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Sample records for benign inguinal lump

  1. 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, ...

  2. 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.

  3. 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.

  4. 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

  5. Breast Lumps

    MedlinePlus

    ... 2015. Raftery AT, et al. Breast lumps. In: Churchill's Pocketbook of Differential Diagnosis. 4th ed. Philadelphia, Pa.: Churchill Livingston Elsevier; 2014. http://www.clinicalkey.com. Accessed ...

  6. 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 ...

  7. 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 ...

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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 ...

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  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...

  10. 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...

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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. ...

  20. 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

  1. 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.

  2. 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

  3. 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: ...

  4. 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 ...

  5. 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)

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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.

  4. 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

  5. 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

  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. 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 ...

  8. 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.

  9. 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

  10. 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.

  11. Benign prostatic hyperplasia.

    PubMed Central

    Simpson, R J

    1997-01-01

    The clinical syndrome of benign prostatic hyperplasia reflects a complex interplay between benign prostatic enlargement, which will affect almost all men by the age of 80, and the resulting outlet obstruction and lower urinary tract symptoms. The disease is now known to adversely affect the quality of life of around one man in three over the age of 50. New medical treatments and new surgical interventions are challenging the previous standard treatment of transurethral resection of prostate, which continues to have a morbidity of 17% and some mortality. Primary care will be increasingly involved in shared care with particular emphasis on monitoring of patients on watchful waiting medical therapy- and following operative intervention. PMID:9196969

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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...

  5. 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.

  6. 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

  7. 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…

  8. 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.

  9. 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

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. [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.

  14. Benign Breast Problems and Conditions

    MedlinePlus

    ... with a needle. Another example is a simple fibroadenoma . Simple fibroadenomas usually shrink or go away on their own. ... Cyst: A sac or pouch filled with fluid. Fibroadenoma: A type of solid, benign breast mass. Hormone: ...

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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)

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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…

  5. 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

  6. [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

  7. 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.

  8. [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.

  9. 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

  10. Facts for Life: Benign Breast Changes

    MedlinePlus

    ... microscope. For example, hyperplasia cells look different from fibroadenoma cells. These conditions can also differ in how ... does not need to be removed (unless painful) Fibroadenoma — a smooth, rubbery or hard lump that moves ...

  11. 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.

  12. 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...

  13. 29 CFR 4050.9 - Annuity or elective lump sum-living missing participant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... interest on the missed payments (at the plan rate up to the deemed distribution date and thereafter at the... § 4050.5(a)(3) (no lump sum) or § 4050.5(a)(4) (elective lump sum) and who is living on the date as of... the deemed distribution date. The PBGC will pay the benefit of a missing participant whose benefit...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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; ...

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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...

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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).

  15. 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.

  16. 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.

  17. 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)

  18. 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.

  19. 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

  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. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. [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.

  8. 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.

  9. [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.

  10. [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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. [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.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  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. Genetics Home Reference: benign recurrent intrahepatic cholestasis

    MedlinePlus

    ... All Close All Description Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodes of liver dysfunction called ... a lack of appetite. A common feature of BRIC is the reduced absorption of fat in the ...

  1. 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...

  2. 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.

  3. 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 (...

  4. 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

  5. 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

  6. 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.

  7. 24 CFR 570.513 - Lump sum drawdown for financing of property rehabilitation activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the letter of credit in a lump sum to establish a rehabilitation fund in one or more private financial... recipient's rehabilitation program administrative costs and the administrative costs of the financial... recipient shall execute a written agreement with one or more private financial institutions for...

  8. 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.

  9. 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.

  10. 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.

  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. 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.

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. [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.

  4. 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

  5. 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...

  6. 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.

  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. 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

  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. 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.

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. [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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. Unusual Benign Tumors of the Breast

    PubMed Central

    Adrada, Beatriz E; Krishnamurthy, Savitri; Carkaci, Selin; Posleman-Monetto, Flavia E; Ewere, Adesuwa; Whitman, Gary J

    2015-01-01

    The purpose of this article is to describe the imaging characteristics of a variety of benign breast tumors that may be encountered in daily practice, in order to formulate an appropriate differential diagnosis and to establish concordance between the imaging and the pathologic findings, and to assist the clinician with appropriate management. PMID:26085959

  15. 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.

  16. 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.

  17. Congenital epulis: A rare benign tumour.

    PubMed

    Wong, D K C; Ramli, R; Muhaizan, W M; Primuharsa Putra, S H A

    2016-10-01

    Congenital epulis is a rare benign pedunculated tumour of the oral cavity arising from the alveolar ridges. It is usually detected in newborns and can be successfully resected surgically. We report a case of a newborn baby who had a 5x3x3cm pedunculated lobar mass arising from the upper alveolar ridge.

  18. Benign Prostatic Hyperplasia: from Bench to Clinic

    PubMed Central

    Cho, Hee Ju

    2012-01-01

    Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options. PMID:22468207

  19. 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

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. [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.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  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. 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.

  17. 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

  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. A novel benign solution for collagen processing

    NASA Astrophysics Data System (ADS)

    Arnoult, Olivier

    Collagen is the main protein constituting the extracellular matrix (ECM) of tissues in the body (skin, cartilage, blood vessels...). It exists many types of collagen, this work studies only fibrillar collagen (e.g. collagen type I contained in the skin) that exhibits a triple helical structure composed of 3 alpha-helical collagen chains. This particular and defined hierarchical structure is essential to the biological and mechanical properties of the collagen. Processing collagen into scaffolds to mimic the ECM is crucial for successful tissue engineering. Recently collagen was processed into fibrous and porous scaffold using electrospinning process. However the solvent (HFIP) used for electrospinning is extremely toxic for the user and expensive. This work shows that HFIP can be replaced by a benign mixture composed of water, salt and alcohol. Yet only three alcohols (methanol, ethanol and iso-propanol) enable the dissolution of large quantity of collagen in the benign mixture, with a wide range of alcohol to buffer ratio, and conserve the collagen hierarchical structure at least as well as the HFIP. Collagen can be electrospun from the benign mixture into sub-micron fibers with concentrations as low as 6 wt-% for a wide range of alcohol to buffer ratio, with at least 10wt-% of salt, and any of the three alcohols. Specific conditions yield nano size fibers. After processing from HFIP or a benign mixture, collagen is water soluble and needs to be chemically crosslink for tissue engineering application. Post-crosslinking with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) results in the loss of the scaffold fibrous aspect and porosity, hence it is useless for tissue engineering. Such issue could be prevented by incorporating the crosslinker into the mixture prior to electrospinning. When EDC is used alone, collagen forms a gel in the mixture within minutes, preventing electrospinning. The addition of N-hydroxysuccinimide (NHS) in excess to EDC

  20. Armpit lump

    MedlinePlus

    ... caused by shaving or use of antiperspirants (not deodorants). This is most often seen in teens just ... More Abscess Breast cancer Breast self-exam Cyst Deodorant poisoning Malignancy Tumor Vaccines (immunizations) - overview Review Date ...

  1. Testicle lump

    MedlinePlus

    ... and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ... Neoplasms of the testis. In:Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ...

  2. 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 ...

  3. Benign paroxysmal positional vertigo following septorhinoplasty.

    PubMed

    Koc, Eltaf Ayca Ozbal; Koc, Bulent; Eryaman, Esra; Ozluoglu, Levent N

    2013-01-01

    We present 2 cases of benign paroxysmal positional vertigo (BPPV) following septorhinoplasty. Benign paroxysmal positional vertigo following septorhinoplasty is an unusual entity. Two young women who had difficulty in breathing and nasal deformity underwent septorhinoplasty. On the second and the third postoperative days, the patients experienced vertigo that was induced by position changes. Both patients had neither preexisting ear disease nor vertigo before the surgery. All the examinations were normal. With Dix-Hallpike maneuver, which is the criterion-standard test, the characteristic nystagmus was observed. Right posterior canal BPPV was diagnosed, and they were both treated with Epley canalith repositioning maneuver. Publications related to postsurgical vertigo are available in literature, but it is still an underdiagnosed disorder. We would like to mention about this rare entity and inform the surgeons that they must keep in mind that a patient who is complaining about vertigo or dizziness after the surgery should be observed and investigated for BPPV.

  4. Benign recurrent VI nerve palsy in childhood.

    PubMed

    Bixenman, W W; von Noorden, G K

    1981-01-01

    The case of a child with six documented episodes of benign recurrent unilateral VI nerve palsy between the ages of 2 1/2 months and 3 years is presented. Despite the recognized self-limiting course of this disorder, its possible evolution into a comitant esotropia makes close follow-up mandatory. The practical aspects of management including maintenance occlusion therapy are stressed as well as the need for prompt surgical intervention once the acquired stabismus has become stabilized. The etiology of benign VI nerve palsy of childhood may have the same immunological basis as other cases of para-infectious neuropathy. This isolated postinfective cranial mononeuropathy easily blends into the continuum of neurological involvement seen with the Landry-Guillian-Barre syndrome. With recovery from the initial episode, the abducens nerve may have become predisposed to recurrent inflammatory episodes and recurrent loss of function. Most often these recurrences are triggered by febrile illnesses of childhood.

  5. Laser Thermal Ablation of Thyroid Benign Nodules

    PubMed Central

    Shahrzad, Mohammad Karim

    2015-01-01

    Thermal ablation therapies for benign thyroid nodules have been introduced in recent years to avoid the complications of traditional methods such as surgery. Despite the little complications and the reportedly acceptable efficacy of thermal ablation methods, quite few medical centers have sought the potential benefits of employing them. This paper provides an introduction to the literature, principles and advances of Percutaneous Laser Ablation therapy of thyroid benign nodules, as well as a discussion on its efficacy, complications and future. Several clinical research papers evaluating the thermal effect of laser on the alleviation of thyroid nodules have been reviewed to illuminate the important points. The results of this research can help researchers to advance the approach and medical centers to decide on investing in these novel therapies. PMID:26705459

  6. [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.

  7. [Surgical treatment of benign paroxysmal positional vertigo].

    PubMed

    Zaugg, Y; Grosjean, P; Maire, R

    2012-10-03

    Benign paroxysmal positional vertigo (BPPV) is a common disorder that presents to the general practitioner. This condition represents one of the most common causes of peripheral vertigo. The diagnosis is made on clinical grounds. The treatment relies on repositioning maneuvers with relief of symptoms that occur in a few weeks in the majority of the cases. Rarely, patients are incapacitated by persistent or recurrent BPPV despite multiple repositioning maneuvers. In these cases, surgical therapies are available which provide excellent results.

  8. Management of familial benign chronic pemphigus

    PubMed Central

    Arora, Harleen; Bray, Fleta N; Cervantes, Jessica; Falto Aizpurua, Leyre A

    2016-01-01

    Benign familial chronic pemphigus or Hailey–Hailey disease is caused by an autosomal dominant mutation in the ATP2C1 gene leading to suprabasilar acantholysis. The disease most commonly affects intertriginous areas symmetrically. The chronic nature of the disease and multiple recurrences make the disease bothersome for patients and a treatment challenge for physicians. Treatments include topical and/or systemic agents and surgery including laser. This review summarizes the available treatment options. PMID:27695354

  9. Surgical treatment of benign endobronchial tumours

    PubMed Central

    Halttunen, P; Meurala, H; Standertskjöld-Nordenstam, C-G

    1982-01-01

    Four cases of benign endobronchial tumour are reported which were successfully treated by bronchial resection. In two cases (of fibroma and leiomyoma respectively) a cylinder of bronchus alone was resected; in one case (lipoma) a healthy right upper lobe was preserved by a bronchoplastic procedure and in the other (chondroma) the tumour was removed with the right lower lobe, which was irreversibly damaged. It is important to recognise that such tumours are unsuitable for treatment by endoscopic means alone. Images PMID:7157223

  10. Hemorrhagic, calcified, and ossified benign retroperitoneal schwannoma

    PubMed Central

    Xu, Shao-Yan; Sun, Ke; Xie, Hai-Yang; Zhou, Lin; Zheng, Shu-Sen; Wang, Wei-Lin

    2016-01-01

    Abstract Background: Schwannomas are mesenchymal tumors arising from the neural sheaths of peripheral nerves. They can almost develop in any part of the body, while head, neck and extremities are the most common sites. Occurrence in the retroperitoneum is rare. Schwannomas can show secondary degenerative changes including cyst formation, hyalinization, hemorrhage, and calcification, whereas the ossified retroperitoneal schwannoma was only reported in a malignant one. Case summary: We first present a benign ossified retroperitoneal schwannoma in a 61-year-old female. The mass was found by a routine health examination. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a well-defined mass in the area among duodenum, right liver, and kidney. Definitive preoperative diagnosis of the mass was difficult. By laparotomy, the mass was found in the retroperitoneum. We completely removed the tumor and gross specimen showed a mass with a capsule and 6 × 6 × 4.8 cm in size. Microscopic examination showed the tumor is composed of spindle-shaped cells with degenerative changes of hemorrhage, calcification, and ossification. Immunohistochemically, S-100 protein was strongly positive. Finally, the mass was diagnosed as a hemorrhagic, calcified, and ossified benign schwannoma in the retroperitoneum. The patient was followed up for a period of 21 months, during which she was well with no evidence of recurrence. Conclusion: We report the first case of a benign retroperitoneal schwannoma with secondary degenerative changes including hemorrhage, calcification, and ossification. Precise preoperative diagnosis of the tumor is challenging even with multiple preoperative imaging modalities. After complete resection, patients with benign retroperitoneal schwanommas generally have good prognosis. PMID:27472709

  11. Laparoscopic resection of retroperitoneal benign neurilemmoma

    PubMed Central

    Park, Joon Seong; Kang, Chang Moo; Yoon, Dong Sup; Lee, Woo Jung

    2017-01-01

    Purpose The aim of this study was to verify that laparoscopic resection for treating retroperitoneal benign neurilemmoma (NL) is expected to be favorable for complete resection of tumor with technical feasibility and safety. Methods We retrospectively analyzed 47 operations for retroperitoneal neurogenic tumor at Yonsei University College of Medicine, Severance Hospital and Gangnam Severance Hospital between January 2005 and September 2015. After excluding 21 patients, the remaining 26 were divided into 2 groups: those who underwent open surgery (OS) and those who underwent laparoscopic surgery (LS). We compared clinicopathological features between the 2 groups. Results There was no significant difference in operation time, estimated blood loss, transfusion, complication, recurrence, or follow-up period between 2 groups. Postoperative hospital stay was significantly shorter in the LS group versus the OS group (OS vs. LS, 7.00 ± 3.43 days vs. 4.50 ± 2.16 days; P = 0.031). Conclusion We suggest that laparoscopic resection of retroperitoneal benign NL is feasible and safe by obtaining complete resection of the tumor. LS for treating retroperitoneal benign NL could be useful with appropriate laparoscopic technique and proper patient selection. PMID:28289669

  12. Environmentally benign silicon solar cell manufacturing

    SciTech Connect

    Tsuo, Y.S.; Gee, J.M.; Menna, P.; Strebkov, D.S.; Pinov, A.; Zadde, V.

    1998-09-01

    The manufacturing of silicon devices--from polysilicon production, crystal growth, ingot slicing, wafer cleaning, device processing, to encapsulation--requires many steps that are energy intensive and use large amounts of water and toxic chemicals. In the past two years, the silicon integrated-circuit (IC) industry has initiated several programs to promote environmentally benign manufacturing, i.e., manufacturing practices that recover, recycle, and reuse materials resources with a minimal consumption of energy. Crystalline-silicon solar photovoltaic (PV) modules, which accounted for 87% of the worldwide module shipments in 1997, are large-area devices with many manufacturing steps similar to those used in the IC industry. Obviously, there are significant opportunities for the PV industry to implement more environmentally benign manufacturing approaches. Such approaches often have the potential for significant cost reduction by reducing energy use and/or the purchase volume of new chemicals and by cutting the amount of used chemicals that must be discarded. This paper will review recent accomplishments of the IC industry initiatives and discuss new processes for environmentally benign silicon solar-cell manufacturing.

  13. Laparoscopic adrenalectomy for benign adrenal tumors.

    PubMed

    Ishikawa, T; Inaba, M; Nishiguchi, Y; Ishibashi, R; Ogisawa, K; Yukimoto, K; Ogawa, Y; Onoda, N; Hirakawa, K; Chung, Y S

    2000-06-01

    Laparoscopic adrenalectomy has been rapidly accepted for treatment of benign adrenal tumors. To evaluate the advantages of laparoscopic adrenalectomy, we examined 55 patients who underwent laparoscopic adrenalectomy. In all patients, adrenal tumors were successfully removed. The mean operating time was 143 minutes, and the estimated mean blood loss was 49 mL in all patients. The postoperative course was uneventful in all cases. The mean frequency of administration of analgesics was only 2.9 times, and the time elapsed to first walking after surgery was 17 hours. The peak white blood cell count and C-reactive protein values after surgery were 8,266 +/- 1,963/mm3 and 2.5 +/- 1.2 mg/dL, respectively. Of the 55 patients, 44 underwent total adrenalectomy and another 11 underwent partial adrenalectomy, which was introduced in the expectation of preserving normal adrenal cortex; it is therefore indicated in solitary and peripherally located benign tumors. The mean operating time was 154 minutes for the total adrenalectomy, which was longer than that of partial adrenalectomy (92 minutes). The estimated blood loss was 50 mL for the total and 46 mL for the partial adrenalectomy. The postoperative course was uneventful and surgical outcome was excellent in each group. In conclusion, our results are encouraging enough to suggest that laparoscopic adrenalectomy should be a preferential therapeutic option for benign adrenal tumors; also, partial adrenalectomy could be a safe, effective, and less invasive procedure in selected cases.

  14. Dual-depletion-region lumped electroabsorption modulator for low capacitance and expected high bandwidth

    NASA Astrophysics Data System (ADS)

    Shao, Yongbo; Zhao, Lingjuan; Yu, Hongyan; Pan, Jiaoqing; Wang, Baojun; Zhu, Hongliang; Wang, Wei

    2011-12-01

    A dual-depletion-region lumped electroabsorption modulator (DDR-LEAM) based on InP at 1550nm is designed and fabricated. The measurement results reveal that the dual depletion region structure can reduce the device capacitance significantly without any degradation of extinction ratio. The simulation results show that the highly doped charge layer can concentrate almost all of the external applied voltage in MQW region and thus contribute to the identical extinction ratio curves. The expected 3-dB bandwidth of the DDR-LEAMs using an equivalent circuit model is more than twice lager than that of the conventional LEAM.

  15. Fluid dynamics of heart valves during atrial fibrillation: a lumped parameter-based approach.

    PubMed

    Scarsoglio, S; Camporeale, C; Guala, A; Ridolfi, L

    2016-01-01

    Atrial fibrillation (AF) consequences on the heart valve dynamics are usually studied along with a valvular disfunction or disease, since in medical monitoring, the two pathologies are often concomitant. Aim of the present work is to study, through a stochastic lumped-parameter approach, the basic fluid dynamics variations of heart valves, when only paroxysmal AF is present with respect to the normal sinus rhythm in absence of any valvular pathology. Among the most common parameters interpreting the valvular function, the most useful turns out to be the regurgitant volume. During AF, both atrial valves do not seem to worsen their performance, while the ventricular efficiency is remarkably reduced.

  16. Thermo-mechanical stresses in the lumps of laying of thermal neutron pulsed graphite reactor

    SciTech Connect

    Boyko, V.I.; Guralev, S.S.; Koshelev, F.P.

    1993-12-31

    The research thermal neutron pulsed graphite reactor (PGR) is intended to get powerful neutron and gamma radiation streams. The reactor is the homogeneous carbon-uranium reactor with a graphite reflector. The reactor laying consists of a number of columns and it`s sizes are 2400* 2400*4500mm. The shape of the active zone is almost cubic, it`s sizes are 1400*1400*1330mm. There is a vertical experimental channel in the reactor laying for irradiation of test samples. The operation of the reactor is briefly described. Evaluations about the workability of the reactor laying lumps in the neutron flashout regime are made.

  17. A compact design for the Josephson mixer: The lumped element circuit

    SciTech Connect

    Pillet, J.-D.; Flurin, E.; Mallet, F. Huard, B.

    2015-06-01

    We present a compact and efficient design in terms of gain, bandwidth, and dynamical range for the Josephson mixer, the superconducting circuit performing three-wave mixing at microwave frequencies. In an all lumped-element based circuit with galvanically coupled ports, we demonstrate nondegenerate amplification for microwave signals over a bandwidth up to 50 MHz for a power gain of 20 dB. The quantum efficiency of the mixer is shown to be about 70%, and its saturation power reaches −112 dBm.

  18. Annuity and lump-sum decisions in defined benefit plans: the role of plan rules.

    PubMed

    Banerjee, Sudipto

    2013-01-01

    Amidst growing concerns about workers outliving their retirement savings, a key question-both as a matter of national retirement policy and understanding the potential role of plan design and education in influencing individual decision-making-is how many retiring workers actually choose to annuitize (to take a stream of lifetime income) vs. opting for a lump-sum payment. The key finding of this study is that differences in defined benefit (DB) plan rules or features result in very different annuitization rates in DB plans. In fact, the results show that the rate of annuitization varies directly with the degree to which plan rules restrict the ability to choose a partial or lump-sum distribution. This study shows that annuitization rates vary significantly across these different plan types, which makes any attempt to combine the annuitization rates across these different plan types uninformative. Combining all the plans across the years 2005-2010, workers who made their payout decision between ages 50 and 75 had a minimum job tenure of five years, a minimum account balance of $5,000, and had an annuitization rate of 65.8 percent. But within this group of workers, those who had no plan restrictions on a lump-sum distribution had an annuitization rate of only 27.3 percent. In all the years studied, plans with no lump-sum distribution (LSD) options have the highest annuitization rates, very close to 100 percent. Traditional defined benefit and cash balance plans with no restrictionson LSDs had the lowest annuitization rates. In 2010, the annuitization rate for all plans combined was 65.5 percent, while for plans with no LSD option it was 98.8 percent, but the annuitization rate for defined benefit plans with no restrictions on LSDs was 44.3 percent, while for cash balance plans with no restrictions on LSDs it was 22.3 percent. For older workers across most plan types, annuitization rates increase steadily with account balance, but this is not the case for younger

  19. Design, Fabrication, and Testing of Lumped Element Kinetic inductance Detectors for 3 mm CMB Observations

    NASA Technical Reports Server (NTRS)

    Lowitz, Amy E.; Brown, Ari David; Stevenson, Thomas R.; Timbie, Peter T.; Wollack, Edward J.

    2014-01-01

    Kinetic inductance detectors (KIDs) are a promising technology for low-noise, highly-multiplexible mm- and submm-wave detection. KIDs have a number of advantages over other detector technologies, which make them an appealing option in the cosmic microwave background B-mode anisotropy search, including passive frequency domain multiplexing and relatively simple fabrication, but have suffered from challenges associated with noise control. Here we describe design and fabrication of a 20-pixel prototype array of lumped element molybdenum KIDs. We show Q, frequency and temperature measurements from the array under dark conditions. We also present evidence for a double superconducting gap in molybdenum.

  20. An exceptional case of bilateral gestational gigantomastia with multiple breast lumps

    PubMed Central

    Traoré, Bangaly; Kamate, Bakarou; Conde, Mamoudou; Keita, Ahmed Monzomba; Kourouma, Tidiane; Dem, Ahmadou

    2015-01-01

    Bilateral gigantomastia is a rare condition, often associated with pregnancy that is characterized by a diffuse enlargement of both breasts. Here we present a case of a late 20s woman in her seven months pregnancy with a bilateral gestational gigantomastia associated with multiple breast lumps. Histological analysis revealed a fibroadenoma. Her prolactin level after caesarean delivery was found particularly high. A significant decrease in breast size was achieved with bromocriptine treatment in conjunction with a bilateral lumpectomy. This case report highlights the diversity of gigantomastia and emphasizes the importance of a tailored, multidisciplinary approach to the diagnosis and treatment of this condition. PMID:26161232

  1. The Modeling of Boattail Intrusion in a Lumped Parameter Interior Ballistic Code

    DTIC Science & Technology

    1993-08-01

    AD-A270 702 ARmy RESFARCH LABORATORY The Modeling of Boattail Intrusion in a Lumped Parameter Interior Ballistic Code Frederick W. Robbins Robert T...Puhalla Taquan S. Stewart ARL-TR-181 August 1993 xcf "APROVED MOR PUBC RUEASE; DISTRIBUTION IS UNLIMITED. 93-23103 93 10 1 2 34 A NOTICES Destroy this...to"ration Ooe~attorr% o;.z. Rnc-D" l"’ ’ etier~oin •)av• H*qt •. Ste 1204. Arhngton,. / A 22202-4302 and to the O ,ffie eof Marremerit ao Budget. Pa

  2. Transient Behavior of Lumped-Constant Systems for Sensing Gas Pressures

    NASA Technical Reports Server (NTRS)

    Delio, Gene J; Schwent, Glennon V; Cesaro, Richard S

    1949-01-01

    The development of theoretical equations describing the behavior of a lumped-constant pressure-sensing system under transient operation Is presented with experimental data that show agreement with the equations. A pressure-sensing system 'consisting of a tube terminating in a reservoir is investigated for the transient relation between a presSure disturbance at the open end of the tube and the pressure response in the reservoir. Design parameters are presented that can be adjusted to achieve a desired performance fran such a system when the system is considered as a transfer member of a control loop.

  3. Parametric nonlinear lumped element model for circular CMUTs in collapsed mode.

    PubMed

    Aydoğdu, Elif; Ozgurluk, Alper; Atalar, Abdullah; Köymen, Hayrettin

    2014-01-01

    We present a parametric equivalent circuit model for a circular CMUT in collapsed mode. First, we calculate the collapsed membrane deflection, utilizing the exact electrical force distribution in the analytical formulation of membrane deflection. Then we develop a lumped element model of collapsed membrane operation. The radiation impedance for collapsed mode is also included in the model. The model is merged with the uncollapsed mode model to obtain a simulation tool that handles all CMUT behavior, in transmit or receive. Large- and small-signal operation of a single CMUT can be fully simulated for any excitation regime. The results are in good agreement with FEM simulations.

  4. Rare variant of inguinal hernia, interparietal hernia and ipsilateral abdominal ectopic testis, mimicking a spiegelian hernia. Case report.

    PubMed

    Hirabayashi, Takeshi; Ueno, Shigeru

    2013-07-20

    We report a case in which the combination of an interparietal inguinal hernia and ipsilateral ectopic testicle mimicked a spigelian hernia. The patient was a 22-day-old boy who presented with a reducible mass that extended from the right lumbar region to the iliac fossa region. The right testis was palpable in the right lumbar region. Ultrasonography and magnetic resonance imaging revealed that a small bowel had herniated through the inguinal region below the external oblique aponeurosis. Surgery was performed when the patient was 23 months old. Laparoscopic examination to identify the hernia orifice revealed that it was the deep inguinal ring, and the testicular vessels and the vas deferens passed beneath the hernia sac. An inguinal incision was made, and a hernia sac was observed passing through the deep inguinal ring and extending superiorly below the aponeurosis. The testis was found in the hernia sac. Traditional inguinal herniorrhaphy and traditional orchidopexy were performed, and the postoperative course was uneventful. It is difficult to understand the surgical anatomy of interparietal hernias, but once the surgical anatomy is understood, surgical repair is simple. We report the case with a review of the literature and also emphasize that laparoscopic exploration is helpful during surgery.

  5. Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand's Hernia with Non-Inflamed Appendices

    PubMed Central

    Kose, Emin; Sisik, Abdullah

    2017-01-01

    Amyand's hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand's hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand's hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months), there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand's hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy. PMID:28194430

  6. An Electromagnetic and Thermodynamic Lumped Parameter Model of an Explosively Driven Regenerative Magnetohydrodynamic Generator.

    NASA Astrophysics Data System (ADS)

    Morrison, John Lawrence, Jr.

    1992-01-01

    The objective of this research is to develop a simple, yet accurate, lumped parameter mathematical model for an explosively driven magnetohydrodynamic generator that can predict the pulse power variables of voltage and current from startup through regenerative operation. The inputs to the model will be the plasma properties entering the generator as predicted by the explosive shock model of Reference (1). The strategy used was to simplify electromagnetic and thermodynamic three dimensional effects into a zero dimensional model. The model will provide a convenient tool for researchers to optimize designs to be used in pulse power applications. The model is validated using experimental data of Reference (1). An overview of the operation of the explosively driven generator is first presented. Then a simplified electrical circuit model that describes basic performance of the device is developed. Then a lumped parameter model that incorporates the coupled electromagnetic and thermodynamic effects that govern generator performance is described and developed. The model is based on fundamental physical principles and parameters that were either obtained directly from design data or estimated from experimental data. The model was used to obtain parameter sensitivities and predict beyond the limits observed in the experiments to the levels desired by the potential Department of Defense sponsors. The model identifies process limitations that provide direction for future research.

  7. Comparison of climate datasets for lumped hydrological modeling over the continental United States

    NASA Astrophysics Data System (ADS)

    Essou, Gilles R. C.; Arsenault, Richard; Brissette, François P.

    2016-06-01

    Climate data measured by weather stations are crucially important and regularly used in hydrologic modeling. However, they are not always available due to the low spatial density and short record history of many station networks. To overcome these limitations, gridded datasets have become increasingly available. They have excellent continuous spatial coverage and no missing data. However, these datasets are usually interpolated using station data, with little new information besides elevation. Furthermore, minimal validation has been done on most of these datasets. This study compares three such datasets covering the continental United States to evaluate their differences and their impact on lumped hydrological modeling. Three daily time step gridded datasets with resolutions varying between 0.25° and 1 km were used in this study - Santa-Clara, Daymet and CPC. The hydrological modeling evaluation of these datasets was performed over 424 basins from the MOPEX database. Results show that there are significant differences between the datasets, even though they were essentially all interpolated from almost the same climate databases. Despite those differences, the hydrological model used in this study was able to perform equally well after a specific calibration to each dataset. While there were a few exceptions, by and large, Nash-Sutcliffe efficiency metrics obtained in validation were not statistically different from one database to the other for most basins. It appears that there are no reasons to favor one dataset versus another for lumped hydrological modeling, and that these datasets perform just as well as using the original station data.

  8. Design Optimization Tool for Synthetic Jet Actuators Using Lumped Element Modeling

    NASA Technical Reports Server (NTRS)

    Gallas, Quentin; Sheplak, Mark; Cattafesta, Louis N., III; Gorton, Susan A. (Technical Monitor)

    2005-01-01

    The performance specifications of any actuator are quantified in terms of an exhaustive list of parameters such as bandwidth, output control authority, etc. Flow-control applications benefit from a known actuator frequency response function that relates the input voltage to the output property of interest (e.g., maximum velocity, volumetric flow rate, momentum flux, etc.). Clearly, the required performance metrics are application specific, and methods are needed to achieve the optimal design of these devices. Design and optimization studies have been conducted for piezoelectric cantilever-type flow control actuators, but the modeling issues are simpler compared to synthetic jets. Here, lumped element modeling (LEM) is combined with equivalent circuit representations to estimate the nonlinear dynamic response of a synthetic jet as a function of device dimensions, material properties, and external flow conditions. These models provide reasonable agreement between predicted and measured frequency response functions and thus are suitable for use as design tools. In this work, we have developed a Matlab-based design optimization tool for piezoelectric synthetic jet actuators based on the lumped element models mentioned above. Significant improvements were achieved by optimizing the piezoceramic diaphragm dimensions. Synthetic-jet actuators were fabricated and benchtop tested to fully document their behavior and validate a companion optimization effort. It is hoped that the tool developed from this investigation will assist in the design and deployment of these actuators.

  9. An electromagnetic and thermodynamic lumped parameter model of an explosively driven regenerative magnetohydrodynamic generator

    SciTech Connect

    Morrison, J.L.

    1992-12-01

    The objective of this research is to develop a simple, yet accurate, lumped parameter mathematical model for an explosively driven magnetohydrodynamic generator that can predict the pulse power variables of voltage and current from startup through regenerative operation. The inputs to the model will be the plasma properties entering the generator as predicted by the explosive shock model of Reference [1]. The strategy used was to simplify electromagnetic and thermodynamic three dimensional effects into a zero dimensional model. The model will provide a convenient tool for researchers to optimize designs to be used in pulse power applications. The model is validated using experimental data of Reference [1]. An overview of the operation of the explosively driven generator is first presented. Then a simplified electrical circuit model that describes basic performance of the device is developed. Then a lumped parameter model that incorporates the coupled electromagnetic and thermodynamic effects that govern generator performance is described and developed. The model is based on fundamental physical principles and parameters that were either obtained directly from design data or estimated from experimental data. The model was used to obtain parameter sensitivities and predict beyond the limits observed in the experiments to the levels desired by the potential Department of Defense sponsors. The model identifies process limitations that provide direction for future research.

  10. Modelling rogue waves through exact dynamical lump soliton controlled by ocean currents

    PubMed Central

    Kundu, Anjan; Mukherjee, Abhik; Naskar, Tapan

    2014-01-01

    Rogue waves are extraordinarily high and steep isolated waves, which appear suddenly in a calm sea and disappear equally fast. However, though the rogue waves are localized surface waves, their theoretical models and experimental observations are available mostly in one dimension, with the majority of them admitting only limited and fixed amplitude and modular inclination of the wave. We propose two dimensions, exactly solvable nonlinear Schrödinger (NLS) equation derivable from the basic hydrodynamic equations and endowed with integrable structures. The proposed two-dimensional equation exhibits modulation instability and frequency correction induced by the nonlinear effect, with a directional preference, all of which can be determined through precise analytic result. The two-dimensional NLS equation allows also an exact lump soliton which can model a full-grown surface rogue wave with adjustable height and modular inclination. The lump soliton under the influence of an ocean current appears and disappears preceded by a hole state, with its dynamics controlled by the current term. These desirable properties make our exact model promising for describing ocean rogue waves. PMID:24711719

  11. Level-lumping method for the modeling of CO2 vibrational kinetics

    NASA Astrophysics Data System (ADS)

    Berthelot, Antonin; Bogaerts, Annemie; University of Antwerp, Plasmant Team

    2016-09-01

    The conversion of greenhouse gases, especially CO2, into value-added chemicals is gaining a very large interest among the scientific and industrial communities. It is known that the excitation of the asymmetric vibrational mode of CO2 is one of the most important processes to achieve high energy efficiencies, thus making the CO2 kinetics very complex. Due to this complexity, the only models that have been developed so far were zero-dimensional models, considering only the variations over time. These models require strong approximations on the geometry of the reactor. In order to reduce the calculation time and to allow the modeling of complex plasma problems in 2D or 3D geometries, we have simplified the chemistry set of CO2 and developed a lumped-levels model for the vibrational kinetics. It was found that a 3-groups model gives a good agreement with the state-to-state model at pressures of 100mbar and above, at the conditions under study. The important dissociation and recombination mechanisms of CO2 have also been investigated. This lumped-levels model is being implemented in a 2D self-consistent microwave plasma code. This project has received funding from the European Union's Seventh Framework Programme for research, technological development and demonstration under Grant Agreement No. 606889.

  12. Modelling rogue waves through exact dynamical lump soliton controlled by ocean currents.

    PubMed

    Kundu, Anjan; Mukherjee, Abhik; Naskar, Tapan

    2014-04-08

    Rogue waves are extraordinarily high and steep isolated waves, which appear suddenly in a calm sea and disappear equally fast. However, though the rogue waves are localized surface waves, their theoretical models and experimental observations are available mostly in one dimension, with the majority of them admitting only limited and fixed amplitude and modular inclination of the wave. We propose two dimensions, exactly solvable nonlinear Schrödinger (NLS) equation derivable from the basic hydrodynamic equations and endowed with integrable structures. The proposed two-dimensional equation exhibits modulation instability and frequency correction induced by the nonlinear effect, with a directional preference, all of which can be determined through precise analytic result. The two-dimensional NLS equation allows also an exact lump soliton which can model a full-grown surface rogue wave with adjustable height and modular inclination. The lump soliton under the influence of an ocean current appears and disappears preceded by a hole state, with its dynamics controlled by the current term. These desirable properties make our exact model promising for describing ocean rogue waves.

  13. Lumped parameter analysis of a stringer reinforced plate excited by band limited noise

    NASA Technical Reports Server (NTRS)

    Bilyeu, D. J.; Whitehouse, G. D.; Whitehurst, C. A.

    1972-01-01

    The maximum root-mean-square response of a square clamped plate, subjected to a stationary random excitation, was determined both theoretically and empirically. For the tests, a 40 x 40 x 1/4 aluminum sheet was milled out to provide a thin waffle plate with 9 panels. The plate was acoustically excited, with the frequency range limited between 25 Hz and 500 Hz. The root-mean-square power of the random excitations, 149 decibels, was nearly constant for all natural frequencies of the plate system. Strain gage readings at 14 points were plotted as power spectral densities and root-mean-square displacements. A modal damping ratio matrix was determined from the response curves. Damping ratios were found to be a function of frequency, but not of location on the plate. For comparisons with the theoretical response, the plate was subdivided into 14 modes and anlayzed as a damped, lumped parameter system by use of an approximate normal-mode method. This method gave the best predictions of the power spectral densities for the lower frequencies. That prediction errors increased for the higher frequencies is attributed to improper assumptions for mass distribution and the insufficient number of lumped mass points.

  14. [Principles of the management of adult inguinal hernia--recommendations by the European Hernia Society].

    PubMed

    Wéber, György

    2010-10-01

    The European Hernia Society (EHS) presented the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the management of inguinal hernia from diagnosis to aftercare. These have been developed by a Working Group consisting of expert surgeons with representatives of 14 member countries of the EHS. The Guidelines are evidence-based and, when necessary, a consensus of all members was reached. The Guidelines have been reviewed by a Steering Committee as well. Before finalisation, feedback from the relevant national hernia societies was obtained. The Guidelines can be used to adjust local protocols, training purposes as well as quality control. In order to keep them updated the next revision will be published in 2012. A short update of new high-level evidence will be provided by the Working Group during the EHS annual congress until the next revision.

  15. Scrotal Apocrine Adenocarcinoma with Pagetoid Phenomenon and Inguinal Lymph Node Metastases

    PubMed Central

    Fyllos, Apostolos Haralampos; Havaki, Sophia; Sotiriou, Sotirios; Kotakidis, Georgios; Arvanitis, Dimitrios Leonidas

    2016-01-01

    We report a case of scrotal apocrine adenocarcinoma in a 72-year-old Caucasian male which was initially presented as a reddish superficial lesion which in time became an ulcerated nodule. The initial pathological examination showed an apocrine adenocarcinoma with pagetoid phenomenon. The tumor recurred after four months and then excision biopsy showed tumor with pagetoid phenomenon which reached all the surgical margins. Three months later an ulcerated nodule in the scrotum and greatly enlarged ipsilateral inguinal lymph nodes were noticed. The final pathological examination showed multiple separated malignant foci, some with overlying pagetoid phenomenon and inguinal lymph node metastases. Immunohistochemistry showed positivity for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), androgen receptors, and score 3+ for the Human Epidermal growth factor Receptor-2 (HER2). The aggressive behavior of the present tumor goes along with previous reports showing that HER2 high score cases exhibit a worse prognosis. PMID:27818816

  16. Sertoli cell tumor arising in a cryptorchid testis presenting as a content of inguinal hernial sac.

    PubMed

    Venkatesh, Kusuma; Hemalata, Mahantappa; Sathyavathi, S; Kumar, Satish

    2016-01-01

    Sertoli cell tumors (SCTs) are rare tumors accounting for <1% of all testicular tumors. Here, we report a rare case of SCT in a 60-year-old man presenting as a painless swelling in the right groin since childhood. Clinically, he presented with right-sided inguinal hernia with absence of the right testis. He had normal left testis and had no gynecomastia or infertility. The specimen of hernial sac showed testis with a 1.6 cm × 1.5 cm nodular mass having gray tan-cut surface. Histopathologically, the testis showed atrophy and the nodular portion showed tumor cells arranged in tubular and microcystic pattern, with no solid pattern or necrosis. The diagnosis of SCT was confirmed with immunohistochemical staining for inhibin which showed fine granular cytoplasmic positivity. Cryptorchid testis having SCT and presenting as a content of inguinal hernia is a rare occurrence.

  17. Primo Vascular System in the Lymph Vessel from the Inguinal to the Axillary Nodes

    PubMed Central

    Lee, Seung Hwan; Bae, Kyoung-Hee; Kim, Geum Ock; Nam, Min Ho; Kwon, Hee-Min; Ryu, Yeonhee; Soh, Kwang-Sup

    2013-01-01

    The primo vascular system (PVS) in a lymph system was observed mostly in large caliber ducts around the caudal vena cava of rabbits, rats, and mice. This required a severe surgery with laparectomy and massive removal of fat tissues in the abdomen to expose the lymph vessel. In the current brief report, we presented a new method to evade these shortcomings by observing the PVS in a less large caliber duct in the skin, that is, the lymph vessel from the inguinal to the axillary nodes. The Alcian blue injection into the inguinal node revealed the desired primo vessel in the target lymph vessel. This opened a new perspective for the investigation of the lymphatic PVS without severe damage to subject animals and for monitoring of the PVS in a long period of time. PMID:23762141

  18. Rare complication after totally extraperitoneal endoscopic inguinal hernia repair: Small bowel perforation without peritoneal disruption.

    PubMed

    Kojima, Shigehiro; Sakamoto, Tsuguo; Honda, Masayuki; Nishiguchi, Ryohei; Ogawa, Fumihiro

    2016-11-01

    We report a rare case of visceral injury after totally extraperitoneal endoscopic inguinal hernia repair. A 48-year-old man underwent needlescopic totally extraperitoneal repair of a direct inguinal hernia. Bleeding from a branch of the inferior epigastric vessels occurred at the beginning of the extraperitoneal dissection with a monopolar electrosurgical device. Hemostasis was prolonged. However, herniorrhaphy and mesh repair were successfully performed, and no peritoneal disruption or pneumoperitoneum was visible. The patient was discharged home on the next day. However, 30 h after this operation, he underwent diagnostic and operative laparoscopy because of acute abdominal pain. Ileal perforation was found and repaired, and pathological examination indicated cautery artifact. Thus, thermal damage to the ileum during the initial operation may have caused the bowel perforation. To the best of our knowledge, no other cases of bowel perforation after totally extraperitoneal repair without peritoneal disruption have been reported.

  19. Possibilities of the strong posterior wall of inguinal canal in women.

    PubMed

    Ofili, O P

    1990-12-01

    Three hundred and twenty-nine females aged 15-81 years (mean 51.5 years) and 1,928 males aged 17-76 years (mean 42.9 years) who presented with inguinal hernia over a ten-year period were reviewed. Combined ipsilateral direct = indirect (pantaloon) hernia appeared only from the fourth decade in both sexes with 7 (1.8 pc) and 111 (5.6 pc) cases occurring in females and males respectively. 3.5 pc of the total herniae in females and 18.6 pc in males were of primary direct type. 40 (12.2 pc) females and 270 (14 pc) males had bilateral hernia. There was a marked rise in the incidence of primary direct and bilateral hernia in males from the fourth and fifth decades. It is postulated that this is because defective collagen synthesis in the tissues of the inguinal region occurs more in males than in females.

  20. Treatment of a giant inguinal hernia using transabdominal pre-peritoneal repair

    PubMed Central

    Momiyama, Masato; Mizutani, Fumitoshi; Yamamoto, Tatsuyoshi; Aoyama, Yoshinori; Hasegawa, Hiroshi; Yamamoto, Hideo

    2016-01-01

    We present the case of a male Japanese patient with a giant inguinal hernia that extended to his knees while standing. A transabdominal pre-peritoneal (TAPP) repair was performed under general anesthesia. Complete reduction of the contents of the hernia was achieved within 2 h 50 min. A blood loss of approximately 700 ml was noted. The patient was discharged from the hospital on post-operative Day 12, with no recurrence of the hernia 6 months post-surgery. Factors contributing to the successful outcomes included preparation of several reduction methods before surgery, use of a large size mesh and implementation of pre-operative measures to prevent abdominal compartment syndrome. Further studies are required to evaluate the feasibility of laparoscopic repair in the management of giant inguinal hernia. PMID:27672103

  1. Primo vascular system in the lymph vessel from the inguinal to the axillary nodes.

    PubMed

    Lee, Seung Hwan; Bae, Kyoung-Hee; Kim, Geum Ock; Nam, Min Ho; Choi, Young Bok; Kwon, Hee-Min; Ryu, Yeonhee; Soh, Kwang-Sup

    2013-01-01

    The primo vascular system (PVS) in a lymph system was observed mostly in large caliber ducts around the caudal vena cava of rabbits, rats, and mice. This required a severe surgery with laparectomy and massive removal of fat tissues in the abdomen to expose the lymph vessel. In the current brief report, we presented a new method to evade these shortcomings by observing the PVS in a less large caliber duct in the skin, that is, the lymph vessel from the inguinal to the axillary nodes. The Alcian blue injection into the inguinal node revealed the desired primo vessel in the target lymph vessel. This opened a new perspective for the investigation of the lymphatic PVS without severe damage to subject animals and for monitoring of the PVS in a long period of time.

  2. Clinical Outcome Following Infra-Inguinal Percutaneous Transluminal Angioplasy for Critical Limb Ischemia

    SciTech Connect

    Matsagas, Miltiadis I.; Rivera, Marco A.; Tran, Tan; Mitchell, Adam; Robless, Peter; Davies, Alun H.; Geroulakos, George

    2003-06-15

    Objective: The aim of this study was to assess the efficacy and durability of infra-inguinal PTA in patients with CLI, in terms of clinical outcome. Design:Retrospective study of 50 consecutive patients with CLI that were exclusively treated by infra-inguinal PTA. Methods: The indications for intervention were rest pain in seven (14%) patients,non-healing ulcers in 27 (54%), and gangrenous lesions in 16 (32%).Thirty-three (66%) of these patients presented with a single arterial lesion, and the remaining 17 (34%) with multilevel arterial lesions.Kaplan-Meier analysis was used to assess survival, patency,limb-salvage rates, and amputation-free survival. Results: A total of 67 endovascular procedures were performed and 59 (88.1%) of them were considered to be technically successful. The median follow-up period was 12 months (interquartilerange: 17 months). The 30-day mortality was 4%, while the cumulative survival rates at 12, 24, and 36 months were 73%, 67%, and 59%,respectively. The cumulative primary patency rates at 12 and 24 months were 63% and 52%, respectively, and remained unchanged thereafter.The estimated secondary patency rate was 72% at 36 months. There was only one below-knee amputation in the patients that were treated exclusively with infra-inguinal PTA. The cumulative amputation-free survival at the same period was estimated at 60%. Conclusions: Infra-inguinal PTA had a good early and late outcome in this series of patients with a limited life expectancy.These results are comparable to historical results of surgical revascularization in the treatment of CLI. There is need for a randomized study to determine the primary optimal interventional approach for patients with CLI.

  3. Indirect inguinal hernia sac containing testis and spermatic cord in an adult patient with cryptorchidism.

    PubMed

    Arslan, Yusuf; Karaman, Kerem; Altintoprak, Fatih; Kahyaoglu, Zeynep; Zengin, Ismail; Uzunoglu, Mustafa Yener; Demir, Hakan

    2014-03-07

    Sliding hernias are those in which part of the sac wall is formed by a retroperitoneal organ and/or its mesentery protruding outside the abdominal wall cavity. The hernia sac may contain jejunum, ileum, vermiform appendix, Meckel's diverticulum, stomach, ovary, fallopian tube or urinary bladder. Our report features an adult case with cryptorchidism in which testis and spermatic cord constitute a component of the indirect inguinal hernia sac.

  4. De Garengeot's hernia: 40 years after Bassini inguinal hernioplasty

    PubMed Central

    Liipo, Tommi K E; Seppälä, Toni T; Mattila, Anne K

    2015-01-01

    De Garengeot's hernia (DGH) is a rare entity in which the vermiform appendix is located within the femoral hernia sac. Even though DGH is known to be more common in females, we report a case of a male patient having undergone Bassini-type inguinal hernia repair over 40 years ago. We present the preoperative diagnostic measures and an example of the surgical management of this rare entity. PMID:25733091

  5. The influence of inguinal mesh repair on the spermatic cord: a pilot study in the rabbit.

    PubMed

    Peiper, Christian; Junge, Karsten; Klinge, Uwe; Strehlau, Eva; Krones, Carsten; Ottinger, A; Schumpelick, Volker

    2005-01-01

    The permanent implantation of a polypropylene mesh during inguinal hernia repair causes chronic inflammatory changes in the surrounding tissue. We investigated the effect of this foreign body reaction on the structures of the spermatic cord in the rabbit. Eight Chinchilla rabbits underwent unilateral inguinal hernia repair by the Lichtenstein technique using Marlex (n = 4) or Ultrapro (n = 4) mesh. The contralateral side was operated upon using the Shouldice repair. Three animals served as controls. Three months after operation we analyzed testicular size, testicular temperature, and arterial perfusion by excitation light of a 780-nm laser after injection of 0.5 mg/kg indocyanin green. Histological evaluation included spermatogenesis (Johnsen score) and foreign-body reaction. Testicular volume increased about 10% after each operation. The decrease of arterial perfusion and testicular temperature was more significant after mesh repair than following Shouldice operation. After mesh implantation we found fewer seminiferous tubules classified as Johnsen 10 (Marlex: 51.3%, Ultrapro: 45.0%) than after Shouldice repair (63.8%) or in the controls (65.8%). The spermatic cord showed a typical foreign-body reaction at the interface between mesh and surrounding tissue, which was not detectable after Shouldice repair. Preserved cremasteric muscle fibers protected the structures of the spermatic cord. The inflammatory foreign-body reaction of the surrounding tissue induced by the inguinal prosthetic mesh includes the structures of the spermatic cord. This may have an influence also on spermatogenesis. Therefore, we recommend strict indications for implantation of a prosthetic mesh during inguinal hernia repair.

  6. Indirect inguinal hernia sac containing testis and spermatic cord in an adult patient with cryptorchidism

    PubMed Central

    Arslan, Yusuf; Karaman, Kerem; Altintoprak, Fatih; Kahyaoglu, Zeynep; Zengin, Ismail; Uzunoglu, Mustafa Yener; Demir, Hakan

    2014-01-01

    Sliding hernias are those in which part of the sac wall is formed by a retroperitoneal organ and/or its mesentery protruding outside the abdominal wall cavity. The hernia sac may contain jejunum, ileum, vermiform appendix, Meckel's diverticulum, stomach, ovary, fallopian tube or urinary bladder. Our report features an adult case with cryptorchidism in which testis and spermatic cord constitute a component of the indirect inguinal hernia sac. PMID:24876399

  7. Randomized Prospective Study of Totally Extraperitoneal Inguinal Hernia Repair: Fixation Versus No Fixation of Mesh

    PubMed Central

    Koch, Cody A.; Greenlee, Susan M.; Larson, Dirk R.; Harrington, Jeffrey R.

    2006-01-01

    Background: Fixation of the mesh during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is thought to be necessary to prevent recurrence. However, mesh fixation may increase postoperative pain and lead to an increased risk of complications. We questioned whether elimination of fixation of the mesh during TEP inguinal hernia repair leads to decreased postoperative pain or complications, or both, without an increased rate of recurrence. Methods: A randomized prospective single-blinded study was carried out in 40 patients who underwent laparoscopic TEP inguinal hernia repair with (Group A=20) or without (Group B=20) fixation of the mesh. Results: Patients in whom the mesh was not fixed had shorter hospital length of stay (8.3 vs 16.0 hours, P=0.01), were less likely to be admitted to the hospital (P=0.001), used less postoperative narcotic analgesia in the PACU (P=0.01), and were less likely to develop urinary retention (P=0.04). No significant differences occurred in the level of pain, time to return to normal activity, or the difficulty of the operation between the 2 groups. No hernia recurrences were observed in either group (follow-up range, 6 to 30 months, median=19). Conclusions: Elimination of tack fixation of mesh during laparoscopic TEP inguinal hernia repair significantly reduces the use of postoperative narcotic analgesia, hospital length of stay, and the development of postoperative urinary retention but does not lead to a significant reduction in postoperative pain. Eliminating tacks does not lead to an increased rate of recurrence. PMID:17575757

  8. THE REPAIR OF DIFFICULT INGUINAL HERNIAS—Resection of the Spermatic Cord

    PubMed Central

    Gifford, John H.; Moes, Robert J.

    1961-01-01

    A method of removing the cord structures from the inguinal canal and preserving the testis and the portion of the spermatic cord distal to the external ring was used in repair of large or recurrent hernias in 14 patients. Only one patient had pronounced testicular atrophy. In one case there was recurrence through the femoral canal. The procedure is simpler and shorter than removal of the testicle as well as the cord. PMID:13898486

  9. Small Bowel Neuroendocrine Tumors with Inguinal Metastases: A Diagnostic and Therapeutic Dilemma

    PubMed Central

    Daly, Kevin P; Askarian, Farhad; Saif, Muhammad W

    2016-01-01

    Small bowel neuroendocrine tumors (NETs) are frequently characterized by a strong propensity to metastasize to the liver, mesentery, and peritoneum. However, only a few extra-abdominal metastatic sites have been reported in the published literature. The present paper implicates that primary small bowel NETs may unusually metastasize to the inguinal lymph nodes. Furthermore, we discuss the formidable diagnostic and therapeutic challenges associated with the metastatic NETs. PMID:27555990

  10. Thallium-201 uptake in a benign thymoma

    SciTech Connect

    Campeau, R.J.; Ey, E.H.; Varma, D.G.

    1986-07-01

    A 68-year-old woman was admitted with atypical angina. A chest radiograph showed an anterior mediastinal mass that was confirmed on CT. The mass was relatively avascular and separate from the heart and great vessels. She underwent stress thallium testing that demonstrated no exercise-induced ischemia; however, an abnormal focus of thallium activity was present in the anterior mediastinum on stress and redistribution images. Cardiac catheterization demonstrated a normal left ventriculogram, coronary arteries and thoracic aorta. Subsequent surgery and pathologic examination revealed the mass to be a benign thymoma arising in the right lobe of the thymus gland.

  11. Spatial contrast sensitivity in benign intracranial hypertension.

    PubMed Central

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-01-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting. PMID:3225588

  12. Developmental and benign movement disorders in childhood.

    PubMed

    Bonnet, Cecilia; Roubertie, Agathe; Doummar, Diane; Bahi-Buisson, Nadia; Cochen de Cock, Valérie; Roze, Emmanuel

    2010-07-30

    Developmental and benign movement disorders are a group of movement disorders with onset in the neonatal period, infancy, or childhood. They are characterized by the absence of associated neurological manifestations and by their favorable outcome, although developmental abnormalities can be occasionally observed. Knowledge of the clinical, neurophysiological, and pathogenetic aspects of these disorders is poor. Based on a comprehensive review of the literature and our practical experience, this article summarizes current knowledge in this area. We pay special attention to the recognition and management of these movement disorders in children.

  13. [Extracapsular lobectomy in benign monolobar thyroid diseases].

    PubMed

    Prete, F; Di Ciaula, G; Sammarco, D; Parlati, C

    1995-12-01

    On the basis of their experience acquired in the field of thyroid surgery the authors examine the problems related to extracapsular lobectomy from a tactical and technical point of view, starting with its principal indications: benign monolobar thyroid disease in a single or multiple nodular form. The validity of extemporary histological tests is also assessed on the basis of their experience of rare false negatives and the relative successive totalization programme. Lastly, the paper underlines the fundamental identification of the recurrent nerve as the central point of the operation, before which the authors emphasize that nothing should be cut or ligated apart from the superior vascular peduncle and vena media.

  14. Spatial contrast sensitivity in benign intracranial hypertension.

    PubMed

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-10-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting.

  15. Benign paroxysmal positional vertigo: diagnosis and treatment.

    PubMed

    Bittar, Roseli Saraiva Moreira; Mezzalira, Raquel Mezzalira; Furtado, Paula Lobo; Venosa, Alessandra Ramos; Sampaio, Andre Luis Lopes; Pires de Oliveira, Carlos Augusto Costa

    2011-01-01

    Benign paroxysmal positional vertigo is a common disorder in Neurotology. This vestibular syndrome is characterized by transient attacks of vertigo, caused by change in head position, and associated with paroxysmal characteristic nystagmus. The symptoms result from movement of the free floating otoconia particles in the endolymph or their attachment to the cupulae of the semicircular canal. The diagnosis is essentially clinical and should be confirmed by performing diagnostic maneuvers. Treatment is based on the identification of the affected semicircular canal and performance of liberatory maneuvers or repositioning of free floating particles of otoliths. The effectiveness varies from 70 to 100%.

  16. Benign familial Degos disease worsening during immunosuppression.

    PubMed

    Powell, J; Bordea, C; Wojnarowska, F; Farrell, A M; Morris, P J

    1999-09-01

    We describe a 61-year-old woman with skin lesions consistent with those found in Degos disease, both in clinical and in histological appearance. She had had several of these lesions for many years, as had her mother, sister and niece. In 1991, she underwent cadaveric renal transplantation and was treated with immunosuppression: prednisolone, azathioprine and cyclosporin. At that time, she developed many more characteristic skin lesions, and these were slightly larger and more noticeable than those she had had previously. She and the other affected family members appear to fit into the more benign subgroup of Degos disease, and it seems that her immunosuppression aggravated her cutaneous disease.

  17. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    PubMed

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.

  18. Endoscopic inguinal lymphadenectomy in penile cancer: case report and literature review

    PubMed Central

    Astigueta Pérez, Juan Carlos; Abad-Licham, Milagros; Silva, Eloy; Yan, Edgar; Álvarez, Hugo; Agreda, Folker; Pow-Sang, Mariela

    2015-01-01

    Objectives The objective was to submit our first experience in endoscopic inguinal lymphadenectomy (EIL), evaluate the feasibility of the procedure and carry out a review of the literature. Material and methods A 41-year-old patient was diagnosed with penile cancer with squamous cell carcinoma pT2G1 pathology, with no palpable inguinal lymph nodes. A bilateral inguinal lymphadenectomy was performed with preservation of the saphenous vein, conventional left and endoscopic right procedures. The perioperative data is presented and that obtained is discussed in the literature. Results The total time was 270 minutes, 180 for endoscopic and 90 for conventional procedures. Blood loss was minimal in both cases. Fifteen lymph nodes were dissected on the endoscopic side, and 17 in the conventional side, the latter with more pain and devitalised skin flap. Conclusions EIL for penile cancer is feasible and there is less morbidity with an early recovery. The literature is not conclusive on the indication of EIL. PMID:26557874

  19. A prospective randomised trial comparing mesh types and fixation in totally extraperitoneal inguinal hernia repairs.

    PubMed

    Cristaudo, Adam; Nayak, Arun; Martin, Sarah; Adib, Reza; Martin, Ian

    2015-05-01

    The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique. Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 × 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 × 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 × 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 × 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores. At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12. In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods.

  20. Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

    PubMed Central

    Takebayashi, Katsushi; Matsumura, Masakata; Kawai, Yasuhiro; Hoashi, Takahiko; Katsura, Nagato; Fukuda, Seijun; Shimizu, Kenji; Inada, Takuji; Sato, Masugi

    2015-01-01

    We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block+ group, n = 18) or without peripheral nerve block (Block− group, n = 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Block+ group) and 2.07 days (Block− group; range, 1–3 days in both groups; P = 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block+ and Block− groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block+ group than in the Block− group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery. PMID:25875548

  1. Preoperative radiotherapy followed by radical vulvectomy with inguinal lymphadenectomy for advanced vulvar carcinomas

    SciTech Connect

    Rotmensch, J.; Rubin, S.J.; Sutton, H.G.; Javaheri, G.; Halpern, H.J.; Schwartz, J.L.; Stewart, M.; Weichselbaum, R.R.; Herbst, A.L. )

    1990-02-01

    A therapeutic alternative to exenteration for large locally advanced vulvar carcinoma involving the rectum, anus, or vagina is the use of preoperative radiation followed by radical surgery. Between 1980 and 1988, 13 patients with Stage III and 3 with Stage IV vulvar carcinoma involving the rectum/anus, urethra, or vagina were treated with 4000 rad to the vulva and 4500 rad to the inguinal and pelvic nodes followed by a radical vulvectomy and inguinal lymphadenectomy 4 weeks later. The overall 5 year cumulative survival was 45%. Twelve tumors regressed after radiation with 62.5% of the patients having visceral preservation while in 4 patients there was no major response to radiation and urinary or fecal diversion was required. Of the 6 recurrences 4 were central and 2 distant. Three patients with central recurrences had tumor within 1 cm of the vulvectomy margin. Complications included wet desquamation, inguinal wound separation, lymphedema, and urethral strictures. There were no operative deaths. It is concluded that the use of preoperative radiation followed by radical vulvectomy may be an alternative to pelvic exenteration in selected patients with advanced vulvar lesions.

  2. NiTiNol Hernia Device Stability in Inguinal Hernioplasty Without Fixation

    PubMed Central

    2011-01-01

    Background and Objective: To determine whether the NiTiNol frame of a novel hernia repair device utilizing polypropylene mesh for inguinal hernioplasty remains stable and intransient without fixation after a minimum of 6 months. Methods: Twenty patients had 27 inguinal hernias repaired using a novel hernia repair device that has a NiTiNol frame without any fixation. Initial single-view, postoperative X-rays were compared with a second X-ray obtained at least 6 months later. The NiTiNol frame, which can be easily visualized on a plain X-ray, was measured in 2 dimensions, as were anatomic landmarks. The measurements obtained and the appearances of the 2 X-rays were compared to determine the percentage of change in device size and device stability with regard to device location and shape. Results: There were minimal changes noted between the 2 sets of measurements obtained with an overall trend towards a slight increase in the size of the hernia repair device. The devices demonstrated intransience of position and stability of shape. Conclusions: The NiTiNol frame of a novel hernia repair device utilizing polypropylene mesh exhibits radiographic evidence of size and shape stability and intransience of position without fixation when used in inguinal hernioplasty after a minimum follow-up of 6 months. PMID:21902967

  3. Energy-state formulation of lumped volume dynamic equations with application to a simplified free piston Stirling engine

    NASA Technical Reports Server (NTRS)

    Daniele, C. J.; Lorenzo, C. F.

    1979-01-01

    Lumped volume dynamic equations are derived using an energy state formulation. This technique requires that kinetic and potential energy state functions be written for the physical system being investigated. To account for losses in the system, a Rayleigh dissipation function is formed. Using these functions, a Lagrangian is formed and using Lagrange's equation, the equations of motion for the system are derived. The results of the application of this technique to a lumped volume are used to derive a model for the free piston Stirling engine. The model was simplified and programmed on an analog computer. Results are given comparing the model response with experimental data.

  4. Energy-state formulation of lumped volume dynamic equations with application to a simplified free piston Stirling engine

    NASA Technical Reports Server (NTRS)

    Daniele, C. J.; Lorenzo, C. F.

    1979-01-01

    Lumped volume dynamic equations are derived using an energy-state formulation. This technique requires that kinetic and potential energy state functions be written for the physical system being investigated. To account for losses in the system, a Rayleigh dissipation function is also formed. Using these functions, a Lagrangian is formed and using Lagrange's equation, the equations of motion for the system are derived. The results of the application of this technique to a lumped volume are used to derive a model for the free-piston Stirling engine. The model was simplified and programmed on an analog computer. Results are given comparing the model response with experimental data.

  5. Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group).

    PubMed

    Meyers, W C; Foley, D P; Garrett, W E; Lohnes, J H; Mandlebaum, B R

    2000-01-01

    The purpose of this study was to gain insight into the pathophysiologic processes of severe lower-abdominal or inguinal pain in high-performance athletes. We evaluated 276 patients; 175 underwent pelvic floor repairs. Of the 157 athletes who had not undergone previous surgery, 124 (79%) participated at a professional or other highly competitive level, and 138 patients (88%) had adductor pain that accompanied the lower-abdominal or inguinal pain. More patients underwent related adductor releases during the later operative period in the series. Evaluation revealed 38 other abnormalities, including severe hip problems and malignancies. There were 152 athletes (97%) who returned to previous levels of performance. The syndrome was uncommon in women and the results were less predictable in nonathletes. A distinct syndrome of lower-abdominal/adductor pain in male athletes appears correctable by a procedure designed to strengthen the anterior pelvic floor. The location and pattern of pain and the operative success suggest the cause to be a combination of abdominal hyperextension and thigh hyperabduction, with the pivot point being the pubic symphysis. Diagnosis of "athletic pubalgia" and surgery should be limited to a select group of high-performance athletes. The consideration of other causes of groin pain in the patient is critical.

  6. A rare variant of inguinal hernia: Cryptorchid testis at the age of 50 years. Etiopathogenicity, prognosis and management

    PubMed Central

    Kassir, Radwan; Dubois, Joelle; Berremila, Sid-Ali; Baccot, Sylviane; Boueil-Bourlier, Alexia; Tiffet, Olivier

    2014-01-01

    INTRODUCTION Cryptorchidism is characterized by the extra-scrotal position of the testis. The surgical community has little to no knowledge of cryptorchid testis in adults apart from of pediatric surgeons. Therefore, we sought to describe this unusual cause of inguinal hernia. PRESENTATION OF CASE A 50-year-old man was referred with a inguinal hernia. Diagnosis of cryptorchidism was made during surgery, as the patient underwent an operation for repair of his left inguinal hernia. The testicle was non-viable and a left testicle was resected. Histopathology report confirmed a atrophic testis without testicular germ cell tumor (TGCT). DISCUSSION This is an extremely rare case of cryptorchidism revealed in an adult. The patient remained asymptomatic for 50 years. Most studies have concluded that there is a direct correlation between how long the testis was subjected to a cryptorchid position and TGCT incidence. The recommended age of surgical correction is before the age of 2 years. In our case, we did not find correlation between the time of surgery and risk of TGCT. Histopathology report confirmed the presence of leydig cells, seminiferous tubule and Sertoli cells without TGCT. Very little is known about link between cryptorchidism and TGCT. The correct diagnosis of inguinal hernia is usually made during an inguinal hernia repair. CONCLUSION The surgeon must always be alert to the possibility of cryptorchid testis during a surgical exploration of an inguinal hernia. In suspected cases, laparoscopy ultrasonographic, CT scan and laparoscopy evaluation may be helpful in diagnosing of this atypical inguinal hernia before surgery. PMID:24892247

  7. Benign Pulmonary Metastasizing Leiomyoma of the Uterus

    PubMed Central

    Iscan, Reyyan; Köse, Gültekin; Kaban, Isik

    2016-01-01

    Benign Metastasizing Leiomyoma (BML) is a rare disease which represents with multiple leiomyomatous lesions in many tissues and organs especially in lungs. These patients have been operated for leiomyoma of the uterus. Here we report a case of a 41-year-old woman who was evaluated in a thoracic surgery hospital for dyspnea and bilateral nodules in chest roentgenogram. She had no history of neoplasm, only myomectomy history of uterine leiomyoma 10 years ago. Biopsy and histopathological examination were consistent with pulmonary leiomyoma. The patient was reffered to our clinic and we performed a total abdominal hysterectomy for her multiple uterine leiomyomas. The final diagnosis was ‘benign pulmonary metastasizing leiomyoma’. After this diagnosis, surgical castration was performed but two years later, repeat imaging showed progression in pulmonary lesions and progesterone therapy was administered to the patient. Patient has continued on this hormonal therapy to date and during the 5-years follow-up, the persisting lesions in both lungs regressed. PMID:27790528

  8. Diagnosis and management of benign prostatic hyperplasia.

    PubMed

    Edwards, Jonathan L

    2008-05-15

    Benign prostatic hyperplasia is a common condition affecting older men. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent urinary tract infections. Acute urinary retention, which requires urgent bladder catheterization, is relatively uncommon. Irreversible renal damage is rare. The initial evaluation should assess the frequency and severity of symptoms and the impact of symptoms on the patient's quality of life. The American Urological Association Symptom Index is a validated instrument for the objective assessment of symptom severity. The initial evaluation should also include a digital rectal examination and urinalysis. Men with hematuria should be evaluated for bladder cancer. A palpable nodule or induration of the prostate requires referral for assessment to rule out prostate cancer. For men with mild symptoms, watchful waiting with annual reassessment is appropriate. Over the past decade, numerous medical and surgical interventions have been shown to be effective in relieving symptoms of benign prostatic hyperplasia. Alpha blockers improve symptoms relatively quickly. Although 5-alpha reductase inhibitors have a slower onset of action, they may decrease prostate size and alter the disease course. Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract, and pygeum relieve symptoms. Transurethral resection of the prostate often provides permanent relief. Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery with lower perioperative morbidity. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable.

  9. Implementation of Lumped Plasticity Models and Developments in an Object Oriented Nonlinear Finite Element Code

    NASA Astrophysics Data System (ADS)

    Segura, Christopher L.

    Numerical simulation tools capable of modeling nonlinear material and geometric behavior are important to structural engineers concerned with approximating the strength and deformation capacity of a structure. While structures are typically designed to behave linear elastic when subjected to building code design loads, exceedance of the linear elastic range is often an important consideration, especially with regards to structural response during hazard level events (i.e. earthquakes, hurricanes, floods), where collapse prevention is the primary goal. This thesis addresses developments made to Mercury, a nonlinear finite element program developed in MATLAB for numerical simulation and in C++ for real time hybrid simulation. Developments include the addition of three new constitutive models to extend Mercury's lumped plasticity modeling capabilities, a constitutive driver tool for testing and implementing Mercury constitutive models, and Mercury pre and post-processing tools. Mercury has been developed as a tool for transient analysis of distributed plasticity models, offering accurate nonlinear results on the material level, element level, and structural level. When only structural level response is desired (collapse prevention), obtaining material level results leads to unnecessarily lengthy computational time. To address this issue in Mercury, lumped plasticity capabilities are developed by implementing two lumped plasticity flexural response constitutive models and a column shear failure constitutive model. The models are chosen for implementation to address two critical issues evident in structural testing: column shear failure and strength and stiffness degradation under reverse cyclic loading. These tools make it possible to model post-peak behavior, capture strength and stiffness degradation, and predict global collapse. During the implementation process, a need was identified to create a simple program, separate from Mercury, to simplify the process of

  10. Extending a rainfall-runoff model for lowland catchments from lumped to semi-distributed

    NASA Astrophysics Data System (ADS)

    Brauer, Claudia; Torfs, Paul; Teuling, Ryan; Uijlenhoet, Remko

    2016-04-01

    The Wageningen Lowland Runoff Simulator (WALRUS) is a parametric rainfall-runoff model for catchments with shallow groundwater (Brauer et al., 2014ab). WALRUS was developed using data and experience from two Dutch experimental catchments: the Hupsel Brook catchment (6.5 km2) and the Cabauw polder (0.5 km2). We identified key processes for runoff generation in lowland catchments, notably (1) groundwater-unsaturated zone coupling, (2) wetness-dependent flow routes, (3) groundwater-surface water feedbacks and (4) seepage and surface water supply, and accounted for these in the model structure. Up to now, WALRUS has been used in a lumped manner. However, water managers and researchers have expressed an interest in a semi-distributed version for application to larger catchments with varying forcing and catchment characteristics and to investigate the effect of groundwater flow within the catchment on modelled variables (e.g. groundwater depth). We combined WALRUS and a model for 2-dimensional groundwater flow into a simple modelling framework. WALRUS was already designed to cope with groundwater flow into or out of the model domain, because seepage and lateral groundwater flow are common in lowlands. In the semi-distributed version, we used this feature to couple different WALRUS elements (grid cells or subcatchments) to each other. Groundwater flow was computed using a digital elevation model, groundwater depths computed by WALRUS, soil transmissivity data and Darcy's law. Finally, we implemented a surface routing model including backwater effects, which are relevant in areas with little relief. With respect to the lumped version, the semi-distributed requires more data. Therefore, we investigated the added value of different data sources (forcing, elevation, soil, surface water) separately. We will present the rationale behind the semi-distributed model and show how the model structure compares to observations and and simulations without lateral transport. C.C. Brauer

  11. A new prosthetic implant for inguinal hernia repair: its features in a porcine experimental model.

    PubMed

    Amato, Giuseppe; Lo Monte, Attilio I; Cassata, Giovanni; Damiano, Giuseppe; Romano, Giorgio; Bussani, Rossana

    2011-08-01

    Even after more than 100 years of inguinal hernia repair, the rate of complications and recurrence remains unacceptably high. In the last decades, few effective advances in surgical technique and materials have been made. The authors see them as minor adjustments in the shape and materials of the prosthetic implants. Still, the underlying genesis of inguinal hernia remains undefined. Based upon this, it seems the surgical repair of inguinal protrusions cannot be based upon the pathogenesis because the etiology to date has not been addressed. Most hernia repairs are performed with some degree of point fixation (sutures/tacks) to stop the mesh from migrating and creating high recurrence rates. This should be a priority for our considerations, as fixating mesh puts it in stark contrast to the physiology and dynamics of the myotendineal structures of the groin. Following years of surgical practice, implant fixation, mesh shrinkage, and poor quality of tissue ingrowth still represent an unresolved issue in modern hernia repair. Conventional prosthetics used for inguinal hernia repair are static and passive. They do not move in harmony with the dynamic elements of the groin structure and, as a result, induce the ingrowth of thin scar plates or shrinking regressive tissue that colonizes the implants. The authors strongly believe that these characteristics may be a contributing factor for recurrences and patient discomfort. Other complications are reported in the literature to be a direct result of fixation of the implants, such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications. To improve results by respecting the physiology and kinetics of the inguinal region, we felt that a new type of prosthesis should be designed that induces a more structured tissue ingrowth similar to the natural biologic components of the abdominal wall. This prosthetic device was specifically designed to be placed with no point fixation. This was achieved by

  12. [Benign metastasizing pulmonary leiomyomatosis. A report of 3 cases].

    PubMed

    Pifarré, R; Izquierdo, J; Calatrava, A; Martínez, C; Ruiz, J; Morera, J

    1999-12-01

    The benign metastasizing leiomyoma is an uncommon variety of leiomyoma, tumor derived from smooth muscular tissue. The benign metastasizing leiomyoma affects a middle age women, with antecedents of uterine leiomyoma, the pulmonary lesions appeared as a multiple nodules, without systemic affectation. We present three cases of benign metastasizing leiomyoma that de diagnosis was made for biopsy by thoracotomy; and in one case the markers from estrogens' receivers were positive.

  13. 5 CFR 842.708 - Partial deferred payment of the lump-sum credit if annuity commences after December 2, 1989, and...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... credit if annuity commences after December 2, 1989, and before October 1, 1995. 842.708 Section 842.708... of the lump-sum credit if annuity commences after December 2, 1989, and before October 1, 1995. (a... 2, 1989, and before October 1, 1994, the lump-sum credit payable under § 842.705 is payable to...

  14. 5 CFR 842.708 - Partial deferred payment of the lump-sum credit if annuity commences after December 2, 1989, and...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... credit if annuity commences after December 2, 1989, and before October 1, 1995. 842.708 Section 842.708... of the lump-sum credit if annuity commences after December 2, 1989, and before October 1, 1995. (a... 2, 1989, and before October 1, 1994, the lump-sum credit payable under § 842.705 is payable to...

  15. 5 CFR 842.708 - Partial deferred payment of the lump-sum credit if annuity commences after December 2, 1989, and...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... credit if annuity commences after December 2, 1989, and before October 1, 1995. 842.708 Section 842.708... of the lump-sum credit if annuity commences after December 2, 1989, and before October 1, 1995. (a... 2, 1989, and before October 1, 1994, the lump-sum credit payable under § 842.705 is payable to...

  16. 5 CFR 842.708 - Partial deferred payment of the lump-sum credit if annuity commences after December 2, 1989, and...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... credit if annuity commences after December 2, 1989, and before October 1, 1995. 842.708 Section 842.708... of the lump-sum credit if annuity commences after December 2, 1989, and before October 1, 1995. (a... 2, 1989, and before October 1, 1994, the lump-sum credit payable under § 842.705 is payable to...

  17. 5 CFR 842.708 - Partial deferred payment of the lump-sum credit if annuity commences after December 2, 1989, and...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... credit if annuity commences after December 2, 1989, and before October 1, 1995. 842.708 Section 842.708... of the lump-sum credit if annuity commences after December 2, 1989, and before October 1, 1995. (a... 2, 1989, and before October 1, 1994, the lump-sum credit payable under § 842.705 is payable to...

  18. 20 CFR 404.461 - Nonpayment of lump sum after death of alien outside United States for more than 6 months.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Nonpayment of lump sum after death of alien... Nonpayments of Benefits § 404.461 Nonpayment of lump sum after death of alien outside United States for more than 6 months. Where an individual dies outside the United States after January 1957 and no...

  19. 20 CFR 404.391 - Who is entitled to the lump-sum death payment as a widow or widower who was living in the same...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... years after the date of the insured's death. You need not apply again if, in the month prior to the... 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...

  20. 20 CFR 404.461 - Nonpayment of lump sum after death of alien outside United States for more than 6 months.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Nonpayment of lump sum after death of alien... Nonpayments of Benefits § 404.461 Nonpayment of lump sum after death of alien outside United States for more than 6 months. Where an individual dies outside the United States after January 1957 and no...

  1. The appendix: a spectrum of benign and malignant disease.

    PubMed

    Lord, Christopher; Broadhurst, Jack; Sleight, Simon; McGee, Shaun; Wills, Mark

    2017-02-02

    This article discusses the radiological appearances and subsequent management of a diverse spectrum of benign and malignant appendiceal pathologies, including those masquerading as acute appendicitis.

  2. Renal cancer subtypes: Should we be lumping or splitting for therapeutic decision making?

    PubMed

    Haake, Scott M; Rathmell, W Kimryn

    2017-01-01

    The treatment of advanced renal cell carcinoma has posed a challenge for decades, in part because of common themes related to intrinsic resistance to cytotoxic chemotherapy and the obscure biology of these cancer types. Forward movement in the treatment of the renal cell carcinomas thus can be approached in 2 ways: by splitting the tumor types along histologic and molecular features, in the hopes of coupling highly precision-focused therapy on a subset of patients who have disease with the most potential for benefit; or by lumping the various biologies and histologies together, to include the rarer renal cell carcinoma types with the more common types. The former strategy satisfies the desire for customized precision in treatment delivery, whereas the latter strategy allows clinicians to offer a wider therapeutic menu in a set of diseases we are continuing to learn about on a physiologic and molecular level. Cancer 2017;123:200-209. © 2016 American Cancer Society.

  3. Micro-optical force distribution sensing suitable for lump/artery detection.

    PubMed

    Ahmadi, Roozbeh; Arbatani, Siamak; Packirisamy, Muthukumaran; Dargahi, Javad

    2015-02-01

    Surgeons performing robotic-assisted surgical tasks need to establish the density and constituency of hidden tissue structures using only surgical tools. This is possible by integrating a miniaturized sensor into the end-effectors of robotic surgical systems. In this present work, optical microsystems technology is utilized to develop a miniature force-distribution sensor that can be integrated into surgical end-effectors. The sensing principle of the sensor is based on the mechanism of splice coupling. Since the device is fully optical, the sensor is magnetic-resonance compatible and is also electrically passive. The experimental results performed on the developed sensor confirm its ability to measure the distributed force information. Such information is used to detect different tissue structures such as lumps, arteries, or ureters during robotic-assisted surgical tasks.

  4. Normal modes of a superconducting transmission-line resonator with embedded lumped element circuit components

    NASA Astrophysics Data System (ADS)

    Mortensen, Henrik Lund; Mølmer, Klaus; Andersen, Christian Kraglund

    2016-11-01

    We present a method to identify the coupled, normal modes of a superconducting transmission line with an embedded lumped element circuit. We evaluate the effective transmission-line nonlinearities in the case of Kerr-like Josephson interactions in the circuit and in the case where the embedded circuit constitutes a qubit degree of freedom, which is Rabi coupled to the field in the transmission line. Our theory quantitatively accounts for the very high and positive Kerr nonlinearities observed in a recent experiment [M. Rehák, P. Neilinger, M. Grajcar, G. Oelsner, U. Hübner, E. Il'ichev, and H.-G. Meyer, Appl. Phys. Lett. 104, 162604 (2014), 10.1063/1.4873719], and we can evaluate the accomplishments of modified versions of the experimental circuit.

  5. Lumped Parameter Models of the Central Nervous System for VIIP Research

    NASA Technical Reports Server (NTRS)

    Vera, J.; Mulugeta, L.; Nelson, E. S.; Raykin, J.; Feola, A.; Gleason, R.; Samuels, B.; Myers, J. G.

    2015-01-01

    INTRODUCTION: Current long-duration missions to the International Space Station and future exploration-class missions beyond low-Earth orbit, such as to Mars and asteroids, expose astronauts to increased risk of Visual Impairment and Intracranial Pressure (VIIP) syndrome [1]. It has been hypothesized that the headward shift of cerebral spinal fluid (CSF) and blood in microgravity may cause significant elevation of intracranial pressure (ICP), which in turn induces VIIP syndrome through biomechanical pathways [1, 2]. However, there is insufficient evidence to confirm this hypothesis. In this light, we are developing lumped-parameter models of fluid transport in the central nervous system (CNS) as a means to simulate the influence of microgravity on ICP. The CNS models will also be used in concert with the lumped parameter and finite element models of the eye described in the realted IWS abstracts submitted by Nelson et al., Feola et al. and Ethier et al. METHODS: We have developed a nine compartment CNS model (Figure 1) capable of both time-dependent and steady state fluid transport simulations, based on the works of Stevens et al. [3]. The breakdown of compartments within the model includes: vascular (3), CSF (2), brain (1) and extracranial (3). The boundary pressure in the Central Arteries [A] node is prescribed using an oscillating pressure function PA(t) simulating the carotid pulsatile pressure wave as developed by Linninger et al. [4]. For each time step, pressures are integrated through time using an adaptive-timestep 4th and 5th order Runga-Kutta solver. Once pressures are found, constitutive equations are used to solve for flowrates (Q) between each compartment. In addition to fluid flow between the different compartments, compliance (C) interactions between neighboring compartments are represented. We are also developing a second CNS model based on the works of Linninger et al. [4] which takes a more granular approach to represent the interactions of the

  6. Unusual Presentation of Hydatidosis - Neck Lump Causing Costo-Vertebral Erosion

    PubMed Central

    Alam, Mehtab; Hasan, Syed-Abrar; Hashmi, Shahab-Farkhund

    2016-01-01

    Introduction: Hydatid disease caused by larval stage of Echinococcus has been recognized endemically in many countries. Liver and lungs are the most commonly affected organs. Involvement of the head and neck region is rare and bony erosion due to hydatidosis is even rarer. Case Report: We report a case of a 17-year-old girl from a poor socio-economic background who presented with a right sided supraclavicular lump, which after surgical excision and histopathological examination was diagnosed as hydatid cyst of neck. Conclusion: Because of its rarity in the neck region, primary diagnosis of hydatid cyst is overlooked and usually not included in the differential diagnosis of cystic neck swellings. A high index of suspicion is necessary to diagnose hydatid disease in an unusual location even in endemic areas. PMID:27738614

  7. Malignant peripheral nerve sheath tumor presenting as orbito temporal lump: Case report and review of literature

    PubMed Central

    Panigrahi, Souvagya; Mishra, Sudhansu S.; Mishra, Sanjib; Das, Srikant

    2016-01-01

    Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma. The most common anatomical sites include the upper and lower extremities and trunk and less commonly the head and neck. To our knowledge, few patients with a cranial or facial MPNST have been reported. We report such a lesion in a 35-year-old woman who presented with left sided rapidly progressive proptosis and visual loss due to an orbital lump extending up to the temporal lobe. Cranial imaging showed a huge mass invading the orbital wall and temporal bone. The presumptive diagnosis was a malignant orbital tumor. Preoperative fine needle aspiration cytology of the orbital mass came to be neurofibroma. Near total resection of the tumor was done. Histopathology revealed MPNST which was subsequently confirmed on the basis of immunopositivity for S-100. The patient recovered uneventfully and was discharged 8 days after surgery with an advice to attend cancer institute for possible radiotherapy. PMID:27057226

  8. A numerical investigation of the GRLW equation using lumped Galerkin approach with cubic B-spline.

    PubMed

    Zeybek, Halil; Karakoç, S Battal Gazi

    2016-01-01

    In this work, we construct the lumped Galerkin approach based on cubic B-splines to obtain the numerical solution of the generalized regularized long wave equation. Applying the von Neumann approximation, it is shown that the linearized algorithm is unconditionally stable. The presented method is implemented to three test problems including single solitary wave, interaction of two solitary waves and development of an undular bore. To prove the performance of the numerical scheme, the error norms [Formula: see text] and [Formula: see text] and the conservative quantities [Formula: see text], [Formula: see text] and [Formula: see text] are computed and the computational data are compared with the earlier works. In addition, the motion of solitary waves is described at different time levels.

  9. Horn-coupled, commercially-fabricated aluminum lumped-element kinetic inductance detectors for millimeter wavelengths

    SciTech Connect

    McCarrick, H. Flanigan, D.; Jones, G.; Johnson, B. R.; Araujo, D.; Limon, M.; Luu, V.; Miller, A.; Ade, P.; Doyle, S.; Tucker, C.; Bradford, K.; Che, G.; Cantor, R.; Day, P.; Leduc, H.; Mauskopf, P.; Mroczkowski, T.; Zmuidzinas, J.

    2014-12-15

    We discuss the design, fabrication, and testing of prototype horn-coupled, lumped-element kinetic inductance detectors (LEKIDs) designed for cosmic microwave background studies. The LEKIDs are made from a thin aluminum film deposited on a silicon wafer and patterned using standard photolithographic techniques at STAR Cryoelectronics, a commercial device foundry. We fabricated 20-element arrays, optimized for a spectral band centered on 150 GHz, to test the sensitivity and yield of the devices as well as the multiplexing scheme. We characterized the detectors in two configurations. First, the detectors were tested in a dark environment with the horn apertures covered, and second, the horn apertures were pointed towards a beam-filling cryogenic blackbody load. These tests show that the multiplexing scheme is robust and scalable, the yield across multiple LEKID arrays is 91%, and the measured noise-equivalent temperatures for a 4 K optical load are in the range 26±6 μK√(s)

  10. Continuous high pressure lump coal feeder design study. [fluidized bed processors

    NASA Technical Reports Server (NTRS)

    Fields, S. F.

    1977-01-01

    A continuous lump coal dry feeder was developed for a pressurized fluidized bed combustor. The approach was to adapt the commercially available Fuller-Kinyon pump to feed coal against a pressure differential of 100 psi or more. The pump was modified and tests performed at various pressure differentials, with differently pitched screws, various screw rotational speeds, and various seal lengths and configurations. Successful operation of the modified Fuller-Kinyon pump was generally limited to pressure differentials of 60 psi or less. Although the results are not conclusive, test data and observations were made that indicated that higher pressure differentials could be attained by further modifications of the test setup. In particular, it is recommended that further testing be performed after replacing the 40-horsepower pump motor presently in the test setup with a motor having a significantly high power rating (thereby allowing pump operation with longer seals and at higher pressure differentials than those tested so far).

  11. Mass loss and longevity of gravitationally bound oscillating scalar lumps (oscillatons) in D dimensions

    SciTech Connect

    Fodor, Gyula; Forgacs, Peter; Mezei, Mark

    2010-03-15

    Spherically symmetric oscillatons (also referred to as oscillating soliton stars) i.e. gravitationally bound oscillating scalar lumps are considered in theories containing a massive self-interacting real scalar field coupled to Einstein's gravity in 1+D dimensional spacetimes. Oscillations are known to decay by emitting scalar radiation with a characteristic time scale which is, however, extremely long, it can be comparable even to the lifetime of our universe. In the limit when the central density (or amplitude) of the oscillaton tends to zero (small-amplitude limit) a method is introduced to compute the transcendentally small amplitude of the outgoing waves. The results are illustrated in detail on the simplest case, a single massive free scalar field coupled to gravity.

  12. Static Analysis of the Lumped Mass Cable Model Using a Shooting Algorithm

    SciTech Connect

    Masciola, M. D.; Nahon, M.; Driscoll, F. R.

    2012-03-01

    This paper focuses on a method to solve the static configuration for a lumped mass cable system. The method demonstrated here is intended to be used prior to performing a dynamics simulation of the cable. Conventional static analysis approaches resort to dynamics relaxation methods or root-finding algorithms (such as the Newton-Raphson method) to find the equilibrium profile. The alternative method demonstrated here is general enough for most cable configurations (slack or taut) and ranges of cable elasticity. The forces acting on the cable are attributable to elasticity, weight, buoyancy, and hydrodynamics. For the three-dimensional problem, the initial cable profile is obtained by solving three equations, regardless of the cable discretization resolution. This analysis discusses regions and circumstances under which failures in the method are encountered.

  13. Enhanced Dynamic Range in N-SQUID Lumped Josephson Parametric Amplifiers

    NASA Astrophysics Data System (ADS)

    Eddins, A.; Levenson-Falk, E. M.; Toyli, D. M.; Vijay, R.; Minev, Z.; Siddiqi, I.

    2014-03-01

    Simultaneously providing high gain and nearly quantum-limited noise performance, superconducting parametric amplifiers (paramps) have been used successfully for high fidelity qubit readout, quantum feedback, and microwave quantum optics experiments. The Lumped Josephson Parametric Amplifier (LJPA) consists of a capacitively shunted SQUID coupled to a transmission line to form a nonlinear resonator. Like other paramps employing a resonant circuit, the LJPA's dynamic range-a potentially key ingredient for multiplexing-is limited. Simple theory predicts that the dynamic range can be increased without any reduction in bandwidth or gain by distributing the resonator nonlinearity over a series array of SQUIDs. We fabricated such array devices with up to 5 SQUIDs and observed a clear increase in the critical power for bifurcation about which parametric gain occurs. We discuss in detail amplifier performance as a function of the number of SQUIDs in the array. This research was supported by the Army Research Office under a QCT grant.

  14. Friction damping studies in multiple turbine blade systems by lumped mass method

    NASA Technical Reports Server (NTRS)

    Raju, B. B.; Dominic, R. J.; Held, T. W.

    1983-01-01

    Analytical studies were conducted on multiple turbine blade systems using the lumped mass method. Each blade was idealized by a two mass-two spring model whose modal values were determined from the known frequencies corresponding to the first two bending modes and the frequency corresponding to the platform lockup condition. Two friction damping models were considered namely, the blade-to-blade and the blade-damper-blade. The equations of motion derived on the basis of these models were solved by a method of harmonic balance, assuming, in effect, that under cyclic excitation the blades will exhibit cyclic response at the same frequency. The solutions for 8 blade, 16 blade, and 4 blade systems were obtained using the computer program BLADE. The levels of damping produced by the two friction damping models were compared and evaluated. The optimal values of the friction force, for which the tip amplitude of the blades had a minimum value, were determined.

  15. A lumped parameter mathematical model for simulation of subsonic wind tunnels

    NASA Technical Reports Server (NTRS)

    Krosel, S. M.; Cole, G. L.; Bruton, W. M.; Szuch, J. R.

    1986-01-01

    Equations for a lumped parameter mathematical model of a subsonic wind tunnel circuit are presented. The equation state variables are internal energy, density, and mass flow rate. The circuit model is structured to allow for integration and analysis of tunnel subsystem models which provide functions such as control of altitude pressure and temperature. Thus the model provides a useful tool for investigating the transient behavior of the tunnel and control requirements. The model was applied to the proposed NASA Lewis Altitude Wind Tunnel (AWT) circuit and included transfer function representations of the tunnel supply/exhaust air and refrigeration subsystems. Both steady state and frequency response data are presented for the circuit model indicating the type of results and accuracy that can be expected from the model. Transient data for closed loop control of the tunnel and its subsystems are also presented, demonstrating the model's use as a control analysis tool.

  16. Simple lumped circuit model applied to field flatness tuning of four-rod radio frequency quadrupoles

    NASA Astrophysics Data System (ADS)

    Tan, C. Y.; Schmidt, J. S.; Schempp, A.

    2014-01-01

    The field flatness of any radio frequency quadrupole (RFQ) is an important parameter that needs to be carefully tuned because it can affect beam transmission efficiency. In four-rod RFQs, the heights of a set of tuning plates determine the quality of the field flatness. The goals of this paper are (a) to show that by using a lumped circuit model of a four-rod RFQ, the field flatness profile for any tuning plate height distribution can be quickly calculated, (b) to derive a perturbative solution of the model so that insights into the physics of the tuning process and its effects can be understood, and (c) to compare the predicted field profiles to measurements.

  17. Fault detection in heavy duty wheels by advanced vibration processing techniques and lumped parameter modeling

    NASA Astrophysics Data System (ADS)

    Malago`, M.; Mucchi, E.; Dalpiaz, G.

    2016-03-01

    Heavy duty wheels are used in applications such as automatic vehicles and are mainly composed of a polyurethane tread glued to a cast iron hub. In the manufacturing process, the adhesive application between tread and hub is a critical assembly phase, since it is completely made by an operator and a contamination of the bond area may happen. Furthermore, the presence of rust on the hub surface can contribute to worsen the adherence interface, reducing the operating life. In this scenario, a quality control procedure for fault detection to be used at the end of the manufacturing process has been developed. This procedure is based on vibration processing techniques and takes advantages of the results of a lumped parameter model. Indicators based on cyclostationarity can be considered as key parameters to be adopted in a monitoring test station at the end of the production line due to their not deterministic characteristics.

  18. Accurate BER evaluation for lumped DPSK and OOK systems with PMD and PDL

    NASA Astrophysics Data System (ADS)

    Zhang, Zhongxi; Chen, Liang; Bao, Xiaoyi

    2007-07-01

    New forms using Dirac bra-ket notations and their transformations to express electrically filtered currents are presented for optical systems using either binary differential phase-shift keying (2-DPSK) or ON-OFF keying (OOK) with lumped first-order PMD and PDL, arbitrary optical and electrical filtering and pulse shaping. Based on these forms, the moment generating functions (MGFs) and bit-error-ratios (BERs) for different systems are obtained. Our results show that, for a given BER, 2-DPSK requires ~ 5dB lower input signal-to-noise ratio than OOK. By comparing BERs for different polarization systems, we also show that the PDL-induced partially polarized noise can significantly improve system performance and reduce BER variation caused by the random couplings between signal polarization, PDL and PMD vectors.

  19. A New Lumped Structure Photochemical Mechanism for Large-Scale Applications

    SciTech Connect

    Zaveri, Rahul A.; Peters, Leonard K.

    1999-12-20

    The lumped-structure approach for condensing organic chemical mechanisms is attractive, since it yields fewer species and reactions, and reduces computational costs. This paper leads through the development of a new lumped-structure mechanism, largely based on the widely used Carbon Bond Mechanism (CBM-IV) developed by Gery et al.[1989]. The new mechanism called CBM-Z, extends the original framework to function properly at larger spatial and longer time scales. The major modifications in the mechanism include: revised inorganic chemistry; explicit treatment of the lesser reactive paraffins - methane and ethane; revised parameterizations of the reactive paraffin, olefin and aromatic reactions; inclusion of alkyl and acyl peroxy radical interactions and their reactions with NO3; inclusion of organic nitrates and hydroperoxides; and refined isoprene chemistry based on the condensed one-product mechanism of Carter[1996a,b]. CBM-Z was successfully evaluated along with the CBM-IV, a partially revised CBM-IV and a revised RADM2 mechanism[Stockwell et al., 1990; Kirchner and Stockwell, 1996] using the low VOC and NOx concentration smog chamber experiments of Simonaitis et al.[1997]. Box-model versions of the four mechanisms were also evaluated under a variety of hypothetical urban and rural scenarios for a period of 30 days. Results from CBM-Z and revised RADM2 were found to be within (+/-) 20% of each other, while CBM-IV and revised CBM-IV results deviated significantly by up to 50-95%. Sensitivity tests were performed to elucidate the effects of some of the new features added in CBM-Z. Relative computational memory and time requirements of these mechanisms are also discussed.

  20. Lumped versus distributed thermoregulatory control: results from a three-dimensional dynamic model.

    PubMed

    Werner, J; Buse, M; Foegen, A

    1989-01-01

    In this study we use a three-dimensional model of the human thermal system, the spatial grid of which is 0.5 ... 1.0 cm. The model is based on well-known physical heat-transfer equations, and all parameters of the passive system have definite physical values. According to the number of substantially different areas and organs, 54 spatially different values are attributed to each physical parameter. Compatibility of simulation and experiment was achieved solely on the basis of physical considerations and physiological basic data. The equations were solved using a modification of the alternating direction implicit method. On the basis of this complex description of the passive system close to reality, various lumped and distributed parameter control equations were tested for control of metabolic heat production, blood flow and sweat production. The simplest control equations delivering results on closed-loop control compatible with experimental evidence were determined. It was concluded that it is essential to take into account the spatial distribution of heat production, blood flow and sweat production, and that at least for control of shivering, distributed controller gains different from the pattern of distribution of muscle tissue are required. For sweat production this is not so obvious, so that for simulation of sweating control after homogeneous heat load a lumped parameter control may be justified. Based on these conclusions three-dimensional temperature profiles for cold and heat load and the dynamics for changes of the environmental conditions were computed. In view of the exact simulation of the passive system and the compatibility with experimentally attainable variables there is good evidence that those values extrapolated by the simulation are adequately determined. The model may be used both for further analysis of the real thermoregulatory mechanisms and for special applications in environmental and clinical health care.

  1. Patient-specific parameter estimation in single-ventricle lumped circulation models under uncertainty.

    PubMed

    Schiavazzi, Daniele E; Baretta, Alessia; Pennati, Giancarlo; Hsia, Tain-Yen; Marsden, Alison L

    2017-03-01

    Computational models of cardiovascular physiology can inform clinical decision-making, providing a physically consistent framework to assess vascular pressures and flow distributions, and aiding in treatment planning. In particular, lumped parameter network (LPN) models that make an analogy to electrical circuits offer a fast and surprisingly realistic method to reproduce the circulatory physiology. The complexity of LPN models can vary significantly to account, for example, for cardiac and valve function, respiration, autoregulation, and time-dependent hemodynamics. More complex models provide insight into detailed physiological mechanisms, but their utility is maximized if one can quickly identify patient specific parameters. The clinical utility of LPN models with many parameters will be greatly enhanced by automated parameter identification, particularly if parameter tuning can match non-invasively obtained clinical data. We present a framework for automated tuning of 0D lumped model parameters to match clinical data. We demonstrate the utility of this framework through application to single ventricle pediatric patients with Norwood physiology. Through a combination of local identifiability, Bayesian estimation and maximum a posteriori simplex optimization, we show the ability to automatically determine physiologically consistent point estimates of the parameters and to quantify uncertainty induced by errors and assumptions in the collected clinical data. We show that multi-level estimation, that is, updating the parameter prior information through sub-model analysis, can lead to a significant reduction in the parameter marginal posterior variance. We first consider virtual patient conditions, with clinical targets generated through model solutions, and second application to a cohort of four single-ventricle patients with Norwood physiology. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Lumped-Element Dynamic Electro-Thermal model of a superconducting magnet

    NASA Astrophysics Data System (ADS)

    Ravaioli, E.; Auchmann, B.; Maciejewski, M.; ten Kate, H. H. J.; Verweij, A. P.

    2016-12-01

    Modeling accurately electro-thermal transients occurring in a superconducting magnet is challenging. The behavior of the magnet is the result of complex phenomena occurring in distinct physical domains (electrical, magnetic and thermal) at very different spatial and time scales. Combined multi-domain effects significantly affect the dynamic behavior of the system and are to be taken into account in a coherent and consistent model. A new methodology for developing a Lumped-Element Dynamic Electro-Thermal (LEDET) model of a superconducting magnet is presented. This model includes non-linear dynamic effects such as the dependence of the magnet's differential self-inductance on the presence of inter-filament and inter-strand coupling currents in the conductor. These effects are usually not taken into account because superconducting magnets are primarily operated in stationary conditions. However, they often have significant impact on magnet performance, particularly when the magnet is subject to high ramp rates. Following the LEDET method, the complex interdependence between the electro-magnetic and thermal domains can be modeled with three sub-networks of lumped-elements, reproducing the electrical transient in the main magnet circuit, the thermal transient in the coil cross-section, and the electro-magnetic transient of the inter-filament and inter-strand coupling currents in the superconductor. The same simulation environment can simultaneously model macroscopic electrical transients and phenomena at the level of superconducting strands. The model developed is a very useful tool for reproducing and predicting the performance of conventional quench protection systems based on energy extraction and quench heaters, and of the innovative CLIQ protection system as well.

  3. Deducing Electronic Unit Internal Response During a Vibration Test Using a Lumped Parameter Modeling Approach

    NASA Technical Reports Server (NTRS)

    Van Dyke, Michael B.

    2014-01-01

    During random vibration testing of electronic boxes there is often a desire to know the dynamic response of certain internal printed wiring boards (PWBs) for the purpose of monitoring the response of sensitive hardware or for post-test forensic analysis in support of anomaly investigation. Due to restrictions on internally mounted accelerometers for most flight hardware there is usually no means to empirically observe the internal dynamics of the unit, so one must resort to crude and highly uncertain approximations. One common practice is to apply Miles Equation, which does not account for the coupled response of the board in the chassis, resulting in significant over- or under-prediction. This paper explores the application of simple multiple-degree-of-freedom lumped parameter modeling to predict the coupled random vibration response of the PWBs in their fundamental modes of vibration. A simple tool using this approach could be used during or following a random vibration test to interpret vibration test data from a single external chassis measurement to deduce internal board dynamics by means of a rapid correlation analysis. Such a tool might also be useful in early design stages as a supplemental analysis to a more detailed finite element analysis to quickly prototype and analyze the dynamics of various design iterations. After developing the theoretical basis, a lumped parameter modeling approach is applied to an electronic unit for which both external and internal test vibration response measurements are available for direct comparison. Reasonable correlation of the results demonstrates the potential viability of such an approach. Further development of the preliminary approach presented in this paper will involve correlation with detailed finite element models and additional relevant test data.

  4. Beyond the SCS-CN method: A theoretical framework for spatially lumped rainfall-runoff response

    NASA Astrophysics Data System (ADS)

    Bartlett, M. S.; Parolari, A. J.; McDonnell, J. J.; Porporato, A.

    2016-06-01

    Since its introduction in 1954, the Soil Conservation Service curve number (SCS-CN) method has become the standard tool, in practice, for estimating an event-based rainfall-runoff response. However, because of its empirical origins, the SCS-CN method is restricted to certain geographic regions and land use types. Moreover, it does not describe the spatial variability of runoff. To move beyond these limitations, we present a new theoretical framework for spatially lumped, event-based rainfall-runoff modeling. In this framework, we describe the spatially lumped runoff model as a point description of runoff that is upscaled to a watershed area based on probability distributions that are representative of watershed heterogeneities. The framework accommodates different runoff concepts and distributions of heterogeneities, and in doing so, it provides an implicit spatial description of runoff variability. Heterogeneity in storage capacity and soil moisture are the basis for upscaling a point runoff response and linking ecohydrological processes to runoff modeling. For the framework, we consider two different runoff responses for fractions of the watershed area: "prethreshold" and "threshold-excess" runoff. These occur before and after infiltration exceeds a storage capacity threshold. Our application of the framework results in a new model (called SCS-CNx) that extends the SCS-CN method with the prethreshold and threshold-excess runoff mechanisms and an implicit spatial description of runoff. We show proof of concept in four forested watersheds and further that the resulting model may better represent geographic regions and site types that previously have been beyond the scope of the traditional SCS-CN method.

  5. Laparoscopic treatment for inguinal hernia combined with cryptorchidism: Totally extraperitoneal repair with orchiectomy under the same operative view

    PubMed Central

    Fujishima, Hajime; Sasaki, Atsushi; Takeuchi, Yu; Morimoto, Akio; Inomata, Masafumi

    2015-01-01

    Introduction Approximately 7% of child patients with inguinal hernias also present with cryptorchidism. On the other hand, combined adult cases are uncommon. Here we report two adult cases of inguinal hernia combined with intra-canalicular cryptorchidism who underwent totally extraperitoneal (TEP) repair with orchiectomy under the same operative view. Presentation of cases We treated two patients (49- and 38-year-old men) with right indirect inguinal hernias and cryptorchidism. Both patients underwent TEP repair with orchiectomy. In operative findings, an atrophic testis was drawn out with a hernia sac from the internal inguinal ring. After the testis was separated from the sac and cord structure was sheared, it was removed. The procedure did not require special techniques and devices. In both patients, the postoperative courses were satisfactory. Discussion To our knowledge, there has been only one such reported case till date which demonstrated the feasibility of TEP repair accompanied by orchiectomy. Conclusions TEP repair with orchiectomy under the same operative view could be safely performed in adults with an inguinal hernia combined with extra-abdominal cryptorchidism. This procedure could be an option for the treatment of such adult patients. PMID:26581081

  6. [Testicular cancer with inguinal lymph node metastasis in a patient with prior orchiopexy for undescended testis: a case report].

    PubMed

    Minato, Noriko; Yamaguchi, Yuichiro; Koga, Minoru; Sugao, Hideki; Hoshi, Minako; Mori, Hiroshi

    2011-11-01

    A 36-year-old man referred to our hospital with the chief complaint of painful left inguinal mass and fever. He had undergone left orchiopexy for undescended testis at 10 years of age. With the suspicion of an incarceration of inguinal hernia, an operation was performed. However, there was no hernia sac, and only swelling inguinal lymph nodes were found. Pathological diagnosis of the nodes was metastatic embryonal carcinoma, with suspicion of testicular origin. As scrotal ultrasonography revealed a hypoehcoic mass within the left atrophic testis, left high orchiectomy was performed. Pathological diagnosis of the left testicular mass was seminoma. A definite diagnosis was left testicular cancer, mixed type of seminoma and embryonal carcinoma, with inguinal nodes metastasis, pT1N2M0. He received 3 courses of bleomycin, etoposide, and cisplatin (BEP) chemotherapy, and there has been no sign of metastasis nor recurrence 18 months after the operation. To our knowledge, this is the 11th case in Japan of testicular cancer with inguinal node metastasis in a patient with prior orchiopexy for undescended testis.

  7. 42 CFR 411.47 - Apportionment of a lump-sum compromise settlement of a workers' compensation claim.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of a workers' compensation claim. 411.47 Section 411.47 Public Health CENTERS FOR MEDICARE & MEDICAID... ON MEDICARE PAYMENT Limitations on Medicare Payment for Services Covered Under Workers' Compensation § 411.47 Apportionment of a lump-sum compromise settlement of a workers' compensation claim....

  8. 42 CFR 411.47 - Apportionment of a lump-sum compromise settlement of a workers' compensation claim.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of a workers' compensation claim. 411.47 Section 411.47 Public Health CENTERS FOR MEDICARE & MEDICAID... ON MEDICARE PAYMENT Limitations on Medicare Payment for Services Covered Under Workers' Compensation § 411.47 Apportionment of a lump-sum compromise settlement of a workers' compensation claim....

  9. 42 CFR 411.47 - Apportionment of a lump-sum compromise settlement of a workers' compensation claim.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... of a workers' compensation claim. 411.47 Section 411.47 Public Health CENTERS FOR MEDICARE & MEDICAID... ON MEDICARE PAYMENT Limitations on Medicare Payment for Services Covered Under Workers' Compensation § 411.47 Apportionment of a lump-sum compromise settlement of a workers' compensation claim....

  10. 42 CFR 411.47 - Apportionment of a lump-sum compromise settlement of a workers' compensation claim.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of a workers' compensation claim. 411.47 Section 411.47 Public Health CENTERS FOR MEDICARE & MEDICAID... ON MEDICARE PAYMENT Limitations on Medicare Payment for Services Covered Under Workers' Compensation § 411.47 Apportionment of a lump-sum compromise settlement of a workers' compensation claim....

  11. 42 CFR 411.47 - Apportionment of a lump-sum compromise settlement of a workers' compensation claim.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Apportionment of a lump-sum compromise settlement of a workers' compensation claim. 411.47 Section 411.47 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT Limitations...

  12. 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

    ... costs or selling values subsequent to the rate redetermination which reduce conversion value to less... 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...

  13. 29 CFR 4044.73 - Lump sums and other alternative forms of distribution in lieu of annuities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... lieu of annuities. (a) Valuation. (1) The value of the lump sum or other alternative form of distribution is the present value of the normal form of benefit provided by the plan payable at normal... sum benefit, the present value shall be determined as if the participant were alive on the date...

  14. LUMPED-PARAMETER MODEL ANALYSES OF DATA FROM THE 1992 NEW HOUSE EVALUATION PROJECT - FLORIDA RADON RESEARCH PROGRAM

    EPA Science Inventory

    The report documents analyses of Phase 2 data from the Florida Radon Research Program's New House Evaluation Project (NHEP) that were performed using a lumped-parameter model. The houses evaluated in Phase 2 were monitored by the Florida Solar Energy Center (FSEC) and the Univers...

  15. The debate over robotics in benign gynecology.

    PubMed

    Rardin, Charles R

    2014-05-01

    The debate over the role of the da Vinci surgical robotic platform in benign gynecology is raging with increasing fervor and, as product liability issues arise, greater financial stakes. Although the best currently available science suggests that, in the hands of experts, robotics offers little in surgical advantage over laparoscopy, at increased expense, the observed decrease in laparotomy for hysterectomy is almost certainly, at least in part, attributable to the availability of the robot. In this author's opinion, the issue is not whether the robot has any role but rather to define the role in an institutional environment that also supports the safe use of vaginal and laparoscopic approaches in an integrated minimally invasive surgery program. Programs engaging robotic surgery should have a clear and self-determined regulatory process and should resist pressures in place that may preferentially support robotics over other forms of minimally invasive surgery.

  16. Saw palmetto and benign prostatic hyperplasia.

    PubMed

    Gong, Edward M; Gerber, Glenn S

    2004-01-01

    Benign prostatic hyperplasia (BPH) is a common health issue that affects 8% of all men at the age of 40, 60% of men in their 70s, and 90% of those greater than 80 years of age. One-fourth of these men will develop moderate to severe lower urinary tract symptoms that greatly affect their quality of life. Recent evidence suggests that the use of saw palmetto leads to improvements in urinary function for those suffering from BPH. The favorable comparison of saw palmetto with tamsulosin, a well-known first line agent in the treatment of urinary tract symptoms, demonstrates promise towards a beneficial effect of this herbal agent, with very few, if any, adverse effects. However, what degree of this beneficial activity is due to placebo effects is yet to be determined. In addition, the precise mechanism of action of saw palmetto in men with BPH remains unclear.

  17. Diagnosing and treating benign paroxysmal positional vertigo.

    PubMed

    Kovar, Mary; Jepson, Terry; Jones, Susan

    2006-12-01

    Gerontological nurses play a critical role in the early recognition of benign paroxysmal positional vertigo (BPPV), a condition that accounts for approximately 50% of vertigo in older adults. BPPV results in vertigo when debris collects in one or more of the semicircular canals, most typically the posterior canal. It may be differentiated from other forms of vertigo because it results in dizziness when recumbent or with head position changes. BPPV may be successfully treated with repositioning therapy, such as the Epley maneuver. Nurses working in medical offices, longterm care facilities, and assisted living may be called on to perform this maneuver. Gerontological nurses play a key role in assessing and treating BPPV, therefore minimizing unnecessary testing and medication and reducing the suffering and expense for patients with this condition.

  18. Risk stratification for benign prostatic hyperplasia.

    PubMed

    Zattoni, Fabio; Ficarra, Vincenzo; Novara, Giacomo

    2017-03-18

    Benign prostatic hyperplasia (BPH) represents an important public health problem in ageing men due to frequently associated lower urinary tract symptoms (LUTS), which may impair quality of life. BPH is also a progressive disease, mainly characterized by a worsening of LUTS over time, and in some patients by the occurrence of serious outcomes such as acute urinary retention and need for BPH-related surgery. The management of BPH and LUTS in men should move forward its focus on symptom control only. Indeed, the goals of therapy for BPH are not only to improve bothersome LUTS but also to identify those patients at risk of unfavourable outcomes in order to optimize their management and reduce complications. Risk stratification and tailored treatment should improve the reductions in both symptoms and the long-term consequences of BPH and BPH treatments. To do this, clinicians need to know possible factors that may support the develop of PBH and possible risks due to the BPH itself.

  19. [Isotope nephrographic studies in benign gynecologic diseases].

    PubMed

    Lamm, D

    1977-01-01

    1014 patients with benigne gynaecological diseases (functional incontinence of urine with and without displacement, myoma of uterus, ovarian tumors, chronic salpingoophoritis) were examined by means of isotope nephrogram before gynaecological treatment was begun. A group of 156 patients was parallely examined by means of chromocystoscopy and intravenous urography. For judgement of the ING-curves we applicated an extra parameter--the drain value "A"--, through which it was possible to differenciate between emptying disturbances and functional urinary transport disorders. To obtain this value it is necessary to change the position of the patients during examination. Under these conditions approximately 95% of ING-findings conformed with those vaised by intravenous urography. Giving weight to these conditions, we recommend the application of ING in gynaecology as a screening method. Criteria for optimal usage of this method are mentioned.

  20. Benign prostatic hyperplasia: clinical manifestations and evaluation.

    PubMed

    Santos Dias, José

    2012-12-01

    Benign prostatic hyperplasia (BPH) is a very common condition, related to aging and causing symptoms, called lower urinary tract symptoms. On account of its huge prevalence, it is important for clinicians who are involved in the management of patients with BPH to be aware of the very strict recommendations for BPH evaluation. In this article, we describe the different steps and procedures doctors should follow to evaluate these patients; symptoms and signs of BPH are reviewed, as well as the clinical evaluation steps and examinations available. The basic evaluation of the patients with BPH should include, according to the recommendations of the most relevant international guidelines, lower urinary tract symptoms evaluation with appropriate symptom scores, digital rectal examination, voiding charts, prostate-specific antigen and creatinine measurement, urinalysis, and imaging of the urinary tract.

  1. Optimizing the management of benign prostatic hyperplasia

    PubMed Central

    Elterman, Dean S.; Kaplan, Steven A.

    2012-01-01

    One of the challenges facing primary care physicians and specialists as the population ages is the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While as many as 18% of men in their 40s report bother from an enlarged prostate, that figure rises dramatically, whereby 50% of men in their 50s and 90% of men in their 90s will complain of bothersome symptoms related to an enlarged prostate. Studies have shown that BPH is a progressive disease, which if left untreated can result in worsening of symptoms, acute urinary retention and renal failure. Until about 20 years ago the only management option available to urologists was surgery. In the early 1990s medical therapy emerged as the predominant treatment for BPH. Therapy may be tailored to target symptoms and progression of disease. PMID:22496710

  2. Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study)

    PubMed Central

    Voorbrood, C E H; Goedhart, E; Verleisdonk, E J M M; Sanders, F; Naafs, D; Burgmans, J P J

    2016-01-01

    Introduction Chronic inguinal pain is a frequently occurring problem in athletes. A diagnosis of inguinal disruption is performed by exclusion of other conditions causing groin pain. Up to now, conservative medical management is considered to be the primary treatment for this condition. Relevant large and prospective clinical studies regarding the treatment of inguinal disruption are limited; however, recent studies have shown the benefits of the totally extraperitoneal patch (TEP) technique. This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique. Methods and analysis We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption). The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI are excluded. Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity). Ethics and dissemination An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript version to be published. PMID:26739740

  3. Comparison of three different mesh materials in tension-free inguinal hernia repair: prolene versus Vypro versus surgisis.

    PubMed

    Puccio, F; Solazzo, M; Marciano, P

    2005-01-01

    Using mesh or a synthetic prosthesis during tension-free inguinal hernia repair has been shown to be safe and effective. We compared the final outcome in treating inguinal hernia in 45 patients using three different prosthetic materials: 15 patients underwent tension-free inguinal hernia repair using Prolene (polypropylene) mesh, 15 using Vypro (polyglactin and polypropylene) mesh, and 15 with Surgisis-a new bioactive material derived from porcine small intestinal submucosa. The aim of this study was to evaluate the safety and efficacy of tension-free inguinal repair using Surgisis, comparing it with conventional prosthetic materials. From January 2003 to December 2003, 45 male patients underwent Lichtenstein inguinal hernia repair. Median follow-up was 12 months, with a range of 1-16 months. Each patient underwent ultrasound evaluation of the inguinal region 1 month after surgery. All the procedures were completed under local anesthesia. There were no intraoperative complications, and all patients were discharged home the same day of surgery. No recurrent hernias and wound infections were observed in our post-operative follow-up period. Postoperative pain (visual analog score) and discomfort were lower in patients with Surgisis mesh. There was no statistically significant difference between the groups in terms of overall early and late complications; however, there was a tendency toward a higher incidence of pain and discomfort in Vypro and Prolene group. The median time to full recovery was significantly shorter in the Surgisis group. Surgisis mesh seems to be a promising new prosthetic material for hernia repair. Long-term follow-up is necessary to confirm these preliminary results.

  4. Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

    PubMed Central

    Oguntodu, Olakunle F.; Rodriguez, Francisco; Rassadi, Roozbeh; Haley, Michael; Shively, Cynthia J.; Dzandu, James K.

    2014-01-01

    Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from April 4, 2010, through July 22, 2014. Data assessed were age, sex, body mass index (BMI), hernia repair indications, hernia type, pain, paresthesia, occurrence (bilateral or unilateral), recurrence, and patient satisfaction. Descriptive and regression analyses were performed. Results: Six hundred forty patients underwent laparoscopic preperitoneal hernia surgery with self-adhesive mesh. The average age was 56 years, nearly all were men (95.8%), and the mean BMI was 26.2 kg/m2. Cases involved primary hernia more frequently than recurrent hernia (94% vs 6%; P < .05). After surgery, 92% of the patients reported no more than minimal pain, <1% reported paresthesia, and 0.2% had early recurrence. There were 7 conversions to an open procedure. The patients had no adverse reactions to anesthesia and no bladder injury. Postoperative acute pain or recurrence was not explained by demographics, BMI, or preoperative pain. There were significant associations of hernia side, recurrence, occurrence, and sex with composite end points. Nearly all patients (98%) were satisfied with the outcome. Conclusion: The use of self-adhesive, Velcro-type mesh in laparoscopic TEP inguinal hernia repair is associated with reduced pain; low rates of early recurrence, infection, and hematoma; and improved patient satisfaction. PMID:25587212

  5. Laparoscopic transabdominal preperitoneal approach for recurrent inguinal hernia: A randomized trial

    PubMed Central

    Saber, Aly; Hokkam, Emad N.; Ellabban, Goda M.

    2015-01-01

    INTRODUCTION: The repair of the recurrent hernia is a daunting task because of already weakened tissues and distorted anatomy. Open posterior preperitoneal approach gives results far superior to those of the anterior approach. Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is an evolving technique associated with advantages of a minimally invasive approach. The present work aimed at comparing these three approaches for repair of recurrent inguinal hernia regarding complications and early recurrence. MATERIALS AND METHODS: A total of 180 patients were divided randomly into three equal groups: A, B, and C. Group A patients were subjected to open posterior preperitoneal approach , those of group B were subjected to transinguinal anterior tension-free repair and group C patients were subjected to TAPP. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling, and wound infections. RESULTS: The mean hospital stay, the mean time to return to work and the mean time off from work were less in group C then A and B. Chronic postoperative pain was observed in eight patients in group A (13.33%), in 18 patients in group B (30%) and six patients in group C (10%). The overall complication rate was 19.7% in both groups A and C and 34.36% in group B. CONCLUSION: In recurrent inguinal hernia, the laparoscopic and open posterior approaches are equally effective in term of operative outcome. The open preperitoneal hernia repair is inexpensive, has a low recurrence rate. Postoperative recovery is short and postoperative pain is minimal. This approach gives results far superior to those of the commonly used anterior approach. However, while laparoscopic hernia repair requires a lengthy learning curve and is difficult to learn and perform, it has advantages of less post-operative pain, early recovery with minimal hospital stay, low post-operative complications and recurrence. Trial

  6. Clinical outcomes of single incision laparoscopic surgery and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair

    PubMed Central

    Ece, Ilhan; Yilmaz, Huseyin; Yormaz, Serdar; Sahin, Mustafa

    2017-01-01

    BACKGROUND: Laparoscopic surgery has been a frequently performed method for inguinal hernia repair. Studies have demonstrated that the laparoscopic transabdominal preperitoneal (TAPP) approach is an appropriate choice for inguinal hernia repair. Single-incision laparoscopic surgery (SILS) was developed to improve the cosmetic effects of conventional laparoscopy. The aim of this study was to evaluate the safety and feasibility of SILS-TAPP compared with TAPP technique. MATERIALS AND METHODS: A total of 148 patients who underwent TAPP or SILS-TAPP in our surgery clinic between December 2012 and January 2015 were enrolled. Data including patient demographics, hernia characteristics, operative time, intraoperative and postoperative complications, length of hospital stay and recurrence rate were retrospectively collected. RESULTS: In total, 60 SILS-TAPP and 88 TAPP procedures were performed in the study period. The two groups were similar in terms of gender, type of hernia, and American Society of Anesthesiologists (ASA) classification score. The patients in the SILS-TAPP group were younger when compared the TAPP group. Port site hernia (PSH) rate was significantly high in the SILS-TAPP group, and all PSHs were recorded in patients with severe comorbidities. The mean operative time has no significant difference in two groups. All SILS procedures were completed successfully without conversion to conventional laparoscopy or open repair. No intraoperative complication was recorded. There was no recurrence during the mean follow-up period of 15.2 ± 3.8 months. CONCLUSION: SILS TAPP for inguinal hernia repair seems to be a feasible, safe method, and is comparable with TAPP technique. However, randomized trials are required to evaluate long-term clinical outcomes. PMID:27251835

  7. Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

    PubMed Central

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.

    2015-01-01

    Background and Objectives: Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias. Methods: Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months. Conclusion: Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM. PMID:25848186

  8. Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias

    PubMed Central

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne

    2014-01-01

    Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, “chopsticks” and “inline” dissection, 5.5 mm/52 cm/30° angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM. PMID:25392643

  9. Anterior preperitoneal repair of extremely large inguinal hernias: An alternative technique☆☆☆

    PubMed Central

    Koning, Giel G.; Vriens, Patrick W.H.E.

    2011-01-01

    INTRODUCTION Standard open anterior inguinal hernia repair is nowadays performed using a soft mesh to prevent recurrence and to minimalize postoperative chronic pain. To further reduce postoperative chronic pain, the use of a preperitoneal placed mesh has been suggested. In extremely large hernias, the lateral side of the mesh can be insufficient to fully embrace the hernial sac. We describe the use of two preperitoneal placed meshes to repair extremely large hernias. This ‘Butterfly Technique’ has proven to be useful. Hernias were classified according to hernia classification of the European Hernia Society (EHS) during operation. Extremely large indirect hernias were repaired by using two inverted meshes to cover the deep inguinal ring both medial and lateral. Follow up was at least 6 months. VAS pain score was assessed in all patients during follow up. Outcomes of these Butterfly repairs were evaluated. Medical drawings were made to illustrate this technique. A Total of 689 patients underwent anterior hernia repair 2006–2008. PRESENTATION OF CASE Seven male patients (1%) presented with extremely large hernial sacs. All these patients were men. Mean age 69.9 years (range: 63–76), EHS classifications of hernias were all unilateral. Follow up was at least 6 months. Recurrence did not occur after repair. Chronic pain was not reported. Discussion Open preperitoneal hernia repair of extremely large hernias has not been described. The seven patients were trated with this technique uneventfully. No chronic pain occurred. CONCLUSION The Butterfly Technique is an easy and safe alternative in anterior preperitoneal repair of extremely large inguinal hernias. PMID:22288042

  10. Results of a prospective multicenter trial evaluating the ePTFE peritoneal onlay laparoscopic inguinal hernioplasty.

    PubMed

    Toy, F K; Moskowitz, M; Smoot, R T; Pleatman, M; Bagdasarian, A; Polito, W; Carey, S D; Schatz, R; Janes, K; Zipser, M E

    1996-12-01

    A 2.8-year prospective multicenter trial was conducted to evaluate the ePTFE peritoneal onlay laparoscopic inguinal hernioplasty. A total of 441 inguinal hernias were repaired in 351 patients (326 male; 25 female). Two hundred twenty-six of the hernias were direct, 185 indirect, 4 femoral, 26 pantaloon, 90 bilateral, and 92 recurrent. Standardized data collection forms were used and submitted for centralized data analysis. For the hernioplasty, Cooper's ligament was exposed and an 8 cm x 12 cm x 1 mm GORE-TEX Soft Tissue Patch was stapled circumferentially to Cooper's ligament and the endoabdominal fascia. Patients were followed at 1 week, 6 months, 1 year, and then annually. Three-month intervals were used as needed. There was a mean follow-up of 447 days, with 21% of the total repairs followed for more than 2 years and 56% for more than a year. The overall follow-up rate was 95.5%. The operative and postoperative complication rates were 0.45% and 8%, respectively. There were 17 recurrent hernias (3.8%). The range of experience among the investigators was 13 to 168 hernioplasties. With the completion of 25 cases per investigator, the recurrence rate fell to 0.39%. Postoperative analgesia averaged a 24-hr supply of medication; 12.2% of patients required no analgesia. Convalescence averaged 5.4 days, and return to work averaged 7.7 days. This multicenter trial demonstrates that the ePTFE laparoscopic peritoneal onlay inguinal hernioplasty is a safe and dependable repair, especially after the initial learning curve is surmounted.

  11. Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study

    PubMed Central

    Jakhmola, C.K.; Kumar, Ameet

    2015-01-01

    Background Surgery for inguinal hernia continues to evolve. The most recent development in the field of surgery for inguinal hernia is the emergence of laparoscopic inguinal hernia surgery (LIHS) which is challenging the gold standard Lichtenstein's tension free mesh repair. Our centre has the largest series of LIHS from any Armed Forces hospital. The aim of this study was to analyze the short and long term outcomes at our center since its inception. Methods Retrospective review of prospectively maintained data base of 501 LIHS done in 434 patients by a single surgeon between April 2008 and October 2013. Preoperative, intraoperative, postoperative and follow-up data was analyzed with emphasis on the recurrence rates and the incidence of inguinodynia. Results 402 (92.6%) patients had primary hernias and 367 (84.6%) patients had unilateral hernias. Of the 501 repairs, 453 (90.4 %) were done totally extraperitoneal approach and 48 (9.6 %) were done by the transabdominal preperitoneal approach. The mean operative time for unilateral and bilateral repairs was 40.9 ± 11.2 and 76.2 ± 15.0 minutes, respectively. The conversion rate to open surgery was 0.6%. The intraoperative, and early and late postoperative complication rates were 1.7%, 6.2% and 3%, respectively. The incidence of chronic groin pain was 0.7% and the recurrence rate was 1.6%. The median hospital stay was 1 day (1–5 days). Conclusion We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes. PMID:26663957

  12. Different Management Options for Transplant Ureteral Obstructions within an Inguinal Hernia

    PubMed Central

    Cheung, Felix; Debartolo, Merrit Marion; Copertino, Leonard Michael; Szafran, April Adams; Estrada, Chelsea Caron; Lynch, Patrick Gerard; Darras, Frank Sam

    2016-01-01

    Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement. Both patients continued to do well postoperatively with normalization of renal function on follow-up. PMID:27144049

  13. A laparoscopic intraperitoneal onlay mesh technique for the repair of an indirect inguinal hernia.

    PubMed Central

    Fitzgibbons, R J; Salerno, G M; Filipi, C J; Hunter, W J; Watson, P

    1994-01-01

    OBJECTIVE: This study was done (1) to determine whether congenital indirect inguinal hernias in male pigs could be repaired by placing a polypropylene mesh prosthesis over the defect intra-abdominally, (2) to measure the incidence of adhesions between intra-abdominal viscera and the prosthesis with and without the adhesion barrier oxidized regenerated cellulose, (3) to determine the incidence of other complications, and (4) to assess the effect on fertility. SUMMARY BACKGROUND DATA: Several techniques for laparoscopic inguinal herniorrhaphy are currently being evaluated to determine whether there are advantages over conventional inguinal herniorrhaphy. Perhaps the most controversial is the intraperitoneal onlay mesh procedure (IPOM). Its advantage is its simplicity (in that the repair is accomplished by placing a prosthesis over the hernia defect intra-abdominally, avoiding a groin dissection). Its disadvantage is the potential for complications because the prosthesis is in contact with the intra-abdominal viscera. METHODS: In male pigs, polypropylene mesh alone or polypropylene mesh plus the adhesion barrier oxidized regenerated cellulose (composite prosthesis) was fixed to the peritoneum surrounding the hernia defect. In phase 1 (6-week follow-up), two groups of 13 pigs each underwent herniorrhaphy at laparotomy or laparoscopy. In phase 2 (7.1-month follow-up), 21 pigs underwent laparoscopic herniorrhaphy. RESULTS: All IPOM herniorrhaphies were successful. The prostheses adhered most frequently to the bladder, followed by small bowel, peritoneum, and cord structures. Prosthetic erosion into these organs was not observed. Laparoscopically placed prostheses in phases 1 and 2 had significantly less surface covered by adhesions (13% +/- 13% and 19% +/- 27%, respectively) and a lower adhesion tenacity grade (1.5 +/- 0.9 and 1.3 +/- 1.1, respectively) than those placed at laparotomy (44% +/- 27% and 2.5 +/- 0.7, respectively; p < 0.01). In phase 1, a histologic

  14. Multinucleate Giant Cells in FNAC of Benign Breast Lesions: Its Significance

    PubMed Central

    R, Kalyani; Murthy V, Srinivasa

    2014-01-01

    Background: Multinucleate giant cells are described in breast aspirates. However, due to its rarity very few cases have been described cytologically. Hence recognition and correct interpretation of their presence is difficult, yet crucial for accurate diagnosis. Materials and Methods: The prospective study of FNAC (fine needle aspirate cytology) of breast lumps was conducted for a period of six months. Direct smears were prepared from the material aspirated. In case of fluid aspirates, centrifuge done and cell sediment was used for making smears. Smears were alcohol fixed and stained with PAP/H&E or air dried smears were stained with Leishman stain. Further smears were subjected to immunocytochemistry using vimentin and CD34 markers to know the origin of multinucleate giant cells. Results: We have reported 11 cases of breast lesions, which showed multinucleate giant cells on FNAC. Out of the 11 cases, Cytologically six cases showed granuloma debris with relative proportion of epithelioid histiocytes, lymphocytes, neutrophils and multinucleate giant cells. Two cases were diagnosed as acute suppurative granulomatous mastitis. Two cases of fibroadenoma and one case of fat necrosis showed multinucleate giant cells. Immunocytochemistry showed vimentin positivity in both stromal and histiocytic type of multinucleate giant cells and in isolated histiocytes. CD34 was focally positive in histiocytic type of giant cells. Conclusion: An effort is made to distinguish between the stromal and histiocytic type giant cells in non-neoplastic breast lesions. Further molecular studies have to be done to know the exact histogenesis and role of these multinucleate giant cells in benign lesions. PMID:25653953

  15. Comparing the Normalized Difference Infrared Index (NDII) with root zone storage in a lumped conceptual model

    NASA Astrophysics Data System (ADS)

    Sriwongsitanon, Nutchanart; Gao, Hongkai; Savenije, Hubert H. G.; Maekan, Ekkarin; Saengsawang, Sirikanya; Thianpopirug, Sansarith

    2016-08-01

    With remote sensing we can readily observe the Earth's surface, but direct observation of the sub-surface remains a challenge. In hydrology, but also in related disciplines such as agricultural and atmospheric sciences, knowledge of the dynamics of soil moisture in the root zone of vegetation is essential, as this part of the vadose zone is the core component controlling the partitioning of water into evaporative fluxes, drainage, recharge, and runoff. In this paper, we compared the catchment-scale soil moisture content in the root zone of vegetation, computed by a lumped conceptual model, with the remotely sensed Normalized Difference Infrared Index (NDII) in the Upper Ping River basin (UPRB) in northern Thailand. The NDII is widely used to monitor the equivalent water thickness (EWT) of leaves and canopy. Satellite data from the Moderate Resolution Imaging Spectroradiometer (MODIS) were used to determine the NDII over an 8-day period, covering the study area from 2001 to 2013. The results show that NDII values decrease sharply at the end of the wet season in October and reach lowest values near the end of the dry season in March. The values then increase abruptly after rains have started, but vary in an insignificant manner from the middle to the late rainy season. This paper investigates if the NDII can be used as a proxy for moisture deficit and hence for the amount of moisture stored in the root zone of vegetation, which is a crucial component of hydrological models. During periods of moisture stress, the 8-day average NDII values were found to correlate well with the 8-day average soil moisture content (Su) simulated by the lumped conceptual hydrological rainfall-runoff model FLEX for eight sub-catchments in the Upper Ping basin. Even the deseasonalized Su and NDII (after subtracting the dominant seasonal signal) showed good correlation during periods of moisture stress. The results illustrate the potential of the NDII as a proxy for catchment-scale root zone

  16. Benign paroxysmal torticollis of infancy: An underdiagnosed condition.

    PubMed

    Hadjipanayis, Adamos; Efstathiou, Elisavet; Neubauer, David

    2015-07-01

    Benign paroxysmal torticollis is probably an under-diagnosed condition of infancy. It is a self-limiting disorder characterised by periods of unusual, sustained posture of the head and neck, during which the head tilts to one side. Episodes are often accompanied by marked autonomic features, irritability, ataxia, apathy and drowsiness. They last several hours to a few days and are often recurring every few weeks. They subside within the pre-school years; however, during later childhood, there is a tendency to develop migraine. Three cases of benign paroxysmal torticollis are presented and are compared with cases in the literature. A telephone survey has been conducted to determine what is the general awareness of paediatricians of this condition in Cyprus. Eighty-two paediatricians were randomly selected out of 235 paediatricians. All of them agreed to participate. Our cases revealed that benign paroxysmal torticollis may coexist with other problems during infancy. The telephone survey showed that only two out of eighty-two (2.4%) of the paediatricians are aware of the condition, and none of them was confident regarding the management. Our telephone survey clearly shows that Cypriot paediatricians are not familiar with benign paroxysmal torticollis in infancy which is a benign, self-limiting disorder. It is essential to recognise the condition and to reassure parents of its benign course and not to be misdiagnosed for other disorders, such as epileptic seizures. We have shown again that benign paroxysmal torticollis in infancy may coexist with motor delay and hearing problems.

  17. [Minimally Invasive Treatment of Esophageal Benign Diseases].

    PubMed

    Inoue, Haruhiro

    2016-07-01

    As a minimally invasive treatment of esophageal achalasia per-oral endoscopic myotomy( POEM) was developed in 2008. More than 1,100 cases of achalasia-related diseases received POEM. Success rate of the procedure was more than 95%(Eckerdt score improvement 3 points and more). No serious( Clavian-Dindo classification III b and more) complication was experienced. These results suggest that POEM becomes a standard minimally invasive treatment for achalasia-related diseases. As an off-shoot of POEM submucosal tumor removal through submucosal tunnel (per-oral endoscopic tumor resection:POET) was developed and safely performed. Best indication of POET is less than 5 cm esophageal leiomyoma. A novel endoscopic treatment of gastroesophageal reflux disease (GERD) was developed. Anti-reflux mucosectomy( ARMS) is nearly circumferential mucosal reduction of gastric cardia mucosa. ARMS is performed in 56 consecutive cases of refractory GERD. No major complications were encountered and excellent clinical results. Best indication of ARMS is a refractory GERD without long sliding hernia. Longest follow-up case is more than 10 years. Minimally invasive treatments for esophageal benign diseases are currently performed by therapeutic endoscopy.

  18. Clinical Investigation of Benign Asbestos Pleural Effusion

    PubMed Central

    Fujimoto, Nobukazu; Gemba, Kenichi; Aoe, Keisuke; Kato, Katsuya; Yokoyama, Takako; Usami, Ikuji; Onishi, Kazuo; Mizuhashi, Keiichi; Yusa, Toshikazu; Kishimoto, Takumi

    2015-01-01

    There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up. PMID:26689234

  19. Diode Laser Excision of Oral Benign Lesions

    PubMed Central

    Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi

    2015-01-01

    Introduction: Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Methods: Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Results: Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. Conclusion: We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis. PMID:26464781

  20. [Benign pleural effusion caused by asbestos exposure].

    PubMed

    Vieira, J R; Alfarroba, E; Viegas, J; Freitas e Costa, M

    1992-05-01

    The Authors present the first case described among us of benign pleural effusion of an asbestotic origin. They stress the importance of thoracoscopy (pleuroscopy) in the diagnosis of this situation. Attention is drawn to the fact that asbestotic lesions and asbestotic bodies have been found in the lung and, in particular, in the parietal pleura as well. They emphasize the fact that exposure to asbestos was not realized by the patient, which made the clarification of the situation more difficult. It was a CT scan that showed the signs suggestive of exposure to asbestos which raised the diagnostic suspicion. They conclude that every patient with a pleural effusion must be thoroughly questioned about exposure to asbestos. Even if the exposure is accepted, they consider that one should proceed to a pleuro-pulmonar biopsy by thoracoscopy. This biopsy allows demonstration of the characteristic histopathological lesions and rule out other etiologies, namely malignancy and tuberculosis. They suggest that these patients must be highly motivated to stop any smoking and kept under periodic surveillance.

  1. Laparoscopy for Benign Diseases of the Colon.

    PubMed

    Smith, Radhika; Maron, David J

    2017-04-01

    Laparoscopic surgery has revolutionized the delivery of care to the surgical patient undergoing colorectal resection. Since the first laparoscopic-assisted colectomy in 1991, significant advances have been made in minimally invasive colorectal surgery. For many benign conditions, laparoscopic colectomy has been proven to be safe and effective, and in some instances superior when compared with open surgery. Complex laparoscopic resections such as those for diverticulitis and inflammatory bowel disease have also been shown to have equivalent outcomes when compared with open surgery. Short-term benefits of a minimally invasive approach include less pain, decreased rates of wound infection and postoperative morbidity, faster return of bowel function, and shorter length of stay. Improvements in long-term complications have also been noted with lower incidence of incisional hernias and small bowel obstructions secondary to adhesions. As surgeons become more facile with laparoscopic resection, more complex cases such as those for complicated diverticulitis and reoperative surgery for inflammatory bowel disease can be completed with shorter operative times and decreased cost.

  2. Benign paroxysmal positional vertigo: diagnosis and treatment.

    PubMed

    Salvinelli, F; Firrisi, L; Casale, M; Trivelli, M; D'Ascanio, L; Lamanna, F; Greco, F; Costantino, S

    2004-09-01

    Benign paroxysmal positional vertigo (BPPV) has been recognized as the most common vestibular disorder; it is a term coined in 1952 by Dix and Hallpike, and it is most commonly used to describe a disease with a characteristic clinical presentation believed to be caused by free-floating particles leaving the macula and entering one of the semicircular canals, usually the posterior one, more rarely the horizontal or superior ones. A lot of studies showed as the prevalence is higher in females than in males with a ratio of 2:1; furthermore, prevalence increases with the age: the mean age at onset is 54 years, with a range of 11 to 84 years. The most important clinical manifestations of BPPV are: vertigo, lightheadedness, dysequilibrium and sometimes nausea, vomiting, pallor and sweating. The diagnosis of BPPV is very simple through the Dix-Hallpike test or the diagnostic Semont's maneuver; the increasing information about the BPPV's pathogenesis has led most authors to consider the rehabilitative therapy, and in particular the so-called Semont's "liberatory" maneuver, as the first choice treatment of BPPV, in relation to its quickness and efficacy. In this treatment the debris are moved from the posterior semicircular canal to another location within the vestibular labyrinth. In our review we consider the possible pathogenesis of this disease and the best therapies, like repositioning maneuvers, in a patient affected by BPPV.

  3. Searching for "environmentally-benign" antifouling biocides.

    PubMed

    Cui, Yan Ting; Teo, Serena L M; Leong, Wai; Chai, Christina L L

    2014-05-26

    As the result of the ecological impacts from the use of tributyltins (TBT) in shipping, environmental legislation for the registration of chemicals for use in the environment has grown to a monumental challenge requiring product dossiers to include information on the environmental fate and behavior of any chemicals. Specifically, persistence, bioaccumulation and toxicity, collectively known as PBT, are properties of concern in the assessment of chemicals. However, existing measurements of PBT properties are a cumbersome and expensive process, and thus not applied in the early stages of the product discovery and development. Inexpensive methods for preliminary PBT screening would minimize risks arising with the subsequent registration of products. In this article, we evaluated the PBT properties of compounds reported to possess anti-fouling properties using QSAR (quantitative structure-activity relationship) prediction programs such as BIOWIN™ (a biodegradation probability program), KOWWIN™ (log octanol-water partition coefficient calculation program) and ECOSAR™ (Ecological Structure Activity Relationship Programme). The analyses identified some small (Mr < 400) synthetic and natural products as potential candidates for environmentally benign biocides. We aim to demonstrate that while these methods of estimation have limitations, when applied with discretion, they are powerful tools useful in the early stages of research for compound selection for further development as anti-foulants.

  4. Clinical Investigation of Benign Asbestos Pleural Effusion.

    PubMed

    Fujimoto, Nobukazu; Gemba, Kenichi; Aoe, Keisuke; Kato, Katsuya; Yokoyama, Takako; Usami, Ikuji; Onishi, Kazuo; Mizuhashi, Keiichi; Yusa, Toshikazu; Kishimoto, Takumi

    2015-01-01

    There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840 ng/mL, 23.9 IU/L, and 1.8 ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up.

  5. Emerging drug therapies for benign prostatic hyperplasia.

    PubMed

    Bullock, Travis L; Andriole, Gerald L

    2006-03-01

    Benign prostatic hyperplasia (BPH) is the nonmalignant enlargement of the prostate gland caused by increases in number of both epithelial and stromal cells. Clinically, BPH leads to voiding dysfunction, which is most often referred to as lower urinary tract symptoms (LUTS). Historically, the only treatments for LUTS due to BPH were watchful waiting or surgery (transurethral or open prostatectomy). However, over the last 20 years medical therapy has taken a prominent role in the management of BPH. Current medical treatments for BPH include alpha-adrenergic receptor antagonists, inhibitors of the 5-alpha reductase enzyme and various phytotherapies. These agents are generally effective and safe; however, many patients are unable to tolerate the side effects or are refractory to medical management and require surgery. In light of this, many potential new therapies for the treatment of BPH are under development. Some represent a variation of current treatments, whereas others target novel molecular pathways within the prostate. The aim of this review is to examine current pharmacotherapies as well as to highlight emerging drugs that may improve our treatment of patients with LUTS secondary to BPH.

  6. Dutasteride/tamsulosin: in benign prostatic hyperplasia.

    PubMed

    Keating, Gillian M

    2012-05-01

    The 5α-reductase inhibitor dutasteride and the α(1)-adrenergic receptor antagonist tamsulosin are available as a fixed-dose combination for use in men with symptomatic benign prostatic hyperplasia (BPH) and an enlarged prostate. Dutasteride 0.5 mg/day plus tamsulosin 0.4 mg/day improved lower urinary tract symptoms (LUTS) to a significantly greater extent than dutasteride or tamsulosin alone in men with BPH, moderate to severe LUTS and an increased risk of disease progression, according to the results of the randomized, double-blind, multinational CombAT trial. The mean change from baseline in the total International Prostate Symptom Score was significantly greater with dutasteride plus tamsulosin than with dutasteride or tamsulosin alone after 2 years (primary endpoint) and 4 years of therapy. After 4 years' therapy in the CombAT trial, the time to first acute urinary retention or BPH-related surgery (primary endpoint) significantly favoured men with symptomatic BPH who were receiving dutasteride plus tamsulosin versus those receiving tamsulosin alone, with no significant difference between recipients of dutasteride plus tamsulosin and recipients of dutasteride alone. In the CombAT trial, health-related quality of life and treatment satisfaction were improved to a significantly greater extent with dutasteride plus tamsulosin than with dutasteride or tamsulosin alone. Combination therapy with oral dutasteride plus tamsulosin was generally well tolerated in patients with symptomatic BPH in the CombAT trial.

  7. Serum anti - TPO levels in benign and malignant breast tumors.

    PubMed

    Sabitha; Suneetha; Mohanty, Shruti; Rao, Pragna

    2009-07-01

    Breast cancer is a hormone dependent neoplasm. Conflicting results regarding the clinical correlation between breast cancer and thyroid diseases have been reported. The objective of this study was to determine the association of anti - TPO levels in patients having complaints of a lump in breast. Serum samples and Fine needle aspiration cytology (FNAC) samples were collected from 31 female patients with a lump in breast between the age group of 20-75 years. 31 age matched normal healthy controls were also examined for the same parameters. Serum samples were analyzed for its anti - TPO levels. FNAC reports confirmed patients as having duct cell carcinoma. They had raised serum anti - TPO levels compared to controls. FNAC results of others (n=26) were reported as fibroadenoma whose anti - TPO levels were less than the controls.

  8. A Coupled Lumped-Parameter and Distributed Network Model for Cerebral Pulse-Wave Hemodynamics

    PubMed Central

    Ryu, Jaiyoung; Hu, Xiao; Shadden, Shawn C.

    2015-01-01

    The cerebral circulation is unique in its ability to maintain blood flow to the brain under widely varying physiologic conditions. Incorporating this autoregulatory response is necessary for cerebral blood flow (CBF) modeling, as well as investigations into pathological conditions. We discuss a one-dimensional (1D) nonlinear model of blood flow in the cerebral arteries coupled to autoregulatory lumped-parameter (LP) networks. The LP networks incorporate intracranial pressure (ICP), cerebrospinal fluid (CSF), and cortical collateral blood flow models. The overall model is used to evaluate changes in CBF due to occlusions in the middle cerebral artery (MCA) and common carotid artery (CCA). Velocity waveforms at the CCA and internal carotid artery (ICA) were examined prior and post MCA occlusion. Evident waveform changes due to the occlusion were observed, providing insight into cerebral vasospasm monitoring by morphological changes of the velocity or pressure waveforms. The role of modeling of collateral blood flows through cortical pathways and communicating arteries was also studied. When the MCA was occluded, the cortical collateral flow had an important compensatory role, whereas the communicating arteries in the circle of Willis (CoW) became more important when the CCA was occluded. To validate the model, simulations were conducted to reproduce a clinical test to assess dynamic autoregulatory function, and results demonstrated agreement with published measurements. PMID:26287937

  9. Impact of atrial fibrillation on the cardiovascular system through a lumped-parameter approach.

    PubMed

    Scarsoglio, Stefania; Guala, Andrea; Camporeale, Carlo; Ridolfi, Luca

    2014-11-01

    Atrial fibrillation (AF) is the most common arrhythmia affecting millions of people in the Western countries and, due to the widespread impact on the population and its medical relevance, is largely investigated in both clinical and bioengineering sciences. However, some important feedback mechanisms are still not clearly established. The present study aims at understanding the global response of the cardiovascular system during paroxysmal AF through a lumped-parameter approach, which is here performed paying particular attention to the stochastic modeling of the irregular heartbeats and the reduced contractility of the heart. AF can be here analyzed by means of a wide number of hemodynamic parameters and avoiding the presence of other pathologies, which usually accompany AF. Reduced cardiac output with correlated drop of ejection fraction and decreased amount of energy converted to work by the heart during blood pumping, as well as higher left atrial volumes and pressures are some of the most representative results aligned with the existing clinical literature and here emerging during acute AF. The present modeling, providing new insights on cardiovascular variables which are difficult to measure and rarely reported in literature, turns out to be an efficient and powerful tool for a deeper comprehension and prediction of the arrythmia impact on the whole cardiovascular system.

  10. Role of passive deformation on propulsion through a lumped torsional flexibility model

    NASA Astrophysics Data System (ADS)

    Arora, Nipun; Gupta, Amit

    2016-11-01

    Scientists and biologists have been affianced in a deeper examination of insect flight to develop an improved understanding of the role of flexibility on aerodynamic performance. Here, we mimic a flapping wing through a fluid-structure interaction framework based upon a lumped torsional flexibility model. The developed fluid and structural solvers together determine the aerodynamic forces and wing deformation, respectively. An analytical solution to the simplified single-spring structural dynamics equation is established to substantiate simulations. It is revealed that the dynamics of structural deformation is governed by the balance between inertia, stiffness and aerodynamics, where the former two oscillate at the plunging frequency and the latter oscillates at twice the plunging frequency. We demonstrate that an induced phase difference between plunging and passive pitching is responsible for a higher thrust coefficient. This phase difference is also shown to be dependent on aerodynamics to inertia and natural to plunging frequency ratios. For inertia dominated flows, pitching and plunging always remain in phase. As the aerodynamics dominates, a large phase difference is induced which is accountable for a large passive deformation and higher thrust. Authors acknowledge the financial support received from the Aeronautics Research and Development Board (ARDB) under SIGMA Project No. 1705 and thank the IIT Delhi HPC facility for computational resources.

  11. Lumped Parameter Modeling as a Predictive Tool for a Battery Status Monitor

    SciTech Connect

    Jon P. Christophersen; Chester G. Motloch; Chinh D. Ho; John L. Morrison; Ronald C. Fenton; Vincent S. Battaglia; Tien Q. Duong

    2003-10-01

    The Advanced Technology Development Program is currently evaluating the performance of the second generation of lithium-ion cells (i.e., Gen 2 cells). Both the Gen 2 Baseline and Variant C cells are tested in accordance with the cell-specific test plan, and are removed at roughly equal power fade increments and sent for destructive diagnostic analysis. The diagnostic laboratories did not need all test cells for analysis, and returned five spare cells to the Idaho National Engineering and Environmental Laboratory (INEEL). INEEL used these cells for special pulse testing at various duty cycles, amplitudes, and durations to investigate the usefulness of the lumped parameter model (LPM) as a predictive tool in a battery status monitor (BSM). The LPM is a simplified linear model that accurately predicts the voltage response during certain pulse conditions. A database of parameter trends should enable dynamic predictions of state-of-charge and state-of-health conditions during in-vehicle pulsing. This information could be used by the BSM to provide accurate information to the vehicle control system.

  12. Distributed and Lumped Parameter Models for the Characterization of High Throughput Bioreactors.

    PubMed

    Iannetti, Laura; D'Urso, Giovanna; Conoscenti, Gioacchino; Cutrì, Elena; Tuan, Rocky S; Raimondi, Manuela T; Gottardi, Riccardo; Zunino, Paolo

    Next generation bioreactors are being developed to generate multiple human cell-based tissue analogs within the same fluidic system, to better recapitulate the complexity and interconnection of human physiology [1, 2]. The effective development of these devices requires a solid understanding of their interconnected fluidics, to predict the transport of nutrients and waste through the constructs and improve the design accordingly. In this work, we focus on a specific model of bioreactor, with multiple input/outputs, aimed at generating osteochondral constructs, i.e., a biphasic construct in which one side is cartilaginous in nature, while the other is osseous. We next develop a general computational approach to model the microfluidics of a multi-chamber, interconnected system that may be applied to human-on-chip devices. This objective requires overcoming several challenges at the level of computational modeling. The main one consists of addressing the multi-physics nature of the problem that combines free flow in channels with hindered flow in porous media. Fluid dynamics is also coupled with advection-diffusion-reaction equations that model the transport of biomolecules throughout the system and their interaction with living tissues and C constructs. Ultimately, we aim at providing a predictive approach useful for the general organ-on-chip community. To this end, we have developed a lumped parameter approach that allows us to analyze the behavior of multi-unit bioreactor systems with modest computational effort, provided that the behavior of a single unit can be fully characterized.

  13. Predicting pesticide attenuation in a fractured aquifer using lumped-parameter models.

    PubMed

    Farlin, J; Gallé, T; Bayerle, M; Pittois, D; Braun, C; El Khabbaz, H; Elsner, M; Maloszewski, P

    2013-03-01

    Neighboring springs draining fractured-rock aquifers can display large differences in water quality and flow regime, depending on local variations of the connectivity and the aperture size distribution of the fracture network. Consequently, because homogeneous equivalent parameters cannot be assumed a priori for the entire regional aquifer, the vulnerability to pollution of such springs has to be studied on a case by case basis. In this paper, a simple lumped-parameter model usually applied to estimate the mean transit time of water (or tracer) is presented. The original exponential piston-flow model was modified to take land-use distribution into account and applied to predict the evolution of atrazine concentration in a series of springs draining a fractured sandstone aquifer in Luxembourg, where despite a nationwide ban in 2005, atrazine concentrations still had not begun to decrease in 2009. This persistence could be explained by exponentially distributed residence times in the aquifer, demonstrating that in some real world cases, models based on the groundwater residence time distribution can be a powerful tool for trend reversal assessments as recommended for instance by current European Union guidelines.

  14. Distributed and Lumped Parameter Models for the Characterization of High Throughput Bioreactors

    PubMed Central

    Conoscenti, Gioacchino; Cutrì, Elena; Tuan, Rocky S.; Raimondi, Manuela T.; Gottardi, Riccardo

    2016-01-01

    Next generation bioreactors are being developed to generate multiple human cell-based tissue analogs within the same fluidic system, to better recapitulate the complexity and interconnection of human physiology [1, 2]. The effective development of these devices requires a solid understanding of their interconnected fluidics, to predict the transport of nutrients and waste through the constructs and improve the design accordingly. In this work, we focus on a specific model of bioreactor, with multiple input/outputs, aimed at generating osteochondral constructs, i.e., a biphasic construct in which one side is cartilaginous in nature, while the other is osseous. We next develop a general computational approach to model the microfluidics of a multi-chamber, interconnected system that may be applied to human-on-chip devices. This objective requires overcoming several challenges at the level of computational modeling. The main one consists of addressing the multi-physics nature of the problem that combines free flow in channels with hindered flow in porous media. Fluid dynamics is also coupled with advection-diffusion-reaction equations that model the transport of biomolecules throughout the system and their interaction with living tissues and C constructs. Ultimately, we aim at providing a predictive approach useful for the general organ-on-chip community. To this end, we have developed a lumped parameter approach that allows us to analyze the behavior of multi-unit bioreactor systems with modest computational effort, provided that the behavior of a single unit can be fully characterized. PMID:27669413

  15. Experimental errors and artifacts for a time-domain lumped capacitor dielectric spectrometer

    NASA Astrophysics Data System (ADS)

    Eadline, Douglas J.; Leidheiser, Henry, Jr.

    1986-05-01

    An analysis of possible experimental errors and artifacts for a time-domain dielectric spectrometer (frequency range 107-109 Hz) is performed using mathematical models. The spectrometer requires an incident and reflected pulse to be referenced in time and aligned in amplitude. Effects due to time misreferencing and amplitude misalignment are studied using a simple Teflon dielectric model. The calculated spectra for misreferencing and misalignment errors for a Teflon model are compared to real spectrometer data. Time misreferencing errors greater than 40 ps produce large errors at high frequencies and the absolute time reference can vary by one-half the sampling interval. Amplitude misalignment can create both false and forced convergence at the end of the pulses. Most importantly, misreference and misalignment errors may generate pseudodielectric effects. Other general models dealing with artifacts due to the solid nature of the sample were developed to include contact resistance, contact inductance, and fringe capacitance. The inclusion of contact resistance produced loss behavior that moved to higher frequencies with lower resistances. When contact inductance is included, the ɛ' values increase in the frequency range examined. Inclusion of fringe capacitance produced a slight rise in the ɛ' values, proportional to the sample thickness. The time-domain lumped capacitor dielectric spectrometer becomes a viable tool in studies of dielectric materials at high frequencies when attention is given to possible experimental errors and artifacts.

  16. Identifying capacitive and inductive loss in lumped element superconducting hybrid titanium nitride/aluminum resonators

    NASA Astrophysics Data System (ADS)

    Vissers, Michael R.; Weides, Martin P.; Kline, Jeffrey S.; Sandberg, Martin; Pappas, David P.

    2012-07-01

    We present a method to systematically locate and extract capacitive and inductive losses in superconducting resonators at microwave frequencies by use of mixed-material, lumped element devices. In these devices, ultra-low loss titanium nitride was progressively replaced with aluminum in the inter-digitated capacitor and meandered inductor elements. By measuring the power dependent loss at 50 mK as the Al/TiN fraction in each element is increased, we find that at low electric field, i.e., in the single photon limit, the loss is two level system in nature and is correlated with the amount of Al capacitance rather than the Al inductance. In the high electric field limit, the remaining loss is linearly related to the product of the Al area times its inductance and is likely due to quasiparticles generated by stray IR radiation. At elevated temperature, additional loss is correlated with the amount of Al in the inductance, with a power independent TiN-Al interface loss term that exponentially decreases as the temperature is reduced. The TiN-Al interface loss is vanishingly small at the 50 mK base temperature.

  17. A Lumped-Parameter Subject-Specific Model of Blood Volume Response to Fluid Infusion

    PubMed Central

    Bighamian, Ramin; Reisner, Andrew T.; Hahn, Jin-Oh

    2016-01-01

    This paper presents a lumped-parameter model that can reproduce blood volume response to fluid infusion. The model represents the fluid shift between the intravascular and interstitial compartments as the output of a hypothetical feedback controller that regulates the ratio between the volume changes in the intravascular and interstitial fluid at a target value (called “target volume ratio”). The model is characterized by only three parameters: the target volume ratio, feedback gain (specifying the speed of fluid shift), and initial blood volume. This model can obviate the need to incorporate complex mechanisms involved in the fluid shift in reproducing blood volume response to fluid infusion. The ability of the model to reproduce real-world blood volume response to fluid infusion was evaluated by fitting it to a series of data reported in the literature. The model reproduced the data accurately with average error and root-mean-squared error (RMSE) of 0.6 and 9.5% across crystalloid and colloid fluids when normalized by the underlying responses. Further, the parameters derived for the model showed physiologically plausible behaviors. It was concluded that this simple model may accurately reproduce a variety of blood volume responses to fluid infusion throughout different physiological states by fitting three parameters to a given dataset. This offers a tool that can quantify the fluid shift in a dataset given the measured fractional blood volumes. PMID:27642283

  18. The Comparison of Lichtenstein Procedure with and without Mesh-Fixation for Inguinal Hernia Repair

    PubMed Central

    Ersoz, Feyzullah; Culcu, Serdar; Duzkoylu, Yigit; Bektas, Hasan; Sari, Serkan; Arikan, Soykan; Deniz, Mehmet Mehdi

    2016-01-01

    Aim. Although inguinal hernia repair is the most frequently performed surgical procedure in the world, the best repair method has not gained acceptance yet. The ideal repair must be safe, simple, and easy to perform and require minimal dissection which provides enough exploration, maintain patient's comfort in the early stage, and also be cost-effective, reducing operation costs, labor loss, hospital stay, and recurrence. Materials and Methods. There were eighty-five patients between the ages of 18 and 75, diagnosed with inguinal hernia in our clinic. Lichtenstein procedure for hernia repair was performed under spinal anesthesia in all patients. Forty-two patients had the standard procedure and, in 43 patients, the polypropylene mesh was used without fixation. All patients were examined and questioned on the 7th day of the operation in terms of pain, scrotal edema, and the presence of seroma and later on in the 6th postoperative month in terms of paresthesia, neuropraxia, and recurrence by a single physician. Results. Operative time and pain scores in the nonfixation group were significantly lower, without any increase in rates of recurrence. Conclusion. Based on these findings, in Lichtenstein hernia repair method, nonfixation technique can be used safely with better results. PMID:27200411

  19. Previous appendicitis may affect peritoneal overlap of the mesh in laparoscopic inguinal hernia repair.

    PubMed

    Vecchio, R; Di Martino, M; Lipari, G; Sambataro, L

    2002-02-01

    Laparoscopic inguinal hernia repair is now increasingly performed in bilateral and recurrent groin hernias. The avoidance of direct exposure of the commonly used meshes to the abdominal viscera is considered essential to reduce the risk of bowel adhesions. We report a case of bilateral inguinal hernia repair in a patients who had had an appendectomy performed 8 years earlier for a perforated appendicitis. Probably as a result of previous inflammation, any attempt to dissect the preperitoneal layer in the right side resulted in peritoneal lacerations. Since the peritoneum could not be used to cover the mesh, we decided to position an expanded polytetrafluoroethylene (e-PTFE) mesh to avoid postoperative adhesions. The mesh was fixed with tacks to the symphysis pubis, Cooper's ligament, the ilio-pubic tract, and the transversalis fascia 2 cm above the hernia defect. This case suggests that in patient with previous appendicitis, a difficult preperitoneal dissection can be expected. In such cases, especially in young patients for whom future surgical operations cannot be excluded, any attempt to reduce adhesions is justified. At the present time, the use of e-PTFE meshes, which induce no tissue reaction, is a good option in this situation.

  20. The learning curve in laparoscopic inguinal hernia repair for the community general surgeon

    PubMed Central

    Voitk, Andrus J.

    1998-01-01

    Objective To determine the learning curve (number of operations required) to stabilize operating times and complication rates for a general surgeon doing laparoscopic inguinal hernia repair in a community practice. Design A prospective analysis. Setting A 256-bed secondary-care community hospital. Patients Ninety-eight consecutive patients booked for elective laparoscopic hernia repair on an outpatient basis. Interventions Using the transabdominal preperitoneal approach, 100 operations were carried out to repair 138 groins and a total of 164 separate hernial defects. Outcome measures The number of operations required to decrease operative times and complication rates to a steady level. Results There were no deaths. There were 5 conversions and 10 admissions, all occurring between the 1st and 46th operations. Two reoperations for reasons other than recurrence were required between the 45th and 55th operations. There were 24 other complications. Complications and surgical times began to level off after 50 operations. The 1 readmission was after the 42nd operation. There were 4 recurrences (2.9% recurrence rate), 2 in each group of 50 operations. Both groups of 2 recurrences occurred within the first 10 operations involving the use of a new stapler. Twenty-two other patients had open hernia repairs because laparoscopy was unsuitable for them. Conclusion The learning curve for laparoscopic inguinal hernia repair in the hands of a general surgeon in community practice who is experienced in open herniorraphy and laparoscopic cholecystectomy is at least 50 operations. PMID:9854534

  1. Laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children

    PubMed Central

    Yin, Yiyu; Zhang, Hongwei; Zhang, Xiang; Sun, Fang; Zou, Huaxin; Cao, Hui; Wen, Cheng

    2016-01-01

    We aimed to explore the feasibility and the safety of the laparoscopic surgery for incarcerated indirect inguinal hernia (IIH) in children. From January 2012 to December 2014, 64 children were enrolled into this study. All 64 patients received laparoscopic surgery and we reviewed their perioperative and postoperative follow-up studies. In addition, we enrolled 60 cases of children who received traditional surgery of IIH administered through minimally invasive surgery as the control group. Results from the present study showed that the mean operation time for the laparoscopic group was 41.5 min (range, 15–80 min) which was significantly shorter than the control group. Nine cases developed incarcerated intestine necrosis, expanded umbilical incision and parallel resection anastomosis. They received laparoscopic hernia sac high ligation. Only 5 cases developed scrotum edema after the surgery. The postoperative length of the stay ranged from 2 to 7 days (average, 3.2). The postoperative follow-up was from 6 months to 1 year and no relapse or secondary testicular atrophy was observed in the laparoscopic group. The operation time, incidence of postoperative complications and length of stay in the laparoscopic group were decreased compared to the control group, and differences were statistically significant (P<0.05). In conclusion, laparoscopic surgery treatment for incarcerated inguinal hernia is safe and feasible and produced better results compared with the alternative. PMID:28105089

  2. An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty

    PubMed Central

    Daggett, Justin; Harrington, Michael; Dayicioglu, Deniz

    2017-01-01

    Introduction: We describe a novel technique of contralateral pedicled deepithelialized superficial inferior epigastric artery flaps, followed by abdominal advancement coverage, as an alternative treatment of radiated complicated inguinal or lower abdominal defects, avoiding the donor-site defect typically seen with other methods of coverage. Methods: Two male patients with histories of liposarcoma after excision and radiation to one side of lower abdomen/inguinal area presented with complicated wounds that were reconstructed with this technique. Results: Successful obliteration of dead space and wound closure were achieved with the combination of a superficial inferior epigastric artery flap with an abdominal advancement flap. In each case, patients went on to heal uneventfully without need for any secondary procedures. Discussion: The use of a superficial inferior epigastric artery flap for lower abdomen/groin defect closure is an option as an alternative to rectus abdominis myocutaneous flap and anterolateral thigh flaps and should be considered in patients with vascular anatomy conducive for this muscle-sparing procedure. Conclusions: A second layer-overlay coverage with an abdominal advancement flap creates a more durable repair in the complicated radiated wound and a well-concealed abdominoplasty scar. PMID:28197296

  3. MRI findings of benign monomelic amyotrophy of lower limb.

    PubMed

    Hamano, T; Mutoh, T; Hirayama, M; Ito, K; Kimura, M; Aita, T; Kiyosawa, K; Ohtaki, T; Kuriyama, M

    1999-06-01

    We report here magnetic resonance imaging (MRI) findings of two patients with benign monomelic amyotrophy of lower limb. Both subjects showed unilateral amyotrophy of the lower limb with a benign clinical course, and the affected muscles demonstrated neurogenic changes. On T1- and T2-weighted MRI, marked atrophy and increased signal intensity were found mainly in gastrocnemius and soleus muscles. Moreover, MRI examination also revealed that thigh muscles including semitendinosus, semimembranosus, and vastus intermedius and lateralis muscles were involved in one of the patients. We concluded that muscle MRI is very useful for detecting affected muscles, especially deep skeletal muscles in patients with benign monomelic amyotrophy of lower limb.

  4. Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

    SciTech Connect

    Mistrangelo, Massimiliano; Pelosi, Ettore; Bello, Marilena; Castellano, Isabella; Cassoni, Paola; Ricardi, Umberto; Munoz, Fernando; Racca, Patrizia; Contu, Viviana; Beltramo, Giancarlo; Morino, Mario; Mussa, Antonio

    2010-05-01

    Background: Inguinal lymph node metastases in patients with anal cancer are an independent prognostic factor for local failure and overall mortality. Inguinal lymph node status can be adequately assessed with sentinel node biopsy, and the radiotherapy strategy can subsequently be changed. We compared this technique vs. dedicated 18F-fluorodeoxyglucose positron emission tomography (PET) to determine which was the better tool for staging inguinal lymph nodes. Methods and Materials: In our department, 27 patients (9 men and 18 women) underwent both inguinal sentinel node biopsy and PET-CT. PET-CT was performed before treatment and then at 1 and 3 months after treatment. Results: PET-CT scans detected no inguinal metastases in 20 of 27 patients and metastases in the remaining 7. Histologic analysis of the sentinel lymph node detected metastases in only three patients (four PET-CT false positives). HIV status was not found to influence the results. None of the patients negative at sentinel node biopsy developed metastases during the follow-up period. PET-CT had a sensitivity of 100%, with a negative predictive value of 100%. Owing to the high number of false positives, PET-CT specificity was 83%, and positive predictive value was 43%. Conclusions: In this series of patients with anal cancer, inguinal sentinel node biopsy was superior to PET-CT for staging inguinal lymph nodes.

  5. Incidence of pain after inguinal hernia repair in the elderly. A retrospective historical cohort evaluation of 18-years’ experience with a mesh & plug inguinal hernia repair method on about 3000 patients

    PubMed Central

    2013-01-01

    Background Chronic pain after prosthetic inguinal hernioplasty is one of the most important current issues in the current literature debate. Mechanisms related to pain development are only partially known. Influence of age as well as other factors is still unclear. The aim of this work was to evaluate whether development of chronic pain after open prosthetic plug and mesh inguinal hernioplasty is influenced by age. Methods Analysis was retrospectively conducted, dividing our cohort of patients (2,902) who had undergone prosthetic open plug&mesh inguinal hernioplasty from Jannuary 1994 to May 2012, following only the age criterion (cut-off 65 yrs.), into two groups (Gr.A<65 yrs, Gr.B>65 yrs.). All patients were routinely submitted to a postoperative questionnaire. Complications such as analgesic assumption were registered in both groups. Pain intensity was classified following the Visual Analogic Scale (VAS). Incidence of chronic pain, discomfort, and numbness, was assessed in both groups. Statistical significance was assessed by X2-test. Results Only 0.2% of patients suffered from a recurrence in our cohort. Postoperative chronic pain was observed in Gr. A in 0.12% of patients vs Gr.B 0.09% (p>0.05). Incidence of other postoperative symptoms such as discomfort or numbness were slightly prevalent on young patients (respectively p = 0.0286 and p = 0.01), while for hyperesthesia and sensation of foreign body no statistically significant difference of incidence between groups was observed. Conclusions Real chronic pain after inguinal hernioplasty is a rare clinical entity. Other causes of chronic pain should be accurately researched and excluded. In young patients psychological factors seem to show a slight influence. There was no influence of age on chronic postoperative pain incidence after inguinal hernioplasty. PMID:24268023

  6. Complete transection of the urethra and corpora cavernosa: a complication after laparoscopic repair (TEP) of an inguinal hernia.

    PubMed

    Rehme, C; Rübben, H; Heß, J

    2016-06-01

    Complete transection of both corpora cavernosa and the urethra is a very rare condition in urology. We report the case of a 59-year-old man with complete transection of the corpora cavernosa and the urethra during a laparoscopic repair of a recurrent inguinal hernia.

  7. Comparison of Treatment Outcomes of Surgical Repair in Inguinal Hernia with Classic versus Preperitoneal Methods on Reduction of Postoperative Complications

    PubMed Central

    Mahmoudvand, Hormoz; Forutani, Shahab

    2017-01-01

    Background. This study aims to evaluate and compare the results of inguinal herniorrhaphy with mesh in classic and preperitoneal method. Methods. Our study community includes 150 candidate patients for inguinal herniorrhaphy with mesh. Totally, 150 candidate patients for inguinal herniorrhaphy were randomly divided into two groups: (1) classic group in which the floor of the canal was repaired and the mesh was located on the floor of the canal and (2) preperitoneal group in which the mesh was installed under the canal and then the floor was repaired. Results. The frequency of recurrence was 10 (13.3%) and 2 (2.66%) in the classic and preperitoneal group, respectively. The frequency of postsurgical pain was 21 (28%) in the classic group and 9 (12%) in the preperitoneal group. The postsurgical hematoma was observed in 7 (9.3%) and 9 (12%) in the classic and preperitoneal group, respectively. Also, the frequency of postsurgical seroma was 8 (10.7%) and 1 (1.3%) in the patients treated with the classic and preperitoneal method, respectively. Conclusion. The findings of the present study demonstrated that the preperitoneal method is a more suitable method for inguinal herniorrhaphy than the classic one because of fewer complications, according to the findings of this study. PMID:28232939

  8. INFLUENCE OF TOBACCO, ALCOHOL AND DIABETES ON THE COLLAGEN OF CREMASTER MUSCLE IN PATIENTS WITH INGUINAL HERNIAS

    PubMed Central

    MÓDENA, Sérgio Ferreira; CALDEIRA, Eduardo José; PERES, Marco Antonio O; ANDREOLLO, Nelson Adami

    2016-01-01

    ABSTRACT Background: New findings point out that the mechanism of formation of the hernias can be related to the collagenous tissues, under activity of aggressive agents such as the tobacco, alcohol and diabetes. Aim: To analyze the collagen present in the cremaster muscle in patients with inguinal hernias, focusing the effect of tobacco, alcohol, and diabetes. Methods: Fifteen patients with inguinal hernia divided in three groups were studied: group I (n=5) was control; group II (n=5) were smokers and/or drinkers; and group III (n=5) had diabetes mellitus. All subjects were underwent to surgical repair of the inguinal hernias obeying the same pre, intra and postoperative conditions. During surgery, samples of the cremaster muscle were collected for analysis in polarized light microscopy, collagen morphometry and protein. Results: The area occupied by the connective tissue was higher in groups II and III (p<0.05). The collagen tissue occupied the majority of the samples analyzed in comparison to the area occupied by muscle cells. The content of total protein was higher in groups II and III compared to the control group (p<0.05). Conclusion: The tobacco, alcohol and diabetes cause a remodel the cremaster muscle, leading to a loss of support or structural change in this region, which may enhance the occurrences and damage related to inguinal hernias. PMID:28076473

  9. Infection of laparoscopically inserted inguinal hernia repair mesh following subsequent emergency open surgery: a report of two cases

    PubMed Central

    Panagiotopoulou, IG; Richardson, C; Gurunathan-Mani, S; Lagattolla, NRF

    2012-01-01

    We present two cases of laparoscopically inserted mesh for inguinal hernia repair that became infected following emergency open bowel surgery. We believe that there is an increased risk of infection due to the larger size of mesh used in the laparoscopic repair but also due to the patient not volunteering the information because of the minimally invasive nature of the procedure. PMID:22524902

  10. Absent external oblique musculo-aponeurotic complex during inguinal hernioplasty: a case report and review of literature.

    PubMed

    Dsouza, Royson; Shankar, Nachiket; Gurubatham, Rohin; Rajaleelan, Wesley; Menon, Nandakumar

    2017-03-03

    The external oblique musculo-aponeurotic complex is an important contributor to the strength of the inguinal canal. The present case report describes the bilateral absence of the external oblique muscle in a patient. A 40-year-old male patient presented with a history of intermittent lower abdominal pain for 15 years which had increased over the past 2 years. Abdominal examination revealed bilateral reducible, incomplete, direct inguinal hernia. Elective bilateral Lichtenstein's mesh hernioplasty was planned for the patient. Intraoperatively, there was no evidence of the external oblique aponeurosis and the spermatic cord was noted deep to the membranous fascial layer. The inguinal ligament was thin and atrophic and was attached to the pubic tubercle medially and anterior superior iliac spine laterally. There was no evidence of any superior aponeurotic connection to the inguinal ligament. A postoperative ultrasound examination of the abdomen confirmed the bilateral absence of the external oblique musculo-aponeurotic complex. The isolated absence of the external oblique musculo-aponeurotic complex in adults is an exceedingly rare anomaly. The possibility of such an anomaly should be considered in patients without other risk factors for hernia.

  11. Current Laser Treatments for Benign Prostatic Hyperplasia

    PubMed Central

    Son, Hwancheol; Song, Sang Hoon

    2010-01-01

    The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient. PMID:21165192

  12. Diagnosis and treatment of pediatric benign pneumoperitoneum

    PubMed Central

    Duan, Shou-Xing; Sun, Zong-Bo; Wang, Guang-Huan; Zhong, Jun; Ou, Wen-Hui; Fu, Ma-Xian; Wang, Fu-Sheng; Ma, Shu-Hua; Li, Jian-Hong

    2017-01-01

    Abstract Introduction: Benign pneumoperitoneum (BPPT) is defined as asymptomatic free intraabdominal air or as pneumoperitoneum without peritonitis. Symptomatic free air requires surgical anagement, but management of asymptomatic pneumoperitoneum is controversial. In this study, we investigate the diagnosis and treatment of BPPT in children. Clinical Findings: The clinical data of 9 pediatric patients with BPPT who were admitted to our hospital from January 2000 to January 2015 were retrospectively analyzed to summarize the diagnosis and treatment. Overall, 9 cases were included with 8 males and 1 female, aged from 4 days to 4 years. Among them there were 6 newborns (including 1 premature infant). Patients were all admitted to hospital with the major clinical symptom of abdominal distension, including 2 cases accompanied by tachypnea, 2 cases with vomiting, 1 case with diarrhea, and 2 cases with fever. No previous constipation or obstructive defecation existed. Six newborns had meconium defecation within 24 hours after birth. Physical examination revealed all patients with relaxed abdominal wall except 1 patient with abdominal distension had slight muscle stiffness and hyperactive bowel sounds. Abdominal X-ray suggested free air under the diaphragm in all cases. Interventions/Outcomes: All patients except for one case of laparotomy were conservatively treated and cured with fasting, infection prevention, rehydration, abdominocentesis, and close observation. Nine cases of patients were all discharged with no death occurrence. After discharge follow-up of 7 months to 6 years was conducted. There was no recurrence of similar symptoms, and children were in good growth and development. Conclusion: The diagnosis of BPPT mainly relies on clinical symptoms in patient, careful abdominal examination, abdominal X-ray combined with abdominocentesis, and the exclusion of gastrointestinal perforation for confirmation. Conservative treatment can cure the disease. Attention

  13. Benign Nodular Goiter Causing Upper Airway Obstruction

    PubMed Central

    Başoğlu, Mahmut; Öztürk, Gürkan; Aydınlı, Bülent; Yıldırgan, M. İlhan; Atamanalp, S. Selçuk; Celebi, Fehmi

    2009-01-01

    Objective Benign nodular goiter (BNG) can cause narrowing of the upper airway. In some rare cases, obstruction of the upper airway also occurs. The following paper reports our experiences with regard to BNG patients who experienced obstruction of the upper airway. Materials and Methods. We retrospectively investigated the records of 13 patients with acute airway obstruction due to BNG who were admitted to the General Surgery Department of Ataturk University Medical School between January 2000 and December 2007. Results Thirteen patients with airway obstruction secondary to BNG were hospitalized during this period. There were two males and 11 females, and the mean age was 58.5 years (range 37–74 years). For all patients, the primary symptom upon admission was defined as respiratory distress; all patients had varying degrees of respiratory distress upon admission. Three of the patients underwent emergent endotracheal intubation in the emergency room. A preoperative radiological evaluation was performed with thyroid ultrasonography (US) and computed tomography (CT). There were retrosternal or substernal components of the BNG in nine patients. Twelve patients underwent operations, while one patient with mild respiratory distress elected not to be operated on. Ten patients underwent total thyroidectomies, while two patients underwent near-total thyroidectomies. One patient with retrosternal goiter also underwent a median sternotomy. Three patients received a tracheostomy after the operation. Suction drains were utilized in all operations. During the post-operative period, two patients suffered from voice impairment, and seven patients experienced hypocalcemia. Two patients died. Pathological examination of the thyroidectomy tissue revealed BNG in all cases. In addition, two patients had micropapillary carcinomas. Conclusion Although BNG causing upper airway obstruction is rare, it is an important clinical entity because of the need for emergent operation, the

  14. The role of antibiotic prophylaxis in mesh repair of primary inguinal hernias using prolene hernia system: a randomized prospective double-blind control trial.

    PubMed

    Jain, S K; Jayant, M; Norbu, C

    2008-04-01

    Antibiotic prophylaxis is being commonly used in mesh repair of inguinal hernia but its role has been questioned in a recent Cochrane analysis performed in 2003. Routine use of antibiotic prophylaxis in mesh repair of inguinal hernia can lead to bacterial resistance and increase in cost. In a present double-blind placebo controlled trial involving 120 patients undergoing inguinal hernia repair using prolene hernia system, we did not find any benefit of the routine use of antibiotic prophylaxis in terms of wound infection rate.

  15. Use of prolene mesh in surgical treatment of tissue defects after radical inguinal and pelvic lymph node dissection in vulvar cancer--a brief report.

    PubMed

    Olejek, A

    2006-01-01

    Surgery is still the procedure of choice in treatment of advanced vulvar cancer. Radical vulvar surgery is often associated with severe vulvar and inguinal skin and fat-tissue deficits resulting from wide "butterfly" shape resection. Primary closure of large vulvar and inguinal defects is hampered by lack of tissue. The study presents the case of using prolene mesh in filling up the tissue defects over femoral vein and artery after radical excision of enlarged inguinal superficial, femoral, and pelvic nodes to prevent vessels in hiatus saphenus. It is the first report describing the use of prolene mesh in such a procedure.

  16. Benign Multicystic Peritoneal Mesothelioma: A Rare Tumour of the Abdomen

    PubMed Central

    Somasundaram, Soundappan; Khajanchi, Monty; Vaja, Tejas; Jajoo, Bhushan; Dey, Amit Kumar

    2015-01-01

    Benign multicystic peritoneal mesothelioma: a rare tumor of the abdomen, is a diagnostic dilemma. This report emphasizes the importance of diagnostic laparoscopy in the diagnosis of the tumour. PMID:25866695

  17. Water content and structure in malignant and benign skin tumours

    NASA Astrophysics Data System (ADS)

    Gniadecka, M.; Nielsen, O. F.; Wulf, H. C.

    2003-12-01

    Analysis of the low frequency region of Raman spectra enables determination of water structure. It has been previously demonstrated by various techniques that water content and possibly also the water structure is altered in some malignant tumours. To further elucidate possible change in water structure in tumours we performed NIR FT Raman spectroscopy on biopsies from selected benign and malignant skin tumours (benign: seborrheic keratosis, pigmented nevi; malignant: malignant melanoma, basal cell carcinoma). We did not observe any differences in water content between malignant and benign skin tumours with an exception of seborrheic keratosis, in which the water content was decreased. Increase in the tetrahedral (free) water was found in malignant skin tumours and sun-damaged skin relative to normal young skin and benign skin tumours. This finding may add to the understanding of molecular alterations in cancer.

  18. THE DESIGN OF TECHNOLOGICALLY EFFECTIVE AND ENVIRONMENTALLY BENIGN SOLVENT SUBSTITUTES

    EPA Science Inventory

    There is presently considerable interest in finding environmentally benign replacement solvents that can perform in many different applications as solvents normally do. This requires solvents with desirable properties, e.g., ability to dissolve certain compounds, and without oth...

  19. Gamma images in benign and metabolic bone diseases: volume 1

    SciTech Connect

    Sy, W.M.

    1981-01-01

    Volume 1 of ''Gamma images in benign and metabolic bone diseases'' comprises chapters devoted to: general remarks and considerations, radiopharmaceuticals, Paget disease, osteomyelitis, trauma, benign bone tumors, chronic renal dialysis, acute renal failure, osteomalacia and rickets, and osteoporosis. Although published in 1981, the most recent references in the book were 1978 and most are 1977 or earlier. One of the strongest aspects of the volume are tables which categorize diseases, pathophysiology of disease, and image abnormalities. (JMT)

  20. Diagnostic and therapeutic pitfalls in benign vocal fold diseases

    PubMed Central

    Bohlender, Jörg

    2013-01-01

    More than half of patients presenting with hoarseness show benign vocal fold changes. The clinician should be familiar with the anatomy, physiology and functional aspects of voice disorders and also the modern diagnostic and therapeutic possibilities in order to ensure an optimal and patient specific management. This review article focuses on the diagnostic and therapeutic limitations and difficulties of treatment of benign vocal fold tumors, the management and prevention of scarred vocal folds and the issue of unilateral vocal fold paresis. PMID:24403969

  1. Efficacy of Sonoelastography in Distinguishing Benign from Malignant Breast Masses

    PubMed Central

    Balçık, Adile; Polat, Ahmet Veysel; Bayrak, İlkay Koray; Polat, Ayfer Kamalı

    2016-01-01

    Objective The study aimed to evaluate the influence of sonoelastographic strain ratio in distinguishing benign from malignant breast masses. Materials and Methods Patients who were referred for diagnostic biopsy of a breast mass were examined by ultrasound and sonoelastography prior to percutaneous biopsy. Sonoelastography was performed twice by the same observer in the same session. The strain ratios (SR) were calculated for both measurements as well as the mean strain ratio. Results were compared with histopathologic findings. For each strain ratio, a threshold value was determined using a ROC analysis for the differentiation of benign and malignant masses. Results After histopathological examination of 135 mass lesions in 132 female patients (mean age 48±12 years), 65 masses were diagnosed as benign and 70 as malignant. According to the Tsukuba classification with 5 scores; 44 of 65 benign masses had scores of either 1 or 2 while 56 of 70 malignant lesions had scores of either 4 or 5. No benign lesion was classified as score 5, and no malignant lesion as score 1. The mean cut-off in the two ROC measurements in distinguishing benign from malignant lesions was calculated as 4.52. When a threshold value of 4.52 was used for the mean strain ratio: the sensitivity, specificity, PPV, NPV, and accuracy rates were determined as 85.5%, 84.8%, 85.5%, 84.8% and 85.2%, respectively. Conclusion The threshold value for strain ratio in the differentiation of benign and malignant masses was detected as 4.52, and a significant intra-observer difference was not observed in this study. The diagnostic value of sonoelastograghy in distinguishing benign from malignant breast masses was higher in comparison to conventional ultrasound.

  2. [Localized benign pleural mesothelioma observed at the Dakar University Hospital].

    PubMed

    Ndiaye, M; Hane, A A; Ba, M; Ndir, M; Ba, O; Diop-dia, D; Kandji, M; Ndiaye, S; Diatta, A; Toure, N O; Niang, A; Dia, Y; Thiam, A; Dangou, J M; Ndiaye, M

    2001-06-01

    We report two cases of localized benign pleural mesothelioma with different clinical features. Neuropsychiatric symptoms, including coma, hemiplegia, seizures and misbehavior predominated in the first case, associated with hypoglycemia. The symptoms in the second case were essentially respiratory (cough, dyspnea, and chest pain). Treatment consisted in thoracotomy and complete surgical resection. Histopathology revealed fusiform cells and collagen stroma. These two cases illustrate the diversity of clinical expression of benign localized pleural mesothelioma and confirm their complete resolution after surgical treatment.

  3. Local Anesthesia Versus Local Anesthesia and Conscious Sedation for Inguinal Hernioplasty: Protocol of a Randomized Controlled Trial

    PubMed Central

    Toppin, Patrick J; Reid, Marvin; Plummer, Joseph M; Roberts, Patrick O; Harding-Goldson, Hyacinth; McFarlane, Michael E

    2017-01-01

    Background Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. Reports suggest that the addition of conscious sedation to local anesthesia for inguinal hernioplasty is safe and effective in improving patient satisfaction. No previous randomized controlled trial has assessed the benefit of conscious sedation in this regard. Objective To determine whether the addition of conscious sedation to local anesthesia improves patient satisfaction with inguinal hernioplasty. Methods This trial is designed as a single-center, randomized, placebo-controlled, blinded trial of 148 patients. Adult patients diagnosed with a reducible, unilateral inguinal hernia eligible for hernioplasty using local anesthesia will be recruited. The intervention will be the use of intravenous midazolam for conscious sedation. Normal saline will be used as placebo in the control group. The primary outcome will be patient satisfaction, measured using the validated Iowa Satisfaction with Anesthesia Scale. Secondary outcomes will include intra- and postoperative pain, operative time, volumes of sedative agent and local anesthetic used, time to discharge, early and late complications, and postoperative functional status. Results To date, 171 patients have been recruited. Surgery has been performed on 149 patients, meeting the sample size requirements. Follow-up assessments are still ongoing. Trial completion is expected in August 2017. Conclusions This randomized controlled trial is the first to assess the effectiveness of conscious sedation in improving patient satisfaction with inguinal hernioplasty using local anesthesia. If the results demonstrate improved patient satisfaction with conscious sedation, this would support routine incorporation of conscious sedation in local inguinal hernioplasty and potentially influence national and international hernia surgery guidelines. Trial registration Clinicaltrials.gov NCT02444260; https

  4. The clinical characteristics of benign oral mucosal tumors

    PubMed Central

    Kaplan, Ilana; Gal, Gavriel; Chaushu, Gavriel; Allon, Dror M.

    2014-01-01

    Objectives: To investigate the clinical characteristics and pre-biopsy provisional diagnoses of benign oral mucosal tumors. Material and Methods: A 10- year retrospective analysis of all benign tumors of the oral mucosa, from a university- affiliated oral and maxillofacial surgery department. Results: 146 benign tumors were included. The mean age was 49.6 years, with an approximately equal gender distribution. The most prevalent tumor types were lipomatous tumors (27.4%), vascular (23.3%), and salivary gland tumors (16.5%). Tongue, labial and buccal mucosa were the most frequently involved sites. The vast majority (98.6%) presented as non-ulcerated masses. Only 2 (1.4%) presented as ulcerated masses. The clinical provisional diagnosis correctly classified lesions as non-malignant in 93.3%. In only 9 (6.7%) suspicion of malignancy was included in the provisional diagnosis. However, benign neoplasia was unsuspected in 42.1% of tumors. These cases were clinically classified as reactive. Conclusions: Benign tumors were most likely to be clinically correctly classified as non-malignant, but even in the setting of experienced oral surgeons, neoplasia was unsuspected in more than 40% of cases. This data strongly supports the need to biopsy every oral mucosal mass, since inaccurate clinical evaluation of the lesion’s biological nature was a frequent event. Key words:Malignant, benign, reactive, ulcerated mass, non-ulcerated mass, clinical diagnosis. PMID:24316705

  5. Eosinophilic Cholangitis—A Challenging Diagnosis of Benign Biliary Stricture

    PubMed Central

    Fragulidis, Georgios Panagiotis; Vezakis, Antonios I.; Kontis, Elissaios A.; Pantiora, Eirini V.; Stefanidis, Gerasimos G.; Politi, Aikaterini N.; Koutoulidis, Vasilios K.; Mela, Maria K.; Polydorou, Andreas A.

    2016-01-01

    Abstract When confronting a biliary stricture, both benign and malignant etiologies must be carefully considered as a variety of benign biliary strictures can masquerade as hilar cholangiocarcinoma (CCA). Therefore, patients could undergo a major surgery despite the possibility of a benign biliary disease. Approximately 15% to 24% of patients undergoing surgical resection for suspected biliary malignancy will have benign pathology. Eosinophilic cholangitis (EC) is a rare benign disorder of the biliary tract, which can cause obstructive jaundice and can pose a difficult diagnostic task. We present a rare case of a young woman who was referred to our hospital with obstructive painless jaundice due to a biliary stricture at the confluence of the hepatic bile ducts, with a provisional diagnosis of cholangiocarcinoma. Though, during her work up she was found to have EC, an extremely rare benign cause of biliary stricture, which is characterized by a dense eosinophilic infiltration of the biliary tree causing stricturing, fibrosis, and obstruction and which is reversible with short-term high-dose steroids. Despite its rarity, EC should be taken into consideration when imaging modalities demonstrate a biliary stricture, especially if preoperative diagnosis of malignancy cannot be made, in the setting of peripheral eosinophilia and the absence of cardinal symptoms of malignancy. PMID:26735539

  6. Treatment of oral soft tissues benign tumors using laser

    NASA Astrophysics Data System (ADS)

    Crisan, Bogdan; Baciut, Mihaela; Crisan, Liana; Bran, Simion; Rotar, Horatiu; Dinu, Cristian; Moldovan, Iuliu; Baciut, Grigore

    2014-01-01

    The present study aimed to assess the efficacy and indications of surgical laser therapy in the treatment of oral soft tissues benign tumors compared to classic surgery. A controlled clinical study was conducted in a group of 93 patients presenting various forms of oral soft tissues benign tumors. These patients were examined pre-and postoperatively and the oral benign tumors were measured linearly and photographed. The surgery of laser-assisted biopsy excision of oral benign tumors was carried out using a diode laser device of 980 nm. In patients who received surgical laser treatment, therapeutic doses of laser to biostimulate the operated area were administered on the first day after the surgery. The interventions of conventional excision of oral soft tissues benign tumors consisted in removing them using scalpel. In patients who have received therapeutic doses of laser for biostimulation of the operated area, a faster healing of wound surfaces and tumor bed was observed during the first days after surgery. Two weeks after the surgical treatment, good healing without scarring or discomfort in the area of excision was documented. Surgical treatment of oral soft tissues benign tumors with laser assisted postoperative therapy confirms the benefits of this surgical procedure. A faster healing process of the excision area due to laser biostimulation of low intensity has been observed in patients with surgical laser assisted treatment in the postoperative period.

  7. Benign skin disease with pustules in the newborn*

    PubMed Central

    Reginatto, Flávia Pereira; Villa, Damie De; Cestari, Tania Ferreira

    2016-01-01

    The neonatal period comprises the first four weeks of life. It is a period of adaptation where the skin often presents several changes: transient lesions, resulting from a physiological response, others as a consequence of transient diseases and some as markers of severe disorders. The presence of pustules in the skin of the newborn is always a reason for the family and for the assisting doctor to be worried, since the newborn is especially vulnerable to bacterial, viral or fungal infection. However, the majority of neonatal skin pustules is not infectious, comprising the benign neonatal pustulosis. Benign neonatal pustuloses are a group of clinical disease characterized by pustular eruptions in which a contagious agent is not responsible for its etiology. The most common ones are erythema toxicum neonatorum, the transient neonatal pustular melanosis and the benign cephalic pustulosis. These dermatoses are usually benign, asymptomatic and self-limited. It is important that the dermatologist and the neonatologist can identify benign and transient lesions, those caused by genodermatoses, and especially differentiate between neonates with systemic involvement from those with benign skin lesions, avoiding unnecessary diagnostic tests and worries. PMID:27192509

  8. Lumpy - an interactive Lumped Parameter Modeling code based on MS Access and MS Excel.

    NASA Astrophysics Data System (ADS)

    Suckow, A.

    2012-04-01

    Several tracers for dating groundwater (18O/2H, 3H, CFCs, SF6, 85Kr) need lumped parameter modeling (LPM) to convert measured values into numbers with unit time. Other tracers (T/3He, 39Ar, 14C, 81Kr) allow the computation of apparent ages with a mathematical formula using radioactive decay without defining the age mixture that any groundwater sample represents. Also interpretation of the latter profits significantly from LPM tools that allow forward modeling of input time series to measurable output values assuming different age distributions and mixtures in the sample. This talk presents a Lumped Parameter Modeling code, Lumpy, combining up to two LPMs in parallel. The code is standalone and freeware. It is based on MS Access and Access Basic (AB) and allows using any number of measurements for both input time series and output measurements, with any, not necessarily constant, time resolution. Several tracers, also comprising very different timescales like e.g. the combination of 18O, CFCs and 14C, can be modeled, displayed and fitted simultaneously. Lumpy allows for each of the two parallel models the choice of the following age distributions: Exponential Piston flow Model (EPM), Linear Piston flow Model (LPM), Dispersion Model (DM), Piston flow Model (PM) and Gamma Model (GM). Concerning input functions, Lumpy allows delaying (passage through the unsaturated zone) shifting by a constant value (converting 18O data from a GNIP station to a different altitude), multiplying by a constant value (geochemical reduction of initial 14C) and the definition of a constant input value prior to the input time series (pre-bomb tritium). Lumpy also allows underground tracer production (4He or 39Ar) and the computation of a daughter product (tritiugenic 3He) as well as partial loss of the daughter product (partial re-equilibration of 3He). These additional parameters and the input functions can be defined independently for the two sub-LPMs to represent two different recharge

  9. Development of Lumped Element Kinetic Inductance Detectors for the W-Band

    NASA Astrophysics Data System (ADS)

    Paiella, A.; Coppolecchia, A.; Castellano, M. G.; Colantoni, I.; Cruciani, A.; D'Addabbo, A.; de Bernardis, P.; Masi, S.; Presta, G.

    2016-07-01

    We are developing a lumped element kinetic inductance detector (LEKID) array which can operate in the W-band (75-110 GHz) in order to perform ground-based cosmic microwave background (CMB) and mm-wave astronomical observations. The W-band is close to optimal in terms of contamination of the CMB from Galactic synchrotron, free-free, and thermal interstellar dust. In this band, the atmosphere has very good transparency, allowing interesting ground-based observations with large (>30 m) telescopes, achieving high angular resolution (<0.4 arcmin). In this work we describe the startup measurements devoted to the optimization of a W-band camera/spectrometer prototype for large aperture telescopes like the 64-m Sardinia Radio Telescope. In the process of selecting the best superconducting film for the LEKID, we characterized a 40-nm-thick aluminum 2-pixel array. We measured the minimum frequency which can break CPs (i.e., hν =2Δ ( T_c) =3.5 k_BT_c) obtaining ν =95.5 GHz, which corresponds to a critical temperature of 1.31 K. This is not suitable to cover the entire W-band. For an 80-nm layer the minimum frequency decreases to 93.2 GHz, which corresponds to a critical temperature of 1.28 K; this value is still suboptimal for W-band operation. Further increase of the Al film thickness results in bad performance of the detector. We have thus considered a Titanium-Aluminum bi-layer [10-nm-thick Ti + 25-nm-thick Al, already tested in other laboratories (Catalano et al. in Astron Astrophys 580:A15, 2015)], for which we measured a critical temperature of 820 mK and a cut-on frequency of 65 GHz, so this solution allows operation in the entire W-band.

  10. Lumped-equivalent circuit model for multi-stage cascaded magnetoelectric dual-tunable bandpass filter

    NASA Astrophysics Data System (ADS)

    Zhang, Qiu-Shi; Zhu, Feng-Jie; Zhou, Hao-Miao

    2015-10-01

    A lumped-equivalent circuit model of a novel magnetoelectric tunable bandpass filter, which is realized in the form of multi-stage cascading between a plurality of magnetoelectric laminates, is established in this paper for convenient analysis. The multi-stage cascaded filter is degraded to the coupling microstrip filter with only one magnetoelectric laminate and then compared with the existing experiment results. The comparison reveals that the insertion loss curves predicted by the degraded circuit model are in good agreement with the experiment results and the predicted results of the electromagnetic field simulation, thus the validity of the model is verified. The model is then degraded to the two-stage cascaded magnetoelectric filter with two magnetoelectric laminates. It is revealed that if the applied external bias magnetic or electric fields on the two magnetoelectric laminates are identical, then the passband of the filter will drift under the changed external field; that is to say, the filter has the characteristics of external magnetic field tunability and electric field tunability. If the applied external bias magnetic or electric fields on two magnetoelectric laminates are different, then the passband will disappear so that the switching characteristic is achieved. When the same magnetic fields are applied to the laminates, the passband bandwidth of the two-stage cascaded magnetoelectric filter with two magnetoelectric laminates becomes nearly doubled in comparison with the passband filter which contains only one magnetoelectric laminate. The bandpass effect is also improved obviously. This research will provide a theoretical basis for the design, preparation, and application of a new high performance magnetoelectric tunable microwave device. Project supported by the National Natural Science Foundation of China (Grant Nos. 11172285 and 11472259) and the Natural Science Foundation of Zhejiang Province, China (Grant No. LR13A020002).

  11. Partial hepatectomy hemodynamics changes: Experimental data explained by closed-loop lumped modeling.

    PubMed

    Audebert, Chloe; Bekheit, Mohamed; Bucur, Petru; Vibert, Eric; Vignon-Clementel, Irene E

    2017-01-04

    The liver function may be degraded after partial liver ablation surgery. Adverse liver hemodynamics have been shown to be associated to liver failure. The link between these hemodynamics changes and ablation size is however poorly understood. This article proposes to explain with a closed-loop lumped model the hemodynamics changes observed during twelve surgeries in pigs. The portal venous tree is modeled with a pressure-dependent variable resistor. The variables measured, before liver ablation, are used to tune the model parameters. Then, the liver partial ablation is simulated with the model and the simulated pressures and flows are compared with post-operative measurements. Fluid infusion and blood losses occur during the surgery. The closed-loop model presented accounts for these blood volume changes. Moreover, the impact of blood volume changes and the liver lobe mass estimations on the simulated variables is studied. The typical increase of portal pressure, increase of liver pressure loss, slight decrease of portal flow and major decrease in arterial flow are quantitatively captured by the model for a 75% hepatectomy. It appears that the 75% decrease in hepatic arterial flow can be explained by the resistance increase induced by the surgery, and that no hepatic arterial buffer response (HABR) mechanism is needed to account for this change. The different post-operative states, observed in experiments, are reproduced with the proposed model. Thus, an explanation for inter-subjects post-operative variability is proposed. The presented framework can easily be adapted to other species circulations and to different pathologies for clinical hepatic applications.

  12. Uniformity of Chronic Pain Assessment after Inguinal Hernia Repair: A Critical Review of the Literature

    PubMed Central

    Molegraaf, Marijke; Lange, Johan; Wijsmuller, Arthur

    2016-01-01

    Background Chronic postoperative inguinal pain (CPIP) is the most common long-term complication of inguinal hernia repair. As such procedures are routinely performed, CPIP can be considered a significant burden to global health care. Therefore, adequate preventative measures relevant to surgical practice are investigated. However, as no gold standard research approach is currently available, study and outcome measures differ between studies. The current review aims to provide a qualitative analysis of the literature to seek out if outcomes of CPIP are valid and comparable, facilitating recommendations on the best approach to preventing CPIP. Methods A systematic review of recent studies investigating CPIP was performed, comprising studies published in 2007-2015. Study designs were analyzed regarding the CPIP definitions applied, the use of validated instruments, the availability of a baseline score, and the existence of a minimal follow-up of 12 months. Results Eighty eligible studies were included. In 48 studies, 22 different definitions of CPIP were identified, of which the definition provided by the International Association for the Study of Pain was applied most often. Of the studies included, 53 (66%) used 33 different validated instruments to quantify CPIP. There were 32 studies (40%) that assessed both pain intensity (PI) and quality of life (QOL) with validated tools, 41% and 4% had a validated assessment of only PI or QOL, respectively, and 15% lacked a validated assessment. The visual analog scale and the Short Form 36 (SF36) were most commonly used for measuring PI (73%) and QOL (19%). Assessment of CPIP was unclear in 15% of the studies included. A baseline score was assessed in 45% of the studies, and 75% had a follow-up of at least 12 months. Conclusion The current literature addressing CPIP after inguinal hernia repair has a variable degree of quality and lacks uniformity in outcome measures. Proper comparison of the study results to provide

  13. Comparative Study of Prolene Hernia System and Lichtenstein Method for Open Inguinal Hernia Repair

    PubMed Central

    Badkur, Mayank

    2015-01-01

    Background Prolene Hernia System (PHS) is a bi-layered polypropylene mesh with a connector that combines the anterior and posterior inguinal hernia repair, but still not very popular in this part of the country. Hence a prospective & randomized comparative study was undertaken to compare PHS with the already popular Lichtenstein Hernia Repair (LHR) and determine the post-operative outcome. Materials and Methods Total 67 inguinal hernia repairs were randomly assigned to either PHS or LHR method, and data was collected regarding various outcome measures like duration of surgery, post-operative pain, requirement of analgesia, return to normal activity, and early and late complications. Results Mean duration of surgery was significantly higher for PHS group than LHR group (65.4 min vs 51.26 min, p-value <0.0001). Significant difference was noted between the PHS and LHR group in terms of moderate to severe post-operative pain (15.15% vs 41.18%,p-value 0.018), time of requirement of analgesia (3.7 vs 4.6 days, p-value 0.024), and time to return to normal activity (2.7 vs 3.4 days, p-value 0.023), all in favour of the former technique. No intra-operative complication was noted in either of the groups. 5 patients had early complications in PHS group and 6 in LHR group, but this was statistically not significant. The average time of follow-up for the study was 7.8 month, ranging from 1 to 18 months. Chronic inguinal pain was noted in 1 and 2 patients respectively in PHS and LHR group, again statistically not significant. No recurrence was noted in both the groups till the time of follow-up. Conclusion PHS is a safe and better alternative to the time honored Lichtenstein hernia repair with the added advantage of strengthening whole of myopectineal orifice, and virtually eliminating any risk of recurrence. PMID:26266158

  14. Smoking habits and benign prostatic hyperplasia

    PubMed Central

    Xu, Huan; Fu, Shi; Chen, Yanbo; Chen, Qi; Gu, Meng; Wang, Zhong

    2016-01-01

    Abstract Previous studies have warned against the promoting effects of cigarette smoking on benign prostatic hyperplasia (BPH). In contrast, some have argued that smoking confers a protective effect regarding BPH, while others have observed an aggravated effect. Thus, we performed this meta-analysis to determine whether cigarette use is associated with BPH risk. To identify articles from observational studies of relevance, a search was performed concurrent to March 21, 2016, on PubMed, Web of Science, Cochrane, EBSCO, and EMBASE databases. Random-effect model, according to the heterogeneity, was calculated to reveal the relative risks (RRs) and corresponding 95% confidence intervals (CIs). Eight articles were included in this meta-analysis, representing data for 44,100 subjects, of which 5221 (11.8%) had BPH as defined according to the criteria. Seven reports are concerned with analysis between nonsmokers and ex-smokers, in which no significant difference was observed (RR = 0.99, 95% CI 0.94–1.05). Another meta-analysis of 7 studies indicated an observable trend, but without significant difference between groups of nonsmokers and current smokers (RR = 1.17, 95% CI 0.98–1.41). Between groups of heavy (6 articles; RR = 1.02, 95% CI 0.84–1.24) and light smokers (5 articles; RR = 0.90, 95% CI 0.71–1.15), again no significant difference appears. Finally, we combined individuals as never-smokers and ever-smokers and still found no significant difference between the 2 groups of patients (RR = 1.03, 95% CI 0.92–1.15). Sensitivity analysis was displayed and confirmed the stability of the present results. Combined evidence from observational studies shows no significant association between cigarette smoking and BPH risk, either for ex-smokers or for current smokers. The trend of elevated BPH risk from smoking was observed only in current smokers compared with nonsmokers, while marginal significance was observed in comparing ever-smokers with

  15. Ascending colon cancer with synchronous external iliac and inguinal lymph node metastases but without regional lymph node metastasis: a case report and brief literature review.

    PubMed

    Kitano, Yuki; Kuramoto, Masafumi; Masuda, Toshiro; Kuroda, Daisuke; Yamamoto, Kenichiro; Ikeshima, Satoshi; Iyama, Ken-Ichi; Shimada, Shinya; Baba, Hideo

    2017-12-01

    Lymph node metastasis to the iliac or inguinal region of colon cancer is extremely rare. We experienced a case of ascending colon cancer with synchronous isolated right external iliac and inguinal lymph node metastases but without any regional lymph node metastasis. An 83-year-old woman was admitted to our hospital due to anemia. Colonoscopy and computed tomography revealed an ascending colon cancer and also right external iliac and inguinal lymph node swelling. Further examination by F-deoxyglucose positron emission tomography strongly suggested that these lymph nodes were metastatic. Right hemicolectomy with lymph node dissection along the superior mesenteric artery, and right external iliac and inguinal lymph node dissection were performed. Histological examination revealed that both lymph nodes were metastasized from colon cancer, and there was no evidence of regional lymph node metastasis. The patient has shown no sign of recurrence at 27 months after surgery.

  16. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting

    PubMed Central

    2012-01-01

    Background Inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. There is paucity of published data on surgical management of inguinal hernias in our environment. This study is intended to describe our own experiences in the surgical management of inguinal hernias and compare our results with that reported in literature. Methods A descriptive prospective study was conducted at Bugando Medical Centre in northwestern Tanzania. Ethical approval to conduct the study was obtained from relevant authorities before the commencement of the study. Statistical data analysis was done using SPSS software version 17.0. Results A total of 452 patients with inguinal hernias were enrolled in the study. The median age of patients was 36 years (range 3 months to 78 years). Males outnumbered females by a ratio of 36.7:1. This gender deference was statistically significant (P = 0.003). Most patients (44.7%) presented late (more than five years of onset of hernia). Inguinoscrotal hernia (66.8%) was the commonest presentation. At presentation, 208 (46.0%) patients had reducible hernia, 110 (24.3%) had irreducible hernia, 84 (18.6%) and 50(11.1%) patients had obstructed and strangulated hernias respectively. The majority of patients (53.1%) had right sided inguinal hernia with a right-to-left ratio of 2.1: 1. Ninety-two (20.4%) patients had bilateral inguinal hernias. 296 (65.5%) patients had indirect hernia, 102 (22.6%) had direct hernia and 54 (11.9%) had both indirect and direct types (pantaloon hernia). All patients in this study underwent open herniorrhaphy. The majority of patients (61.5%) underwent elective herniorrhaphy under spinal anaesthesia (69.2%). Local anaesthesia was used in only 1.1% of cases. Bowel resection was required in 15.9% of patients. Modified Bassini’s repair (79.9%) was the most common technique of posterior wall repair of the inguinal canal. Lichtenstein mesh repair was used in only one (0.2%) patient

  17. Duplicate Vas Deferens Encountered during Inguinal Hernia Repair: A Case Report and Literature Review

    PubMed Central

    Roszkowski, Evan H.; Bauermeister, Adam J.

    2016-01-01

    Duplication of the vas deferens is a rare anomaly, defined as the presence of two distinct vasa deferentia within one spermatic cord, with only 28 cases reported worldwide since 1959. We report the case of a 63-year-old man with a duplicate vas deferens, presenting with abdominal pain from bowel obstruction secondary to incarcerated inguinal hernia. Spermatic cord dissection during hernioplasty revealed duplication of the vas deferens within the right spermatic cord. Doppler ultrasonography confirmed absence of waveforms in both vasa deferentia with arterial signal in the accompanying vessel. The hernia was repaired without complication. This report emphasizes recognition of duplicate vas deferens in avoiding iatrogenic injury and optimizing surgical outcome. PMID:27840763

  18. A new fixation-free 3D multilamellar preperitoneal implant for open inguinal hernia repair

    PubMed Central

    Brescia, Antonio; Tomassini, Federico; Berardi, Giammauro; Pezzatini, Massimo; Cosenza, Umile Michele; Castiglia, Davide; Dall’Oglio, Anna; Salaj, Adelona; Gasparrini, Marcello

    2017-01-01

    Summary Between September 2014 and December 2015, 32 patients with inguinal hernia were treated using a new 3D mesh in our department. This mesh is characterized by a multilamellar flower-shaped central core with a flat, large-pore polypropylene ovoid disk that has to be implanted preperitoneally. Compared with the traditional Lichtenstein procedure, we observed a shorter mean duration of surgery and a significantly lower mean visual analogue scale (VAS) postoperative pain score recorded immediately after the procedure in the 3D mesh group. The mean VAS score recoded after 4 and 8 postoperative days showed better results in the 3D mesh group than the control group. Moreover, there was reduced postoperative morbidity in the 3D mesh group than the control group, even if no patients experienced severe complications. PMID:28234593

  19. Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

    PubMed Central

    Tonolini, Massimo

    2016-01-01

    Inguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since radiologists are increasingly requested to investigate suspected iatrogenic complications, this paper aims to provide an increased familiarity with early CT studies after IHR, including complications and normal postoperative appearances such as focal pseudolesions, in order to avoid misinterpretation and inappropriate management. PMID:27460285

  20. [Idiopathic varicocele. Ligature of the reflexive vessels to the internal inguinal ring].

    PubMed

    Sperlongano, P; Corsale, I; Pisaniello, D; Anastasio, V; Ronia, G; Di Mauro, U

    1999-10-01

    The idiopathic varicocele is involved in 40-50% of the male sterility. The angiographic studies undertaken by Coolsaet in the 1980 have showed the different anatomic conditions that are at origin of the varicocele, explaining the recurrence or persistence of the illness after surgical operations. The high ligature of spermatic vein (Ivanissevich), eventually with ligature of spermatic artery also (Palomo), and the micro-surgical anastomoses result in high percentage of varicocele persistence. On the basis of such considerations, the Authors reviewed their experience on 371 patient surgically treated for idiopathic varicocele by inguinal ligature of the refluxive venous vessels. They emphasize the role of the intraoperative Doppler, that consents preserving spermatic artery and not-refluxive venous vessels, and need to respect the lymphatics.