    The authors report their preliminary experience in laparoscopic repair of associated inguinal and umbilical hernias in children. Twenty-six patients affected by the association of inguinal and umbilical hernia with an umbilical defect larger than 5 mm underwent a laparoscopic procedure. A 5-mm trocar was placed through the umbilical defect for the optic. To fix the trocar to avoid loss of carboperitoneum, we fashioned and tightened a purse-string non-absorbable suture with a sliding knot around the defect. In this manner, we ensured the trocar, fixing it and avoiding any loss of CO2, proceeding safely to the laparoscopic IH repair, by means of two additional 3 mm operative trocars. At the end of the inguinal herniorrhaphy, the previously fashioned purse-string suture was tightened to repair the umbilical defect. The mean operative time for the repair of associated inguinal and umbilical hernias was 30.1 ± 7.4 min in cases of unilateral inguinal hernia and 39.5 ± 10.6 for bilateral inguinal hernia. Follow-up ranged from 8 to 32 months. Neither intra- nor post-operative complications nor recurrences were seen. This small sample suggests that this simple method is safe, effective and might be useful for pediatric surgeons performing laparoscopic repair for inguinal hernia in presence of an associated UH with a statistically significant decrease of operative time.

  5. Inguinal canal development: the muscular wall and the role of the gubernaculum.

    PubMed

    Biasutto, Susana N; Repetto, Emanuel; Aliendo, Mirta M; Borghino, Valeria N

    2009-07-01

    The inguinal canal is an anatomically complex region. Although much has been written about the gubernaculum and the descent of the testis, little is known about the development of the abdominal wall itself. We dissected this inguinal canal in 75 fetuses between 10 and 25 weeks of gestation, 42 males and 33 females. We identified the anterior body-wall muscular layers, located the gonads and uterus, and observed the formation of the scrotum. The gubernaculum was dissected, from the deep to the superficial ends and its distal attachments were determined. We proved that the muscular-fibrous layers of the wall were well-differentiated and observed how the inguinal canal enlarged with embryological development. In only one of the cases, an abnormal testis was found located in the scrotum. The upper end of the gubernaculum inserted into the inferior pole of the testis or the lateral angle of the uterus, according to gender. The lower end was attached by one or multiple tails, mainly on the pubic bone. This fact explained the clinical findings of ectopic testis. Observations of the abdominal wall and its relationship with the gubernaculum assisted us in explaining the development of the inguinal region, the formation of the inguinal canal, and the presence of the gubernaculum, in both genders. We intend to explain how the deep inguinal ring moves upwards, bringing the gubernaculum along with it, and thus determines the final form of the inguinal canal. Copyright 2009 Wiley-Liss, Inc.

  6. Assessment of Abdominal Muscle's Maximal Force of Contraction Using Surface EMG in Inguinal Hernia Patients

    PubMed Central

    Sreenath, G. S.; Subramanian, Senthil Kumar

    2016-01-01

    Introduction Reduction in abdominal muscle’s strength has been implicated in the development of inguinal hernia. Patients with inguinal hernia on one side are shown to be at higher risk of developing inguinal hernia on the other side. Aim To assess the abdominal muscle strength in inguinal hernia subjects using surface Electromyography (EMG) and compare it with healthy controls. Materials and Methods This is a cross-sectional study involving only male subjects. Abdominal (Inguinal) hernia subjects without any known complications were recruited from surgery department and the accompanying healthy individuals were taken as control (Control, n=44, inguinal hernia subjects, n=43). The subjects were asked to perform maximal contraction for three seconds targeting external and internal oblique muscles of right and left sides separately. Motor unit potentials were recorded using surface EMG for individual muscles on both sides during maximal contraction. The maximum amplitude of the motor unit potentials obtained was considered as the strength of the respective muscle. Results In control group, there was no significant difference in strength of external and internal oblique muscles between the two sides. Strength of external and internal oblique muscles of both herniated and unaffected side was reduced in inguinal hernia subjects as compared to healthy controls. Further, the muscle strength of herniated side was less as compared to unaffected side in the inguinal hernia subjects. Conclusion Abdominal muscle strength is reduced in hernia subjects and even the apparently normal side strength is less as compared to controls. This should be considered while performing corrective surgeries in inguinal hernia subjects. PMID:28208924

  7. Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case.

    PubMed

    Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-02-01

    Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs.

  8. The Case of Huge Pure Lipoma of the Spermatic Cord Misdiagnosed as Inguinal Hernia.

    PubMed

    Jo, Dong In; Choi, Sang Kyu; Kim, Soon Heum; Kim, Cheol Keun; Chung, Hong; Kim, Hong Sup

    2017-07-01

    Clinically, pure spermatic-cord lipoma has not been recognized as a disease entity but regarded as an incidental finding at the time of hernia repair, because it presents groin symptoms and clinical findings indistinguishable from those of inguinal hernia. We report the successful treatment of case of huge pure spermatic-cord lipoma originally misdiagnosed as inguinal hernia. The patients had tumor excision without orchiectomy. Symptoms improved without any complication. In patients with inguinal hernia symptoms, pure spermatic-cord lipoma should be recognized as a significant clinical entity, and differential diagnosis should be achieved using ultrasonography and computed tomography to avoid unnecessary hernia repair.

  9. Bilateral round ligament varicosities mimicking an inguinal hernia in pregnancy: case report.

    PubMed

    Kahriman, Guven; Donmez, Halil; Mavili, Ertugrul; Ozcan, Nevzat

    2010-01-01

    A 22-year-old pregnant woman presented with a painful swelling in the right groin. Sonography was performed to confirm a presumptive diagnosis of inguinal hernia based on physical examination. Gray-scale sonography examination revealed bilateral inguinal cystic lesion expanding with the Valsalva maneuver. Color Doppler imaging demonstrated multiple prominent vessels with retrograde venous flow during Valsalva maneuver. Bilateral round ligament varicosities were diagnosed and inguinal hernia was excluded by sonographic findings. Round ligament varicosities should be considered in the differential diagnosis of groin swelling during pregnancy.

  10. Irreducible inguinal hernia due to crossed testicular ectopia in an infant.

    PubMed

    Vaos, G; Zavras, N

    2004-12-01

    The usual presentation of crossed testicular ectopia (CTE) is that of inguinal hernia with contralateral absent testis. We report on a 10-month-old infant with CTE, which presented as irreducible inguinal hernia. Diagnosis was made during surgery, as the child underwent an emergency operation for repair of his irreducible right inguinal hernia. A normal-sized and normal-shaped testis was found in the hernial sac with its blood vessels and vas deferens. A herniotomy with fixation of the ectopic gonad to the opposite hemiscrotum was done. The child remained asymptomatic 1 year postoperatively. Crossed testicular ectopia in infancy may present as irreducible hernia, requiring urgent surgery.

  11. The Inguinal Herniation of the Ovary in the Newborn: Ultrasound and Color Doppler Ultrasound Findings

    PubMed Central

    Kaya, Omer; Esen, Kaan; Gulek, Bozkurt; Yilmaz, Cengiz; Soker, Gokhan; Onem, Onder

    2014-01-01

    Inguinal hernias in the newborn age group are seldom encountered. In the affected female patient, the ovaries, fallopian tubes, and the intestines may settle in the hernia sac. The early diagnosis of torsion in cases in which the ovary is herniated into the inguinal canal is of utmost importance in order to give surgery the chance of reduction and correction. In this paper, a case of an ovarian herniation into the inguinal canal without the presence of torsion is being presented, and the place of US and CDUS in the differential diagnosis of the situation is being discussed. PMID:24795829

  12. Paralysis of the femoral nerve following totally extraperitoneal laparascopic inguinal hernia repair.

    PubMed

    Lange, B; Langer, C; Markus, P M; Becker, H

    2003-07-01

    Totally extraperitoneal preparation (TEP) of an inguinal hernia is an established method of treating inguinal hernias associated with an acceptable complication rate (2-12%) and low rate of recurrence (0-3%). This is the first reported case of sensorimotor paralysis of the femoral nerve following the complete endoscopic mesh treatment of a primary inguinal hernia to the left side. Following a discussion of the necessary diagnostic and therapeutic steps, traumatic postsurgical paralysis of the nerve as well as spontaneous paralysis of the femoral nerve are discussed. The prognosis is positive given the lack of macroscopic evidence of any direct damage to the nerve.

  13. [Inguinal hernia repair: classification and the choice of adequate anaesthesia techniques].

    PubMed

    Antadze, A A; Rtveliashvili, N Z

    2008-01-01

    In spite of the great achievements in herniology, the problem of inguinal hernia is not solved. The adequate classification is a step to its proper treaty. The classification of the disease is presented in the article. The study confirms the benefits of local anaesthetic-based techniques over both general and spinal anaesthesia for inguinal hernia repair and presents new methods of treatment. The direct and indirect costs of anaesthesia for inguinal hernia repair are lowest when using local anaesthesia with or without sedation. Local anaesthesia-based techniques with conscious sedation fulfil all the requirements for the ideal ambulatory anaesthetic.

  14. [A case report of eosinophilic funiculitis difficult to distinguish from incarceration of inguinal hernia].

    PubMed

    Araki, Azumi; Yanagisawa, Masahiro; Nagasima, Masazumi; Komiya, Atushi; Takano, Tetuzo; Ikeda, Ichiro

    2013-02-01

    A 45-year-old man visited our emergency room with left inguinal pain, mass and high-grade fever. Emergency surgery was performed with a primary diagnosis of left inguinal hernia. Although there was no hernia, there was a mass involving the spermatic cord in the left inguinal canal. We performed high orchiectomy because of the possibility of malignancy. Pathological findings showed eosinophilic infiltration in the mass lesion. An allergic inflammation was suspected to have occurred in the spermatic cord. His postoperative course was good.

  15. Exuberant cortical thymocyte proliferation mimicking T-lymphoblastic lymphoma within recurrent large inguinal lymph node masses of localized Castleman disease.

    PubMed

    Kansal, Rina; Nathwani, Bharat N; Yiakoumis, Xanthi; Moschogiannis, Maria; Sachanas, Sotirios; Stefanaki, Kalliopi; Pangalis, Gerassimos A

    2015-07-01

    We report a 13-year-old adolescent girl, the youngest thus far, with "an indolent T-lymphoblastic" proliferation (~10%) that uniquely presented within recurrent, large inguinal lymph node masses in a predominating (90%) background of Castleman disease. These nodal masses were resected thrice; the patient is well 5 years after diagnosis without further treatment. Histologically, the features of Castleman disease, hyaline vascular type, were present. Importantly, the interfollicular T-lymphoblastic component occurred as multiple clusters and islands of variable shapes and sizes composed of small "lymphoblasts" indistinguishable from normal cortical thymocytes but without thymic epithelial cells. Immunohistochemically, these lymphoblasts were consistent with the intermediate stage of T-cell differentiation (TdT(+)CD34(-)CD99(+)CD1a(+)CD2(+)CD3(+)CD4(+)CD8(+)CD5(+)CD7(+)CD10(+) [subset]), with 80% Ki-67. Molecularly, the T cells were nonclonal. Our case provides evidence for the benign nature of this highly unusual and poorly understood entity; because the current terminology can be readily misinterpreted as an indolent lymphoblastic lymphoma, we suggest a new term accurately reflecting this entity. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Rare benign tumours of the nipple.

    PubMed

    Spyropoulou, G A; Pavlidis, L; Trakatelli, M; Athanasiou, E; Pazarli, E; Sotiriadis, D; Demiri, E

    2015-01-01

    Benign lesions of the breast in total are much more frequent than malignant ones. However, there are no epidemiologic data on the prevalence of benign or malignant tumours of the nipple, and the bibliography on benign nipple tumours in general is limited. To present some rare cases of benign nipple tumours and review the literature. Four cases of rare benign nipple tumours: neurofibromas, wart, leiomyoma and milium are presented. The literature search on benign nipple tumours was performed using MEDLINE, Pubmed, and Cochrane databases with limits: English language, human species and available abstract. The keyword used was 'benign nipple tumours'. The initial search retrieved 337 articles. The papers were reviewed and the articles that referred to benign lesions that appeared at the nipple specifically were identified. Different entities that were described included: neurofibroma, leiomyoma, milium, florid papillomatosis, syringomatous adenoma, nevoid hyperkeratosis, fibroma, pseudolymphoma and haemangioma. Differential diagnosis of benign tumours of the nipple can be demanding for the physicians. Many of the symptoms and signs like pruritus, serosanguinous discharge, lichenification, erosion and nodular enlargement are produced by either malignant or benign nipple lesions. Radiology can be unclear in the diagnosis of nipple abnormalities. Histological examination of the lesion can be the only definite answer in these cases. © 2014 European Academy of Dermatology and Venereology.

  17. [Inguinal hernia in Africa and laparoscopy: utopia or realism?].

    PubMed

    Pallas, G; Simon, F; Sockeel, P; Chapuis, O; Jancovici, R

    2000-01-01

    Inguinal hernia is a common indication for surgery in Africa. Most cases involve men and are treated in advanced stages often with complications. Until now the benchmark technique for surgical management has been the well-defined herniorrhaphy technique. Use of prosthetic implants has been rare because of high cost. Recently there has been a growing interest in video-assisted surgery throughout developing countries. However this enthusiasm should not obscure the fact that the technique is still in the developing stage and thus is more costly for the local economy. Indications for video-assisted surgery should be carefully selected in function of local conditions as well as problems specific to developing countries.

  18. Transitioning to Single-Incision Laparoscopic Inguinal Herniorrhaphy

    PubMed Central

    2010-01-01

    Background: Laparoendoscopic single-site surgery (LESS) offers cosmetic benefits and may represent further progress towards reducing the invasiveness of surgical interventions. We report our initial experience with LESS totally extraperitoneal (TEP) inguinal herniorrhaphy. Materials and Methods: Beginning March 2009, we transitioned from a multiport laparoscopic TEP (MLH) technique to a single-incision TEP (SITE) technique. The first 52 consecutive patients who underwent SITE at our institution were compared with the preceding 52 MLH repairs. Results: Of the first 52 patients undergoing SITE, there were no conversions to either open or multiport surgery. The mean operative time for the SITE cases did not differ significantly from that of MLH. Complications were equivalent between the 2 groups and included postoperative seroma and urinary retention. Conclusions: Transitioning from MLH to SITE was readily accomplished without significantly altering operative time or morbidity. PMID:21333187

  19. Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia

    PubMed Central

    Hollinsky, Christian

    2015-01-01

    Background and Objectives: In recent years, 2 modifications of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair—needlescopic (nTAPP) surgery and single-port (sTAPP) surgery—have greatly improved patient outcomes over traditional approaches. For a comparison of these 2 modifications, we sought to investigate and compare the extent of surgical trauma and postoperative consequences for the abdominal wall in these two procedures. Methods: In a retrospective study, 50 nTAPP and 35 sTAPP procedures occurring at a community hospital from November 1, 2009, through July 31, 2012 were reviewed. Intraoperative data, including length of the umbilical skin incision and operative time, were recorded. A follow-up evaluation included investigation of hernia recurrence, postoperative pain, abdominal wall mobility, cosmetic satisfaction, and period of sick leave. Results: The mean umbilical skin incision was 13 ± 4 mm in nTAPP vs 27 ± 3 mm in sTAPP (P < .001). The nTAPP procedure required less operating time than the sTAPP procedure (54.8 ± 16.9 minutes vs 85.9 ± 19.7 minutes; P < .001). The mean immediate postoperative pain score on the visual analog scale was 2.7 ± 2.1 in the nTAPP group and 4.4 ± 1.9 in the sTAPP group (P = .016). In addition, patients who underwent nTAPP had a shorter period of sick leave (11.2 ± 8.4 days vs 24.1 ± 20.1 days; P = .02). At the follow-up evaluation after approximately 30 months, abdominal wall mobility and cosmetic satisfaction were equally positive, with no hernia recurrence. Conclusion: In patients with uncomplicated inguinal hernia, the nTAPP procedure, with less surgical trauma and operating time, has distinct advantages in reduction of immediate postoperative pain and sick leave time. PMID:26229421

  20. Surgical approach for recurrent inguinal hernias: a Nationwide Cohort Study.

    PubMed

    Öberg, S; Andresen, K; Rosenberg, J

    2016-12-01

    Guidelines recommend that the reoperation of a recurrent inguinal hernia should be by the opposite approach (anterior-posterior) than the primary repair. However, the level of evidence supporting the guidelines is partially low. The purpose of this study was to compare re-reoperation rates between repairs performed according to the guidelines with the ones performed against it. This cohort study was based on the Danish Hernia Database, including 4344 patients with two inguinal hernia repairs in the same groin. Four groups were compared as follows: Lichtenstein-Lichtenstein vs. Lichtenstein-Laparoscopy, and Laparoscopy-Laparoscopy vs. Laparoscopy-Lichtenstein. The outcome was re-reoperation rates, which were compared by crude rates, cumulated rates, and hazard ratios. There was no difference in the re-reoperation rates when the primary repair was laparoscopic, regardless of the type of reoperation. However, Lichtenstein-Lichtenstein had a significantly higher re-reoperation rate compared with Lichtenstein-Laparoscopy (crude rate 8.7 vs. 3.1 %, p value <0.0005; Hazard Ratio 2.46, 95 % CI 1.76-3.43). Further analysis showed that the higher risk of re-reoperation for Lichtenstein-Lichtenstein was only seen if the primary hernia was medial. A primary Lichtenstein repair of a primary medial hernia should be reoperated with a laparoscopic repair. A primary Lichtenstein repair of a primary lateral hernia can be reoperated with either a Lichtenstein or a laparoscopic repair according to surgeon's choice. For a primary laparoscopic operation, the method of repair of a recurrent hernia did not affect the re-reoperation rate.

  1. Quality of inguinal hernia operative reports: room for improvement

    PubMed Central

    Ma, Grace W.; Pooni, Amandeep; Forbes, Shawn S.; Eskicioglu, Cagla; Pearsall, Emily; Brenneman, Fred D.; McLeod, Robin S.

    2013-01-01

    Background Operative reports (ORs) serve as the official documentation of surgical procedures. They are essential for optimal patient care, physician accountability and billing, and direction for clinical research and auditing. Nonstandardized narrative reports are often of poor quality and lacking in detail. We sought to audit the completeness of narrative inguinal hernia ORs. Methods A standardized checklist for inguinal hernia repair (IHR) comprising 33 variables was developed by consensus of 4 surgeons. Five high-volume IHR surgeons categorized items as essential, preferable or nonessential. We audited ORs for open IHR at 6 academic hospitals. Results We audited 213 ORs, and we excluded 7 femoral hernia ORs. Tension-free repairs were the most common (82.5%), and the plug-and-patch technique was the most frequent (52.9%). Residents dictated 59% of ORs. Of 33 variables, 15 were considered essential and, on average, 10.8 ± 1.3 were included. Poorly reported elements included first occurrence versus recurrent repair (8.3%), small bowel viability in incarcerated hernias (10.7%) and occurrence of intraoperative complications (32.5%). Of 18 nonessential elements, deep vein thrombosis prophylaxis, preoperative antibiotics and urgency were reported in 1.9%, 11.7% and 24.3% of ORs, respectively. Repair-specific details were reported in 0 to 97.1% of ORs, including patch sutured to tubercle (55.1%) and location of plug (67.0%). Conclusion Completeness of IHR ORs varied with regards to essential and nonessential items but were generally incomplete, suggesting there is opportunity for improvement, including implementation of a standardized synoptic OR. PMID:24284146

  2. Multicystic mesothelioma of the liver with secondary involvement of peritoneum and inguinal region.

    PubMed

    Di Blasi, Arturo; Boscaino, Amedeo; De Dominicis, Gianfranco; Marsilia, Giuseppina Marino; D'Antonio, Antonio; Nappi, Oscar

    2004-01-01

    A case of multicystic mesothelioma of the liver with secondary involvement of the pelvic peritoneum and the inguinal region is presented. The case is of interest because of its unusual location and peculiar biological behavior.

  3. Concurrent nephrosplenic entrapment and acquired inguinal herniation of the jejunum in a Standardbred stallion

    PubMed Central

    Burns, Jennifer J.; MacMillan, Kathleen; Uehlinger, Fabienne D.; Riley, Christopher B.

    2011-01-01

    A stallion presenting for surgical correction of an acquired inguinal hernia was also diagnosed with a nephrosplenic entrapment (NSE) intraoperatively. Surgical intervention resulted in a successful outcome. To date, these conditions have not been reported to occur simultaneously. PMID:21629423

  4. Antibiotic prophylaxis in open inguinal hernia repair: a literature review and summary of current knowledge

    PubMed Central

    Makarewicz, Wojciech; Ropel, Jerzy; Bobowicz, Maciej; Kąkol, Michał; Śmietański, Maciej

    2016-01-01

    More than 1 million inguinal hernia repairs are performed in Europe and the US annually. Although antibiotic prophylaxis is not required in clean, elective procedures, the routine use of implants (90% of inguinal hernia repairs are performed with mesh) makes the topic controversial. The European Hernia Society does not recommend routine antibiotic prophylaxis for elective inguinal hernia repairs. However, the latest randomized controlled trial, published by Mazaki et al., indicates that the use of prophylaxis is effective for the prevention of surgical site infection. Unnecessary prophylaxis contributes to the development of bacterial resistance and significantly increases healthcare costs. This review documents clinical trials on inguinal hernia repairs with mesh and summarizes the current knowledge. It also tries to solve certain problems, namely: what constitutes a real risk factor, late-onset infection, and how the “surgical environment” impacts on the need to use antibiotic prophylaxis. PMID:27829934

  5. A Rare Case Report of Inguinal Hernia with Persistent Mullerian Duct and Klinefelter Syndrome.

    PubMed

    Dadheech, Darpan; Om, Prabha; Shridatt, Sharma Ankit; Patni, Ankur; Verma, Naveen

    2016-06-01

    Inguinal hernia in male is a common problem but having female reproductive organs in hernial sac is rare. It occur because of failure of mullerian duct to regress in a male fetus during embryonic development, result in a syndrome known as Persistent Mullerian Duct Syndrome (PMDS), which is a rare entity of male pseudohermaphroditism. We hereby present a case of 21-year-old male patient reported with complains of cryptorchidism and inguinal hernia. Generally diagnosis of PMDS was established during investigation like ultrasonography, MRI for localization of undescended testis and during surgical exploration for inguinal hernia or cryptorchidism. Our patient was operated by bilateral inguinal incision; hernial sac contained adult size uterus fallopian tube and upper 2/3(rd) of vagina. On karyotyping it was found that he was a case of klinefelter syndrome also. Association of PMDS with klinefelter syndrome is very rare.

  6. A Rare Case Report of Inguinal Hernia with Persistent Mullerian Duct and Klinefelter Syndrome

    PubMed Central

    Om, Prabha; Shridatt, Sharma Ankit; Patni, Ankur; Verma, Naveen

    2016-01-01

    Inguinal hernia in male is a common problem but having female reproductive organs in hernial sac is rare. It occur because of failure of mullerian duct to regress in a male fetus during embryonic development, result in a syndrome known as Persistent Mullerian Duct Syndrome (PMDS), which is a rare entity of male pseudohermaphroditism. We hereby present a case of 21-year-old male patient reported with complains of cryptorchidism and inguinal hernia. Generally diagnosis of PMDS was established during investigation like ultrasonography, MRI for localization of undescended testis and during surgical exploration for inguinal hernia or cryptorchidism. Our patient was operated by bilateral inguinal incision; hernial sac contained adult size uterus fallopian tube and upper 2/3rd of vagina. On karyotyping it was found that he was a case of klinefelter syndrome also. Association of PMDS with klinefelter syndrome is very rare. PMID:27504355

  7. Depilatory laser: a potential causative factor for inguinal hyperhidrosis: report of three cases.

    PubMed

    Obeid, Grace; Helou, Josiane; Maatouk, Ismael; Moutran, Roy; Tomb, Roland

    2013-10-01

    Hyperhidrosis has recently been described as a novel adverse effect of laser-assisted hair removal in the axillary area. Inguinal Hyperhidrosis (IH) is a localized and, typically, a primary form of hyperhidrosis affecting the groin area in individuals before age 25. IH has been reported in the literature after traumas and as a dysfunction of the central sympathetic nervous system. To the best of our knowledge, IH has never been reported as secondary to laser-assisted hair removal. Herein, we report three cases of IH following depilatory laser of the inguinal zone. Three female patients with no relevant medical history presented with the complaint of excessive sweating in the inguinal area after undergoing full bikini depilatory laser sessions. Although never described before, depilatory laser seems to trigger the occurrence of hyperhidrosis in the inguinal zone.

  8. Unusual findings in inguinal hernia surgery: Report of 6 rare cases

    PubMed Central

    Ballas, K; Kontoulis, Th; Skouras, Ch; Triantafyllou, A; Symeonidis, N; Pavlidis, Th; Marakis, G; Sakadamis, A

    2009-01-01

    Background and aim: To present our experience with unexpected findings during hernia surgery, either unusual hernial contents or pathologic entities, like neoplastic masses, masquerading as a hernia. Patients and methods: We studied retrospectively 856 patients with inguinal hernia who were admitted to our surgical department over a 9-year period. In addition, our study included patients complaining of inguinal protrusion, even without a definitive diagnosis of inguinal hernia upon admission. Results: Five patients presented with unusual hernial contents. Three of them had a vermiform appendix in their sac. Acute appendicitis (Amyands hernia) was found in only one case. One patient had epiploic appendagitis related with a groin hernia. Moreover, an adult woman was diagnosed with ovarian and tubal inguinal hernia. Finally, we report a case of a massive extratesticular intrascrotal lipoma, initially misdiagnosed as a scrotal hernia. Conclusion: a hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment. PMID:19918306

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

    PubMed

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

    2016-03-15

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

  10. Exact epidemic models on graphs using graph-automorphism driven lumping.

    PubMed

    Simon, Péter L; Taylor, Michael; Kiss, Istvan Z

    2011-04-01

    The dynamics of disease transmission strongly depends on the properties of the population contact network. Pair-approximation models and individual-based network simulation have been used extensively to model contact networks with non-trivial properties. In this paper, using a continuous time Markov chain, we start from the exact formulation of a simple epidemic model on an arbitrary contact network and rigorously derive and prove some known results that were previously mainly justified based on some biological hypotheses. The main result of the paper is the illustration of the link between graph automorphisms and the process of lumping whereby the number of equations in a system of linear differential equations can be significantly reduced. The main advantage of lumping is that the simplified lumped system is not an approximation of the original system but rather an exact version of this. For a special class of graphs, we show how the lumped system can be obtained by using graph automorphisms. Finally, we discuss the advantages and possible applications of exact epidemic models and lumping.

  11. Ultrathin lightweight plate-type acoustic metamaterials with positive lumped coupling resonant

    NASA Astrophysics Data System (ADS)

    Ma, Fuyin; Huang, Meng; Wu, Jiu Hui

    2017-01-01

    The experimental realization and theoretical understanding of a two-dimensional multiple cells lumped ultrathin lightweight plate-type acoustic metamaterials structures have been presented, wherein broadband excellent sound attenuation ability at low frequencies is realized by employing a lumped element coupling resonant effect. The basic unit cell of the metamaterials consists of an ultrathin stiff nylon plate clamped by two elastic ethylene-vinyl acetate copolymer or acrylonitrile butadiene styrene frames. The strong sound attenuation (up to nearly 99%) at low frequencies is experimentally revealed by the precisely designed metamaterials, for which the physical mechanism of the sound attenuation could be explicitly understood using the finite element simulations. As to the designed samples, the lumped effect from the frame compliance leads to a coupling flexural resonance at designable low frequencies. As a result, the whole composite structure become strongly anti-resonant with the incident sound waves, followed by a higher sound attenuation, i.e., the lumped resonant effect has been effectively reversed to be positive from negative for sound attenuation, and the acoustic metamaterial design could be extended to the lumped element containing multiple cells, rather than confined to a single cell.

  12. Lump Solutions and Interaction Phenomenon for (2+1)-Dimensional Sawada-Kotera Equation

    NASA Astrophysics Data System (ADS)

    Huang, Li-Li; Chen, Yong

    2017-05-01

    In this paper, a class of lump solutions to the (2+1)-dimensional Sawada-Kotera equation is studied by searching for positive quadratic function solutions to the associated bilinear equation. To guarantee rational localization and analyticity of the lumps, some sufficient and necessary conditions are presented on the parameters involved in the solutions. Then, a completely non-elastic interaction between a lump and a stripe of the (2+1)-dimensional Sawada-Kotera equation is obtained, which shows a lump solution is drowned or swallowed by a stripe soliton. Finally, 2-dimensional curves, 3-dimensional plots and density plots with particular choices of the involved parameters are presented to show the dynamic characteristics of the obtained lump and interaction solutions. Supported by the Global Change Research Program of China under Grant No. 2015CB953904, National Natural Science Foundation of China under Grant Nos. 11675054 and 11435005, Outstanding Doctoral Dissertation Cultivation Plan of Action under Grant No. YB2016039, and Shanghai Collaborative Innovation Center of Trustworthy Software for Internet of Things under Grant No. ZF1213

  13. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia.

    PubMed

    Mahadevappa, Basant; Suresh, Sumanth Channapatna; Natarajan, K; Thomas, Joseph

    2009-01-01

    Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera. Case reports and series have been published with various organs and rare organs being part of the hernia. Urinary bladder is a known content of sliding hernias. This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.

  14. An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania.

    PubMed

    Beard, J H; Oresanya, L B; Akoko, L; Mwanga, A; Dicker, R A; Harris, H W

    2014-04-01

    Surgical conditions represent a significant source of global disease burden. Little is known about the epidemiology of inguinal hernia in resource-poor settings. We present a method to estimate inguinal hernia disease burden in Tanzania. Using data from the United States National Health and Nutrition Examination Survey (NHANES) prospective cohort study and Tanzanian demographic figures, we calculated inguinal hernia incidence and prevalence in Tanzanian adults under three surgical rate scenarios. Gender-specific incidence figures from NHANES data were adjusted according to Tanzanian population age structure. Hernia duration was adjusted for Tanzanian life expectancy within each age group. The prevalence of inguinal hernia in Tanzanian adults is 5.36% while an estimated 12.09% of men had hernias. Today, 683,904 adults suffer from symptomatic inguinal hernia in Tanzania. The annual incidence of symptomatic hernias in Tanzanian adults is 163 per 100,000 population. At Tanzania's current hernia repair rate, a backlog of 995,874 hernias in need of repair will develop over 10 years. 4.4 million disability-adjusted life-years would be averted with repair of prevalent symptomatic hernias in Tanzania. Our data indicate the extent of inguinal hernia disease burden in Tanzania. By adjusting our figures for the age structure of Tanzania, we have demonstrated that while the incidence of symptomatic cases may be lower than previously thought, prevalence of inguinal hernia in Tanzania remains high. This approach provides an update to our previously described methodology for calculation of inguinal hernia epidemiology in resource-poor settings that may be used in multiple country contexts.

  15. Management of a large abdominal aortic aneurysm in conjunction with a massive inguinal hernia.

    PubMed

    Wartman, Sarah M; Woo, Karen; Brewer, Michael; Weaver, Fred A

    2017-04-04

    The majority of inguinal hernias that are concomitant with abdominal aortic aneurysms (AAA) are clinically insignificant. However, management of AAA associated with a complex hernia can be challenging. We report a case of a 72-year-old male with a 7 cm AAA and a massive inguinal hernia involving loss of abdominal domain. Using a multidisciplinary approach, a staged hybrid endovascular and open repair of the AAA was performed followed by hernia repair.

  16. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair Using 3-dimensional Mesh Without Mesh Fixation.

    PubMed

    Aliyazicioglu, Tolga; Yalti, Tunc; Kabaoglu, Burcak

    2017-08-01

    Approximately one fifth of patients suffer from inguinal pain after laparoscopic total extraperitoneal (TEP) inguinal hernia repair. There is existing literature suggesting that the staples used to fix the mesh can cause postoperative inguinal pain. In this study, we describe our experience with laparoscopic TEP inguinal hernia surgery using 3-dimensional mesh without mesh fixation, in our institution. A total of 300 patients who had undergone laparoscopic TEP inguinal hernia repair with 3-dimensional mesh in VKV American Hospital, Istanbul from November 2006 to November 2015 were studied retrospectively. Using the hospital's electronic archive, we studied patients' selected parameters, which are demographic features (age, sex), body mass index, hernia locations and types, duration of operations, preoperative and postoperative complications, duration of hospital stays, cost of surgery, need for analgesics, time elapsed until returning to daily activities and work. A total of 300 patients underwent laparoscopic TEP hernia repair of 437 inguinal hernias from November 2006 to November 2015. Of the 185 patients, 140 were symptomatic. Mean duration of follow-up was 48 months (range, 6 to 104 mo). The mean duration of surgery was 55 minutes for bilateral hernia repair, and 38 minutes for unilateral hernia repair. The mean duration of hospital stay was 0.9 day. There was no conversion to open surgery. In none of the cases the mesh was fixated with either staples or fibrin glue. Six patients (2%) developed seroma that were treated conservatively. One patient had inguinal hernia recurrence. One patient had preperitoneal hematoma. One patient operated due to indirect right-sided hernia developed right-sided hydrocele. One patient had wound dehiscence at the umbilical port entry site. Chronic pain developed postoperatively in 1 patient. Ileus developed in 1 patient. Laparoscopic TEP inguinal repair with 3-dimensional mesh without mesh fixation can be performed as safe as

  17. [Benign myoclonic epilepsy in infancy].

    PubMed

    Mukhin, K Iu; Petrukhin, A S; Pylaeva, O A; Iukhalina, N S; Glukhova, L Iu; Abramova, M F

    1999-01-01

    Benign myoclonic epilepsy in infancy (NMEI) is one of rare epileptic syndromes. 5 patients (all female sex) aged 4-16 years were observed. NMEI debuted at the age from 7 months till 2.5 years (mean age 1.3 years). Pathology of pregnancy and labor, disorders in both psychomotor development and genetic predisposition were not found. In all the cases the disease began with typical transitory repeated myoclonic paroxysms of different intensity and frequency, without loss of consciousness and with primary involvement of the muscles of the neck and the upper extremities. Most patients had muscular hypotension, mild coordinatory disorders, delayed psycho-speech development, mental retardation, EEG signs of generalized epileptic activity. Valproates, suxilep, clonazepam and lamotrigin (lamiktal) were used for treatment. The most pronounced effect was achieved using either monotherapy with valproates (depakin) or a combination depakin + lamiktal. A stable clinical-encephalographic remission was achieved in all the patients, but during puberty in 2 patients (15 and 16 years old) rare generalized convulsive fits debuted. High frequency of intellectual-mnestic disorders were found even after a complete remission. So benign definition concerns only a course of the fits, but not NMEI prognosis.

  18. Benign External Hydrocephalus in Infants

    PubMed Central

    Adele Marino, Maria; Morabito, Rosa; Vinci, Sergio; Germanò, Antonino; Briguglio, Marilena; Alafaci, Concetta; Mormina, Enricomaria; Longo, Marcello; Granata, Francesca

    2014-01-01

    Summary External hydrocephalus (EH) is a benign clinical entity in which macrocephaly is associated with an increase in volume of the subarachnoid space, especially overlying both frontal lobes, and a normal or only slight increase in volume of the lateral ventricles. Several pathogenic hypotheses have been proposed but the most accredited theory seems to be delayed maturation of the arachnoid villi. There is a consensus that this is a benign entity, correlated to a familial predisposition and, in some cases, inheritance. CT and MRI are very important to make a diagnosis but also to establish the prognosis in patients who encounter the rare complications such as subdural haematomas. In conclusion, CT and MRI can provide a highly accurate diagnosis in these patients, allowing a preliminary assessment of the prognosis, particularly regarding the enlarged subarachnoid space limits and the “cortical vein" sign which can predict a further complication. These results are obtained with the same examination performed in a standard CT or MRI study of the brain and no injection of contrast medium is needed. PMID:24750715

  19. Benign paroxysmal vertigo of childhood.

    PubMed

    Drigo, P; Carli, G; Laverda, A M

    2001-03-01

    Benign paroxysmal vertigo of childhood (BPV) is a paroxysmal, non-epileptic, recurrent event characterized by subjective or objective vertigo that occurs in neurologically intact children. We recorded the history and the clinical aspects of 19 cases presenting with neurological problems to the outpatient clinic at the Pediatrics Department of Padova University between 1987 and 1998 and re-examined in 1999. Details were collected on the characteristics of their vertigo: age at onset, mode of onset, trigger factors, duration, frequency and recurrence of episodes, duration of symptoms in time and age at disappearance. An attempt was also made to establish any family history of migraine and kinetosis and the most important data were compared, when possible, with those reported in the literature. Differential diagnosis and pathogenetic hypothesis were also reported. It is worth emphasizing that it is important for pediatricians to be aware of these benign events to ensure a correct diagnostic approach, avoiding the child and family any pointless anxiety or costly and sometimes invasive diagnostic procedures.

  20. [The significance of minimally invasive surgery in the treatment of inguinal hernia and hypertrophic pyloric stenosis].

    PubMed

    Muensterer, O J

    2014-12-01

    Inguinal hernia repair and pyloromyotomy are among the most common operations performed on children. In the last two decades minimally invasive surgery has been employed for an increasing number of these procedures. This review describes the development of the techniques involved, and their current role in therapy. A systematic review of the paediatric surgical literature since 1990 was performed on laparoscopic inguinal hernia repair and pyloromyotomy. Relevant publications were summarised. The first laparoscopic pyloromyotomy was described in 1991, the first laparoscopic inguinal hernia repair in children was published in 1998. The learning curve for both procedures is initially steep and reaches a plateau only after about 20 to 30 cases. Both randomised controlled trials and meta-analyses are available comparing the laparoscopic and open techniques for both procedures. The advantages of laparoscopic versus open pyloromyotomy include faster recovery and shorter hospital stay, at similar complication rates. The operation times of laparoscopic inguinal hernia repair are shorter in bilateral cases, while the complication rate again is similar. However, the incidence of metachronous contralateral inguinal hernia is lower after laparoscopic repair. Laparoscopic pyloromyotomy and paediatric inguinal hernia repair require special skills. As a minimum, a surgeon's first 20 cases should therefore be performed under competent supervision. Besides resulting in smaller scars, both procedures have concrete advantages and the same complication rates compared to the open techniques. Therefore, both operations can be regarded as the current gold standard. Georg Thieme Verlag KG Stuttgart · New York.

  1. Laparoscopic Repair of Inguinal Hernia Using Surgisis Mesh and Fibrin Sealant

    PubMed Central

    2006-01-01

    Objective: We tested the hypothesis that laparoscopic inguinal herniorrhaphy using Surgisis mesh secured with fibrin sealant is an effective long-term treatment for repair of inguinal hernia. This case series involved 38 adult patients with 51 inguinal hernias treated in a primary care center. Methods: Between December 2002 and May 2005, 38 patients with 45 primary and 6 recurrent inguinal hernias were treated with laparoscopic repair by the total extra-peritoneal mesh placement (TEP) technique using Surgisis mesh secured into place with fibrin sealant. Postoperative complications, incidence of pain, and recurrence were recorded, as evaluated at 2 weeks, 6 weeks, 1 year, and with a follow-up questionnaire and telephone interview conducted in May and June 2005. Results: The operations were successfully performed on all patients with no complications or revisions to an open procedure. Average follow-up was 13 months (range, 1 to 30). One hernia recurred (second recurrence of unilateral direct hernia), indicating a 2% recurrence rate. Conclusions: Laparoscopic repair of inguinal hernia using Surgisis mesh secured with fibrin sealant can be effectively used to treat primary, recurrent, direct, indirect, and bilateral inguinal hernias in adults without complications and minimal recurrence within 1-year of follow-up. PMID:17575758

  2. [Round ligament cyst simulating incarcerated inguinal hernia. Report of a case].

    PubMed

    Vargas-Ávila, Arcenio Luis; Gómez-Montoya, Luis Ernesto; Guidos-Gil, José César; Ávila-Rivera, José Luis; Huerta-García de León, Óscar; Medina-Tirado, Manuel Alejandro

    Round ligament cysts are rare lesions, often diagnosed as irreducible inguinal hernias. Most patients are in the third to fourth decade of life, but they can occur in younger patients. They are usually clinically asymptomatic or tend to produce subtle symptoms such as pain, discomfort, or a feeling of heaviness, and swelling. Cysts should not be resized with the Valsalva manoeuvre. Ultrasound is the diagnostic method of choice. The definitive diagnosis is made during surgery, and confirmed by pathological examination. To present a case of round ligament cyst, initially diagnosed as an incarcerated inguinal hernia, and a review of the literature. A 19 year-old female, who was admitted to the emergency department due to her current condition of 5 days of onset. She had an increased volume in right inguinal region that increased with physical exertion, throbbing pain, and nausea without vomiting. A right inguinal mass of approximately of 6cm in diameter was found, which was painful on mid-superficial palpation, reaching a pre-surgical diagnosis of incarcerated right inguinal hernia with an indication of surgical intervention. Round ligament cysts are a rare pathology, often confused with incarcerated inguinal hernias. Although ultrasound is the study of choice, the final diagnosis is usually made during surgery and confirmed by histopathology. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

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

    SciTech Connect

    Romanov, Vyacheslav; Soong, Yee

    2009-01-01

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

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

    SciTech Connect

    Romanov, V.N.; Soong, Yee

    2009-01-01

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

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

    SciTech Connect

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

    1994-12-31

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

  7. Imaging of lumps and bumps in pediatric patients: an algorithm for appropriate imaging and pictorial review.

    PubMed

    Morrow, Michael S; Oliveira, Amy M

    2014-08-01

    Superficial lumps and bumps are a common presenting complaint in the pediatric patient population. Although encountered frequently, the path to a definitive diagnosis is not always a straightforward one. Imaging offers a valuable tool to aid in this diagnostic challenge. Radiologists must be familiar with pediatric lumps and bumps, their imaging characteristics, and the best way to further evaluate challenging clinical presentations. This will not only allow the radiologist to serve as a valuable asset to the treating physician in choosing the most appropriate imaging modality but also help in accurate diagnosis, all while ensuring the "image gently" principle. An algorithm for imaging in the pediatric patient with lumps and bumps has been presented in this article and a few example entities along with their imaging findings have also been reviewed.

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

    PubMed

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

    2016-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

  10. Lumped element modeling of air-coupled capacitive micromachined ultrasonic transducers with annular cell geometry.

    PubMed

    Na, Shuai; Wong, Lawrence L P; Chen, Albert I H; Li, Zhenhao; Macecek, Mirek; Yeow, John T W

    2017-04-01

    Air-coupled capacitive micromachined ultrasonic transducers (CMUTs) based on annular cell geometry have recently been reported. Finite element analysis and experimental studies have demonstrated their significant improvement in transmit efficiency compared with the conventional circular-cell CMUTs. Extending the previous work, this paper proposed a lumped element model of annular-cell CMUTs. Explicit expressions of the resonance frequency, modal vector, and static displacement of a clamped annular plate under uniform pressure were first derived based on the plate theory and curve fitting method. The lumped model of an annular CMUT cell was then developed by adopting the average displacement as the spatial variable. Using the proposed model, the ratio of average-to-maximum displacement was derived to be 8/15. Experimental and simulation studies on a fabricated annular CMUT cell verified the effectiveness of the lumped model. The proposed model provides an effective and efficient way to analyze and design air-coupled annular-cell CMUTs.

  11. Characterization of the pharmacokinetics of gasoline using PBPK modeling with a complex mixtures chemical lumping approach.

    PubMed

    Dennison, James E; Andersen, Melvin E; Yang, Raymond S H

    2003-09-01

    Gasoline consists of a few toxicologically significant components and a large number of other hydrocarbons in a complex mixture. By using an integrated, physiologically based pharmacokinetic (PBPK) modeling and lumping approach, we have developed a method for characterizing the pharmacokinetics (PKs) of gasoline in rats. The PBPK model tracks selected target components (benzene, toluene, ethylbenzene, o-xylene [BTEX], and n-hexane) and a lumped chemical group representing all nontarget components, with competitive metabolic inhibition between all target compounds and the lumped chemical. PK data was acquired by performing gas uptake PK studies with male F344 rats in a closed chamber. Chamber air samples were analyzed every 10-20 min by gas chromatography/flame ionization detection and all nontarget chemicals were co-integrated. A four-compartment PBPK model with metabolic interactions was constructed using the BTEX, n-hexane, and lumped chemical data. Target chemical kinetic parameters were refined by studies with either the single chemical alone or with all five chemicals together. o-Xylene, at high concentrations, decreased alveolar ventilation, consistent with respiratory irritation. A six-chemical interaction model with the lumped chemical group was used to estimate lumped chemical partitioning and metabolic parameters for a winter blend of gasoline with methyl t-butyl ether and a summer blend without any oxygenate. Computer simulation results from this model matched well with experimental data from single chemical, five-chemical mixture, and the two blends of gasoline. The PBPK model analysis indicated that metabolism of individual components was inhibited up to 27% during the 6-h gas uptake experiments of gasoline exposures.

  12. [Phytotherapy of benign prostatic hyperplasia].

    PubMed

    Bracher, F

    1997-01-01

    Phytopharmaceutical agents have been used for a long time in the treatment of symptomatic benign prostatic hyperplasia (BPH). However, until recently, it has been questioned whether phytotherapy is superior to a placebo treatment. In this article, the most widely used phytopharmaceutical agents, such as saw palmetto berry extracts, Radix urticae extracts, pumpkin seeds, pollen extracts and different phytosterols, are described. In addition, both in vitro and in vivo studies are discussed in an attempt to explain a possible mechanism of action. There are several new clinical studies which demonstrate a significant benefit compared with placebo treatment. Based on these results, the use of phytopharmaceutical agents for the treatment of mild to moderate symptomatic BPH seems to be well justified. So far, no significant inhibition of further prostate growth has been demonstrated. For this, a careful follow-up of the patients is necessary so as not to miss a deterioration and perhaps the need for an operation.

  13. [Radiotherapy of benign intracranial tumors].

    PubMed

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects.

  14. Benign Lymphangioendothelioma - A Case Report

    PubMed Central

    Kamoji, Sushruth Guruputra; Dastikop, Shilpa Vinay

    2016-01-01

    Benign lymphangioendothelioma is an uncommon locally infiltrative lymphatic tumour, presenting as a slow-growing, asymptomatic, reddish-violaceous macule or plaque. Histopathologically, it is characterized by thin-walled endothelial-lined spaces that are interspersed between strands of collagen. It must be recognized and differentiated from angiosarcoma, early Kaposi’s sarcoma, in view of major differences in treatment and prognosis. A 24-year-old female presented with a raised lesion over the left leg since 2 years which was associated with minimal itching. Biopsy of the lesion showed thin walled vascular channels lined by single layer of bland endothelial cells at the dermo-epidermal junction, few vessels in the dermis. PMID:26894162

  15. Concussion or benign paroxysmal torticollis?

    PubMed

    Reynolds, Ellen

    2012-01-01

    This case report describes a patient who presented to the trauma service on 3 occasions over the course of 2 years, each time with symptoms typical of concussion (e.g., crying, change in mentation, and vomiting). On more in-depth evaluation, it was discovered that the child had torticollis, pallor, and brief dizziness or vertigo with each episode. Benign paroxysmal torticollis is a periodic, paroxysmal syndrome that may be mistaken for the more common concussion. In addition to illustrating a uniquely pediatric neurological syndrome, this case demonstrates the importance of taking a careful history and considering a full range of differential diagnoses when evaluating every patient, even those with seemingly routine injuries.

  16. Crossing the canal: Looking beyond hernias - Spectrum of common, uncommon and atypical pathologies in the inguinal canal.

    PubMed

    Ramanathan, Subramaniyan; Palaniappan, Yegu; Sheikh, Adnan; Ryan, John; Kielar, Ania

    Inguinal canal can have diverse range of pathologies due to its complex anatomy and multiple different contents in the males and females. Imaging plays a dominant role in the appropriate diagnosis and management as inguinal pathologies have fairly similar clinical presentation with pain and swelling. Various pathologies in the inguinal region include congenital, infectious/inflammatory, vascular, neoplastic and iatrogenic. This paper gives an overview of the role of various modalities like Ultrasound, CT and MRI in the evaluation of inguinal pathologies. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report.

    PubMed

    Ueda, Junji; Yoshida, Hiroshi; Makino, Hiroshi; Maruyama, Hiroshi; Yokoyama, Tadashi; Hirakata, Atsushi; Akagi, Ichiro; Watanabe, Manabu; Uchida, Eiichi; Uchida, Eiji

    2016-01-01

    The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.

  18. Benign intracranial hypertension: diagnosis and conservative management.

    PubMed

    Theisler, C W

    1986-03-01

    The clinical features of benign intracranial hypertension are described. Pathological components are discussed and are contrasted against the current theoretical model of pain production in benign intracranial hypertension. Diagnosis and associated conditions are discussed from a review of the literature, and conservative management is outlined.

  19. Benign lesions of the external auditory canal.

    PubMed

    Tran, L P; Grundfast, K M; Selesnick, S H

    1996-10-01

    Benign mass lesions of the external auditory canal, such as exostoses and osteomas, are common findings on physical examination but most often do not require treatment. The differential diagnosis of lesions in the external auditory canal, however, should not be limited to those benign processes discussed here, but should also include infectious, dermatologic, congenital, and malignant processes.

  20. Malignant Transformation of Pulmonary Benign Metastasizing Leiomyoma

    PubMed Central

    Song, Kyung Sub; Keum, Dong Yoon; Hwang, Il Seon

    2017-01-01

    Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML. PMID:28180107

  1. 5 CFR 831.2011 - Effect of part 772 of this chapter on CSRS lump-sum payments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Effect of part 772 of this chapter on CSRS lump-sum payments. 831.2011 Section 831.2011 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Payment of Lump Sums § 831.2011...

  2. Emergency repair of inguinal hernia in the premature infant is associated with high direct medical costs.

    PubMed

    Verhelst, J; de Goede, B; van Kempen, B J H; Langeveld, H R; Poley, M J; Kazemier, G; Jeekel, J; Wijnen, R M H; Lange, J F

    2016-08-01

    Inguinal hernia repair is frequently performed in premature infants. Evidence on optimal management and timing of repair, as well as related medical costs is still lacking. The objective of this study was to determine the direct medical costs of inguinal hernia, distinguishing between premature infants who had to undergo an emergency procedure and those who underwent elective inguinal hernia repair. This cohort study based on medical records concerned premature infants with inguinal hernia who underwent surgical repair within 3 months after birth in a tertiary academic children's hospital between January 2010 and December 2013. Two groups were distinguished: patients with incarcerated inguinal hernia requiring emergency repair and patients who underwent elective repair. Real medical costs were calculated by multiplying the volumes of healthcare use with corresponding unit prices. Nonparametric bootstrap techniques were used to derive a 95 % confidence interval (CI) for the difference in mean costs. A total of 132 premature infants were included in the analysis. Emergency surgery was performed in 29 %. Costs of hospitalization comprised 65 % of all costs. The total direct medical costs amounted to €7418 per premature infant in the emergency repair group versus €4693 in the elective repair group. Multivariate analysis showed a difference in costs of €1183 (95 % CI -1196; 3044) in favor of elective repair after correction for potential risk factors. Emergency repair of inguinal hernia in premature infants is more expensive than elective repair, even after correction for multiple confounders. This deserves to be taken into account in the debate on timing of inguinal hernia repair in premature infants.

  3. Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: A comparative study

    PubMed Central

    de Araújo, Felipe Brandão Corrêa; Starling, Eduardo Simão; Maricevich, Marco; Tobias-Machado, Marcos

    2014-01-01

    OBJECTIVE: To demonstrate the feasibility of endoscopic extraperitoneal single site (EESS) inguinal hernia repair and compare it outcomes with the conventional totally extraperitoneal (TEP) technique. BACKGROUND: TEP inguinal hernia repair is a widely accepted alternative to conventional open technique with several perioperative advantages. Transumbilical laparoendoscopic singlesite surgery (LESS) is an emerging approach and has been reported for a number of surgical procedures with superior aesthetic results but other advantages need to be proven. PATIENTS AND METHODS: Thirty-eight uncomplicated inguinal hernias were repaired by EESS approach between January 2010 and January 2011. All procedures were performed through a 25 cm infraumbilical incision using the Alexis wound retractor attached to a surgical glove and three trocars. Body mass index, age, operative time, blood loss, complications, conversion rate, analgesia requirement, hospital stay, return to normal activities and patient satisfaction with aesthetic results were analysed and compared with the last 38 matched-pair group of patients who underwent a conventional TEP inguinal hernia repair by the same surgeon. RESULTS: All procedures were performed successfully with no conversion. In both unilateral and bilateral EESS inguinal repairs, the mean operative time was longer than conventional TEP (55± 20 vs. 40± 15 min, P = 0.049 and 70± 15 vs. 55± 10 min, P = 0.014). Aesthetic result was superior in the EESS group (2.88± 0.43 vs. 2.79± 0.51, P = 0.042). There was no difference between the two approaches regarding blood loss, complications, hospital stay, time until returns to normal activities and analgesic requirement. CONCLUSION: EESS inguinal hernia repair is safe and effective, with superior cosmetic results in the treatment of uncomplicated inguinal hernias. Other advantages of this new technique still need to be proven. PMID:25336820

  4. Impact of postoperative complications on the risk for chronic groin pain after open inguinal hernia repair.

    PubMed

    Olsson, Anders; Sandblom, Gabriel; Fränneby, Ulf; Sondén, Anders; Gunnarsson, Ulf; Dahlstrand, Ursula

    2017-02-01

    Chronic pain is common after inguinal hernia repair and has become one of the most important outcome measures for this procedure. The purpose of this study was to determine whether or not there is a relationship between specific postoperative complications and risk for chronic pain after open inguinal hernia repair. A prospective cohort study was designed in which participants responded to the Inguinal Pain Questionnaire regarding postoperative groin pain 8 years after inguinal hernia repair. Responses to the questionnaire were matched with data from a previous study regarding reported postoperative complications after open inguinal hernia repair. Participants were recruited originally from the Swedish Hernia Register. Response rate was 82.4% (952/1,155). The primary outcome was chronic pain in the operated groin at follow-up. Grading of pain was performed using the Inguinal Pain Questionnaire. A total of 170 patients (17.9%) reported groin pain and 29 patients (3.0%) reported severe groin pain. The risk for developing chronic groin pain was greater in patients with severe pain in the preoperative or immediate postoperative period (odds ratio 2.09; 95% confidence interval 1.28-3.41). Risk for chronic pain decreased for every 1-year increase in age at the time of operation (odds ratio 0.99, 95% confidence interval 0.98-1.00). Both preoperative pain and pain in the immediate postoperative period are strong risk factors for chronic groin pain. Risk factor patterns should be considered before operative repair of presumed symptomatic inguinal hernias. The problem of postoperative pain must be addressed regarding both pre-emptive and postoperative analgesia. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Extramedullary hematopoiesis in a case of benign mixed mammary tumor in a female dog: cytological and histopathological assessment

    PubMed Central

    2010-01-01

    Backgroud Extramedullary hematopoiesis (EMH) is defined as the presence of hematopoietic stem cells such as erythroid and myeloid lineage plus megakaryocytes in extramedullary sites like liver, spleen and lymph nodes and is usually associated with either bone marrow or hematological disorders. Mammary EMH is a rare condition either in human and veterinary medicine and can be associated with benign mixed mammary tumors, similarly to that described in this case. Case presentation Hematopoietic stem cells were found in a benign mixed mammary tumor of a 7-year-old female mongrel dog that presents a nodule in the left inguinal mammary gland. The patient did not have any hematological abnormalities. Cytological evaluation demonstrated two distinct cell populations, composed of either epithelial or mesenchymal cells, sometimes associated with a fibrillar acidophilic matrix, apart from megakaryocytes, osteoclasts, metarubricytes, prorubricytes, rubricytes, rubriblasts, promyelocytes, myeloblasts. Histological examination confirmed the presence of an active hematopoietic bone marrow within the bone tissue of a benign mammary mixed tumor. Conclusions EMH is a rare condition described in veterinary medicine that can be associated with mammary mixed tumors. It's detection can be associated with several neoplastic and non-neoplastic mammary lesions, i.e. osteosarcomas, mixed tumors and bone metaplasia. PMID:20846427

  6. DRAINMOD-GIS: a lumped parameter watershed scale drainage and water quality model

    Treesearch

    G.P. Fernandez; G.M. Chescheir; R.W. Skaggs; D.M. Amatya

    2006-01-01

    A watershed scale lumped parameter hydrology and water quality model that includes an uncertainty analysis component was developed and tested on a lower coastal plain watershed in North Carolina. Uncertainty analysis was used to determine the impacts of uncertainty in field and network parameters of the model on the predicted outflows and nitrate-nitrogen loads at the...

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

    SciTech Connect

    Romanov, Vyacheslav; Soong, Yee

    2008-03-01

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

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

    SciTech Connect

    Romanov, V; Soong, Y

    2008-03-01

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

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

    SciTech Connect

    Vyacheslav Romanov; Yee Soong

    2008-03-15

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

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

    NASA Technical Reports Server (NTRS)

    Van Dyke, Michael B.

    2013-01-01

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

  11. 5 CFR 831.2005 - Designation of beneficiary for lump-sum payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  12. 5 CFR 838.1010 - Court orders or decrees preventing payment of lump sums.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Court orders or decrees preventing... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Court Orders Affecting Civil Service Retirement Benefits § 838.1010 Court orders or decrees preventing payment of lump...

  13. 5 CFR 838.1010 - Court orders or decrees preventing payment of lump sums.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Court orders or decrees preventing... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Court Orders Affecting Civil Service Retirement Benefits § 838.1010 Court orders or decrees preventing payment of lump...

  14. Comparison of logging residue from lump sum and log scale timber sales.

    Treesearch

    James O Howard; Donald J. DeMars

    1985-01-01

    Data from 1973 and 1980 logging residues studies were used to compare the volume of residue from lump sum and log scale timber sales. Covariance analysis was used to adjust the mean volume for each data set for potential variation resulting from differences in stand conditions. Mean residue volumes from the two sale types were significantly different at the 5-percent...

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

    PubMed

    Garg, Pankaj

    2016-06-10

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

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

    NASA Technical Reports Server (NTRS)

    Van Dyke, Michael B.

    2013-01-01

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

  17. Low-frequency and broadband metamaterial absorber based on lumped elements: design, characterization and experiment

    NASA Astrophysics Data System (ADS)

    Yuan, Wenshan; Cheng, Yongzhi

    2014-12-01

    In this paper, we propose and experimentally validate a low-frequency metamaterial absorber (MMA) based on lumped elements with broadband stronger absorptivity in the microwave regime. Compared with the electric resonator structure MMA, the composite MMA (CMMA) loaded with lumped elements has stronger absorptivity and nearly impedance-matched to the free space in a broadband frequency range. The simulated voltage in lumped elements and the absorbance under different substrate loss conditions indicate that incident electromagnetic wave energy is mainly transformed to electric energy in the absorption band with high efficiency and subsequently consumed by lumped resistors. Simulated surface current and power loss density distributions further clarify the mechanism underlying observed absorption. The CMMA also shows a polarization-insensitive and wide-angle strong absorption. Finally, we fabricate and measure the MMA and CMMA samples. The CMMA yields below -10 dB reflectance from 2.85 to 5.31 GHz in the experiment, and the relative bandwidth is about 60.3 %. This low-frequency microwave absorber has potential applications in many martial fields.

  18. 20 CFR 222.31 - Relationship as child for annuity and lump-sum payment purposes.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... by the employee's widow or widower after the employee's death); or (3) The equitably adopted child of... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Relationship as child for annuity and lump... UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.31 Relationship...

  19. 20 CFR 222.31 - Relationship as child for annuity and lump-sum payment purposes.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... by the employee's widow or widower after the employee's death); or (3) The equitably adopted child of... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Relationship as child for annuity and lump-sum... THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.31 Relationship as...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... by the employee's widow or widower after the employee's death); or (3) The equitably adopted child of... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Relationship as child for annuity and lump... UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.31 Relationship...

  1. 20 CFR 10.422 - May compensation payments be issued in a lump sum?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...-sum payments for wage-loss benefits, OWCP will not exercise further discretion in the matter. This... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false May compensation payments be issued in a lump sum? 10.422 Section 10.422 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...

  2. 20 CFR 10.422 - May compensation payments be issued in a lump sum?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...-sum payments for wage-loss benefits, OWCP will not exercise further discretion in the matter. This... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false May compensation payments be issued in a lump sum? 10.422 Section 10.422 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...

  3. 20 CFR 10.422 - May compensation payments be issued in a lump sum?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-sum payments for wage-loss benefits, OWCP will not exercise further discretion in the matter. This... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true May compensation payments be issued in a lump sum? 10.422 Section 10.422 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and other benefits to be provided by the financial institution in return for the lump sum deposit, and... exercise of corrective or remedial actions authorized under § 570.910(b), § 570.911, § 570.912 or § 570.913... financial institution, the deposit must result in appropriate benefits in support of the recipient's local...

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

    PubMed

    Olufsen, Mette S; Nadim, Ali

    2004-06-01

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

  6. [Inguinal hernia repair by the tension free technique of Lichtenstein].

    PubMed

    Prywiński, S; Zomrowski, L; Kapała, A; Mackiewicz, Z

    1997-01-01

    Failure rate in standard groin hernia repair varies from 3 to 10%. Polypropylene mesh implantation based on Lichtenstein "tension free" method in 1986 year reduced the failure rate to less than 1%. From Feb. '95 to Dec.'96, 115 patients were operated on with 127 groin hernias repair. The average age of patients was 58 years 52 direct hernias, 74 indirect hernias and 1 pantaloon hernia have been diagnosed in examined material, 101 primary repairs and 26 repairs of recurrent hernia have been performed. The operations were performed in subarachnoid anaesthesia--66 patients, in general anaesthesia--11 patients in local anaesthesia--38 patients. After having opened the inguinal canal estimated the type of its wall defect. In case of direct hernia the sac usually was invaginated by absorbing suture. In case of indirect hernia sac was cut and peritoneal cavity left opened. The patch made of polypropylene monofilament mesh (size 6 x 8 cm) was sewn with "tension free" method under spermatic funiculus. As a complication 6 patients had haematomas in operating wounds. Four of the patients had wound infections. One of these patients was operated again and the patch was removed. The patients had no recurrence of hernia during the previous 10.6 months of observation. We haven't confirmed recurrence in examined material, yet it was too short time to estimate the efficiency of repair. The proposed way of groin hernia repair is easy and simple in every-day surgery practice.

  7. A prospective study of bilateral inguinal hernia repair.

    PubMed Central

    Serpell, J. W.; Johnson, C. D.; Jarrett, P. E.

    1990-01-01

    A prospective study of outcome after inguinal hernia repair in patients undergoing simultaneous repair of bilateral hernias (n = 31), sequential repair of bilateral hernias (n = 5), and unilateral hernia repair (n = 75) is reported. There were no differences in wound complications, post-operative respiratory complications, or other adverse effects in the three groups. Operating time was similar in the unilateral and bilateral simultaneous repairs (median 55 min), but was longer (100 min) for the combination of two sequential repairs. Hospital stay was shortest for patients undergoing unilateral repair (2 days) but was less with bilateral simultaneous repair (4 days) than after two sequential repairs (total of 6 days). There were 12 (11%) wound complications of which five (5%) were infections. There was no difference in complication rate between unilateral and bilateral hernia repair. Postoperative recovery was assessed prospectively and was recorded at 1 month. There was no difference between unilateral and bilateral simultaneous repairs in the number of days before the patient was able to climb stairs easily, drive a car or return to work. The duration of the requirement for analgesia was similar in each group. We conclude that bilateral simultaneous hernia repair can be carried out with no greater morbidity than a unilateral repair, and the return to normal activity is as rapid. Bilateral hernias should be repaired simultaneously rather than sequentially. PMID:2221764

  8. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    PubMed Central

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain. PMID:27635414

  9. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study.

    PubMed

    Matsutani, Takeshi; Nomura, Tsutomu; Hagiwara, Nobutoshi; Matsuda, Akihisa; Takao, Yoshimune; Uchida, Eiji

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40-132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

  10. Incarceration of a colonoscope in an inguinal hernia: Case report and literature review

    PubMed Central

    Tan, Victoria Ping-Yi; Lee, Yuk Tong; Poon, Jensen Tung Chung

    2013-01-01

    Incarceration of an endoscope in an inguinal hernia may occur during the course of routine colonoscopy. The incarceration may occur on insertion or withdrawal and frequently the hernia is not suspected prior to the colonoscopy. Most commonly, a left sided inguinal hernia is involved, however right inguinal hernias may be implicated in subjects with altered anatomy post abdominal surgery. Incarceration of an endoscope in an inguinal hernia has been seldom reported in the literature which is likely to be related to under reporting. A range of techniques have been suggested by various authors over the last four decades to manage this unusual complication of colonoscopy. These techniques include utilizing fluoroscopy, manual external pressure and/or the fitting of a cap onto the tip of the colonoscope to facilitate colonoscopic navigation. The authors present a case report of incarceration of the colonoscope on withdrawal in an unsuspected left inguinal hernia with a review of the literature on the management of this colonoscopic complication. A management strategy is suggested. PMID:23772270

  11. Surgical site infection of scrotal and inguinal lesions after urologic surgery.

    PubMed

    Uehara, Teruhisa; Takahashi, Satoshi; Ichihara, Kohji; Hiyama, Yoshiki; Hashimoto, Jiro; Kurimura, Yuichiro; Masumori, Naoya

    2014-03-01

    To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18-81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.

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

    PubMed

    Swartjes, Frank A; Janssen, Paul J C M

    2016-09-01

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

  13. Benign Hereditary Chorea: An Update

    PubMed Central

    Peall, Kathryn J.; Kurian, Manju A.

    2015-01-01

    Benign hereditary chorea (BHC) is a childhood-onset, hyperkinetic movement disorder normally with little progression of motor symptoms into adult life. The disorder is caused by mutations to the NKX2.1 (TITF1) gene and also forms part of the “brain–lung–thyroid syndrome”, in which additional developmental abnormalities of lung and thyroid tissue are observed. In this review, we summarize the main clinical findings in “classical” BHC syndrome and discuss more recently reported atypical features, including non-choreiform movement phenotypes. We highlight additional non-motor characteristics such as cognitive impairment and psychiatric symptoms, while discussing the evidence for BHC as a developmental disorder involving impaired neural migration and other multisystem developmental abnormalities. Finally, we will discuss the efficacy of available therapies in both affected pediatric and adult cohorts. Delineation of the BHC disease spectrum will no doubt expand our understanding of this disorder, facilitating better targeting of genetic testing and establish a framework for future clinical trials. PMID:26196025

  14. Management of Benign Biliary Strictures

    SciTech Connect

    Laasch, Hans-Ulrich; Martin, Derrick F.

    2002-12-15

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

  15. Safety and Effectiveness Evidence of SAM (registered trademark) Junctional Tourniquet to Control Inguinal Hemorrhage in a Perfused Cadaver Model

    DTIC Science & Technology

    2014-01-01

    The SJT was tested in a perfused cadaver experiment simulating inguinal or axillary wound hemorrhage. No safety problems or tissue damage occurred...to be safe and effective in hemorrhage control in a cadaver model for both the axillary and inguinal areas. The SJT’s Target Compression Devices

  16. A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

    ERIC Educational Resources Information Center

    Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

    2014-01-01

    Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

  17. Benign breast lesions that mimic malignancy.

    PubMed

    Torous, Vanda F; Schnitt, Stuart J; Collins, Laura C

    2017-02-01

    Many benign and reactive lesions of the breast show morphological overlap with malignant lesions. These benign mimics of malignancy often present diagnostic challenges to even the most experienced pathologists. This review focuses on several benign lesions of the breast that mimic malignant entities. For each of these lesions, we describe the key morphological and immunohistochemical features, potential diagnostic pitfalls, and our approach to arriving at the correct diagnosis. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  18. 20 CFR 404.392 - Who is entitled to the lump-sum death payment when there is no widow(er) who was living in the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Who is entitled to the lump-sum death payment...-Age, Disability, Dependents' and Survivors' Insurance Benefits; Period of Disability Lump-Sum Death Payment § 404.392 Who is entitled to the lump-sum death payment when there is no widow(er) who was...

  19. Direct radionuclide cystography imaging in colovesical fistula due to inguinal hernia operation complication.

    PubMed

    Tamam, Muge; Yavuz, Hatice Sümeyye; Hacimahmutoğlu, Serafettin; Mülazimoğlu, Mehmet; Kacar, Tulay; Ozpacaci, Tevfik

    2009-09-01

    Colovesical fistula is an abnormal connection between the enteric and urinary systems, usually sigmoid colon, caused by various conditions. One cause of colovesical fistula is iatrogenic injury, such as induced by inguinal hernia surgery. We present a case of colovesical fistula. A 57-year-old male was admitted to a local hospital with complaints of dysuria and pneumaturia. He had a past history of total extraperitoneal laparoscopic inguinal hernia repair operation 7 years previously for bilateral inguinal hernia. The case was assessed with radiologic and scintigraphic techniques. Radiologic techniques (plain abdominal radiography, intravenous pyelogram, ultrasound examination, double-contrast barium enema, CT, MRI) were inadequate to determine the colovesical fistula. The colovesical fistula was visualized with direct radionuclide voiding cystography as an alternative scintigraphic method.

  20. Triorchidism: Presenting as Undescended Testis in a Case of Indirect Inguinal Hernia.

    PubMed

    Bhandarwar, Ajay H; Gandhi, Saurabh S; Patel, Chintan B; Wagh, Amol N; Gawli, Virendra; Jain, Nimesh A

    2016-04-26

    Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility. Intraoperatively indirect inguinal hernia was noted with supernumerary testis at deep ring in addition to normal left testis in left scrotal sac. The ectopic testis were small (2.5×2.5×1 cm) lacking epididymis and with short vas deferens. An evident normal semen analysis and varied anatomy, the decision for orchidectomy of ectopic testis was taken. The histopathological finding was consistent with arrest in germ cell development.

  1. Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn

    PubMed Central

    Karadeniz Cerit, Kıvılcım; Ergelen, Rabia; Colak, Emel; Dagli, Tolga E.

    2015-01-01

    A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence. PMID:26351609

  2. Triorchidism: Presenting as Undescended Testis in a Case of Indirect Inguinal Hernia

    PubMed Central

    Gandhi, Saurabh S.; Patel, Chintan B.; Wagh, Amol N.; Gawli, Virendra; Jain, Nimesh A.

    2016-01-01

    Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility. Intraoperatively indirect inguinal hernia was noted with supernumerary testis at deep ring in addition to normal left testis in left scrotal sac. The ectopic testis were small (2.5×2.5×1 cm) lacking epididymis and with short vas deferens. An evident normal semen analysis and varied anatomy, the decision for orchidectomy of ectopic testis was taken. The histopathological finding was consistent with arrest in germ cell development. PMID:27478577

  3. Peritoneal colon cancer metastasis to bilateral inguinal hernia repair sites: report of a case.

    PubMed

    Kudou, Michihiro; Murayama, Yasutoshi; Konishi, Hirotaka; Morimura, Ryo; Komatsu, Shuhei; Shiozaki, Atsushi; Kuriu, Yoshiaki; Ikoma, Hisashi; Kubota, Takeshi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Fujiwara, Hitoshi; Okamoto, Kazuma; Sakakura, Chouhei; Kojima, Osamu; Otsuji, Eigo

    2015-08-01

    We report a rare case of peritoneal metastasis from colon cancer being found in the bilateral sites of inguinal hernia repair. The patient was an 85-year-old man who underwent colonoscopy for a positive fecal occult blood test, with a subsequent diagnosis of ascending colon cancer. He had undergone mesh plug repair for bilateral inguinal hernias at another hospital 6 years previously. We performed laparoscopy-assisted right hemi-colectomy and found nodes in the bilateral scars from the inguinal hernioplasty. Biopsy confirmed that both of the nodes were peritoneal metastasis, leading to the assumption that cancer cells disseminated within the abdominal cavity had been implanted at the repair sites, although the mechanism for this was unclear. A relationship between inflammation and peritoneal metastasis has been reported; thus, we speculated that local inflammation resulting from chronic stimulus of mesh plugs and peritoneal trauma caused peritoneal metastasis at the repair sites.

  4. Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling.

    PubMed

    Şahin, Ali Feyzullah; İlbey, Yusuf Özlem; Şahin, Nur

    2013-06-24

    Surgical treatment of female stress urinary incontinence (SUI) has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF) plus inguinal abcess after tension-free vaginal tape (TVT). A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT.

  5. Inguinal hernia containing uterus and uterine adnexa in female infants: report of two cases.

    PubMed

    Ming, Yung-Ching; Luo, Chih-Cheng; Chao, Hsun-Chin; Chu, Shih-Ming

    2011-04-01

    We herein report two female cases, aged 1 and 1.5 months, of inguinal sliding hernias containing the uterus, fallopian tube, and ovary. The diagnosis of inguinal hernia with uterus and uterine adnexa was highly suspected preoperatively by ultrasonography and was confirmed during surgical correction. Freeing the attachment of fallopian tube and uterus from the sac and with reduction of the uterus, ovary, and fallopian tube back to the peritoneal cavity, high ligation of the hernia sac was performed in these cases. In conclusion, the hernia sac containing fallopian tube, ovary, and uterus in the female is very rare. We present our experience of treatment with these rare cases and suggest that sonography be performed routinely in female infants with an inguinal hernia containing a palpable movable mass.

  6. A successful laparoscopic neovaginoplasty using peritoneum in Müllerian agenesis with inguinal ovaries accompanied by primary ovarian insufficiency

    PubMed Central

    Gweon, Seonghye; Lee, Jisun; Hwang, Suna; Hwang, Kyoung Joo

    2016-01-01

    The combination of Müllerian agenesis with inguinal ovaries accompanied by primary ovarian insufficiency is extremely rare. A 21-year-old Korean woman was referred to our center with primary amenorrhea. The patient was diagnosed with Müllerian agenesis with inguinal ovaries. Her hormonal profile showed hypergonadotrophic hypogonadism suggesting primary ovarian insufficiency. We performed laparoscopic neovaginoplasty using modified Davydov's procedure and reposition inguinal ovaries in the pelvic cavity. Oral estrogen replacement was applied for the treatment of primary ovarian insufficiency. This is a rare case report on Mayer-Rokitansky-Kuster-Hauser syndrome accompanied not only by inguinal ovaries but also with primary ovarian insufficiency. We present our first experience on the laparoscopic neovaginoplasty performed on the patient with müllerian agenesis accompanied by inguinal ovaries and primary ovarian insufficiency. PMID:27462606

  7. A longitudinal follow-up using the high trans-scrotal approach for inguinal and scrotal abnormalities in boys.

    PubMed

    Gökçora, I H; Yagmurlu, A

    2003-12-01

    The popular incision for surgical approach to pediatric inguinal pathologies has been the suprapubic transverse inguinal incision. Yet alternative incisions may be considered. A prospectively randomized study of a consecutive series of 256 male infants and children with various inguinal pathologies (mainly indirect inguinal hernias) were treated surgically using the "high trans-scrotal skin-crease incision," over a period of 84 months (7 years) and were compared and found to be clinically better than age- and sex-matched 278 controls with suprapubic transverse inguinal incisions for wound healing/infection, edema, seroma, hematoma, malpositioning or atrophy of testes and recurrence of the primary pathology. The results in the study group were cosmetically and clinically more favorable, and better than the control group. Nosocomial infections, complications of incarceration, and emergency surgery have resulted in an acceptable morbidity rate of approximately 5%. Popularized use of the high trans-scrotal incision and further clinical experience is recommended to facilitate even better results.

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

    NASA Astrophysics Data System (ADS)

    Ozyurt, N. Nur; Bayari, C. Serdar

    2005-04-01

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

  9. Unusual metachronous isolated inguinal lymph node metastasis from adenocarcinoma of the sigmoid colon.

    PubMed

    Pisanu, Adolfo; Deplano, Daniela; Reccia, Isabella; Parodo, Giuseppina; Uccheddu, Alessandro

    2011-10-14

    This study aimed to describe an unusual case of metachronous isolated inguinal lymph nodes metastasis from sigmoid carcinoma. A 62-year-old man was referred to our department because of an obstructing sigmoid carcinoma. Colonoscopy showed the obstructing lesion at 30 cm from the anal verge and abdominal CT revealed a sigmoid lesion infiltrating the left lateral abdominal wall. The patient underwent a colonic resection extended to the abdominal wall. Histology showed an adenocarcinoma of the colon infiltrating the abdominal wall with iuxtacolic nodal involvement. Thirty three months after surgery abdominal CT and PET scan revealed a metastatic left inguinal lymph node involvement. The metastatic lymph node was found strictly adherent to the left iliac-femoral artery and encompassing the origin of the left inferior epigastric artery. Histology showed a metachronous nodal metastasis from colonic adenocarcinoma. Despite metastastic involvement of inguinal lymph node from rectal cancer is a rare but well known clinical entity, to the best of our knowledge, this is the first report of inguinal metastasis from a carcinoma of the left colon. Literature review shows only three other similar reported cases: two cases of inguinal metastasis secondary to adenocarcinoma of the cecum and one case of axillary metastasis from left colonic carcinoma. A metastatic pathway through superficial abdominal wall lymphatic vessels could be possible through the route along the left inferior epigastric artery. The solitary inguinal nodal involvement from rectal carcinoma could have a more favorable prognosis. In the case of nodal metastasis to the body surface lymph nodes from colonic carcinoma, following the small number of such cases reported in the literature, no definitive conclusions can be drawn.

  10. Liquid-injection for preperitoneal dissection of transabdominal preperitoneal (TAPP) inguinal [corrected] hernia repair.

    PubMed

    Mizota, Tomoko; Watanabe, Yusuke; Madani, Amin; Takemoto, Norihiro; Yamada, Hidehisa; Poudel, Saseem; Miyasaka, Yuji; Kurashima, Yo

    2015-03-01

    The creation of an adequate peritoneal flap during laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair, while avoiding injuring surrounding structures can be technically challenging. Liquid infiltration of the preperitoneal space can help facilitate dissection and avoid inadvertent injuries. We describe a novel technique for TAPP inguinal hernia repair using liquid-injection for preperitoneal [corrected] dissection and report our initial experience. TAPP inguinal hernia repair using a liquid-injection technique during preperitoneal dissection was performed by a single surgical resident without prior TAPP repair experience from July 2013 to January 2014. After trocar placement, 60 mL of 0.3 % lidocaine with 1:300,000 dilution of epinephrine was injected percutaneously using a blunt needle under laparoscopic visualization into the preperitoneal space to assist with the dissection and parietalization of the vas deferens, spermatic vessels, and epigastric vessels. The initial peritoneal incision is performed at the lateral side of the inguinal canal, followed by blunt dissection of the preperitoneal space. Eleven patients (median age: 69; 8 male) with a total of 12 inguinal hernias underwent a TAPP repair using a liquid-injection preperitoneal dissection technique. Ten patients had unilateral hernias (4 indirect, 6 direct), and one patient had bilateral direct hernias. The median operative time, median injection time, and median dissection time were 116, 3.5, and 42 min, respectively. Estimated blood loss was less than 10 mL for all cases. No intraoperative injuries, conversions to open repair, or 30-day postoperative complications occurred. There were no hernia recurrences after a median follow-up of 143 days. Our preliminary experience suggests that liquid-injection to assist preperitoneal dissection during TAPP inguinal hernia repair appears to be safe and feasible. This novel method facilitates the dissection of spermatic cord structures, and

  11. Outcomes of pediatric inguinal hernia repair with or without opening the external oblique muscle fascia

    PubMed Central

    Nazem, Masoud; Dastgerdi, Mohamad Masoud Heydari; Sirousfard, Motaherh

    2015-01-01

    Background: Considering that complications and outcome of each method of pediatric inguinal hernia repair are one of the determinants for pediatric surgeons for selection of the appropriate surgical technique, we compared the early and late complications of two inguinal repair techniques, with and without opening the external oblique muscle fascia. Materials and Methods: In this double-blind clinical trial study, boy children aged 1-month to 6 years with diagnosed inguinal hernia were included and randomly allocated into two groups for undergoing two types of hernia repair techniques, with and without opening the external oblique muscle fascia. Surgical complications such as fever, scrotal edema and hematoma, and wound infections classified as early complication and recurrence, testis atrophy and sensory impairment of inguinal area classified as late complications. The rates of mentioned early and late complications were compared in the two interventional groups. Results: In this study, 66 patients were selected and allocated to the two interventional groups. The prevalence of early and late complications in two studied groups were not different significantly in two interventional groups (P > 0.05). Operation time was significantly shorter in inguinal repair techniques without opening the external oblique muscle fascia than the other studied technique (P = 0.001). Conclusion: The findings of our study indicated that though early and late complications of the two repair methods were similar, but the time of procedure was shorter in herniotomy without opening the external oblique muscle, which considered the superiority of this method than inguinal hernia repair with opening the external oblique muscle. PMID:26958052

  12. Current practices of laparoscopic inguinal hernia repair: a population-based analysis.

    PubMed

    Trevisonno, M; Kaneva, P; Watanabe, Y; Fried, G M; Feldman, L S; Andalib, A; Vassiliou, M C

    2015-10-01

    The selection of a laparoscopic approach for inguinal hernias varies among surgeons. It is unclear what is being done in actual practice. The purpose of this study was to report practice patterns for treatment of inguinal hernias among Quebec surgeons, and to identify factors that may be associated with the choice of operative approach. We studied a population-based cohort of patients who underwent an inguinal hernia repair between 2007 and 2011 in Quebec, Canada. A generalized linear model was used to identify predictors associated with the selection of a laparoscopic approach. 49,657 inguinal hernias were repaired by 478 surgeons. Laparoscopic inguinal hernia repair (LIHR) was used in 8 % of all cases. LIHR was used to repair 28 % of bilateral hernias, 10 % of recurrent hernias, 6 % of unilateral hernias, and 4 % of incarcerated hernias. 268 (56 %) surgeons did not perform any laparoscopic repairs, and 11 (2 %) surgeons performed more than 100 repairs. These 11 surgeons performed 61 % of all laparoscopic cases. Patient factors significantly associated with having LIHR included younger age, fewer comorbidities, bilateral hernias, and recurrent hernias. An open approach is favored for all clinical scenarios, even for situations where published guidelines recommend a laparoscopic approach. Surgeons remain divided on the best technique for inguinal hernia repair: while more than half never perform LIHR, the small proportion who perform many use the technique for a large proportion of their cases. There appears to be a gap between the best practices put forth in guidelines and what surgeons are doing in actual practice. Identification of barriers to the broader uptake of LIHR may help inform the design of educational programs to train those who have the desire to offer this technique for certain cases, and have the volume to overcome the learning curve.

  13. Anatomical examination of the great inguinal blood vessels in preterm and term neonates.

    PubMed

    Eifinger, Frank; Lazaridis, Elpida Chochliourou; Roth, Bernhard; Koebke, Jürgen

    2014-04-01

    It is generally accepted that vessel cannulation is technically more difficult and results in more complications in neonates. A sound anatomical knowledge of the inguinal area is therefore important in the selection of appropriately sized central line catheters as well as the approach to central vessel access. Eleven stillborns were investigated. Birth weight (mean: 2,414 g, 900-4,100 g) and gestational age (mean 34 1/7 weeks', 27 6/7-42 1/7) varied within normal range. The outer diameters of the femoral artery (FA), femoral vein (FV), and great saphenous vein (GSV) were determined. The distance between the anterior superior iliac spine and the pubic tubercle was set as 100% and the vessel intersection points were calculated as percentage values of the inguinal ligament length, starting at the iliac spine. The FA has a diameter of 1.9 ± 0.5 mm without correlation to gestational age. The FA crosses the inguinal ligament centrally. The FV has a diameter of 3.1 ± 1.0 mm and does have correlation to gestational age. The FV crosses the inguinal ligament at 63-64%. The GSV has a diameter of 1.4 ± 0.7 mm. Its point of intersection at the level of the inguinal ligament is 68-70%. We conclude that cannulation of the femoral artery or vein should not be performed too far (<1 cm) from the inguinal ligament. The course of the GSV is not suitable for catheter insertion. Copyright © 2012 Wiley Periodicals, Inc.

  14. Ultrasound imaging of the inguinal region of adult male loggerhead sea turtles (Caretta caretta).

    PubMed

    Pease, Anthony; Blanvillain, Gaëlle; Rostal, David; Owens, David; Segars, Al

    2010-03-01

    The biology and reproductive anatomy of male loggerhead sea turtles (Caretta caretta) have been difficult to study. The principle method for evaluation of the coelomic cavity in both adult and juvenile male sea turtles is celioscopy. The purpose of this study was to describe the technique and structures seen when scanning the inguinal region of live, wild-caught, adult male loggerhead sea turtles and to compare these findings to those resulting from celioscopy and necropsy. Twenty-one adult male loggerhead sea turtles were collected by trawling in the Cape Canaveral shipping channel in April 2007. All turtles were placed in dorsal recumbency and imaged with a Sonosite 180 Vet Plus (Sonosite, Inc., Bothell, Washington 98021, USA) and a microconvex, 4-7-MHz curvilinear array probe. The inguinal region was divided into four quadrants: cranial, lateral, medial, and caudal. Celioscopy was performed on 13 turtles, and biopsies were obtained of the testes and the epididymides to confirm correct identification of the structures. In the cranial aspect of the inguinal region, the urinary bladder and large and small intestines were identified. In the lateral inguinal region, the lung and kidney were seen. In the medial aspect of the inguinal region, the testis and epididymis were routinely identified. In the caudal aspect of the inguinal region, the coxofemoral joint was seen. A small learning curve was required; however, correlation with celioscopy and biopsy showed that consistent, repeatable identification of caudal coelomic structures was easily achieved. Ultrasound provided an inexpensive, rapid, noninvasive method to evaluate the reproductive anatomy of live-captured, male loggerhead sea turtles.

  15. Synthesis and Characterization of Environmentally Benign Nanoparticles

    EPA Science Inventory

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

  16. ENVIRONMENTALLY-BENIGN MULTIPHASE CATALYSIS. (R826034)

    EPA Science Inventory

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

  17. Synthesis and Characterization of Environmentally Benign Nanoparticles

    EPA Science Inventory

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

  18. ENVIRONMENTALLY-BENIGN MULTIPHASE CATALYSIS. (R826034)

    EPA Science Inventory

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

  19. Oxidative stress in benign prostate hyperplasia.

    PubMed

    Zabaiou, N; Mabed, D; Lobaccaro, J M; Lahouel, M

    2016-02-01

    To assess the status of oxidative stress in benign prostate hyperplasia, a very common disease in older men which constitutes a public health problem in Jijel, prostate tissues were obtained by transvesical adenomectomy from 10 men with benign prostate hyperplasia. We measured the cytosolic levels of malondialdehyde (MDA) and glutathione (GSH) and cytosolic enzyme activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferase. The development of benign prostate hyperplasia is accompanied by impaired oxidative status by increasing levels of MDA, depletion of GSH concentrations and a decrease in the activity of all the antioxidant enzymes studied. These results have allowed us to understand a part of the aetiology of benign prostate hyperplasia related to oxidative stress.

  20. Percutaneous ablation of benign bone tumors.

    PubMed

    Welch, Brian T; Welch, Timothy J

    2011-09-01

    Percutaneous image-guided ablation has become a standard of practice and one of the primary modalities for treatment of benign bone tumors. Ablation is most commonly used to treat osteoid osteomas but may also be used in the treatment of chondroblastomas, osteoblastomas, and giant cell tumors. Percutaneous image-guided ablation of benign bone tumors carries a high success rate (>90% in case series) and results in decreased morbidity, mortality, and expense compared with traditional surgical methods. The ablation technique most often applied to benign bone lesions is radiofrequency ablation. Because the ablation technique has been extensively applied to osteoid osteomas and because of the uncommon nature of other benign bone tumors, we will primarily focus this discussion on the percutaneous ablation of osteoid osteomas.

  1. Plugoma: CT findings after prosthetic plug inguinal hernia repairs.

    PubMed

    Aganovic, Lejla; Ishioka, Kevin M; Hughes Cassidy, Fiona; Chu, Pauline K; Cosman, Bard C

    2010-10-01

    Unrecognized CT findings of a prosthetic plug used in inguinal hernia repair can lead to incorrect diagnosis or unnecessary workup of a patient. The objective of this study is to review the expected CT findings present in patients with a history of plug repair. Retrospective cohort study retrieving clinical and image data from a single-institution database. Patients who underwent prosthetic plug hernia repair during a 5-year period at our institution had their records queried for subsequent abdominal CT scans. These CT scans were reviewed by 2 radiologists for findings referable to the hernia repair. Five-hundred and sixty-four consecutive patients underwent prosthetic plug hernia repair during a 5-year period. Fifty-one patients who had had 55 surgical procedures had subsequent CT scans, none in the early postoperative period. Readers identified 100% of the plugs, 68% of which were described as round or oval in shape. All the plugs were in close proximity to the inferior epigastric artery and were of low density on CT images. Surgical scar was identifiable in 87% of patients. Thirty-two patients (63%) had a second CT scan, demonstrating no change in size and location of the plugoma. A prosthetic mesh plug is easily seen on CT images, typically appearing as a smooth round or oval hypodense mass close to the inferior epigastric artery, deep to a surgical scar, and stable over time. It can usually be distinguished from pathologic findings. It is important that the radiologist be familiar with the patient's surgical history when interpreting these images. Copyright © 2010. Published by Elsevier Inc.

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

    NASA Astrophysics Data System (ADS)

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

    2014-04-01

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

  3. Intra-abdominal benign multicystic peritoneal mesothelioma.

    PubMed

    Jouvin, I; Dohan, A; Gergi, P; Pocard, M

    2014-04-01

    Benign multicystic peritoneal mesotheliomas are rare: pre-operative diagnosis relies on proper imaging. The differential diagnosis includes pseudomyxoma peritonei and other peritoneal cysts. Absence of previous surgical resection offers the best chance of success when complete resection is performed in a specialized center. We report the case of a 43 year-old man with benign multicystic peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. Oral benign fibrous histiocytoma: two case reports

    PubMed Central

    2009-01-01

    Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported. PMID:20066060

  5. Acute inguinal pain associated with iliopectineal bursitis in four professional soccer players.

    PubMed

    Brunot, S; Dubeau, S; Laumonier, H; Creusé, A; Delmeule, T; Reboul, G; Das Neves, D; Bouin, H

    2013-01-01

    Four professional soccer players were investigated for acute or subacute pain in the inguinal region. Clinical tests were negative for an inguinal hernia or adductor tendinitis. Resisted hip flexion caused pain. MRI in these four patients showed the onset of iliopectineal bursitis, with signal abnormalities predominantly at the periphery of the psoas tendon in contact with the iliopectineal eminence. Ultrasound-guided steroid injection allowed the two players injected to continue their sporting activity. The two other players were treated by 3 and 7 days rest and oral anti-inflammatory treatment. Copyright © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  6. Unusual cause of pneumomediastinum in a laparoscopic extraperitoneal inguinal hernia repair

    PubMed Central

    Teng, Tze Yeong; Lau, Cheryl Chien-Li

    2014-01-01

    Pneumomediastinum is an extremely rare complication after laparoscopic inguinal hernia repair. Very few cases have been reported in the surgical literature to date and most reports indicate pneumoperitoneum from the transabdominal preperitoneal approach as a causative factor. This case report describes a patient in whom an elective total extraperitoneal inguinal hernia repair was complicated by a pneumomediastinum without concomitant pneumoperitoneum, and identifies the tracking of air along the anterior extraperitoneal space and endothoracic fascia as a cause. Previous case reports were reviewed and possible etiologies are discussed. PMID:25348336

  7. Migration after open mesh plug inguinal hernioplasty: a review of the literature.

    PubMed

    Jeans, Sarah; Williams, Gethin L; Stephenson, Brian M

    2007-03-01

    Migration has been highlighted as a serious complication of open inguinal hernia repair with the "plug-and-patch" technique. We used an English language Medline search from 1995 to 2006. Review of the literature found that three cases showed poor surgical technique, one case did not show true migration, another was a case of the wrong operation being done, and in the final case, the patient was in overall very poor health. Mesh plug migration after open inguinal hernia repair can be avoided if proper attention to detail is used at the time of initial repair.

  8. Synchronous Seminoma in Abdominopelvic and Inguinal Testes: A Rare Presentation with Unusual Morphology

    PubMed Central

    Prabhakar, Neha; Nagger, Seema; Saxena, Arun

    2017-01-01

    The development of testes occurs in the abdomen during fetal life, after which they migrate into the scrotal sacs during the third trimester. During their descent, they may get arrested anywhere along the tract. Risk of testicular cancer is higher in patients with undescended testes, abdominal testis being more prone than inguinal. Seminoma is the commonest cancer in undescended testis. However, synchronous seminoma involving bilateral cryptorchid testis is rare. Present case is uncommon due to synchronous involvement of abdominopelvic and inguinal testes in extended age. It also exhibited unusual morphology with marked heterogeneity grossly as well as microscopically, instead of a common homogenous appearance. PMID:28286686

  9. Radiotherapy of stage I and II Hodgkin disease with inguinal presentation

    SciTech Connect

    Lanzillo, J.H.; Moylan, D.J.; Mohiuddin, M.; Kramer, S.

    1985-01-01

    Seventeen patients who presented with inguinal adenopathy were found to have stage I or II infradiaphragmatic Hodgkin disease. Two patients with stage IIB disease also received MOPP chemotherapy. Fifteen patients currently have no evidence of recurrence; one died of acute myelogenous leukemia 6 years after total nodal irradiation, while another died of cardiopulmonary disease but had no evidence of Hodgkin disease at autopsy. In one patient, progressive peripheral atherosclerosis developed in an irradiated inguinal area, requiring angioplasty. Patient characteristics and results of treatment are analyzed and implications for management presented.

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

    NASA Astrophysics Data System (ADS)

    Ito, Mitsuyo; Koya, Yoshiharu; Mizoshiri, Isao

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

  11. Ectopic Spleen Presenting as Lump Abdomen: A Rare Case Report and Review of Literature

    PubMed Central

    Venkanna, Madipeddi; Kumar, Dodda Ramesh; Kumaraswamy, Boda; Reddy, Bachannagari Srinivas

    2015-01-01

    Ectopic spleen is due to failure of fusion of the mesogastrium and the lining body wall epithelium, resulting in lax or absent supporting ligaments of spleen, making it abnormally mobile. This case presented as lump abdomen with history of recurrent attacks of abdominal pain. Clinical diagnosis was unidentified abdominal mass. The radiological imaging was suggestive of the diagnosis, and the exploration of abdomen has clinched the diagnosis. PMID:26500956

  12. Using added value of weather radar rainfall estimates with regard to hydrological lumped modeling

    NASA Astrophysics Data System (ADS)

    Krier, R.; Görgen, K.; Matgen, P.; Pfister, L.; Uhlenbrook, S.; Savenije, H. H. G.

    2010-05-01

    The uncertainty associated with precipitation observations largely influences the performance of rainfall-runoff models. In this study we present results of a procedure that consists in integrating the spatial distribution of rainfall provided by radar data with lumped hydrological models. The study area is the well-equipped meso-scale catchment of the Alzette River in the Grand Duchy of Luxembourg. The rainfall data that is used are radar rainfall estimations from the German Weather Service (RADOLAN dataset). The proposed two step approach consists in generating a flow path distance map of the catchment based on a DEM and in using rainfall pattern in order to calculate for each time step mean weighted flow path distances of the water routing from the location of rainfall to the catchment outlet. By putting those weighted mean distances into relation with the general catchment mean flow distance, we are able to calculate a weighted mean flow path distance ratio for a specific rainfield at a specific time step. The resulting ratio time series include the information of the spatial distribution of the rainfall and its movement inside the catchment. These ratios can be used to sequentially adapt the time lag function of a lumped model, thereby implementing information on the time space distribution of rainfall in a non-spatially distributed hydrological lumped model. The model setup is calibrated using a multiobjective optimization approach with a focus on the timing of simulated discharge and based on the concept of Pareto optimality. The two objective functions are the correlation coefficient R and the coefficient of determination R2. Results of first applications of the method on the Alzette catchment and by using the FLEX lumped model show that the weighted mean distance ratios significantly impacts the routing of flood hydrographs and may thus be considered as a promising approach for improving the prediction of the timing and magnitude of floods.

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

    SciTech Connect

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

    2015-07-22

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

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

    PubMed

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

    2013-01-01

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

  15. Lumped Parameter Model for Dynamic Performances of Plate-Fin Recuperator

    SciTech Connect

    Ming Ding; Jie Wang; Xiaoyong Yang; Lei Shi; Qingshan Su

    2006-07-01

    A lumped parameter model was developed to study dynamic performances of plate-fin recuperator in high temperature gas-cooled reactor with direct helium turbine cycle (HTGR-GT). For the core heat capacitance of recuperator was far larger than heat capacitance and thermal flow rate of helium, it was reasonable to ignore the influence of heat capacitance of fluid on dynamic characteristics of recuperator and develop the lumped parameter model with infinite core heat capacitance. The model was solved by four-order Runge-Kutta method, considering the influence of temperature on helium thermal properties. Based on the lump parameter model, transient response of outlet temperatures of recuperator was analyzed when step and ramp changes of inlet temperatures of recuperator took place in hot side, as well as mass flow rate of recuperator. Transient responses of the core temperature and outlet temperatures of helium were also analyzed while power was regulated in course of normal operation and total electric load was rejected from full power. (authors)

  16. Planetary gear modal vibration experiments and correlation against lumped-parameter and finite element models

    NASA Astrophysics Data System (ADS)

    Ericson, Tristan M.; Parker, Robert G.

    2013-04-01

    Experimental modal analysis techniques are applied to characterize the planar dynamic behavior of two spur planetary gears. Rotational and translational vibrations of the sun gear, carrier, and planet gears are measured. Experimentally obtained natural frequencies, mode shapes, and dynamic response are compared to the results from lumped-parameter and finite element models. Two qualitatively different classes of mode shapes in distinct frequency ranges are observed in the experiments and confirmed by the lumped-parameter model, which considers the accessory shafts and fixtures in the system to capture all of the natural frequencies and modes. The finite element model estimates the high-frequency modes that have significant tooth mesh deflection without considering the shafts and fixtures. The lumped-parameter and finite element models accurately predict the natural frequencies and modal properties established by experimentation. Rotational, translational, and planet mode types presented in published mathematical studies are confirmed experimentally. The number and types of modes in the low-frequency and high-frequency bands depend on the degrees of freedom in the central members and planet gears, respectively. The accuracy of natural frequency prediction is improved when the planet bearings have differing stiffnesses in the tangential and radial directions, consistent with the bearing load direction.

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

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

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

  18. Tactile sensor using acoustic reflection for lump detection in laparoscopic surgery.

    PubMed

    Tanaka, Yoshihiro; Fukuda, Tomohiro; Fujiwara, Michitaka; Sano, Akihito

    2015-02-01

    Laparoscopic surgery limits a surgeon's tactile sense. A tactile sensor could allow real-time tumor detection in laparoscopic surgery through lump inspection. This study was aimed at developing a simple and biocompatible tactile sensor for laparoscopic surgery. The proposed tactile sensor has a forceps-like shape, has no electrical elements in the tissue contact area, and can be sterilized and cleaned. We developed a tactile sensor using acoustic reflection. It is composed of a handle with a speaker and a microphone, an aluminum tube, and a sensor tip with a deformable elastic cavity. The acoustic wave in the tube is the superposition of the input wave and two waves reflected at the closed edge and the projection generated by deformation due to contact with an object. By measuring the acoustic wave in the tube, information of the deformation is derived. The sensor is modeled, and the output is analyzed to determine design parameters of the sensor. Then, a prototype of the sensor is assembled. Fundamental experiments show that the sensor output increases with increasing normal deformation. Moreover, experiments using a phantom of the stomach wall with a 0-IIc type tumor (most common early stage gastric cancer) show that large sensor output is obtained for the lump when the sensor is moved across the back surface of the tumor. The theoretical and experimental results show that the sensor is sensitive to the deformation due to contact with an object and has the potential to detect a lump in laparoscopic surgery.

  19. 5 CFR 831.2002 - Eligibility for lump-sum payment upon filing an Application for Refund of Retirement Deductions...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... date of filing an application for refund is eligible for a refund for the total lump-sum credit to...

  20. 41 CFR 301-11.528 - If I do not elect lump sum payment is there any additional reimbursement?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE... Employee Responsibilities § 301-11.528 If I do not elect lump sum payment is there any additional...

  1. 41 CFR 301-11.627 - If I elect a lump sum payment, how is the ITRA paid?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee... illustrated: Lump Sum ITRA Tax Paid to Employee ITRA reimbursement for tax year 1995 $14,435 Federal Tax...

  2. 41 CFR 301-11.627 - If I elect a lump sum payment, how is the ITRA paid?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee... illustrated: Lump Sum ITRA Tax Paid to Employee ITRA reimbursement for tax year 1995 $14,435 Federal Tax...

  3. 41 CFR 301-11.627 - If I elect a lump sum payment, how is the ITRA paid?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee... illustrated: Lump Sum ITRA Tax Paid to Employee ITRA reimbursement for tax year 1995 $14,435 Federal Tax...

  4. 41 CFR 301-11.627 - If I elect a lump sum payment, how is the ITRA paid?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee... illustrated: Lump Sum ITRA Tax Paid to Employee ITRA reimbursement for tax year 1995 $14,435 Federal Tax...

  5. 41 CFR 301-11.627 - If I elect a lump sum payment, how is the ITRA paid?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DIEM EXPENSES Income Tax Reimbursement Allowance (ITRA), Tax Years 1995 and Thereafter Employee... illustrated: Lump Sum ITRA Tax Paid to Employee ITRA reimbursement for tax year 1995 $14,435 Federal Tax...

  6. 36 CFR 223.64 - Appraisal on a lump-sum value or rate per unit of measure basis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. a Nonlinear Hybrid and VR Stepping Motor Analysis via AN Integrated Finite Element and Lumped Parameter Modeling Technique

    NASA Astrophysics Data System (ADS)

    Huard, Steven Roger

    The work involves the magnetic modeling of a variable reluctance and a hybrid stepping motor. The model combines two traditional methods for creating a magnetic model. Nonlinear two dimensional finite element analysis is combined with nonlinear lumped element modeling to create a three dimension lumped model. The two dimensional finite element analysis is used to numerically calculate the effective reluctance function of the motor tooth region. After the finite element analysis is completed, a two terminal tooth region reluctance element that is a function of both rotor angle and tooth region flux density results. The two terminal lumped element is then used to represent the tooth region of the motor in a lumped parameter model. The process by which the tooth region finite element field solution is transformed into the two terminal lumped reluctance is a new modeling approach; and, it is the foundation of the modeling method in this dissertation. Torque, back EMF, and inductance are some of the more important motor parameters predicted by the modeling method. The model predictions are compared to experimental data in the dissertation. The final motor parameter predictions from the model correlated quite well with experimental data. Also included in the dissertation is a unique derivation which defines the constraints that a region must satisfy such that a general three dimensional region of non-homogenous material can be modeled as a two terminal lumped reluctance element. The final restrictions imposed on the general three dimensional region are quite liberal. A method for solving any arbitrarily connected network of nonlinear lumped reluctances and sources is shown in detail. The method was developed specifically for use in this dissertation research, however, it is general enough to be applied to a wide variety of lumped element magnetic problems. The method explains how a Newton-Raphson iteration loop can be used to solve the nonlinear matrix equation created

  8. Torsion of Undescended Third Testis, as Rare Cause of Painful Inguinal Mass

    PubMed Central

    Nasrallah, Najib

    2015-01-01

    Twenty years old young was referred to our department due to painful inguinal mass. The mass was diagnosed as torsion of third testis which was treated by orchiectomy. Polyorchidism is a rare entity with increased risk for malignancy and torsion. PMID:25688325

  9. Minilaparoscopic Technique for Inguinal Hernia Repair Combining Transabdominal Pre-Peritoneal and Totally Extraperitoneal Approaches

    PubMed Central

    Loureiro, Marcelo P.; Bonin, Eduardo A; Claus, Christiano P.; Silva, Frederico W.; Cury, Antonio M.; Fernandes, Flavio A.M.

    2012-01-01

    Introduction: Endoscopic surgical repair of inguinal hernia is currently conducted using 2 techniques: the totally extraperitoneal (TEP) and the transabdominal (TAPP) hernia repair. The TEP procedure is technically advantageous, because of the use of no mesh fixation and the elimination of the peritoneal flap, leading to less postoperative pain and faster recovery. The drawback is that TEP is not performed as frequently, because of its complexity and longer learning curve. In this study, we propose a hybrid technique that could potentially become the gold standard of minimally invasive inguinal hernia surgery. This will be achieved by combining established advantages of TEP and TAPP associated with the precision and cosmetics of minilaparoscopy (MINI). Materials and Surgical Technique: Between January and July 2011, 22 patients were admitted for endoscopic inguinal hernia repair. The combined technique was initiated with TAPP inspection and direct visualization of a minilaparoscopic trocar dissection of the preperitoneum space. A10-mm trocar was then placed inside the previously dissected preperitoneal space, using the same umbilical TAPP skin incision. Minilaparoscopic retroperitoneal dissection was completed by TEP, and the surgical procedure was finalized with intraperitoneal review and correction of the preperitoneal work. Discussion: The minilaparoscopic TEP-TAPP combined approach for inguinal hernia is feasible, safe, and allows a simple endoscopic repair. This is achieved by combining features and advantages of both TAPP and TEP techniques using precise and sophisticated MINI instruments. Minilaparoscopic preperitoneal dissection allows a faster and easier creation of the preperitoneal space for the TEP component of the procedure. PMID:23484566

  10. Flexible transinguinal laparoscopy to assess the contralateral ring in pediatric inguinal hernias.

    PubMed

    Pavlovich, C P; Gmyrek, G A; Gardner, T A; Poppas, D P; Mininberg, D T

    1998-09-01

    The incidence of contralateral patent processus vaginalis (CPPV) is >50% in infants with clinical unilateral inguinal hernia (CUIH) and decreases only slowly with advancing age. Laparoscopy through the hernia sac (transinguinal laparoscopy) to detect suspected CPPV is a safe and efficient way to minimize routine contralateral inguinal exploration, but can be technically difficult. We used flexible urologic instruments and/or angled cystoscopic lenses to make transinguinal laparoscopy easier. Over a 3-year period, 37 patients (34 boys and 3 girls) ranging in age from 4 months to 12 years (mean age 59 months) with CUIH underwent ipsilateral groin exploration and diagnostic transinguinal laparoscopy. Laparoscopy was performed with flexible 17F cystoscopes (26 cases), flexible 9F ureteroscopes (2 cases), and rigid 70 degrees cystoscope lenses (9 cases). We detected eight CPPV (22%) in our series of 20 right and 17 left inguinal hernias, in a mean transinguinal laparoscopy time of 4.5 minutes. At 26-month mean follow-up, no patient whose contralateral inguinal ring was deemed closed had developed a hernia. Flexible fiberoptic urologic scopes and/or angled cystoscope lenses make transinguinal laparoscopy easy and efficacious in the pediatric population. Our series represents the longest longitudinal study of transinguinal laparoscopy for the diagnosis of CPPV.

  11. Vasal Injury During Inguinal Herniorrhaphy: A Case Report and Review of the Literature

    PubMed Central

    Flechner, Lawrence; Smith, James; Treseler, Patrick; Maa, John

    2014-01-01

    An injury to the vas deferens during inguinal herniorrhaphy from possible tethering of the vas has not, to our knowledge, previously been described in the surgical literature. We report a case of iatrogenic injury of the vas deferens that occurred during elective hernia repair in a 28-year-old man who had previously sustained blunt trauma to the abdomen and pelvis. PMID:25662530

  12. Medial Versus Traditional Approach to US-guided TAP Blocks for Open Inguinal Hernia Repair

    ClinicalTrials.gov

    2012-04-30

    Abdominal Muscles/Ultrasonography; Adult; Ambulatory Surgical Procedures; Anesthetics, Local/Administration & Dosage; Ropivacaine/Administration & Dosage; Ropivacaine/Analogs & Derivatives; Hernia, Inguinal/Surgery; Humans; Nerve Block/Methods; Pain Measurement/Methods; Pain, Postoperative/Prevention & Control; Ultrasonography, Interventional

  13. The Onstep Method for Inguinal Hernia Repair: Operative Technique and Technical Tips

    PubMed Central

    Andresen, Kristoffer

    2016-01-01

    Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique together with tips and tricks to make it easy and without complications. PMID:27379255

  14. Athlete's hernia--a true, early direct inguinal hernia: diagnosis, pathophysiology, and surgical treatment.

    PubMed

    Chernyavsky, Victoriya S; Davidov, Tomer; Trooskin, Stanley Z; Boyarsky, Andrew

    2011-11-01

    Athlete's hernia (AH) is an activity limiting condition that presents as chronic inguinal pain in elite athletes. The diagnosis involves a thorough history and physical examination and can be aided by ultrasound interrogation of the groin. Operative treatment with a direct tissue repair of the inguinal floor successfully alleviates symptoms and allows for full return to activity. A retrospective analysis of patients with the diagnosis of AH from January 1998 to May 2010 who underwent operative repair was reviewed. Patients were evaluated based on age, gender, sport, time to presentation, subjective and objective physical findings, imaging findings, operative findings, length of follow-up, and return to activity. Ninety-six patients (6 females) with a median age of 22.6 years were evaluated. In the majority of these patients, operative exploration revealed a wide external ring with separation of the fibers of the external oblique aponeurosis and an unprotected and bulging transverses abdominis aponeurosis, very akin to an early direct inguinal hernia. The mean initial follow-up time was 6 weeks at which point all but two of the patients were able to resume their full level of activity without restrictions. The diagnosis of AH, although somewhat elusive, can be easily established with a high degree of suspicion after doing a thorough history and physical exam augmented with ultrasonography. AH is equivalent to an early direct inguinal hernia found in young athletes and can be surgically corrected allowing return to full activity.

  15. Staged rotation flap scrotoplasty and orchidopexy in a patient with inguinal ectopic scrotum.

    PubMed

    Daniel, Gwion; Coleman, Robert

    2015-10-30

    Ectopic scrotum is a rare and unusual presentation to paediatric urology. It is usually characterized by accessory scrotum with adequate scrotum in the anatomically normal position. We describe a case of inguinal ectopia of the right hemiscrotum containing the right testis, and its staged surgical management by rotation flap scrotoplasty and subsequent orchidopexy.

  16. Malignant peritoneal mesothelioma in an inguinal hernial sac: an unusual presentation.

    PubMed

    Aggarwal, M; Lakhar, B; Shetty, D; Ullal, S

    2000-01-01

    Malignant peritoneal mesothelioma, which is a rare neoplasm, usually presents with abdominal complaints. Though such tumours have been reported from tunica vaginalis testis presenting as para-testicular mass, there is only one documented case of the tumour arising from the inguinal hernial sac. In this paper, we are reporting a rare presentation of this tumour.

  17. [Results of follow-up of operations in pediatric patients with indirect inguinal hernia].

    PubMed

    Hecker, W C; Ring-Mrozik, E

    1987-01-01

    This paper present the results of follow-up examinations of 2801 operated inguinal hernias. In comparison with the high excision of the hernial sac plus "crude suture", the standard Bassini technique produces poorer results as regards recurrence, testicular atrophy and secondary maldescent. The mortality of elective herniotomy was 0.016% in this series.

  18. Polypropylene mesh repair of a unilateral, congenital hernia in the inguinal region in a Thoroughbred filly

    PubMed Central

    Moorman, Valerie J.; Jann, Henry W.

    2009-01-01

    A 2-day-old Thoroughbred intact female was presented for a large subcutaneous swelling in the right inguinal region. Surgical repair was performed using a double layer polypropylene mesh. To the authors’ knowledge, there have been no previous reports of surgical repair of congenital body wall hernias with polypropylene mesh in foals. PMID:19721780

  19. Lichtenstein inguinal herniorraphy under local infiltration anaesthesia as rapid outpatient procedure.

    PubMed

    Paajanen, H

    2001-01-01

    In Scandinavian countries the use of local anaesthesia combined with fast patient's discharge is still uncommon in inguinal herniorraphy. To report the feasibility, safety, costs and long-term outcome in terms of pain and recurrence after 101 open inguinal herniorraphies operated under local anaesthesia as rapid outpatient procedure. All patients were selected and operated using Lichtenstein polypropylene mesh herniorraphy by the same senior surgeon and one nurse. The incidence of pain and recurrences were asked by questionnaire after the mean follow-up of 2 years. The rate of clinically important wound hematomas (n = 3) and infections (n = 1) were low as well as the number of recurrences (n = 1). Although 23 % of the patients felt later some pain sensations in the inguinal region, only 2 patients needed occasionally pain-relieving drugs. Over 90 per cent of the patients were very satisfied with the operation. Lichtenstein inguinal hernioplasty under local infiltration anaesthesia is rapid, well-tolerated, simple and inexpensive operation, which gives excellent results.

  20. Lichtenstein inguinal herniorraphy under local infiltration anaesthesia as rapid outpatient procedure.

    PubMed

    Paajanen, H

    2001-01-01

    In Scandinavian countries the use of local anaesthesia combined with fast patient's discharge is still uncommon in inguinal herniorraphy. To report the feasibility, safety, costs and long-term outcome in terms of pain and recurrence after 101 open inguinal herniorraphies operated under local anesthesia as rapid outpatient procedure. All patients were selected and operated using Lichtenstein polypropylene mesh herniorraphy by the same senior surgeon and one nurse. The incidence of pain and recurrences were asked by questionnaire after the mean follow-up of 2 years. The rate of clinically important wound hematomas (n = 3) and infections (n = 1) were low as well as the number of recurrences (n = 1). Although 23% of the patients felt later some pain sensations in the inguinal region, only 2 patients needed occasionally pain-relieving drugs. Over 90 per cent of the patients were very satisfied with the operation. Lichtenstein inguinal hernioplasty under local infiltration anaesthesia is rapid, well-tolerated, simple and inexpensive operation, which gives excellent results.

  1. Staged rotation flap scrotoplasty and orchidopexy in a patient with inguinal ectopic scrotum

    PubMed Central

    Daniel, Gwion; Coleman, Robert

    2015-01-01

    Ectopic scrotum is a rare and unusual presentation to paediatric urology. It is usually characterized by accessory scrotum with adequate scrotum in the anatomically normal position. We describe a case of inguinal ectopia of the right hemiscrotum containing the right testis, and its staged surgical management by rotation flap scrotoplasty and subsequent orchidopexy. PMID:26518318

  2. A genome-wide association study identifies four novel susceptibility loci underlying inguinal hernia

    PubMed Central

    Jorgenson, Eric; Makki, Nadja; Shen, Ling; Chen, David C.; Tian, Chao; Eckalbar, Walter L.; Hinds, David; Ahituv, Nadav; Avins, Andrew

    2015-01-01

    Inguinal hernia repair is one of the most commonly performed operations in the world, yet little is known about the genetic mechanisms that predispose individuals to develop inguinal hernias. We perform a genome-wide association analysis of surgically confirmed inguinal hernias in 72,805 subjects (5,295 cases and 67,510 controls) and confirm top associations in an independent cohort of 92,444 subjects with self-reported hernia repair surgeries (9,701 cases and 82,743 controls). We identify four novel inguinal hernia susceptibility loci in the regions of EFEMP1, WT1, EBF2 and ADAMTS6. Moreover, we observe expression of all four genes in mouse connective tissue and network analyses show an important role for two of these genes (EFEMP1 and WT1) in connective tissue maintenance/homoeostasis. Our findings provide insight into the aetiology of hernia development and highlight genetic pathways for studies of hernia development and its treatment. PMID:26686553

  3. Is there a Place for Prebiotics in the Management of Neonatal Inguinal Hernia? A Preliminary Study

    PubMed Central

    Dhaou, Mahdi Ben; Zouari, Mohamed; Ammar, Saloua; Bouraoui, Amira; Gassara, Imene; Feki, Ines; Zitouni, , Hayet; Jallouli, Mohamed; Masmoudi, Jawaher; Gargouri, Abdellatif; Mhiri, Riadh

    2017-01-01

    The objective of this study was to assess the place of prebiotics in the management of neonatal inguinal hernia. Boys with a diagnosis of unilateral non-complicated inguinal hernia, aged less than 40 days, were prospectively followed from January 2012 to December 2014. Clinical and psychiatric data and outcomes were collected before and after prebiotics (Primalac AC) administration. Ninety-eight patients were included. There were 75 inguinal hernias and 23 inguino-scrotal hernias. Before prebiotics administration 72.2% of infants had abdominal distention and 98% had colic. After prebiotics, abdominal distention and colic regressed in 85.2% and 73.2% of patients, respectively. Hernias disappeared clinically in 66.3% of cases. The factors associated with the disappearance of hernias were the type of the hernia (p<0.001), colic (p<0.001), and abdominal distention (p<0.001). Prebiotics would be a new adjunct in the management of neonatal inguinal hernia. They decrease colic and abdominal distention, which seems helpful to prevent strangulation and probably get spontaneous resolution of small hernias. PMID:28083493

  4. Is there a Place for Prebiotics in the Management of Neonatal Inguinal Hernia? A Preliminary Study.

    PubMed

    Dhaou, Mahdi Ben; Zouari, Mohamed; Ammar, Saloua; Bouraoui, Amira; Gassara, Imene; Feki, Ines; Zitouni, Hayet; Jallouli, Mohamed; Masmoudi, Jawaher; Gargouri, Abdellatif; Mhiri, Riadh

    2017-01-01

    The objective of this study was to assess the place of prebiotics in the management of neonatal inguinal hernia. Boys with a diagnosis of unilateral non-complicated inguinal hernia, aged less than 40 days, were prospectively followed from January 2012 to December 2014. Clinical and psychiatric data and outcomes were collected before and after prebiotics (Primalac AC) administration. Ninety-eight patients were included. There were 75 inguinal hernias and 23 inguino-scrotal hernias. Before prebiotics administration 72.2% of infants had abdominal distention and 98% had colic. After prebiotics, abdominal distention and colic regressed in 85.2% and 73.2% of patients, respectively. Hernias disappeared clinically in 66.3% of cases. The factors associated with the disappearance of hernias were the type of the hernia (p<0.001), colic (p<0.001), and abdominal distention (p<0.001). Prebiotics would be a new adjunct in the management of neonatal inguinal hernia. They decrease colic and abdominal distention, which seems helpful to prevent strangulation and probably get spontaneous resolution of small hernias.

  5. Proposed technique for inguinal hernia repair with self-gripping mesh: avoiding fixation to undesired structures.

    PubMed

    Porrero, J L; Cano-Valderrama, O; Castillo, M J; Alonso, M T

    2015-10-01

    Self-gripping meshes have been developed to avoid fixing sutures during inguinal hernia repair. Operative time is shorter when using a self-gripping mesh than with conventional Lichtenstein repair. However, these meshes can be difficult to handle because they fix to undesired structures. The aim of this report is to describe a new technique to avoid this problem. Inguinal hernia dissection is made as usual. Once dissection is finished, a Parietex ProGrip(®) (Covidien, Dublin, Ireland) flat sheet mesh is cut depending on the size needed. A small split is made between the lower and medium third of the mesh to mark where the split for the spermatic cord will be. Using this mark, the upper third of the mesh is folded over the medium third, hiding the microgrips that make this a self-gripping mesh. In this way, only the lower third of the mesh has the microgrips exposed and the mesh can be fixed to the pubic bone and inguinal ligament without fixation to undesired structures. Once the lower third of the mesh is fixed, the split for the spermatic cord is completed and the upper part of the mesh is passed below the spermatic cord. Then, the mesh is unfolded to expose the microgrips again and the medium and upper third of the mesh are descended to its final position. This proposed technique for inguinal hernia repair with self-gripping mesh makes the surgery easier, avoiding mesh fixation to undesired structures.

  6. Bowel Obstruction in the Postoperative Period of Laparoscopic Inguinal Hernia Repair (TAPP): Review of the Literature

    PubMed Central

    Vázquez, J.A.; Solís, M.A.; Valdéz, G.; Valencia, S.; Weber, A.

    1998-01-01

    A case is presented of a male patient that presented with intestinal obstruction in the early postoperative period of a transabdominal preperitoneal inguinal repair (TAPP) that was diagnosed and repaired successfully using laparoscopy. Whenever a total extraperitoneal procedure (TEP) cannot be performed, the peritoneal closure of the TAPP should be done water-tight using interrupted stitches of absorbable monofilament sutures. PMID:9876754

  7. Use of an inguinal approach adapted from equine surgery for cryptorchidectomy in dogs and cats: 26 cases (1999-2010).

    PubMed

    Steckel, Robert R

    2011-10-15

    OBJECTIVE-To determine whether a surgical technique used in cryptorchid horses can be used successfully to remove testicles retained in the inguinal region or abdominal cavity in dogs and cats. DESIGN-Retrospective case series. ANIMALS-22 dogs and 4 cats with cryptorchidism. PROCEDURES-In 1999 through 2010, 26 cryptorchid patients underwent surgery during which an incision was made over the inguinal ring and the undescended testicle was located for removal via identification of the vaginal process and the embryonic gubernaculum. Castration was performed once a testicle was located in the inguinal region or via removal of an intra-abdominally located testicle through the inguinal canal. RESULTS-4 dogs and 1 cat were bilaterally cryptorchid. Testicles were retained in the abdominal cavity in 18 dogs and in the inguinal region in 4 dogs; in all 4 cats, undescended testicles were located in the inguinal region. Twenty-one dogs and 4 cats were castrated without breaching the abdominal cavity; in one of those dogs, the inguinal ring was enlarged to permit extraction of a tumorous testicle. In 1 dog, the inguinal ring was enlarged into a paramedian laparotomy and viscera were manipulated to exteriorize an intra-abdominally located testicle because the gubernaculum had ruptured. Major intraoperative or long-term complications did not occur. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that as in horses, the surgical approach over the inguinal ring, wherein the vaginal process and the remnant of the gubernaculum are identified and used to locate an undescended testicle for removal, can be used successfully in dogs and cats.

  8. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

    PubMed Central

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Abstract Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt

  9. Endobronchial ultrasound: morphological predictors of benign disease.

    PubMed

    Gogia, Pratibha; Insaf, Tabassum Z; McNulty, William; Boutou, Afroditi; Nicholson, Andrew G; Zoumot, Zaid; Shah, Pallav L

    2016-01-01

    The objective of this study was to assess the utility of endobronchial ultrasound (EBUS) morphology of lymph nodes in predicting benign cytology of transbronchial needle aspirates in a prospective observational study. Five ultrasonic morphological characteristics of mediastinal and hilar lymph nodes were recorded: size, shape, margins, echogenic appearance and the presence of a central blood vessel. These characteristics were correlated with the final diagnosis. A total of 402 consecutive patients (237 males and 165 females) undergoing EBUS were studied. The final diagnosis was malignant disease in 244 (60.6%) and benign disease in 153 (38.05%) subjects. Out of 740 sampled nodes, in 463 (62.6%) malignant cells were identified, whereas in 270 (36.5%) nodes, no malignant cells were identified. On univariate analysis small size, triangular shape and the presence of a central vessel were predictive of a benign aetiology. In the final multivariate model, a predictive probability of 0.811 (95% CI 0.72-0.91) for benign disease was found if lymph node size was <10 mm and a central vessel was present. Sonographic appearances of lymph nodes improve the predictive probability of EBUS for benign aetiologies, and may reduce the number of nodes requiring sampling and the need for further invasive investigations.

  10. Zooming of states and parameters using a lumping approach including back-translation

    PubMed Central

    2010-01-01

    Background Systems biology models tend to become large since biological systems often consist of complex networks of interacting components, and since the models usually are developed to reflect various mechanistic assumptions of those networks. Nevertheless, not all aspects of the model are equally interesting in a given setting, and normally there are parts that can be reduced without affecting the relevant model performance. There are many methods for model reduction, but few or none of them allow for a restoration of the details of the original model after the simplified model has been simulated. Results We present a reduction method that allows for such a back-translation from the reduced to the original model. The method is based on lumping of states, and includes a general and formal algorithm for both determining appropriate lumps, and for calculating the analytical back-translation formulas. The lumping makes use of efficient methods from graph-theory and ϵ-decomposition and is derived and exemplified on two published models for fluorescence emission in photosynthesis. The bigger of these models is reduced from 26 to 6 states, with a negligible deviation from the reduced model simulations, both when comparing simulations in the states of the reduced model and when comparing back-translated simulations in the states of the original model. The method is developed in a linear setting, but we exemplify how the same concepts and approaches can be applied to non-linear problems. Importantly, the method automatically provides a reduced model with back-translations. Also, the method is implemented as a part of the systems biology toolbox for matlab, and the matlab scripts for the examples in this paper are available in the supplementary material. Conclusions Our novel lumping methodology allows for both automatic reduction of states using lumping, and for analytical retrieval of the original states and parameters without performing a new simulation. The two

  11. Nucleotide sequence and functional analysis of regulatory region of the lumP and the lux operon from Photobacterium leiognathi.

    PubMed

    Lin, J W; Chao, Y F; Weng, S F

    1995-05-25

    The lumP gene is linked to the lux operon, but runs in the opposite direction in Photobacterium leiognathi PL741. The gene order of the lumP and the lux operon is < -lumP-R & R-luxC-luxD-luxA-luxB-luxN-luxE- > (R & R: regulatory region). The nucleotide sequence of the regulatory region (827-bp) between the lumP and the lux operon was determined. Sequence analysis illustrates that the regulatory region includes two divergent promoter systems, PR-promoter system for the lux operon (R-operon) and PL-promoter system for the lumP or lum operon (L-operon). Functional analysis of the regulatory region shows that the PR- and PL-promoter systems both are able to lead the gene expression. The deletion experiment result elicits that the PR- and PL-promoter are coordinatively and negatively regulated; the PR- and PL-promoter might be competing for recognition by RNA polymerase to initiate transcription. The fact of the LumP responsible for the spectral blue shift in P. leiognathi implied that the lumP gene closedly linked to the lux operon is for coordinative regulation with the lux operon. In addition, the glucose repression on the PR-promoter system shows that the expression of the lux operon is regulated by cAMP-CRP induction in E. coli.

  12. Condensing complex atmospheric chemistry mechanisms. 1: The direct constrained approximate lumping (DCAL) method applied to alkane photochemistry

    SciTech Connect

    Wang, S.W.; Georgopoulos, P.G.; Li, G.; Rabitz, H.

    1998-07-01

    Atmospheric chemistry mechanisms are the most computationally intensive components of photochemical air quality simulation models (PAQSMs). The development of a photochemical mechanism, that accurately describes atmospheric chemistry while being computationally efficient for use in PAQSMs, is a difficult undertaking that has traditionally been pursued through semiempirical (diagnostic) lumping approaches. The limitations of these diagnostic approaches are often associated with inaccuracies due to the fact that the lumped mechanisms have typically been optimized to fit the concentration profile of a specific species. Formal mathematical methods for model reduction have the potential (demonstrated through past applications in other areas) to provide very effective solutions to the need for computational efficiency combined with accuracy. Such methods, that can be used to condense a chemical mechanism, include kinetic lumping and domain separation. An application of the kinetic lumping method, using the direct constrained approximately lumping (DCAL) approach, to the atmospheric photochemistry of alkanes is presented in this work. It is shown that the lumped mechanism generated through the application of the DCAL method has the potential to overcome the limitations of existing semiempirical approaches, especially in relation to the consistent and accurate calculation of the time-concentration profiles of multiple species.

  13. A cured patient who came back for consultation: neuropathic scrotal pruritus relieved after ipsilateral inguinal hernia repair.

    PubMed

    Koh, W L; Liu, T T

    2010-09-01

    When no demonstrable cause is uncovered after excluding inflammatory dermatosis, infectious disease or a manifestation of anorectal disease, anogenital pruritus is often described as 'idiopathic'. Lumbosacral radiculopathy was described by Cohen et al. as one of the possible causes of 'idiopathic' anogenital pruritus. We report a case of a patient with chronic pruritus of the right scrotum that was relieved immediately post-ipsilateral inguinal hernia repair. This is, to the best of our knowledge, the first case of neuropathic scrotal pruritus secondary to direct nerve compression by an inguinal hernia. We propose that a proper examination for the presence of inguinal hernia be performed in the work-up for scrotal pruritus.

  14. [Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

    PubMed

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

    2013-05-01

    Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  16. Incidental Non-Inguinals Hernias in Totally Extra-Peritoneal Hernia Repair

    PubMed Central

    Old, OJ; Kulkarni, SR; Hardy, TJ; Slim, FJ; Emerson, LG; Bulbulia, RA; Whyman, MR

    2015-01-01

    Introduction Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Materials and Methods Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. Results A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p<0.01). The risk for patients >60 years of age was 4.0% vs 1.4% for those aged <60 years (p<0.01). Incidental hernias were found in 29.2% of females vs 2.2% of males, (p<0.0001). Risk of incidental hernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Conclusions Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females. PMID:25723688

  17. Trends in operation rates for inguinal hernia over five decades in England: database study.

    PubMed

    Maisonneuve, J J; Yeates, D; Goldacre, M J

    2015-10-01

    We aimed to study trends over time in operation rates for inguinal hernia with and without obstruction over five decades. Routine hospital statistics were used to analyse trends in National Health Service hospitals in England (1968-2011). All-England admission rates for elective repair of unobstructed inguinal hernia in males were 240.8 episodes per 100,000 population [95 % confidence interval (CI) 234.5-247.2] in 1968 and were relatively stable until 2003 after which they declined to 217.1 (215.4-218.8) by 2011. However, the stability of the all ages rates masked a large decline in admission rates in the young (e.g. 425 per 100,000 in 1968-1970 in males under 1 year of age, down to 155 per 100,000 in 2007-2011) and a large increase in the elderly (e.g. 247 in 1968-1970 per 100,000 males aged 75-84, up to 799 per 100,000 in 2007-2011). All-England admission rates for obstructed inguinal hernia in males almost halved, from 19.3 episodes (17.4-21.2) in 1968 to 10.7 episodes (10.3-11.0) per 100,000 population in 2011. Admission rates for females gradually declined over time for both unobstructed and obstructed inguinal hernia. Hospital admission rates for elective operation on inguinal hernia without obstruction, for all ages combined, have been relatively stable over five decades, but this masked big differences between age groups. Rates of obstructed hernia have declined over time, particularly in the early years covered by the study, and have not shown an increase associated with the recent fall in elective surgery for hernia repair.

  18. A 5-year Review of Darning Technique of Inguinal Hernia Repair

    PubMed Central

    Olasehinde, Olalekan O; Adisa, Adewale O; Agbakwuru, Elugwaraonu A; Etonyeaku, Amarachukwu C; Kolawole, Oladapo A; Mosanya, Arinze O

    2015-01-01

    Context: The Darning technique of inguinal hernia repair is a tissue-based technique with documented low recurrence rate in some parts of the world. Though practiced in our setting, little is documented on its outcome. Aims: The aim was to review the outcome of Darning technique of inguinal hernia repair in our setting. Study Design: A descriptive retrospective study. Patients and Methods: Clinical records of all patients who had inguinal hernia repair using the Darning technique between January 2007 and December 2011 in our institution were obtained. Details of sociodemographic data, intraoperative findings and postoperative complications were reviewed. Statistical Analysis Used: simple frequencies, proportions and cross-tabulations. Results: A total of 132 patients whose ages ranged from 15 to 84 years (mean = 49.4 years) with a male: female ratio of 12:1 were studied. Majority of the hernias were right sided (68.9%), mostly indirect (81.8%). The procedures were for emergencies in 17 (12.9%) cases whereas the rest (87.1%) were done electively. Most procedures, 110 (83.3%) were performed under local anesthesia. Surgical site infection was the most common complication occurring in six patients (4.5%), while four patients (3%) had chronic groin pain. At a mean follow-up period of 15 months there were two recurrences (1.5%) both occurring in patients with bilateral hernias (P = 0.001). Conclusions: The Darning technique of inguinal hernia repair is a safe and effective method for inguinal hernia repair in our setting. PMID:25838768

  19. Incidental non-inguinals hernias in totally extra-peritoneal hernia repair.

    PubMed

    Old, O J; Kulkarni, S R; Hardy, T J; Slim, F J; Emerson, L G; Bulbulia, R A; Whyman, M R; Poskitt, K R

    2015-03-01

    Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p<0.01). The risk for patients >60 years of age was 4.0% vs 1.4% for those aged <60 years (p<0.01). Incidental hernias were found in 29.2% of females vs 2.2% of males, (p<0.0001). Risk of incidental hernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females.

  20. Occult hernias detected by laparoscopic totally extra-peritoneal inguinal hernia repair: a prospective study.

    PubMed

    Dulucq, J-L; Wintringer, P; Mahajna, A

    2011-08-01

    One distinct advantage of laparoscopic inguinal hernia repair is the opportunity for clear visualization of the direct, indirect, femoral, obturator and other groin spaces. The aim of this study was to examine/assess the potential of the laparoscopic totally extraperitoneal (TEP) inguinal hernia repair method in detecting unexpected additional hernias. Patients who underwent an elective inguinal hernia repair, in the department of abdominal surgery at the institute of laparoscopic surgery (ILS, Bordeaux, France) between September 2003 and July 2005 were enrolled prospectively in the study. The patients' demographic data, operative, postoperative course and outpatient follow-up were studied. A total of 337 laparoscopic inguinal hernia repairs were performed in 263 patients. Of these, 189 patients had unilateral hernia (109 right and 80 left) and 74 patients had bilateral hernias. Indirect hernias were the most common, followed by direct and then femoral hernias. There were 218 male patients and 45 female patients with a mean age of 60 ± 15 years. There were 44 unexpected hernias: 6 spegilian hernias, 19 obturator hernias and another 19 femoral hernias. Two patients were converted to transabdominal preperitoneal (TAPP) due to surgical difficulties. There were no major intraoperative complications in all patients except for three cases of bleeding arising from the inferior epigastric artery. Only one patient had postoperative bleeding and was re-operated on several hours after the hernia repair. No recurrence occurred in the present series. The laparoscopic inguinal hernia repair approach allows viewing of the entire myopectineal orifice, facilitating repair of any unexpected hernias and thereby reducing the chance of recurrence.

  1. The secondary external inguinal ring and associated fascial planes: surgical anatomy, embryology, applications.

    PubMed

    Mirilas, P; Mentessidou, A

    2013-06-01

    Classically, two inguinal rings are defined: internal and external. We previously introduced a third one, the secondary internal inguinal ring, deep to the classic internal. Here, we present a fourth ring, the secondary external inguinal ring, initially described by McGregor (Surg Gynecol Obstet 49:273-307, 1929), but now forgotten. Embryologically, this ring may be formed by evagination of Scarpa's fascia during testicular descent. Anatomically, it is located 2 cm below the pubic tubercle. It is formed by Scarpa's fascia that covers the spermatic cord anteriorly; medial and lateral fascial reflections delineate the ring and form the spermatic cord canal. The cord is attached to the posterior wall of the canal. The canal ends at the entrance of the scrotum, where Colles' fascia fuses with coverings of the cord. Adjoining the secondary external ring, at the same surgical layer and communicating with the subcutaneous abdominal space, are four subcutaneous pouches: laterally, the superficial inguinal pouch; medially, the perineal, femoral, and pubic pouches. Surgically, an inguinoscrotal hernia passes though the secondary external ring and obtains an extra outer layer by entering the spermatic cord canal. Underdevelopment of the ring leads to incomplete testicular descent or ectopic testis. We recommend reconstruction of Scarpa's ring after orcheopexies and herniotomies in children. After urethral rupture distal to the urogenital diaphragm, urine may fill the subcutaneous abdominal space, pouches, and scrotum, due to their communication around the secondary external ring. In females, this ring was not found, possibly because of the non-descent of the ovaries through (and beyond) the inguinal canal.

  2. Unintended consequences of policy change to watchful waiting for asymptomatic inguinal hernias.

    PubMed

    Hwang, M J; Bhangu, A; Webster, C E; Bowley, D M; Gannon, M X; Karandikar, S S

    2014-07-01

    In 2009 the Department of Health instructed McKinsey & Company to provide advice on how commissioners might achieve world class National Health Service productivity. Asymptomatic inguinal hernia repair was identified as a potentially cosmetic procedure, with limited clinical benefit. The Birmingham and Solihull primary care trust cluster introduced a policy of watchful waiting for asymptomatic inguinal hernia, which was implemented across the health economy in December 2010. This retrospective cohort study aimed to examine the effect of a change in clinical commissioning policy concerning elective surgical repair of asymptomatic inguinal hernias. A total of 1,032 patients undergoing inguinal hernia repair in the 16 months after the policy change were compared with 978 patients in the 16 months before. The main outcome measure was relative proportion of emergency repair in groups before and after the policy change. Multivariate binary logistic regression was used to adjust the main outcome for age, sex and hernia type. The period after the policy change was associated with 59% higher odds of emergency repair (3.6% vs 5.5%, adjusted odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.03-2.47). In turn, emergency repair was associated with higher odds of adverse events (4.7% vs 18.5%, adjusted OR: 3.68, 95% CI: 2.04-6.63) and mortality (0.1% vs 5.4%, p<0.001, Fisher's exact test). Introduction of a watchful waiting policy for asymptomatic inguinal hernias was associated with a significant increase in need for emergency repair, which was in turn associated with an increased risk of adverse events. Current policies may be placing patients at risk.

  3. Benign multicystic mesothelioma: a case report.

    PubMed

    Adolph, A J; Smith, T E; Adolph, J

    2002-03-01

    Benign multicystic mesothelioma (also known as multilocular peritoneal inclusion cyst) is a rare lesion found on any abdominal peritoneal surface that occurs most frequently in premenopausal women. We report the case of a 36-year- old woman, who presented with a history of generalized abdominal pain, intermittent abdominal bloating, and episodes of loose stools. A pelvic ultrasound revealed a complex cystic mass with fine internal septations. The patient was managed by laparotomy with removal of mass, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Final pathology revealed benign multicystic mesothelioma. Although mesothelioma is a rare tumour, it is important for all gynaecologists to recognize its existence, the appearance of this lesion, and its generally benign course. This is especially important as it occurs in young women where fertility considerations must be part of the discussion of any pelvic surgery.

  4. Benign multicystic peritoneal mesothelioma: a case report

    PubMed Central

    2010-01-01

    Introduction We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. Case presentation A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Conclusions Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis. PMID:21114811

  5. Benign multicystic peritoneal mesothelioma: a case report.

    PubMed

    Pitta, Xanthi; Andreadis, Efstathios; Ekonomou, Athanasios; Papachristodoulou, Athanasia; Tziouvaras, Chrisostomos; Papapaulou, Leonidas; Sapidis, Nikolaos; Chrisidis, Thomas

    2010-11-29

    We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

  6. Benign bone tumors--recent developments.

    PubMed

    Garcia, Roberto A; Inwards, Carrie Y; Unni, Krishnan K

    2011-02-01

    Benign bone tumors frequently pose a diagnostic challenge for general surgical pathologists. Accurate pathologic diagnosis requires careful clinical and radiological correlation. The most significant recent advances in some benign bone tumors have occurred at the molecular and cytogenetic level. The detection of clonal chromosomal aberrations, various specific molecular genetic events, and the description of the bone cell signaling pathways in the field of osteoimmunology have provided a better understanding of the pathophysiology of certain tumors and an important aid in the diagnostic workup and differential diagnosis of some bone lesions demonstrating overlapping clinical and pathologic features. Future directions include prognostic and therapeutic applications of these findings. Newer less invasive therapeutic techniques and medical management have been developed for the treatment of certain benign bone tumors.

  7. [Modern pharmacotherapy of benign prostatic hyperplasia].

    PubMed

    Krysiak, Robert; Okopień, Bogusław; Szkróbka, Witold; Herman, Zbigniew Stanisław

    2005-11-01

    Benign prostatic hyperplasia is the most common medical problem affecting elderly men throughout the world. With increasing awareness of health issues amongst males, the morbidity caused by this disease is not longer being accepted as just part of growing old. Until about 10 years ago, surgery was the only effective treatment for symptomatic benign prostatic hyperplasia. Now, many men suffering from this disorder may be effectively treated with a medical therapy. This article provides an overview of the efficacy and safety of 5alpha-reductase inhibitors, alpha1-adrenoceptor antagonists and herbal remedies, putting special emphasis on the current place of these agents in the modem therapy of benign prostatic hyperplasia. Wherever possible, our opinion is based on the detailed analysis of the results of available clinical trials.

  8. Finasteride for benign prostatic hyperplasia.

    PubMed

    Tacklind, James; Fink, Howard A; Macdonald, Roderick; Rutks, Indy; Wilt, Timothy J

    2010-10-06

    Benign prostatic hyperplasia (BPH), a non-malignant enlargement of the prostate in aging men, can cause bothersome urinary symptoms (intermittency, weak stream, straining, urgency, frequency, incomplete emptying). Finasteride, a five-alpha reductase inhibitor (5ARI), blocks the conversion of testosterone to dihydrotestosterone, reduces prostate size, and is commonly used to treat symptoms associated with BPH. To compare the clinical effectiveness and harms of finasteride versus placebo and active controls in the treatment of lower urinary tract symptoms (LUTS). We searched The Cochrane Library (which includes CDSR (Cochrane Database of Systematic Reviews), DARE (Database of Abstracts of Reviews of Effects), HTA (Heath Technology Assessments), and CENTRAL (Cochrane Central Register of Controlled Trials, and which includes EMBASE and MEDLINE), LILACS (Latin American and Caribbean Center on Health Sciences Information) and Google Scholar for randomized, controlled trials (RCTs). We also handsearched systematic reviews, references, and clinical-practice guidelines. Randomized trials in the English language with placebo and/or active arms with a duration of at least 6 months. JT extracted the data, which included patient characteristics, outcomes, and harms. Our primary outcome was change in a validated, urinary symptom-scale score, such as the AUA/IPSS. A clinically meaningful change was defined as 4 points. We also categorized outcomes by trial lengths of ≤ 1 year (short term) and > 1 year (long term). Finasteride consistently improved urinary symptom scores more than placebo in trials of > 1 year duration, and significantly lowered the risk of BPH progression (acute urinary retention, risk of surgical intervention, ≥ 4 point increase in the AUASI/IPSS). In comparison to alpha-blocker monotherapy, finasteride was less effective than either doxazosin or terazosin, but equally effective compared to tamsulosin. Both doxazosin and terazosin were significantly more

  9. Osteoid osteoma and benign osteoblastoma in childhood.

    PubMed Central

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

    1979-01-01

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

  10. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

    PubMed Central

    Shin, Hyun Deok; Kim, Suk Bae

    2016-01-01

    Benign cystic mesothelioma (BCM) is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis. PMID:27403112

  11. Radiofrequency ablation for benign thyroid nodules.

    PubMed

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

    2016-09-01

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

  12. Testicle lump

    MedlinePlus

    ... AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016: ... AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016: ...

  13. Skin lumps

    MedlinePlus

    ... DM. Dermal and subcutaneous tumors. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical ... Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  14. Groin lump

    MedlinePlus

    ... lymphadenopathy; Localized lymphadenopathy - groin; Bubo; Lymphadenopathy - groin Images Lymphatic system Swollen lymph nodes in the groin References ... and the A.D.A.M. Editorial team. Lymphatic Diseases Read more Latest Health News Read more ...

  15. Armpit lump

    MedlinePlus

    ... nodes enlargement - axillary; Axillary abscess Images Female breast Lymphatic system Swollen lymph nodes under arm References Armitage ... Editorial team. Arm Injuries and Disorders Read more Lymphatic Diseases Read more Latest Health News Read more ...

  16. [Recurrence of bladder cancer in remnant urethra and inguinal lymph node metastasis nine years after total cystectomy: a case report].

    PubMed

    Obata, Jun; Kikuchi, Eiji; Kaneko, Gou; Miyajima, Akira; Kameyama, Kaori; Jinzaki, Masahiro; Oya, Mototsugu

    2011-01-01

    A 68-year-old man underwent total cystectomy, urethrectomy preserving fossa navicularis, and an Indiana pouch urinary diversion in 1997. The histopathology was UC, G3, pT4 (prostate). Nine years after the operation, he had multiple metastases to the inguinal and paraaortic lymph nodes (LNs), and he complained of erosion around the glans. Histological diagnosis of the glans revealed recurrent UC to the urethra of the glans. We considered the possibility that the inguinal LN metastasis was due to lymphatic spread from a remnant urethral recurrence. Thus, a partial penectomy and inguinal LN dissection were undertaken. Systemic chemotherapy was administered. Remnant urethral recurrence after urethrectomy preserving the fossa navicularis and inguinal LN metastasis are rare.

  17. Simulation and study of the behaviour of the transversalis fascia in protecting against the genesis of inguinal hernias.

    PubMed

    Fortuny, G; Rodríguez-Navarro, J; Susín, A; López-Cano, M

    2009-10-16

    Simulating the muscular system has many applications in biomechanics, biomedicine and the study of movement in general. We are interested in studying the genesis of a very common pathology: human inguinal hernia. We study the effects that some biomechanical parameters have on the dynamic simulation of the region, and their involvement in the genesis of inguinal hernias. We use the finite element method (FEM) and current models for the muscular contraction to determine the deformed fascia transversalis for the estimation of the maximum strain. We analysed the effect of muscular tissue density, Young's modulus, Poisson's coefficient and calcium concentration in the genesis of human inguinal hernia. The results are the estimated maximum strain in our simulations, has a close correlation with experimental data and the accepted commonly models by the medical community. Our model is the first study of the effect of various biological parameters with repercussions on the genesis of the inguinal hernias.

  18. Exploring a Third Confirmed Case of Hemoperitoneum following Open Inguinal Hernia Repair Caused by Sampson Artery Hemorrhage

    PubMed Central

    Hebert, Jordan; Jagtiani, Manoj; Schmelzer, David; Wolodiger, Fred

    2017-01-01

    Hemoperitoneum is a rare complication of open inguinal hernia repair. This is the third reported case of this complication attributed to the same bleeding source: Sampson's artery. Sampson's artery courses along the round ligament of the uterus in the inguinal canal of females, originating from the arcade formed between the uterine and ovarian arteries. Usually obliterated in postembryonic development, this artery can persist in some adult female patients. Disruption of Sampson's artery can lead to hemoperitoneum following ligation of the uterine round ligament during open inguinal hernia repair in females. This case report describes a third confirmed case of hemoperitoneum complicating an open inguinal hernia repair. We review all three reported cases to date and discuss the recurring signs, symptoms, epidemiologic factors, and diagnostic findings associated. Our review suggests that females of childbearing age, particularly those in the peripartum period, are most at risk of developing this rare complication. PMID:28487804

  19. Huge benign mesenchymoma in pharynx-esophagus.

    PubMed

    Li, Jun; Omo, Alfred; Liu, Ligang; Liu, Lisi; Tang, Yinxiong; Pan, Tiecheng

    2006-06-01

    Benign mesenchymoma is an uncommon neoplastic disease and its occurrence in pharynx-esophagus is even more rarely reported. A successful case operation is reported. The origin of this tumor was in the pharynx-esophagus, and complete excision was achieved through a laterocervical approach.

  20. Imaging features of benign adrenal cysts.

    PubMed

    Sanal, Hatice Tuba; Kocaoglu, Murat; Yildirim, Duzgun; Bulakbasi, Nail; Guvenc, Inanc; Tayfun, Cem; Ucoz, Taner

    2006-12-01

    Benign adrenal gland cysts (BACs) are rare lesions with a variable histological spectrum and may mimic not only each other but also malignant ones. We aimed to review imaging features of BACs which can be helpful in distinguishing each entity and determining the subsequent appropriate management.