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Sample records for entre anastomoses intestinais

  1. Computational modeling of vascular anastomoses.

    PubMed

    Migliavacca, Francesco; Dubini, Gabriele

    2005-06-01

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

  2. Anastomosing Rivers are Disequilibrium Patterns

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  3. [Surgeon's strategy in forming large intestine anastomoses].

    PubMed

    Shestopalov, S S; Mikhaĭlova, S A; Ibatullin, R D; Bogdanov, A V; Komkov, A V; Dan'ko, N A

    2009-01-01

    The article includes experience with treatment of 103 patients with the formed different large intestine anastomoses. Primary operations for cancer of the rectum were made on 76 patients, restorative operations--on 27 patients. The following techniques were used: manual formation of the large intestine anastomosis, apparatus anastomoses using AKA-2, "ETHICON CDH" and double apparatuses method using "CONTOUR" and "ETHICON CDH". It was found that the application of stitching apparatuses required shorter time necessary for applying large intestine anastomosis and for operation. When forming the large intestine anastomoses in the abdominal cavity the manual method should be preferred. The formation of anastomosis in the small pelvis cavity is accompanied by technical problems and requires using stitching apparatuses. The method using apparatuses "CONTOUR" and "ETHICON CDH" decreases the number of postoperative complications and can extend the list of indications for performing sphincter-sparing operations.

  4. Dilatation in anastomosed arteries can be an artifact of explantation.

    PubMed

    LeGrand, E K; Stoloff, D R; Kirsch, W M; Zhu, Y H; Boukouvalas, Z; Hardesty, R

    1992-01-01

    Fusiform dilation of the anastomotic site was found at explantation in the majority of rabbit femoral arteries anastomosed with newly developed microclips. This observation was also noted at sutured anastomoses. The mechanism responsible for this morphologic finding was studied by the following experiments: 1) measuring and explanting anastomosed arteries relaxed with 20% lidocaine, 2) latex casts of microclipped arteries, 3) comparing angiographic and histologic morphometric data, and 4) examining synthetic vascular graft anastomoses with identical dilatation. The observations demonstrate that trauma associated with explantation (direct dissection and fixative perfusion) leads to arterial vasoconstriction, but focal medial damage at the anastomotic site prevents constriction at this site.

  5. Factors involved in disruption of intestinal anastomoses.

    PubMed

    Nahai, F; Lamb, J M; Havican, R G; Stone, H H

    1977-01-01

    Bowel anastomoses, as performed on 181 dogs, were studied: (1) by interposing segments of colon into small bowel and vice versa, (2) by comparing clean anastomoses to those contaminated by feces before and after suturing, (3) with and without parenteral preoperative antibiotic, and (4) with and without coaptation of an inverted serosa. All animals with a timed sacrifice as well as an unexplained death had careful autopsy. Results demonstrated no difference in the healing capacity of large (91%) versus small (92%) intestine under identical circumstances. Intraluminal bacteria were of importance only if spillage caused contamination during operation and thereby subsequent infection of the peritoneal surface of the suture line. Peritonitis preceded all 28 leaks, yet the converse never occurred. Likelihood of a complicating peritonitis (67%) and thus an anastomotic leak (24%) was significantly reduced through the preoperative administration of prophylactic cefazolin (19 and 4%, respectively). A "serosal seal" also appeared important in obviating suture line disruption. Our data emphasize the value of an inverted and serosal lined anastomosis, bowel preparatory measures, prophylactic antibiotic, and the disruptive action of local bacterial peritonitis. PMID:318813

  6. Healing of colonic anastomoses: comparative experimental study of glued, manually sutured, and stapled anastomoses

    SciTech Connect

    Jansson, O.K.; Zilling, T.L.; Walther, B.S. )

    1991-07-01

    In 10 pigs a nonsutured, glued colonic anastomosis was constructed with a modified stapling device without staples and compared with an EEA-stapled anastomosis and a one-layer-sutured anastomosis concerning radiologic appearance, breaking strength, circulation, and collagen concentration. 141Ce-labeled microspheres were used for measurements of the anastomotic blood flow before the animals were sacrificed on the 4th postoperative day. The breaking strength was recorded and an anastomotic index calculated. No leakage was found. The anastomotic width did not differ between the groups, but the interindividual variation was more prominent in the sutured group. The handsewn and stapled anastomoses were stronger than the glued anastomosis (P = 0.0009 and 0.0054, respectively). There was an increase in the anastomotic circulation in all of the anastomoses, but no differences were seen between groups. The collagen concentration was independent of the technique used.

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

    SciTech Connect

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

    1984-02-01

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

  8. Effects of radiation therapy in microvascular anastomoses

    SciTech Connect

    Fried, M.P.

    1985-07-01

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

  9. Tolerance of canine anastomoses to intraoperative radiation therapy

    SciTech Connect

    Tepper, J.E.; Sindelar, W.; Travis, E.L.; Terrill, R.; Padikal, T.

    1983-07-01

    Radiation has been given intraoperatively to various abdominal structures in dogs, using a fixed horizontal 11 MeV electron beam at the Armed Forces Radiobiologic Research Institute. Animals were irradiated with single doses of 2000, 3000 and 4500 rad to a field which extended from the bifurcation of the aorta to the rib cage. All animals were irradiated during laparotomy under general anesthesia. Because the clinical use of intraoperative radiotherapy in cancer treatment will occasionally require irradiation of anastomosed large vessels and blind loops of bowel, the tolerance of aortic anastomoses and the suture lines of blind loops of jejunum to irradiation were studied. Responses in these experiments were scored at times up to one year after irradiation. In separate experiments both aortic and intestinal anastomoses were performed on each animal for evaluation of short term response. The dogs with aortic anastomoses showed adequate healing at all doses with no evidence of suture line weakening. On long-term follow-up one animal (2000 rad) had stenosis at the anastomosis and one animal (4500 rad) developed an arteriovenous fistula. Three of the animals that had an intestinal blind loop irradiated subsequently developed intussusception, with the irradiated loop acting as the lead point. One week after irradiation, bursting pressure of an intestinal blind loop was normal at 3000 rad, but markedly decreased at 4500 rad. No late complications were noted after the irradiation of the intestinal anastomosis. No late complicatons were observed after irradiation of intestinal anastomoses, but one needs to be cautious with regards to possible late stenosis at the site of an irradiated vascular anastomosis.

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

    PubMed

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

    2014-08-01

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

  11. Technical Feasibility of TachoSil Application on Esophageal Anastomoses.

    PubMed

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

    2015-01-01

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

  12. Spectral and Instantaneous Flow Characteristics of Vascular Anastomoses.

    NASA Astrophysics Data System (ADS)

    Einav, Shmuel; Grad, Ygael

    1997-11-01

    A large percentage of patient implanted vascular bypass grafts fail early post- implantation. Biofluid factors as abnormal shear stresses and turbulence have been cited to promote graft failure. Previous studies were based on mean flow properties, while the pulsating flow field is affected by instantaneous and spectral distribution. Laminar to turbulent transition, flow separation, rotation and waves reflected from host artery leave characteristic spectral signature which escapes detection when only mean data is sampled. Our work was aimed into the time and frequency domain characteristics. Our in-vitro model consists of pulsating pump, transparent distensible graft tubes and variable anastomoses angles. Dimensions were based on in-vivo data. High speed Digital Particle Image Velocimetry (DPIV) was used to map the flow field and obtain the anastomoses spectral signature. High shear stress peaks and vortices were observed at the anastomosis toe. Flow reversal or separation was Womersley parameter dependent. The flow profile and spectra were dependent on graft angle and elasticity. Better host- graft match resulted in less flow disturbances and flatter spectral distribution. This can be translated in Doppler ultrasound or sound frequencies terms and thus potentially assist clinical observations. [DPIV Sample of Vascular Anastomosis]

  13. Technical Feasibility of TachoSil Application on Esophageal Anastomoses.

    PubMed

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

    2015-01-01

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

  14. Technical Feasibility of TachoSil Application on Esophageal Anastomoses

    PubMed Central

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

    2015-01-01

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

  15. Methylene blue solder re-absorption in microvascular anastomoses

    NASA Astrophysics Data System (ADS)

    Birch, Jeremy F.; Hepplewhite, J.; Frier, Malcolm; Bell, Peter R. F.

    2003-06-01

    Soldered vascular anastomoses have been reported using several chromophores but little is known of the optimal conditions for microvascular anastomosis. There are some indications of the optimal protein contents of a solder, and the effects of methylene blue on anastomotic strength. The effects of varying laser power density in vivo have also been described, showing a high rate of thrombosis with laser power over 22.9Wcm-2. However no evidence exists to describe how long the solder remains at the site of the anastomosis. Oz et al reported that the fibrin used in their study had been almost completely removed by 90 days but without objective evidence of solder removal. In order to address the issue of solder re-absorption from the site of an anastomosis we used radio-labelled albumin (I-125) incorporated into methylene blue based solder. This was investigated in both the situation of the patent and thrombosed anastomosis with anastomoses formed at high and low power. Iodine-125 (half life: 60.2 days) was covalently bonded to porcine albumin and mixed with the solder solution. Radio-iodine has been used over many years to determine protein turnover using either I-125 or I-131. Iodine-125 labelled human albumin is regularly used as a radiopharmaceutical tool for the determination of plasma volume. Radio-iodine has the advantages of not affecting protein metabolism and the label is rapidly excreted after metabolic breakdown. Labelling with chromium (Cr-51) causes protein denaturation and is lost from the protein with time. Labelled albumin has been reported in human studies over a 21-day period, with similar results reported by Matthews. Most significantly McFarlane reported a different rate of catabolism of I-131 and I-125 over a 22-day period. The conclusion from this is that the rate of iodine clearance is a good indicator of protein catabolism. In parallel with the surgery a series of blank standards were prepared with a known mass of solder to correct for isotope

  16. Fluid dynamical implications of anastomosing slope streaks on Mars

    NASA Astrophysics Data System (ADS)

    Miyamoto, Hideaki; Dohm, James M.; Beyer, Ross A.; Baker, Victor R.

    2004-06-01

    The Mars Global Surveyor mission has imaged slope streaks, some of which have formed in periods as short as 109 days. These features are one of the most currently active surface processes on Mars. Some slope streaks have flow-like morphologic characteristics, which include anastomosing patterns influenced by small topographic barriers. In order to understand what processes gave rise to these specific features, we applied viscoplastic flow numerical modeling techniques to simulated Martian surfaces. We simulate Martian surfaces with observed slope streaks by using Mars Orbiter Laser Altimeter measurements to obtain large-scale slope measurements and a photoclinometry technique on Mars Orbiter Camera images to obtain meter-scale topographic information. Our numerical simulations of slow-moving plastic flows show that a fluid rheology and a short formation period are necessary to explain these features. We estimate that the typical values of bulk viscosity and bulk yield strength are less than 10 Pa s and less than 10 Pa, respectively. The fluid rheology can be explained by a water-related flow with a solid content less than about 20%. An alternative explanation is a dry grain flow with extremely low cohesion and friction angle supported by dispersive pressure or a lubricant, such as electric conditions of particles. The continuous nature of anastomosing slope streaks that originate from point sources is best explained by continuous discharges of material or lubricant. In this case, the estimated flow rate is less than several cubic meters per second, and the flow duration is estimated to be less than a day.

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    1993-04-01

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

  19. [The blind-loop syndrome after side-to-side anastomoses of the gut (author's transl)].

    PubMed

    Seitz, W; Mangold, G; Grönniger, J

    1977-04-01

    The postoperative blind-loop syndrome can occur after side-to-side, end-to side or by-pass anastomoses of the gut and presents clinically as malabsorption syndrome. Pathogenetically, stasis or slowing of the bowel movements will cause a rapid increase of pathogenic bacteria in the small intestine. Malabsorption is characterized by 3 symptoms: Loss of weight, anemia, steatorrhoea. The method of choice for therapy is to perform a new, end-to-end, anastomosis of the intestine in order to re-establish a physiological situation. During the last 6 years 14 patients with malabsorption syndromes of varying degrees were operated upon: 6 had pure small intestinal anastomoses, 7 anastomoses between the small and large intestine and 1 patient had a side-to-side sigmoidal anastomosis. In all patients the side-to-side or by-pass anastomoses could be reversed.

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

    USGS Publications Warehouse

    Schumann, R.R.

    1989-01-01

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

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

    PubMed

    Slim, K; Joris, J; Beloeil, H

    2016-08-01

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

  2. Vasomotion in chicken foot: dual innervation of arteriovenous anastomoses.

    PubMed

    Hillman, P E; Scott, N R; van Tienhoven, A

    1982-05-01

    Blood exits the foot of the domestic chicken via two major venous routes: a counter-current network surrounding the major incoming artery and a large collateral vein. Between these two routes are numerous large collateral vein. Between these two routes are numerous anastomotic veins. Both venous routes drain capillaries and arteriovenous anastomoses (AVAs). Blood flow through the foot was measured on unanesthetized hens. Flow varies with ambient temperature: 0.2 ml/min at 5 degrees C, 2.2 ml/min at thermoneutrality, and 5.4 ml/min at 36 degrees C; the AVAs contribute 8, 26, and 63% to this flow, respectively. Flow through capillaries is reduced by alpha-adrenergic agonists and is increased by beta-adrenergic agonists. Blocking nerve conduction to the foot at thermoneutrality releases alpha-adrenergic tone and increase AVA flow. Faradic stimulation of foot nerves after adrenergic blockage increases AVA flow, but not capillary flow, suggesting active vasodilation of the AVAs. Such AVA vasodilation normally occurs during body heating, since AVA flow decreases after denervation. Dopaminergic or beta-adrenergic nerves are not involved in active vasodilatation, however, purinergic nerves may play a role. Thus AVAs have a functional dual innervation.

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

    PubMed

    Gianaroli, L; Livani, M F

    1980-11-15

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  6. Anastomosing rivers: a review of their classification, origin and sedimentary products

    NASA Astrophysics Data System (ADS)

    Makaske, Bart

    2001-04-01

    Anastomosing rivers constitute an important category of multi-channel rivers on alluvial plains. Most often they seem to form under relatively low-energetic conditions near a (local) base level. It appears to be impossible to define anastomosing rivers unambiguously on the basis of channel planform only. Therefore, the following definition, which couples floodplain geomorphology and channel pattern, is proposed in this paper: an anastomosing river is composed of two or more interconnected channels that enclose floodbasins. This definition explicitly excludes the phenomenon of channel splitting by convex-up bar-like forms that characterize braided channels. In present definitions of anastomosing rivers, lateral stability of channels is commonly coupled with their multi-channel character. Here, it is suggested that these two properties be uncoupled. At the scale of channel belts, the terms 'straight', 'meandering' and 'braided' apply, whereas at a larger scale, a river can be called anastomosing if it meets the definition given above. This means that, straight, meandering and braided channels may all be part of an anastomosing river system. Straight channels are defined by a sinuosity index; i.e., the ratio of the distance along the channel and the distance along the channel-belt axis is less than 1.3. They are the type of channel that most commonly occurs in combination with anastomosis. The occurrence of straight channels is favoured by low stream power, basically a product of discharge and gradient, and erosion-resistant banks. Anastomosing rivers are usually formed by avulsions, i.e., flow diversions that cause the formation of new channels on the floodplain. As a product of avulsion, anastomosing rivers essentially form in two ways: (1) by formation of bypasses, while bypassed older channel-belt segments remain active for some period; and (2) by splitting of the diverted avulsive flow, leading to contemporaneous scour of multiple channels on the floodplain. Both

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

    PubMed

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

    2015-06-01

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

  8. Use of fibrin sealant for reinforcing arterial anastomoses.

    PubMed

    Jakob, H; Campbell, C D; Qiu, Z K; Pick, R; Replogle, R L

    1984-01-01

    Despite improvements in needles, sutures, and technique, hemorrhage remains a problem in cardiovascular surgery. In this study conventional vascular suture lines and suture lines reinforced with fibrin sealant are compared for blood loss and burst strength. Bilateral femoral arteries in 20 dogs were divided at 50% of their circumference and repaired with six 6-0 polypropylene sutures. Ten animals were systemically heparinized (3 mg/kg), and 10 were not on anticoagulants. The right femoral artery anastomosis was treated with fibrin sealant in all animals, and the left suture line served as the control. Three minutes after initiation of the sealing procedure, blood flow was reinstituted in both femoral arteries. After 3 minutes a significant difference in blood loss between the conventional suture technique and fibrin-reinforced anastomoses was noted in both heparinized (12.1 +/- 2.79 vs. 0.13 +/- 0.06 ml/min; p less than 0.01) and nonheparinized dogs (8.45 +/- 1.37 vs. 0.20 +/- 0.08 ml/min; p less than 0.001). After 30 minutes volume inflow and pressure catheters were inserted into snared compartments encompassing the femoral artery anastomosis. Continuous pressure recordings during volume loading with normal saline solution demonstrated increased bursting pressures of the fibrin-sealed suture lines in both the heparinized (317.5 +/- 13.18 vs. 135 +/- 23.17 mm Hg; p less than 0.001) and nonheparinized animals (474.5 +/- 26.82 vs. 311 +/- 29.31 mm Hg; p less than 0.001). Histologic examination revealed no fibrosis or foreign body reaction and complete resorption of the fibrin sealant within 3 weeks. Fibrin sealant, a powerful hemostatic agent produced from human donors not suffering from hepatitis, decreases blood loss and strengthens suture lines.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Frequency of transverse anastomoses with and without apical communication in Japanese population teeth.

    PubMed

    Villegas, Juan C; Yoshioka, Takatomo; Kobayashi, Chihiro; Suda, Hideaki

    2004-08-01

    The aim of this study was to describe and measure the frequency of transverse anastomoses with and without an apical communication in Japanese population teeth. One hundred and twenty-three extracted teeth from Japanese people were used in this study. The sample consisted of: 63 mandibular first molars, 30 maxillary first molars and 30 maxillary first premolars. Access openings were made through the crowns to the pulp chamber and India ink was injected into the coronal pulp space and vacuumed from the apical end. The teeth were cleaned and digital micrographs taken from several angles to identify transverse anastomoses. Fourteen teeth had only one canal and 81 teeth out of 109 (74%) had transverse anastomoses including 6 teeth (5.5%) that had an apical communication. Most of the anastomoses (50) were located in the middle portion of the canal and 22 (20%) teeth showed multiple anastomoses. Special attention must be taken after resection of roots with apparent multiple canals. The potentially exposed exits and/or isthmuses should be taken into consideration during surgical endodontic treatment.

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

    SciTech Connect

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

    1990-03-01

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

  11. Anastomosing reach control on hydraulics and sediment distribution on the Sabie River, South Africa

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

    Rivers in the Kruger National Park, South Africa, have variable degrees of bedrock and alluvial influence. Pre-2000 aerial imagery for the Sabie River (catchment area 6320 km2) reveals downstream alternations from alluvial single thread or braided, to bedrock anastomosed or mixed anastomosed channel types, with pool-rapids also present locally. In 2000 and 2012, extreme floods resulted in significant alluvial erosion, widely exposing the underlying bedrock. Since the 2012 flood, aerial LiDAR surveys reveal the strong gradient control exerted by the bedrock and mixed anastomosed channel types, which influences hydraulic conditions and sediment dynamics. Two dimensional hydraulic modelling of moderate floods (<1500 m3 s-1) reveals reduced velocities upstream of bedrock or mixed anastomosed channel types, which promotes deposition. During more extreme floods (>3500 m3 s-1), the bedrock or mixed anastomosed channel types are drowned out, resulting in dramatically increased velocities along the entire river and widespread alluvial stripping regardless of initial channel type or location.

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

    NASA Astrophysics Data System (ADS)

    Wohl, E. E.

    2010-12-01

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

  13. Anastomosing river deposits, sedimentation rates and basin subsidence, Magdalena River, northwestern Colombia, South America

    NASA Astrophysics Data System (ADS)

    Smith, Derald G.

    1986-02-01

    Situated in a tectonically active foreland basin, the Magdalena River consists of vertically accreting, levee-confined channels and adjacent extensive wetlands, which are interpreted as an anastomosing river sedimentary system. Equivalent rates of basin filling and subsidence average 3.8 mm yr -1 based on 18 14C dates from five bore holes drilled to depths of 55 m and sediment transport budgets from 35 years of measurement. Located in a savanna-tropical climate, anastomosing river deposits of the Magdalena are remarkably similar to the anastomosing deposits of the upper Columbia River in a temperate-cold climate in western Canada, suggesting that climate is not a controlling factor of anastomosis. The geometry of anastomosing channel-fills in the Magdalena consists of stratigraphically non-uniform, low sinuous, narrow stringers of sand up to 30 m thick by 600 m wide, a width-depth ratio of 20. Thin (1-2 m) off-channel crevasse-splay sand sheets extend laterally up to 10 km distance. When buried, both sand deposits become encased by lacustrine or marsh mud to form stratigraphic traps. While there are few modern anastomosing river systems as compared to braiding and meandering, there may be a disproportionately large number of ancient anastomosed fluvial rock sequences due to the rapid rate of vertical accretion. Such a different depositional style and geometry of sand bodies have considerable significance in the interpretation of some ancient fluvial rock sequences because it provides an alternative to the meandered and braided-river deposition models.

  14. Hydraulic and sedimentary processes causing anastomosing morphology of the upper Columbia River, British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Makaske, Bart; Smith, Derald G.; Berendsen, Henk J. A.; de Boer, Arjan G.; van Nielen-Kiezebrink, Marinka F.; Locking, Tracey

    2009-10-01

    The upper Columbia River, British Columbia, Canada, shows typical anastomosing morphology — multiple interconnected channels that enclose floodbasins — and lateral channel stability. We analysed field data on hydraulic and sedimentary processes and show that the anastomosing morphology of the upper Columbia River is caused by sediment (bedload) transport inefficiency, in combination with very limited potential for lateral bank erosion because of very low specific stream power (≤ 2.3 W/m 2) and cohesive silty banks. In a diagram of channel type in relation to flow energy and median grain size of the bed material, data points for the straight upper Columbia River channels cluster separately from the data points for braided and meandering channels. Measurements and calculations indicate that bedload transport in the anastomosing reach of the upper Columbia River decreases downstream. Because of lateral channel stability no lateral storage capacity for bedload is created. Therefore, the surplus of bedload leads to channel bed aggradation, which outpaces levee accretion and causes avulsions because of loss of channel flow capacity. This avulsion mechanism applies only to the main channel of the system, which transports 87% of the water and > 90% of the sediment in the cross-valley transect studied. Because of very low sediment transport capacity, the morphological evolution of most secondary channels is slow. Measurements and calculations indicate that much more bedload is sequestered in the relatively steep upper anastomosing reach of the upper Columbia River than in the relatively gentle lower anastomosing reach. With anastomosing morphology and related processes (e.g., crevassing) being best developed in the upper reach, this confirms the notion of upstream rather than downstream control of upper Columbia River anastomosis.

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

    NASA Astrophysics Data System (ADS)

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

    2001-03-01

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

  16. A comparison of the flow of iodine 125 through three different intestinal anastomoses: standard, Gambee, and stapler

    SciTech Connect

    Wheeless, C.R. Jr.; Smith, J.J.

    1983-10-01

    Angiogenesis determines blood supply, and it is postulated that after surgery, the healing of a wound is directly related to the blood supplied to the surrounding tissues. As a first step in evaluating the process of flow through different surgical anastomoses, the flow rate of /sup 125/I through three different types of anastomoses in the intestines of dogs was determined. When the results were compared, the flow rate through the stapler anastomosis was significantly higher than the flow rate through the standard and Gambee anastomoses.

  17. Haemostatic effects of laser tissue solder as a reinforcement to anastomoses with PTFE grafts

    NASA Astrophysics Data System (ADS)

    Birch, Jeremy F.; Seifalian, Alexander M.; Bell, Peter R.

    2003-06-01

    Laser activated tissue solders have been used for sutureless anastomosis in various contexts. Solders were initially developed in response to the finding that the use of lasers alone caused vessel damage resulting in aneurysm formation and medical damage. Many reports exist of the use of lasers to perform micro-anastomoses, but little has been reported on the use of laser tissue solder in the formation of medium sized vessel anastomoses or in vivo. This group has recently developed a methylene blue based albumin solder for use in vascular anastomoses. The early work concentrated on a rabbit carotid end-to-end model. More recently this has progressed into its application in medium sized vessels. The use of PTFE is common in clinical practice particularly relating to peripheral vascular reconstruction or vascular access surgery. In these instances conventional surgical techniques applied to PTFE will result in excessive bleeding at the site of the anastomosis. Suture materials commonly used such as polypropylene or polyamide leave holes in such prostheses. To compound the problem patients are often anticoagulated or suffer impaired platelet function, improving the chances of graft survival, but increasing bleeding time, the time required to achieve haemostasis and also the post operative complications related to bleeding such as haematoma formation. It was therefore intended to apply the techniques of soldered vascular anastomoses to such a scenario, by reinforcing the anastomotic suture line of grafts placed in an animal model, with MB based solder. The bleeding times, overall operating times and postoperative complications were then analyzed and compared to sutured controls.

  18. Fibrinogen-thrombin collagen patch reinforcement of high-risk colonic anastomoses in rats

    PubMed Central

    Suárez-Grau, Juan Manuel; Bernardos García, Carlos; Cepeda Franco, Carmen; Mendez García, Cristina; García Ruiz, Salud; Docobo Durantez, Fernando; Morales-Conde, Salvador; Padillo Ruiz, Javier

    2016-01-01

    AIM To evaluate the effectiveness of human fibrinogen-thrombin collagen patch (TachoSil®) in the reinforcement of high-risk colon anastomoses. METHODS A quasi-experimental study was conducted in Wistar rats (n = 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group (24 rats) and treatment group (24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil® (a piece of TachoSil® was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. RESULTS Overall survival was 71.4% and 57.14% in the TachoSil® group and control group, respectively (P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage (P > 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups (P = 0.066). CONCLUSION In our study, the use of TachoSil® was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil® has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions. PMID:27721926

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

    PubMed

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

    2015-06-01

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

  20. End-to-end microvascular anastomoses with a 1.9-un diode laser

    NASA Astrophysics Data System (ADS)

    Mordon, Serge R.; Martinot, Veronique L.; Mitchell, Valerie A.

    1996-01-01

    This in-vivo study examines the interest of vessel anastomosis with a 1.9 micrometer diode laser. Ten end-to-end carotid anastomoses and 10 end-to-end jugular anastomoses are performed in Wistar rats. The technique requires brief applications (20 to 25 spots) with a diode laser (lambda equals 1.9 micrometer, (phi) equals 220 micrometer, P equals 60 mW, t equals 0.7 s, F equals 110 J/cm2) after placement of three equidistant stay sutures. The macroscopic aspect and patency are evaluated at different post-operative intervals. Vessel histology is performed at 15, 21, and 30 days after the procedure. These anastomoses reveal minimal thermal damage in the adventitial layer only at depth of 200 micrometer. No medial or intimal thermal damage is identified. No thrombosis is observed, giving a permeability of 100% for both arteries and veins. The mean clamping time is 9 plus or minus 3 min. For 1.9 micrometer, the water extinction length is 0.15 mm. The welded thickness is comparable to the extinction length of the wavelength giving consequently a weld strength of 4 multiplied by 106 dynes/cm2 comparable to the strength of suture repairs: 5 - 6 multiplied by 106 dynes/cm2. These findings suggest that a low-energy 1.9 micrometer diode laser has potential clinical application for anastomosis of small vessels.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2013-06-01

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

  3. Effect of irradiation on healing of newly made colonic anastomoses in the rat

    SciTech Connect

    Biert, J.; Wobbes, T.; Hendriks, T.; Hoogenhout, J. )

    1993-12-01

    Short-term effects of radiotherapy on the healing process of newly made colonic anastomoses are investigated by measuring the anastomotic strength in a rat model. Four groups of Wistar rats were used. In all groups, rats underwent a 1 cm sigmoid resection with end-to-end anastomosis. Group I served as a control group. In group II the anastomosis was irradiated after closure of the abdominal wall with a single dose of 20 Gy of 250 kV [times] rays. Group III was irradiated with a single dose of 20 Gy while the abdominal wall was not closed, and the surrounding tissues were carefully covered by a lead plate, simulating intra-operative radiotherapy. Group IV was treated as group III, but a larger dose of 25 Gy was applied. Animals were sacrificed 3 or 7 days after the operation. General condition of the rats was determined by observation, weight loss, serum protein and albumin at sacrifice. Anastomotic healing was evaluated by inspection, bursting pressure, hydroxyproline and protein contents of the anastomotic segment. Direct postoperative externally irradiated rats (group II) showed a marked weight loss, hypoproteinaemia and hypo-albuminaemia because of involvement of small bowel in the irradiated volume. With respect to anastomotic healing there were no significant differences between control and irradiated groups. These data suggest that the application of a single dose of irradiation (20 and 25 Gy) on colonic anastomoses given in a direct postoperative or intraoperative model has no measurable side effect on the early healing of newly made colonic anastomoses. Direct postoperative external irradiation results in unwanted side effects in the adjacent bowel. 33 refs., 4 figs., 3 tabs.

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

    PubMed Central

    Wolfenson, D

    1983-01-01

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

  5. Waterhole form and process in the anastomosing channel system of Cooper Creek, Australia

    NASA Astrophysics Data System (ADS)

    Knighton, A. David; Nanson, Gerald C.

    2000-10-01

    One of the most distinctive features of Cooper Creek's anastomosing channel system is the preponderance of waterholes, enlarged segments of channel ranging in length from 100 m to over 20 km. Enlargement occurs in both the width and depth dimensions to give bankfull cross-sectional areas four to eight times the average size of individual anastomosing channels. The anastomosing system is cut into a floodplain of subtle relief but depths of incision can be highly variable, giving rise to changes in the degree of anastomosis as different sets of channels are activated during the filling stage of a flood. Also, cross-sectional form and bed topography can vary markedly over short channel distances, which has implications for local flow conditions and erosive potential. Hydraulic geometry analyses suggest that cross-sectional area adjusts much more readily than velocity to increasing discharge in waterholes, particularly if there is limited lateral confinement. Consequently, velocities tend to be rather modest across a wide spectrum of flows, with average values rarely reaching 1 m s -1. Nevertheless, observations made during a 1:20-year flood reveal a deeply penetrative band of relatively high velocity in one waterhole, suggesting that localized values of bed shear could be quite large even when sectional averages are moderate. Waterholes appear to be a product of the present regime, since they concentrate flow from both feeder channels and the floodplain during flood discharges. In several respects they resemble chains-of-ponds morphology [Eyles, R.J., 1977. Birchams Creek: the transition from a chain of ponds to a gully. Aust. Geogr. Stud. 15, 146-157.], and could represent the discontinuous sections of a present-day channel, which cannot be maintained in that form over its entire length. That the one waterhole to accommodate the entire cross-valley flow at bankfull stage (Meringhina Waterhole) has cross-sectional dimensions similar to those predicted by appropriate

  6. Repair of Internal Iliac Artery Aneurysm Anastomosed to Donor Renal Artery in a Renal Transplant Patient

    PubMed Central

    Takano, Hiroshi; Kin, Keiwa; Maeda, Shuusaku

    2016-01-01

    We herein report a successful repair of an internal iliac artery aneurysm in a renal transplant patient. At renal transplantation, the main renal artery and accessory renal artery had been anastomosed to the right internal iliac artery and right external iliac artery, respectively. The patient underwent resection and graft replacement of the iliac artery aneurysm with reattachment of the main renal artery to the right external iliac artery through a midline laparotomy with repeated topical cold perfusion for renal protection. The postoperative course was uneventful, and no evidence of renal function impairment was present at discharge. PMID:27738467

  7. Comparison between absorbable and nonabsorbable sutures in arterial anastomoses in growing dogs.

    PubMed

    Gersak, B

    1991-01-01

    Five dogs, 10 weeks old, underwent operation using ketamin-HCl anesthesia and end-to-end anastomoses of the femoral and brachial arteries were made using polyfilament nonabsorbable material (Ethibond), monofilament nonabsorbable material (Prolene), polyfilament absorbable material (Vicryl) and monofilament absorbable material (PDS). The arterial diameter using a micrometer and blood flow using an electromagnetic flow meter were determined. After six months another operation was performed and diameter and blood flow were measured again. No statistically significant differences were found between the different materials used with respect to growth related increases either in arterial diameter or blood flow.

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

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

  10. Anastomosed river deposits, sedimentation rates, basin subsidence and locations in proximal molasse basins

    SciTech Connect

    Smith, D.G.

    1984-07-01

    Recent research on large sized modern anastomosing river systems (upper Columbia River, British Columbia, Canada, and Magdalena River, Colombia, South America) has recognized six depositional environments: channel, levee, crevasse-splay, lacustrine, marsh, and peat bog or swamp. Average sedimentation rates in both river systems are 5 mm/yr and 3.8 mm/yr, respectively. Such rapid sedimentation rates (vertical accretion) are keeping pace with equivalent rates of basin subsidence. High rates of sedimentation and basin subsidence are most likely to be found at proximal locations in molasse basins during major orogenic pulses. Such conditions were present during the Columbian and Laramide orogenies during the early Cretaceous and Tertiary in the foreland adjacent to the Rocky Mountain system. Thus, channel and crevasse-splay shale-encased sandstone reservoirs and coal, common in anastomosed fluvial rock sequences in proximal molasse settings, should be encountered in parts of the Western Interior sedimentary basin. Such deposits probably have been interpreted as deltaic or alluvial plain and should be reexamined to better predict sandstone trends for hydrocarbon exploration.

  11. Effect of pyloric drainage on the healing of esophagogastric anastomoses in rats

    PubMed Central

    Cui, Yingjie; Urschel, John D.; Petrelli, Nicholas J.

    2000-01-01

    Background and objectives Esophagogastric anastomotic leaks complicate 5% to 20% of esophagectomies for esophageal cancer and are responsible for approximately one-third of perioperative deaths. Poor gastric emptying is a predisposing factor for anastomotic leakage. An animal experiment was used to test the hypothesis that a pyloric drainage procedure (pyloromyotomy) would have a positive effect on esophagogastric anastomotic healing. Methods In 40 rats single-layer esophagogastric anastomoses were constructed with interrupted 7-0 polypropylene sutures. A pyloromyotomy was done in the experimental group (20 rats) but not in the control group (20 rats). Rats were sacrificed on the 7th postoperative day and their anastomoses were excised, mounted in a tensiometer, and distracted at 10 mm/min to measure breaking strength. After that, the hydroxyproline concentration (an indicator of wound collagen) of the anastomotic tissue was measured. Results There were no anastomotic leaks. The mean (and standard deviation) breaking strength of the esophagogastric anastomosis was 3.96 (1.14) N in the pyloromyotomy rats and 4.11 (0.75) N in the control rats (p = 0.64). The mean (and SD) hydroxyproline concentration in esophagogastric anastomotic tissue was 368.6 (31.5) nmol/mg in the pyloromyotomy rats and 376.6 (31.3) nmol/mg in the control rats (p = 0.77). Conclusion Pyloric drainage (pyloromyotomy) did not have any effect on esophagogastric anastomotic wound healing in this rat model. PMID:11129835

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

    PubMed

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

    2016-06-01

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

  13. Comparison of laser-assisted fibrinogen-bonded and sutured canine arteriovenous anastomoses.

    PubMed

    Oz, M C; Libutti, S K; Ashton, R C; Lontz, J F; Lemole, G M; Nowygrod, R

    1992-07-01

    The effect of laser-assisted fibrinogen bonding (LAFB) on the development of intimal hyperplasia was studied with stress-strain profiles and histologic evaluation of canine arteriovenous fistulas (AVFs). In 19 animals femoral AVFs were created with an 808 nm diode laser after topical application of fibrinogen mixed with indocyanine green dye; in the contralateral limb a sutured AVF was created. The animals were divided into three groups. Group 1 dogs (n = 6) were killed serially up to 4 weeks after surgery to examine the healing of the anastomoses created with LAFB. Group 2 dogs (n = 6) were killed 1 month after surgery, and the fresh specimens were strained axially to produce a stress-strain profile graph. Group 3 dogs (n = 7) were killed 7 months after surgery, and the AVFs were infused with formalin under pressure and histologically prepared to allow comparison of the ratio of maximum to minimum intimal hypertrophy. Fibrinogen used for LAFB was resorbed during the first month after operation without evidence of foreign body reaction or inflammation. Tensile break force was not significantly different in the laser-bonded group (4.6 +/- 2.4 pounds) and the sutured group (4.3 +/- 1.7 pounds). The modulus (tensile break force per square inch), a measure of elasticity, identified the laser-bonded AVF (149 +/- 44 pounds per square inch) to be less rigid than the sutured AVF (203 +/- 35 pounds per square inch) (p less than 0.05). No significant differences in the degree of intimal hyperplasia were noted in any area of the anastomoses. Use of LAFB neither accelerates nor prevents intimal hyperplasia in a canine AVF model.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

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

  15. A scanning electron microscopic study of microvascular anastomoses on irradiated vessels: short-term effect of irradiation

    SciTech Connect

    De Wilde, R.; Boeckx, W.; Van Der Schueren, E.; Guelinckx, P.; Gruwez, J.

    1983-01-01

    Experiments were carried out to determine the effect of previous irradiation on microvascular arterial anastomoses. The study focused on regeneration of endothelial cells and thrombus formation. Careful examination with scanning electron microscopy (SEM) showed a difference between irradiated animals and a control group. In the irradiated group one can notice a decreased regeneration, a greater amount of fibrin and platelets, and a higher incidence of microthrombi.

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

    NASA Astrophysics Data System (ADS)

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

    1993-05-01

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

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

    NASA Astrophysics Data System (ADS)

    Hart, Jane; Young, David; Martinez, Kirk

    2016-04-01

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

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

    PubMed

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

    2016-06-01

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

  19. Structure and development of an anastomosing network of ductile shear zones

    NASA Astrophysics Data System (ADS)

    Carreras, Jordi; Czeck, Dyanna M.; Druguet, Elena; Hudleston, Peter J.

    2010-05-01

    A detailed structural analysis of an anastomosing shear zone network in metagabbros from the Archean Rainy Lake zone (Canada) revealed the existence of prevalent dextral and minor sinistral conjugate shear zones with the obtuse angle (>130°) facing the main shortening direction. A typology of shear zone intersections, confluences, and other features shows that all shears formed during a single deformation event, with dextral and sinistral shears being active together or in an alternating fashion. In spite of the difficulty of establishing a complete kinematic sequence, early and late shears can be distinguished. The final angular pattern between dextral and sinistral shears is not an original feature. Dextral and sinistral shears formed at nearly right angles, and the angles progressively opened towards the extension direction as a result of increasing strain. The obtuse angles were achieved by the combined effects of continued shearing on newly forming shears and internal deformation of the lozenge-shaped domains of lesser-deformed rock bounded by the shears. Through time, there was an increasing prevalence of dextral shears over sinistral ones. The studied pattern and sequential analysis indicate that the bulk deformation was noncoaxial with a deformation regime evolving from a pure shear-dominated dextral transpression to a higher vorticity dextral transpression.

  20. Blood flow measurement system for fetoscopic laser photocoagulation of chorionic plate anastomosing vessels (FLPC).

    PubMed

    Seki, Takeshi; Oka, Kiyoshi; Naganawa, Akihiro; Yamashita, Hiromasa; Kim, Keri; Chiba, Toshio

    2009-01-01

    Fetoscopic laser photocoagulation of chorionic plate anastomosing vessels (FLPC) applies to the treatment of previable fetuses with severe twin-twin transfusion syndrome (TTTS). The ultimate goal of FLPC is selective blood flow interruption of anastomotic communicating vessels on the placenta fetoscopically. However, there has not been an established method to confirm that the blood flow is blocked, thus, it depends on the operator's experience or intuition to evaluate whether the FLPC was performed successfully or not. For this issue, we have developed a composite-type optical fiberscope (2.2 mm in diameter), which has centrally-located cautery laser fiber and surrounding located fiberglasses for viewing. This fiberscope enables transmission of 50 W Yb fiber laser which can be focused to 10 mm focal length using two lenses on the fiberscope tip. In this study, we combined the fiberscope and a laser blood-flow meter, and irradiated cautery laser to porcine mesenteric vein with measuring blood flow at the same time. From the experimental results, we could quantitatively measure the blood flow before and after laser irradiation, and confirm the blood flow blocking with our system. PMID:19929297

  1. Typology of lozenges and their development in anastomosing shear zones in foliated rocks

    NASA Astrophysics Data System (ADS)

    Ponce, Carlos; Carreras, Jordi; Druguet, Elena

    2010-05-01

    Lozenges are characteristic common structures related to anastomosing networks of shear zones. They are ellipsoid-shaped bodies of undeformed (or less deformed) country rock bounded by mylonites. They have been studied since the 1980's (Bell and Rubenach 1980, Bell 1981, Simpson, 1982, Choukroune and Gapais 1987, Hudleston 1999, Fusseis 2006), and various formation processes have been proposed. However, the lack of a systematic typology has led to confronting interpretations about their origin, development and significance in the context of anastomosing shear zones. A typology of shear zone-related lozenges is proposed with regard to the pre-shearing rock properties: 1) Lozenges in rheologically heterogeneous rocks. Their development is related to the presence of volumes of rock that behave more competent than the surrounding media. These are therefore typically developed in shear zones affecting rocks with a marked competence constrast. This is the case e.g. of a sheared competent dyke in a less competent schistose matrix. 2) Lozenges in homogeneous (2a, isotropic or 2b, anisotropic) rocks that arise from the confluence of differently oriented shears. The development of this type of lozenges is at present less understood than type 1 lozenges. The present work is focused in the formation and development of type 2 lozenges. The here presented preliminary results are based on a 2D approach (sections parallel to the shear direction) and supported by the analysis of natural examples from the Cap de Creus shear belt Eastern Pyrenees). Two main variables are taken into account for the interpretation of this type of lozenges. First, the relative kinematics of the bounding shear zones, i.e., shear zones have the same shear sense or, instead, they have opposite shear sense (conjugate sets). Second, only for foliated rocks, the relative orientation of the previous foliation with regard to the lozenge major axis. Furthermore, some models are presented to explain the

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

    PubMed Central

    Walløe, Lars

    2016-01-01

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

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

    PubMed

    Walløe, Lars

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2006-05-01

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

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

    PubMed Central

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

    1996-01-01

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

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

    PubMed Central

    2015-01-01

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

  7. Waterholes and their significance in the anastomosing channel system of Cooper Creek, Australia

    NASA Astrophysics Data System (ADS)

    Knighton, A. David; Nanson, Gerald C.

    1994-06-01

    Cooper Creek has developed a very extensive system of anastomosing channels, a distinctive feature of which is the preponderance of waterholes, which are readily identified as deepened and widened reaches of channel with more or less permanent water. They are widely distributed over the floodplain but tend to decrease in number downstream, possibly as a result of transmission losses which reduce erosive potential, and to develop preferentially towards the west, which has implications for the long-term relocation of the system. Classification of waterholes according to degree of lateral restriction and flow status reveals only muted contrasts in waterhole form between the various types. The one clear distinction is the unexpectedly low width/length ratio of the most restricted (dune-flanked) type, its squat form being attributable to erodible banks and limited downstream confinement. That waterholes have developed in abundance along Cooper Creek appears to be related to the presence of a more easily eroded sand sheet at depths of only 2-9 m below cohesive surface sediments. Sediment splays at their downstream ends indicate that waterholes can be maintained by the present regime but whether they were formed by that or a prior regime is a matter of debate. Some degree of inheritance cannot be discounted but a contemporary origin is favoured in view of the fact that most waterholes are located at points of flow convergence. By focusing erosional energy when the floodplain is extremely broad, waterholes play a significant role not only in maintaining existing channel lines but also in promoting the development of new ones, as the invasion of a dune field testifies.

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

    PubMed

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

    2014-10-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    2000-09-15

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-10-01

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

  12. Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know.

    PubMed

    Geibprasert, S; Pongpech, S; Armstrong, D; Krings, T

    2009-09-01

    Transarterial embolization in the external carotid artery (ECA) territory has a major role in the endovascular management of epistaxis, skull base tumors, and dural arteriovenous fistulas. Knowledge of the potential anastomotic routes, identification of the cranial nerve supply from the ECA, and the proper choice of embolic material are crucial to help the interventionalist avoid neurologic complications during the procedure. Three regions along the skull base constitute potential anastomotic routes between the extracranial and intracranial arteries: the orbital, the petrocavernous, and the upper cervical regions. Branches of the internal maxillary artery have anastomoses with the ophthalmic artery and petrocavernous internal carotid artery (ICA), whereas the branches of the ascending pharyngeal artery are connected to the petrocavernous ICA. Branches of both the ascending pharyngeal artery and the occipital artery have anastomoses with the vertebral artery. To avoid cranial nerve palsy, one must have knowledge of the supply to the lower cranial nerves: The petrous branch of the middle meningeal artery and the stylomastoid branch of the posterior auricular artery form the facial arcade as the major supply to the facial nerve, and the neuromeningeal trunk of the ascending pharyngeal artery supplies the lower cranial nerves (CN IX-XII).

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

    PubMed

    John, Ivy; Folpe, Andrew L

    2016-08-01

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

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

    SciTech Connect

    Nadon, G.C. )

    1993-02-01

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

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

    PubMed

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

    2016-01-01

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

  16. Effects of intraoperative electron irradiation in the dog on cell turnover in intact and surgically-anastomosed aorta and intestine

    SciTech Connect

    Sindelar, W.F.; Morrow, B.M.; Travis, E.L.; Tepper, J.; Merkel, A.B.; Kranda, K.; Terrill, R.

    1983-04-01

    Adults dogs were subjected to laparotomy and intraoperative electron irradiation after division and reanastomosis of aorta or after construction of a blind loop of small intestine having a transverse suture line and an end-to-side anastomosis. Dogs received intraoperative irradiation of both intact and anastomosed aorta or intestine in doses of 0, 2000, 3000, or 4500 rad. Animals were sacrificed at seven days or three months following treatment. At 24 hours prior to sacrifice, dogs received 5 mCi tritiated thymidine intravenously. Irradiated and non-irradiated segments of aorta and small intestine, including intact and anastomotic regions, were analyzed for tritiated thymidine incorporation and were subjected to autoradiography. Incorporation studies showed diminution in tritiated thymidine uptake by irradiated portions of aorta and small intestine, in both intact and anastomotic regions. Autoradiograms revealed that irradiated areas of intact or anastomotic aorta or intestine had diminished labeling of stromal cells, suggesting a lowered cell proliferative capacity of irradiated tissue compared to non-irradiated portions. Inflammatory cells showed similar labeling indices in irradiated and non-irradiated tissues, both intact and surgically-manipulated, suggesting that irradiation does not significantly affect a subsequent local inflammatory response. Radiation-induced decreases in tritiated thymidine incoporation in irradiated aorta and small intestine were generally more marked at seven days than at three months following irradiation, suggesting that radiation-induced depression of cell turnover rates decreases with time.

  17. 5-Carboxamide tryptamine, a compound with high affinity for 5-hydroxytryptamine1 binding sites, dilates arterioles and constricts arteriovenous anastomoses.

    PubMed Central

    Saxena, P. R.; Verdouw, P. D.

    1985-01-01

    The effects of 5-carboxamide tryptamine, which activates non-5-hydroxytryptamine2-'atypical' receptors for 5-hydroxytryptamine (5-HT) in the dog saphenous vein, was studied on the complete distribution of cardiac output and common carotid blood flow in anaesthetized pigs. The drug was infused for 10 min at the rate of 0.025, 0.1 and 0.4 micrograms kg-1 min-1 either intravenously (cardiac output distribution) or intra-arterially (carotid distribution). 5-Carboxamide tryptamine decreased arterial blood pressure due to a reduction of cardiac output. This reduction was confined to its arteriovenous anastomotic component; the component used for the tissue perfusion (nutrient part) in fact increased. Similar changes were observed in the carotid blood flow distribution. Vasodilation was observed in several tissues, but the skin, ears and stomach responded most prominently. The effects of 5-carboxamide tryptamine on the carotid distribution were not significantly modified by cyproheptadine (1 mg kg-1). It is concluded that, like 5-HT, 5-carboxamide tryptamine constricts arteriovenous anastomoses and dilates arterioles by activating non-5-HT2-'atypical' receptors. These 'atypical' 5-HT receptors appear to be of the 5-HT1 type since both 5-carboxamide tryptamine and BEA 1654, a new piperazine derivative, produced similar vascular effects in the carotid bed of the pig and also showed a high and selective affinity for the 5-HT1 binding sites. PMID:3978321

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2011-05-01

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

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

    SciTech Connect

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

    1982-07-01

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

  1. Sildenafil, nifedipine and acetazolamide do not allow for blood flow through intrapulmonary arteriovenous anastomoses during exercise while breathing 100% oxygen.

    PubMed

    Elliott, Jonathan E; Friedman, Jonathan M; Futral, Joel E; Goodman, Randall D; Lovering, Andrew T

    2014-12-01

    Blood flow through intrapulmonary arteriovenous anastomoses (IPAVAs) is known to increase in healthy humans during exercise while breathing room air, but is prevented or significantly reduced during exercise while breathing 100% O2, potentially due to vasoconstriction of IPAVAs. Thus, pharmacological interventions that target known pathways regulating the cardiopulmonary circulation may be able to prevent the hyperoxia-induced reduction in IPAVA blood flow (Q̇ IPAVA ) during exercise. In nine healthy human subjects, we investigated the effects of sildenafil (100 mg p.o.), nifedipine (20 mg p.o.) and acetazolamide (250 mg p.o. three times a day for 3 days) on Q̇ IPAVA at rest and during cycle ergometer exercise at 50, 100, 150, 200 and 250 W, while breathing room air (normoxia) and 100% O2 (hyperoxia). Transthoracic saline contrast echocardiography and a 0-5 bubble scoring system were used to detect and assess Q̇ IPAVA qualitatively; ultrasound was used to assess the blood flow velocity oftricuspid regurgitation and the left ventricular outflow tract blood flow to calculate pulmonary artery systolic pressure (PASP) and cardiac output, respectively. Without drugs, bubble scores increased significantly to ≥2 at 150 W in normoxia and to ≤2 at 200 W in hyperoxia. Only nifedipine consistently increased cardiac output at rest and during low-intensity exercise in normoxia and hyperoxia. However, there was no detectable effect of any drug on Q̇ IPAVA ; specifically, bubble scores were the same during exercise in either normoxia or hyperoxia. Accordingly, the reduction in Q̇ IPAVA during exercise while breathing 100% O2 is likely not to be due to the independent pharmacological mechanisms of action associated with sildenafil, nifedipine or acetazolamide.

  2. 1.9-um diode-laser-assisted anastomoses in reconstructive microsurgery: preliminary results in 12 patients

    NASA Astrophysics Data System (ADS)

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

    1998-01-01

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

  3. Anastomoses between lower cranial and upper cervical nerves: a comprehensive review with potential significance during skull base and neck operations, part I: trigeminal, facial, and vestibulocochlear nerves.

    PubMed

    Shoja, Mohammadali M; Oyesiku, Nelson M; Griessenauer, Christoph J; Radcliff, Virginia; Loukas, Marios; Chern, Joshua J; Benninger, Brion; Rozzelle, Curtis J; Shokouhi, Ghaffar; Tubbs, R Shane

    2014-01-01

    Descriptions of the anatomy of the neural communications among the cranial nerves and their branches is lacking in the literature. Knowledge of the possible neural interconnections found among these nerves may prove useful to surgeons who operate in these regions to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections among the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized in two parts. Part I concerns the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches with any other nerve trunk or branch in the vicinity. Part II concerns the anastomoses among the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or among these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part I is presented in this article. An extensive anastomotic network exists among the lower cranial nerves. Knowledge of such neural intercommunications is important in diagnosing and treating patients with pathology of the skull base.

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

    PubMed

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

    2016-05-01

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

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

    PubMed Central

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

    2012-01-01

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

  6. New Approaches for Vascular Anastomoses.

    PubMed

    Bonilla, Luis F.; Sullivan, Daniel J.

    2001-02-01

    Increasing interest in minimally invasive cardiac surgical procedures has generated a renewed interest in facilitated methods to create vascular anastomosis. These devices, in order to be viable, must perform equally or better than sutures. An extensive review of the literature was performed on the different ways to create a mechanical vascular anastomosis. The experience of the authors with the development of a family of connectors (The Symmetry Bypass System; St. Jude Medical, Minneapolis, MN) is presented. The Aortic Connector System (St. Jude Medical) has undergone extensive animal testing with 30-, 90-, and 180-day follow-up. Over 250 human implants have been performed successfully. Preliminary animal studies with the stainless steel coronary connector are also presented. The creation of a facilitated mechanical vascular anastomosis should not compromise quality or patency rates, and produce at least the same results as those obtained with standard suturing techniques. These devices dramatically reduce the time to perform an anastomosis and eliminate the need for aortic clamping and cardiopulmonary bypass. These advantages should result in a significant reduction in surgical complications, and may facilitate a move to true endoscopic and/or percutaneous bypass. PMID:11177719

  7. The Issue of Motivating Entre(Intra)Preneurial Behavior.

    ERIC Educational Resources Information Center

    Winslow, Erik K.

    1990-01-01

    Six principles of motivating entre(intra)preneurial behavior are considered including the climate must allow the expression of such activity; motivation is broadly distributed in the general population; behavior is a function of its consequences; and motivating environments have an aura of excitement and experimentation. (DB)

  8. Autologous adventitial overlay method reinforces anastomoses in aortic surgery.

    PubMed

    Minato, Naoki; Okada, Takayuki; Sumida, Tomohiko; Watanabe, Kenichi; Maruyama, Takahiro; Kusunose, Takashi

    2014-05-01

    In this study, we present an inexpensive and effective method for providing a secure and hemostatic anastomosis using autologous adventitia obtained from a dissected or aneurysmal wall. The resected aortic wall is separated between the adventitia and media, and a soft, 2 × 10-cm adventitial strip is overlaid to cover the anastomotic margin. A graft is sutured to the aortic stump. This autologous adventitial overlay method can inexpensively and strongly reinforce the anastomosis during aortic surgery for dissection or aneurysm and will contribute to anastomotic hemostasis and long-term stability.

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

    PubMed

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

    1980-11-15

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

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

    NASA Astrophysics Data System (ADS)

    Jimenez Tolentino, Dinorah

    2011-12-01

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

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

    ERIC Educational Resources Information Center

    Smokowski, Paul R.; Bacallao, Martica

    2009-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2003-08-01

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

  14. Relaciones entre el sueño y la adicción

    PubMed Central

    Cañellas, Francesca; de Lecea, Luis

    2016-01-01

    Resumen La interacción entre los trastornos del sueño y el abuso de sustancias es ya conocida, pero seguramente más compleja de lo que se pensaba. Existe tanto una relación positiva entre tener un trastorno por uso de substancias y sufrir un trastorno de sueño, como viceversa. Los efectos sobre el sueño dependen de la substancia utilizada, pero se ha demostrado que tanto durante su uso como en período de abstinencia los consumidores tienen diferentes problemas de sueño y fundamentalmente un sueño más fragmentado. Sabemos que hay que tener en cuenta los problemas de sueño para evitar recaídas en la adicción. Investigaciones recientes indican que el sistema hipocretinérgico definido por el neuropéptido hipocretina/orexina (Hcrt/ox), localizado en el hipotálamo lateral e implicado entre otros en la regulación del ciclo sueño-vigilia, jugaría un papel importante en las conductas adictivas. Diferentes estudios han demostrado interacciones entre el sistema hipocretinérgico, los circuitos de respuesta aguda al estrés y los sistemas de recompensa. También sabemos que la activación optogenética selectiva del sistema hipocretinérgico incrementa la probabilidad de la transición del sueño a la vigilia, y también es suficiente para iniciar un comportamiento compulsivo de recaída adictiva. La activación del sistema hipocretinérgico podría explicar la hipervigilia asociada al estrés y a la adicción. El mayor conocimiento de esta interacción permitiría entender mejor los mecanismos de la adicción y encontrar nuevas estrategias para el tratamiento de las adicciones. PMID:23241715

  15. Mycoflora and mycotoxins natural occurrence in corn from entre rios province, Argentina.

    PubMed

    Am, P; LE, B; Sl, R; Hhl, G

    2001-03-01

    Corn samples were collected in 1999 from three departments of Entre Réos province, Argentina, and were surveyed for mould contamination and natural occurrence ofFusarium mycotoxins, ochratoxin A and aflatoxins.Fusarium verticillioides was the most prevalent fungal species recorded at all departments. Zearalenone, deoxynivalenol and ochratoxin A were not found in any samples. Only one of the 52 corn samples analysed was contaminated with aflatoxin B1 (17 μg/kg). Fumonisin B1 was found in 58 % of samples (range of positive samples: 47- 3,347 μg/kg), fumonisin B2 in 33.0 % (range of positive samples: 23-537 μg/kg) and fumonisin B3 in 25.0 % (range of positive samples: 24-287 μg/kg) of them. This is the first report on the natural occurrence of mycotoxins in corn from Entre Ríos province, Argentina. Levels of fumonisins were lower than detected in other Argentinian provinces. PMID:23605614

  16. Mycoflora and mycotoxins natural occurrence in corn from entre rios province, Argentina.

    PubMed

    Am, P; LE, B; Sl, R; Hhl, G

    2001-03-01

    Corn samples were collected in 1999 from three departments of Entre Réos province, Argentina, and were surveyed for mould contamination and natural occurrence ofFusarium mycotoxins, ochratoxin A and aflatoxins.Fusarium verticillioides was the most prevalent fungal species recorded at all departments. Zearalenone, deoxynivalenol and ochratoxin A were not found in any samples. Only one of the 52 corn samples analysed was contaminated with aflatoxin B1 (17 μg/kg). Fumonisin B1 was found in 58 % of samples (range of positive samples: 47- 3,347 μg/kg), fumonisin B2 in 33.0 % (range of positive samples: 23-537 μg/kg) and fumonisin B3 in 25.0 % (range of positive samples: 24-287 μg/kg) of them. This is the first report on the natural occurrence of mycotoxins in corn from Entre Ríos province, Argentina. Levels of fumonisins were lower than detected in other Argentinian provinces. PMID:23605615

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

    NASA Astrophysics Data System (ADS)

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

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

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

    PubMed Central

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

    2009-01-01

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

  20. El espectro de KX TrA entre 1990 y 1996

    NASA Astrophysics Data System (ADS)

    Brandi, E.; García, L.; Ferrer, O.; Barbá, R.

    La estrella simbiótica KX TrA = He2-177 fue observada espectroscópicamente con el telescopio de 2.15 m del CASLEO entre los años 1990 y 1996, utilizándose resoluciones intermedia y alta. El rango espectral estudiado se extiende desde 4400 Åa 7200 Å. La historia fotométrica de KX TrA presenta explosiones del mismo tipo que las mostradas por la nova lenta RR Tel y su espectro de alta excitación, muy rico en líneas de emisión, es también similar al de RR Tel. Por lo tanto, es importante analizar la evolución espectral de KX TrA en el tiempo, prestando especial atención a los posibles cambios en los niveles de excitación. Las emisiones presentes corresponden a transiciones permitidas y prohibidas con un amplio rango de ionización, incluyéndose las anchas e intensas líneas originadas por scattering Raman de O VI en λλ 6825 y 7082 Å. En el período cubierto por nuestras observaciones se estudia la variación de la intensidad relativa de las emisiones, el comportamiento de las velocidades radiales y los cambios de perfiles de las líneas, especialmente en Hα y Hβ. El contínuo de la región roja observada indica un tipo espectral no más tardío que M3 para la componente gigante fría del sistema.

  1. Does pancreatic ductal anatomy play a role in determining outcomes of pancreatic anastomoses?

    PubMed

    Shukla, P J; Sakpal, S V; Maharaj, R

    2011-02-01

    Pancreatoduodenectomy (PD) is the surgical procedure performed for cancers of the head of the pancreas. Despite a substantial reduction in mortality rates following PD, morbidity remains high secondary to major post-operative complications. Post-operative pancreatic fistula (POPF), the commonest major complication following PD, results from the failure of the pancreato-enteric anastomosis. There appears to be a correlation between intrinsic pancreatic features like the texture of the gland and duct size and the outcome of the pancreatic anastomosis. Based on current clinical research data, we propose a new hypothesis called the "pancreatic ductal anatomy" concept. We hypothesize that morphological variations, anomalies or aberrations of the main pancreatic duct play a role in the outcome of the pancreatic anastomosis, irrespective of its type. The consequence of aberrant ductal anatomy is that certain areas of the remnant pancreas remain either undrained or partially drained, or have blocked ductules/ducts. This results in localized obstructive pancreatitis causing an inflammatory reaction which jeopardizes the anastomosis. We also propose two maneuvers which could possibly play a role in predicting potential problems and also planning the surgical resection and reconstruction in order to reduce the incidence of POPF. The first modality is the use of pre-operative magnetic resonance imaging (MRI) of the pancreatic duct, and the second maneuver is the gentle cannulation test of the pancreatic duct with a soft, narrow tube following transection of the pancreatic neck. These factors would alert the surgeon about potential ductal variations and could facilitate the surgical approach.

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

    SciTech Connect

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

    1993-04-01

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

  3. Surgical repair of refractory strictures of esophagogastric anastomoses caused by leakage following esophagectomy.

    PubMed

    Kinoshita, Y; Udagawa, H; Tsutsumi, K; Ueno, M; Mine, S; Ehara, K

    2009-01-01

    Refractory strictures of esophagogastric anastomosis caused by leakage following an esophagectomy are a severe complication, for which either repeated balloon dilations or bougies are not necessarily effective. In such a case, surgical repair is quite difficult because the esophageal substitute such as the stomach or colon is usually located in the mediastinum and severely adhesive to the neighboring organs. Furthermore, in case the resected stricture is too long for direct re-anastomosis to be performed, a free jejunal graft or a new esophageal substitute should be prepared. This paper proposes a procedure for the re-reconstruction of refractory stricture in the case of a retrosternal reconstruction with a gastric conduit, which frequently employs pull-up route. The anterior plate of the manubrium was divided medially from the notch to the symphysis with the sternal saw. The manubrium is then removed, bite by bite, like breaking up rocks, with a bone rongeur forceps, starting with the anterior plate, then the posterior plate, from upper median part to the lower and lateral part of the sternum until it reaches the symphysis and the sternoclavicular and the sternocostal joints. It is safer to destroy the manubrium little by little from the anterior side so that the posterior periosteum, which is likely to adhere tightly to the gastric conduit, can be preserved. After the manubrium is almost completely resected and the posterior periosteum of the manubrium is preserved, a median longitudinal incision is carefully made on the periosteum so as not to damage the gastric conduit that may be adhesive to the periosteum. The periosteum was gradually opened bilaterally separating the periostium and the gastric conduit. Although gastroenterological surgeons may hesitate to remove the manubrium, removing the manubrium and preserving the posterior periosteum make it possible to avoid injuring the gastric conduit and to provide a wide view around the stenosis for safely resecting the anastomotic stricture. Furthermore, this procedure allows direct re-anastomosis between the cervical esophagus and the gastric conduit without a complicated reconstruction such as a free jejunal graft. This procedure is strongly recommended as an alternative option so that a second reconstruction can be performed both safely and steadily.

  4. [Proctocolectomy with ileoanal anastomoses and desmoid tumor treated with resection. One case of familial adenomatous polyposis].

    PubMed

    Villalón-López, José Sebastián; Souto-del Bosque, Rosalía; Méndez-Sashida, Pedro Gonzalo

    2014-01-01

    Introducción: la poliposis adenomatosa familiar (PAF) es una rara enfermedad causada por una mutación en el gen de la poliposis adenomatosa coli (APC). Caso clínico: mujer de 32 años, con dolor y aumento del perímetro abdominal además de evacuaciones melénicas y pérdida de peso. La paciente presentó un tumor de 12 cm de diámetro en la fosa iliaca derecha. Tras la administración de medio de contraste, en una tomografía se apreció el tumor abdominal con reforzamiento compatible con sarcoma frente a tumor desmoide. Se realizó colonoscopia, por medio de la que se encontraron pólipos en el recto y el colon. La biopsia reportó adenomas túbulo-vellosos. Una panendoscopía demostró pólipos en fondo y cuerpo gástrico; el duodeno se encontraba en estado normal. Se realizó resección del tumor en pared abdominal y reconstrucción con malla además de proctocolectomía restaurativa con un reservorio íleo-anal con una ileostomía temporal. Se reportó tumor desmoide en la pared abdominal y se identificaron 152 pólipos túbulo-vellosos que afectaban todas las porciones del colon y el recto. Conclusiones: la PAF es una enfermedad autosómica dominante causada por una mutación en el gen APC que da como resultado el desarrollo de múltiples pólipos tanto en el colon como en el recto. Descrito en 1991, el gen APC se localiza en el cromosoma 5q21. Sin cirugía profiláctica, todos los pacientes desarrollarán cáncer colorrectal en la tercera década de la vida. Los tumores desmoides y los pólipos duodenales son ahora la causa de muerte en los pacientes con PAF.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2010-01-01

    Abnormal microvascular physiology and function is common in many diseases. Numerous pathologies include hypervascularity, aberrant angiogenesis, or abnormal vascular remodeling among the characteristic features of the disease, and quantitative imaging and measurement of microvessel function can be important to increase understanding of these diseases. Several optical techniques are useful for direct imaging of microvascular function. Spectral imaging is one such technique that can be used to assess microvascular oxygen transport function with high spatial and temporal resolution in microvessel networks through measurements of hemoglobin saturation. We highlight novel observation made with our intravital microscopy spectral imaging system employed with mouse dorsal skin-fold window chambers for imaging hemoglobin saturation in microvessel networks. Specifically, we image acute oxygenation fluctuations in a tumor microvessel network, the development of arteriovenous malformations in a mouse model of hereditary hemorrhagic telangiectasia, and the formation of spontaneous and induced microvascular thromboses and occlusions. PMID:20210437

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. Servicio de Mapas en Internet para la Salud Ambiental en la Region Fronteriza Entre los Estados Unidos y Mexico

    USGS Publications Warehouse

    Buckler, Denny; Stefanov, Jim

    2004-01-01

    La region fronteriza de los Estados Unidos y Mexico abarca una gran diversidad de ambientes fisicos y habitaciones, entre los cuales estan los humedales, desiertos, pastos, montanas, y bosques. Estos a su vez son unicos en cuanto a su diversidad de recursos acuaticos minerales, y biologicos. La region se interconecta economica, politica, y socialmente debido a su herencia binacional. En 1995, cerca de 11 millones de habitantes vivian en la zona adyacente a la frontera. Un estudio sugiere que esa poblacion podria doblarse antes del ano 2020.

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

    PubMed

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

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

  12. Competition entre les phases ferromagnetique metallique et ordre de charges a l'interface de manganites a magnetoresistance colossale

    NASA Astrophysics Data System (ADS)

    Laverdiere, Jonathan

    Dans la these qui suit, l'interaction entre deux manganites a magnetoresistance colossale domines par des phases antagonistes est etudiee a l'interface de bicouches. Un manganite isolant anti-ferromagnetique presentant une phase d'ordre de charges a basse temperature et un manganite metallique domine par les interactions ferromagnetiques. L'objectif est de verifier si l'interaction entre ces deux manganites est susceptible de soit 1) affaiblir la stabilite de l'ordre de charges ou soit 2) de rendre la phase metallique plus resistive afin d'ameliorer les proprietes de magnetoresistance colossale. Deux series de bicouches ont ete preparees par depot par ablation laser pulse et analysees avec une combinaison de plusieurs methodes experimentales telles que la mesure de resistance electrique, la spectroscopie Raman, la mesure d'aimantation et la diffraction des rayons X. Dans la premiere serie de bicouches, la configuration utilisee consiste en une couche tampon ferromagnetique sur laquelle une couche de manganite a ordre de charges est deposee. Il s'est avere que la phase d'ordre de charges n'est pas destabilisee par la phase ferromagnetique metallique dans une couche d'ordre de charges aussi mince que 10 nm. Les mesures de resistance montrent que la phase isolante demeure difficile a rendre metallique sous l'application d'un champ magnetique. La spectroscopie Raman montre egar lement une phase d'ordre de charges tres stable et suggere que les contraintes mecaniques appliquees par la couche tampon sont responsables de cette stabilite, malgre la presence de la phase ferromagnetique a proximite. Dans la deuxieme serie de bicouches, la configuration utilisee consiste en une couche tampon presentant de l'ordre de charges sur laquelle une couche ferromagnetique metallique est deposee. La diminution de l'epaisseur de la couche ferromagnetique metallique se repercute sur une diminution de la temperature de Curie et de la transition metal-isolant. Entre 4 et 5 nm, la

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

  16. Natural co-occurrence of fungi and mycotoxins in poultry feeds from Entre Ríos, Argentina.

    PubMed

    Monge, M P; Dalcero, A M; Magnoli, C E; Chiacchiera, S M

    2013-01-01

    A total of 120 pelleted poultry feed samples from Entre Ríos Province, Argentina, were evaluated. The aims were to investigate (1) the presence of relevant toxigenic fungi, as well as to determine the ability to produce aflatoxins (AFs) by Aspergillus section Flavi isolated strains; and (2) the natural co-occurrence of AFs, fumonisins (FBs), gliotoxin, diacetoxyscirpenol (DAS), HT-2 and T-2 toxin by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Total fungal counts were below the established value (1 × 10⁴ CFU g⁻¹). Aspergillus flavus and A. parasiticus were the only aflatoxigenic species isolated. Co-occurrence of fumonisin B₁ (FB₁), HT-2 and T-2 toxin was detected in 100% of the feeds, with mean levels from 4502 to 5813; 6.7 to 21.6 and 19.6 to 30.3 µg kg⁻¹, respectively. A large number of starter samples were co-contaminated with aflatoxin B₁ (AFB₁), FB₁, HT-2 and T-2 toxins. Gliotoxin and DAS were not found in this survey.

  17. Análisis de la correlación espacio-temporal entre ondas EIT y ondas Moreton

    NASA Astrophysics Data System (ADS)

    Borgazzi, A.; Rovira, M.; Stenborg, G.

    Observaciones de la atmósfera solar en distintas longitudes de onda han demostrado la presencia de fenómenos ondulatorios, tanto a nivel cromosférico como coronal. En el primero de los casos a las ondas observadas se las dió por llamar ondas Moreton, mientras que en el segundo ondas EIT. En el presente trabajo se abordará el estudio de la posible relación causal entre ambos fenómenos ondulatorios. Para concretar dicha meta se hará uso de un conjunto de observaciones del disco solar en Hα (para la determinación y análisis de las ondas Moreton) y en Fe XII (para la determinación y análisis de las ondas EIT). Los observables que se midan serán luego usados para la interpretación física del fenómeno en base a modelos teóricos existentes.

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

    NASA Astrophysics Data System (ADS)

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

    2003-08-01

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

  19. HACCP models for quality control of entrée production in hospital foodservice systems. I. Development of hazard analysis critical control point models.

    PubMed

    Bobeng, B J; David, B D

    1978-11-01

    HACCP models were developed as part of a research project for quality control of entrée production in three types of hospital foodservice systems: Conventional, cook/chill, and cook/freeze. Critical control points at process stages were identified. Time-temperature was a critical control point throughout entrée production in each model; time-temperature parameters were established for critical control points. Equipment sanitation and personnel sanitation are critical control points for which standards must be established by each foodservice system. Determination of the effectiveness of control measures included continuous monitoring of critical control points for time-temperature. Sanitation of equipment and personnel should be monitored using standards established by the foodservice system.

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

    PubMed

    Haws, Kelly L; Liu, Peggy J

    2016-02-01

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

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

    PubMed

    Haws, Kelly L; Liu, Peggy J

    2016-02-01

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

  2. L’expression verbale de la douleur chez l’enfant : Comparaison intermodale entre sensation de douleur et manipulation tactile

    PubMed Central

    Bienvenu, Margaux; Jacquet, Denis; Michelutti, Marjolaine; Wood, Chantal

    2011-01-01

    HISTORIQUE: La présente étude se situe dans le contexte de l’expression verbale de la douleur chez l’enfant. Elle porte plus particulièrement sur la dimension qualitative de la sensation de douleur. OBJECTIF: Nous cherchons à repérer les particularités de l’expression verbale relativement à l’aspect qualitatif de la douleur. MÉTHODOLOGIE: La recherche a été menée auprès de 60 patients de quatre à 18 ans ressentant de la douleur, rencontrés dans un hôpital universitaire pédiatrique. Elle confirme en premier lieu l’origine des descripteurs sensoriels de la douleur, qui renvoient aux expériences perceptives passées de l’enfant, non nécessairement liées à la douleur. Ces expériences sont qualifiées de prototypiques, dans la mesure où, bien qu’elles soient liées à des contextes de vie variés, le type de rapport au monde qu’elles provoquent ne varie pas. RÉSULTATS: Dans ce cadre, le pincement, le tiraillement, le tapement, l’écrasement et l’appuiement, le picotement et le serrement constituent chacune des expériences sensorielles et motrices particulières dont la structure de base ne varie pas d’un contexte à l’autre. En second lieu, les résultats obtenus montrent que dès quatre ans, l’enfant est en mesure de comparer, puis de reconnaître une analogie entre une expérience exclusivement tactile et sa sensation de douleur. CONCLUSION: Ces résultats mettent en lumière le rôle primordial du raisonnement analogique dans l’expression verbale de la douleur, ce qui amène à affirmer que le niveau de développement cognitif de l’enfant n’est pas une variable a priori déterminante lorsqu’il s’agit de qualifier sa douleur. PMID:21766069

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

    NASA Astrophysics Data System (ADS)

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

    1993-04-01

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

  4. La différence épidémiologique des hémorragies digestives hautes entre les hommes et les femmes

    PubMed Central

    El Mekkaoui, Amine; Saâda, Kaoutar; Mellouki, Ihssane; El Yousfi, Mounia; Aqodad, Nourdin; El Abkari, Mohammed; Ibrahimi, Adil; Benajah, Dafr-Allah

    2012-01-01

    Introduction Des différences épidémiologiques, étiologique voire pronostique des hémorragies digestives hautes (HDH) entre les deux sexes opposés ont été cité par différentes études. Méthodes Nous avons essayé de déceler ces différences à travers une analyse rétrospective nichée sur une étude prospective sur les hémorragies digestives hautes ayant inclus 945 patients. Résultats Six cents trente-sept patients étaient des hommes (67,4% Vs 32,6%). Un antécédent d'HDH était trouvé chez 24,2% des cas sans différence significative entre les deux sexes. L'âge de survenue de l'hémorragie était plus élevé chez les femmes que chez les hommes : 51,5 ans ± 18,8 Vs 47,8 ans ± 18,3 (p : 0,003). Les étiologies de l'HDH étaient différentes entre les deux sexes. Alors que l'hémorragie liée à l'HTP était la première cause chez la femme (38 % Vs 23,5 % chez l'homme, p<0,0001), c'est la pathologie ulcéreuse qui venait en premier chez l'homme (62 % Vs 36,7 % chez la femme, p<0,0001). Un besoin transfusionnel était noté chez 42,4 % des patients de sexe masculin contre 35,4 % des patientes avec un p = 0,03. Le taux de récidive et de décès global étaient de 7,5 % et de 5,7 % des cas respectivement, sans différence significative entre les deux sexes. Conclusion L'étude trouve un profil épidémiologique, clinique et étiologique différent selon le sexe des patients. PMID:23077715

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

    PubMed Central

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

    2014-01-01

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

  6. HACCP models for quality control of entrée production in hospital foodservice systems. II. Quality assessment of beef loaves utilizing HACCP models.

    PubMed

    Bobeng, B J; David, B D

    1978-11-01

    HACCP models were developed for quality control of entrée production in three hospital foodservice systems: Conventional, cook/chill, and cook/freeze (1). The three systems were stimulated in a laboratory to evaluate the effectiveness of the HACCP models for quality control and to generate quantitative data for evaluating and comparing the quality of beef loaves produced under controlled conditions. Attributes measured were weight (yield) and microbiologic, nutritional, and sensory qualities. The only significant difference in the beef loaves among systems was sensory quality. Scores for overall acceptability of beef loaves in the conventional system were significantly greater (P less than 0.05) than for those of the cook/chill and cook/freeze systems. The HACCP models were effective quality control tools for entrée production; implementation of the HACCP system is recommended for hospital foodservices. The importance of the time-temperature critical point for monitoring control points in hospital foodservice systems is emphasized.

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2016-07-01

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

  9. Amorçage d'une décharge dans le vide entre deux electrodes d'argent ou des alliages argent-nickel

    NASA Astrophysics Data System (ADS)

    Zouache, N.; Lefort, A.

    1997-03-01

    Comparison of the characteristics of an electric are breakdown in vacuum between two silver or silver-nickel alloy electrodes prompted us to study the evolution of the breakdown voltage with electrode separation, with resistance value placed between the anode and the high voltage supply used for the breakdown, and with the effect of conditionning by heating in vacuum. The measurement of the commutation time and delay time, and the observations by a metallographic microscope of the electrodes surfaces after one breakdown, enabled us to evidence the origin of the electric arc for each of the studied materials. La comparaison des caractéristiques de l'amorçage d'un arc électrique dans le vide entre deux électrodes bombées de 8mm de diamètre et de rayon de courbure en surface de 16mm, constituées d'argent ou de son alliage avec le nickel, nous a amené à étudier l'évolution de la tension d'amorçage avec plusieurs paramètres : la distance inter-électrodes, les valeurs de la résistance intercalée entre la source haute tension servant au claquage et les électrodes et le conditionnement par chauffage sous vide des électrodes. La mesure du temps de commutation, du temps de retard et les observations au microscope métallographique de la surface des électrodes après un amorçage donnent des informations sur l'origine de l'arc électrique concernant chaque matériau étudié.

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

    NASA Astrophysics Data System (ADS)

    Zabot, Alexandre; Baptista, Raymundo

    2005-07-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2015-10-01

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

  13. Études dynamiques des propriétés mécaniques et électriques des contacts entre solides

    NASA Astrophysics Data System (ADS)

    Mayer, Guy; Hauchecorne, Gérard

    1996-08-01

    Dynamical methods are used to study contacts between solids. We describe some devices for exciting and measuring periodical oscillations of a small object laying against a table. For small amplitude (simeq 10^{-8} cm) of relative motion, the normal modes of oscillation are harmonic and their frequencies give the derivative of the force versus displacement. The effects of a static force on those mutual frequencies give the second derivatives. In these modes of relative motion the strain potential energy is concentrated in the small volumes (simeq 10^{12} cm3) near the contacts. They show a rather strong damping coefficient which we have measured. For larger amplitudes of motion, various non-linear effects show up. We have studied with some care sub-harmonic generation. When both solids in contact are electrically conducting the impedance modulation induced by the mechanical oscillations has been measured and brings some more information. Hertz theory has guided us. The fractional exponents we observe in the relations force versus displacement for various contacts are reasonably close to the Hertzian predictions. The effect of a magnetic field on the mutual frequencies of two solids made of ferrite (Mn, Zn) has been found too strong to be accounted for easily. Nous étudions par des méthodes dynamiques le nature des contacts entre deux solides. Nous décrivons divers dispositifs permettant de provoquer et d'observer de petites oscillations périodiques d'un objet appuyé contre une table autour de sa positions d'équilibre statique. Pour des amplitudes de mouvement relatif petites, de l'ordre de l'Angström, les modes propres d'oscillation sont harmoniques et leur fréquence donne la dérivée de la force par rapport au déplacement. L'influence d'une force statique sur cette fréquence mutuelle donne la dérivée seconde. Dans ces modes de mouvement relatif l'énergie potentielle de déformation est localisée dans les très petits volumes proches des contacts

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Azevedo Sobreira, Paulo Henrique

    2012-12-01

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

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

    Paquette, Daniel; Reinharz, Daniel

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Samson, Ghislain

    2003-06-01

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

  19. 1.9-μm diode-laser-assisted anastomoses (LAMA) in reconstructive microsurgery: results of the preliminary clinical study

    NASA Astrophysics Data System (ADS)

    Mordon, Serge R.; Schoofs, Michel; Martinot, Veronique L.; Capon, Alexandre; Buys, Bruno; Patenotre, Philippe; Pellerin, P. N.

    2001-05-01

    The authors report an original 1.9-micrometers diode laser assisted microvascular anastomosis (LAMA) in human. This technique has been applied in 20 patients during reconstructive surgery for digital replantations (nequals6), for digital revascularizations (nequals4) and for free flap transfers (nequals10). LAMA were always performed on vessel (16 arteries and 6 veins) which did not impede the chance of success of the surgical procedure in case of thrombosis. LAMA was performed with a 1.9-micrometers diode laser after placement of 2 equidistant stitches at 180 degrees. The diode spot was obtained by means of a 300-micrometers optic fiber transmitted to the vessel wall via a pencil size hand piece. The following parameters were used: spot size equals 500 micrometers , power equals 70 to 220 mW, pulse duration equals 0.7 to 3 seconds. Ten to 15 spots were applied on each face. The mechanism involved is a thermal effect on the collagen of the adventitia and media leading to a phenomenon which the authors have termed 'heliofusion'. Immediate assessment consisted in evaluating the permeability by patency test (O'Brien) and water tightness. Secondary assessment consisted in evaluating the clinical success, confirmed by Doppler at one month.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Brenes-Camacho, Gilbert

    2014-01-01

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

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

    PubMed

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

    2011-03-01

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

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

    NASA Astrophysics Data System (ADS)

    Roig, F.; Beaugé, C.

    2003-08-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2011-03-01

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

  6. Traces de l'interaction entre galaxies

    NASA Astrophysics Data System (ADS)

    Duc, Pierre-Alain

    2016-08-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2006-08-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  10. [Evaluation of the right internal iliac artery which is anastomosed to transplant renal artery using non-contrast enhanced MR angiography with electrocardiography-gated and 3D True SSFP time-spatial labeling inversion pulse sequence].

    PubMed

    Yoshida, Ayako; Shiratori, Yoko; Suzuki, Makoto; Ozasa, Masaya; Takeyama, Mamoru; Eshima, Mitsuhiro; Shinohara, Maiko; Yamamoto, Takao; Tajima, Tsuyoshi

    2015-05-01

    To evaluate whether electrocardiography-gated is useful in non-contrast-enhanced MRA with time-spatial labeling inversion pulse (Time-SLIP) in renal transplantation patients compared with respiration-triggered free-breathing. Simulation-based analyses of black blood time interval (BBTI) values for spatial selective inversion-recovery pulse and electrocardiography rates were performed, and confirmed on human subjects using a three-dimensional (3D) coherent steady-state free precession (SSFP) sequence on a 1.5 tesla Toshiba MRI scanner. Signal acquisition interval and BBTI values in which signal of a water tissue becomes the null point showed a strong correlation, and successfully suppressed signals from the background and provided better contrast between the arteries and the background. Because electrocardiography-gated non-contrast MRA does not depend on the respiration interval, providing a contrast stable, it was suggested to be an effective screening tool for evaluation of pelvic arteries.

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

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  12. A Astronomia no Ensino Superior Brasileiro entre 1808 e 1889

    NASA Astrophysics Data System (ADS)

    Bretones, Paulo S.; Videira, Antonio A. P.

    2003-05-01

    Este artigo apresenta os principais eventos ocorridos na história do ensino de astronomia nos cursos superiores que existiram no Brasil desde a chegada da Família Real portuguesa em 1808 até o final do período monárquico. Para compor esse esboço histórico, utilizamos, principalmente, livros didáticos, regulamentos, decretos e leis responsáveis pelas organizações dos conteúdos oferecidos e das carreiras dos responsáveis pela disciplina. Na análise do material empregado, investigamos a presença de concepções filosóficas e científicas, que podem ter norteado os conteúdos disciplinares. Não realizamos nenhuma comparação com o ensino de astronomia em outros países. Concluímos mostrando que o estudo de astronomia, durante o período monárquico, foi mais direcionado para a formação d engenheiros do que astrônomos. Gostaríamos de observar que o presente artigo não tem a pretensão de abordar o assunto de maneira completa e detalhada.

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

    PubMed Central

    Charbonneau, Annie

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Endoscopic Evaluation and Management of the Postoperative Crohn's Disease Patient.

    PubMed

    Hashash, Jana G; Binion, David G

    2016-10-01

    Approximately 70% of patients with Crohn's disease (CD) undergo surgical resection for the treatment of medically refractory disease or its complications. The sickest cohort of CD patients experience rapid postoperative relapse at the anastomotic site. Over the past 2 decades, the types of surgical anastomoses used in CD reconstruction have changed; end-to-side and end-to-end anastomoses have been surpassed by the more rapidly created side-to-side anastomoses. This article provides a review of the timing and purpose of endoscopic evaluation in postoperative CD patients and pragmatic information regarding interpretation of endoscopic findings at the different types of surgical anastomoses after ileocecal resection. PMID:27633596

  16. [Micro-organism translocation and acute anastomosis inflammation after stomach resection].

    PubMed

    Gulov, M K; Kurbonov, K M

    2003-10-01

    The results of examination of 42 patients with an acute anastomositis after performance of gastric resection were analyzed. Clinical classification was elaborated for detailed interpretation of the anastomosits diagnosis and choice of therapy. Close correlative inter-relatioship between severity of anastomositis and degree of gastric mucosa colonization by micro-organisms was established basing on analysis of the laboratory and bacteriological investigations results.

  17. Entre Reproduction et Mobilisation: les Rapports de Genre EN Formation Continue EN France et AU Canada

    NASA Astrophysics Data System (ADS)

    Fourner, Christine; Béret, Pierre; Doray, Pierre; Bélanger, Paul

    2009-01-01

    REPRODUCTION OR MOBILISATION? GENDER PROPORTIONS IN CONTINUING EDUCATION IN FRANCE AND CANADA - Initial education provisions for women have evolved greatly over the past 40 years. But what about their situation within adult education and training? This article, comparing Canada and France, shows that, while it is well known that more women than men participate in adult education, their greater presence in professional training courses is a new development. The analysis highlights certain particular findings, such as the growing demand for continuing education in Canada and the increased rate of participation by full-time employees in France. In both countries, a number of social factors continue to influence women's participation.

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

    ERIC Educational Resources Information Center

    Rodriguez, Tracy

    2009-01-01

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

  19. Calculs Numeriques des Interactions Entre les Champs Electromagnetiques et les Tissus Biologiques

    NASA Astrophysics Data System (ADS)

    Mokhtech, Kamel-Eddine

    The understanding of electromagnetic field effects on health is a very acute problem nowadays. Indeed, the daily landscape is invaded by waves generated by affordable state-of-the-art equipment. It becomes urgent to improve the knowledge in order to ensure the safety of the users and the general public. At high frequencies two areas of concern can be distinguished: cellular telephony and wireless indoor communications. This dissertation is devoted to two aspects of the research in this field i.e. the numerical dosimetry and the biological experimentation. A new formulation for an expanding grid algorithm based upon the FDTD that can be applied, in particular, at high frequencies is presented. The energy deposition and the associated temperature rise in a model of the human eye due to a resonant dipole at frequencies of 840, 915, 1500 and 1800 MHz are then calculated. The duty cycle of each system is then introduced and its impact on temperature elevation is examined. Finally, a methodological approach to standard setting for portable transceivers is proposed. On the experimental aspect, a protocol has been elaborated and an experimentation to study athermal effects of electromagnetic fields at 9.3 GHz has been carried out. In particular, the importance of polarization has been examined.

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

    ERIC Educational Resources Information Center

    Ueberschlag, Roger

    1994-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Perdomo, R.

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

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

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

    ERIC Educational Resources Information Center

    Bacallao, Martica L.; Smokowski, Paul R.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Veglio, Ana M.

    1993-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

  7. Los Pactos entre Padres y Maestros (Teacher-Parent Partnerships). ERIC Digest.

    ERIC Educational Resources Information Center

    Swick, Kevin J.

    Research provides insight into parent attributes that support partnerships with teachers. These attributes include warmth, sensitivity, nurturance, the ability to listen, consistency, positive self-image, personal competence, and effective interpersonal skills. Researchers have cited positive attitudes, continuous teacher training, involvement in…

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

    NASA Astrophysics Data System (ADS)

    Balegamire, Bazilashe Juvénal

    1996-11-01

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

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

    ERIC Educational Resources Information Center

    Schiefelbein, Ernesto

    1972-01-01

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

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

    PubMed

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

    2014-07-01

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

  11. [Use of fibrin glue in gynecologic operations].

    PubMed

    Kulakov, V I; Gigauri, V S; Kulakov, V I; Gigauri, V S; Adamian, L V; Zhidkov, I L; Mynbaev, O A

    1990-11-01

    Anastomosing of the uterine horns in 98 experimental rats has employed a fibrin glue FK-1 (USSR) and Beriplast (FRG) or microsurgical techniques in a control group. Intactness and sealing of the anastomoses and the incidence of pelvic adhesions were assessed at 5 minutes, 1 hour and 1, 2, 3, 4, 5, and 6 days following the operation. The fibrin glue Beriplast was used clinically in 6 patients during reconstructive-plastic operations. The results with seamless anastomosing of uterine horns in rats using the fibrin glue and preliminary clinical evidence suggests a high effectiveness of the glue in gynecologic reconstructive plastic surgery.

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

    SciTech Connect

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

    1987-07-01

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

  13. Un modèle animal simple pour l’apprentissage des techniques de microanastomoses vasculaires de congruences différentes

    PubMed Central

    Leclère, Franck Marie P; Kolb, Frédéric; Lewbart, Gregory A; Casoli, Vincent; Vögelin, Esther

    2014-01-01

    INTRODUCTION: Depuis les premiers travaux de Jacobson et Suarez, la microchirurgie a considérablement évolué et celle-ci est devenue omniprésente en chirurgie plastique comme dans les autres spécialités chirurgicales. L’apprentissage au laboratoire des techniques de base est nécessaire avant d’envisager l’exécution de procédures cliniques. Dans cet article, nous avons évalué un modèle animal permettant de fournir une solution aux problèmes suivants : règles d’éthique, coût, anesthésie, temps nécessaire à la formation. MATÉRIEL ET MÉTHODE: Entre juillet et septembre 2012, 150 simulations de microanastomoses de vaisseaux incongruents par la technique d’Harashina ont été réalisées sur 182 Lumbricus terrestris. L’entrainement a été divisé en 10 périodes de 7 jours comprenant chacune 15 simulations de microanastomoses de vaisseaux incongruents, dont le plus petit diamètre était supérieur à 1,5 mm (n = 5), compris entre 1,0 mm et 1,5 mm (n = 5), ou inférieur à 1,0 mm (n = 5). Un modèle linéaire avec le numéro de la période comme variable principale et la taille de l’animal comme facteur étaient utilisés afin de déterminer la tendance de la durée d’exécution de l’exercice microchirurgical ainsi que les différences entre les sous-groupes de tailles différentes au cours des périodes d’apprentissages. RÉSULTATS: Le modèle linéaire montre une tendance significative (P < 0,001) à la réduction du temps opératoire durant le décours du training ainsi qu’une différence significative entre les groupes d’animaux de tailles différentes. Pour les microanastomoses de taille supérieure à 1,5 mm, le temps d’anastomose moyen est passé de 19,6±1,9 min à 12,6±0,7 min entre la première et la dernière semaine de formation (diminution de 35,7 %). Pour un training avec des vaisseaux de diamètre inférieur, les résultats montraient une diminution dans le temps d’exécution de 36,1 % (diamètre compris

  14. Experimental laser anastomosis of the large bowel: conclusive results and future prospect

    NASA Astrophysics Data System (ADS)

    Kawahara, Masaki; Kuramoto, Shu; Ryan, Peter

    2003-06-01

    Completely sutureless end-to-end large bowel anastomoses were successfully performed in New Zealand white rabbits by using 1064 nm, 0.4-W power pulsating Nd:YAG laser to produce welding. Purpose: The aim of this study was to assess the results of our whole experimental data and summarize our experimental work on laser colon anastomosis. Methods: This experimental study investigated integrity of anastomosis, degree of narrowing, macroscopic appearance, microscopic findings, animal body weight change, and collagen concentration of laser colon anastomoses, compared with those of conventional sutured anastomoses up to ninety postoperative days. Results: Bursting pressures of laser anastomoses were at first low and came to be equivalent at seven days, but the laser group exhibited a consistent narrowing tendency. However, laser anastomoses demonstrated fewer and milder adhesions, and animals showed a better recovery of body weight. Histologically, laser anastomoses showed better layer-to-layer reconstitution without foreign body response and with less fibrosis. Difference in collagen concentration did not reach statistical significance. Conclusion: The technique of laser anastomosis presents a promising alternative to suturing in reconstitution of the large bowel.

  15. Experience with the biofragmentable anastomotic ring (BAR) in bowel preoperatively irradiated with 6000 rad

    SciTech Connect

    Croston, J.K.; Jacobs, D.M.; Kelly, P.H.; Feeney, D.A.; Johnston, G.R.; Strom, R.L.; Bubrick, M.P. )

    1990-03-01

    Previous studies from the authors' laboratory using the biodegradable anastomotic ring (BAR) have demonstrated the safety of this device in animals irradiated preoperatively with the equivalent of 5000 rad; sutured, stapled, and BAR anastomoses all had leak rates of 10 percent or less in this setting. This study was undertaken to assess the safety of the BAR after irradiation with the equivalent of 6000 rad. Thirteen mongrel dogs underwent preoperative irradiation to the rectum and rectosigmoid, receiving 6000 rad according to the nominal standard dose equation. After a three-week rest period, each dog underwent anterior resection of the rectosigmoid and anastomosis with the BAR. The anastomoses were evaluated for early and late healing and anastomotic leaks. The results were compared with previous data from the authors' laboratory using an identical model. Radiographic leaks were found in 7 of 10 sutured anastomoses, 8 of 10 stapled anastomoses, and 3 of 13 BAR anastomoses (P less than 0.01). Comparative clinical leaks were 5 of 10 for sutured, 5 of 10 for stapled, and 3 of 13 for BAR anastomoses. These data suggest that the BAR may offer added safety to an anastomosis after preoperative irradiation. Whether this effect is due to the atraumatic technique of placing the device, improved blood flow to the anastomotic margins, or other factors, is still underdetermined.

  16. A new mechanical device for circular compression anastomosis. Preliminary results of animal and clinical experimentation.

    PubMed Central

    Rosati, R; Rebuffat, C; Pezzuoli, G

    1988-01-01

    The authors report the preliminary results obtained in animal and clinical experimentation of a new mechanical device for circular anastomosis which they have developed. It is a gun that places an apparatus consisting of three polypropylene rings that, through the compression among them of the severed edges of the bowel, realize a sutureless anastomosis and are spontaneously evacuated. Fifty-eight colonic anastomoses were performed in dogs with this device; 23 stapled colonic anastomoses were also executed concurrently. Forty-four animals underwent a relaparotomy to remove the colonic specimen containing the anastomoses. Bursting pressure and the histologic features of the anastomoses were evaluated at different time intervals after operation. A good healing of all compression anastomoses was observed, thereby allowing them to initiate the experience in humans. Thirteen anastomoses (6 colorectal extraperitoneal, 1 colorectal intraperitoneal, 5 colocolonic, 1 ileorectal) were performed at the 1st Surgical Department, Milan University. One subclinical leakage (7.7%) spontaneously healed in a few days. No stenoses were observed. Images Fig. 1. Fig. 2., Fig. 4., Fig. 6. Fig. 3., Fig. 5., Fig. 7. Fig. 8. Fig. 9. PMID:3345111

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

    PubMed Central

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

    2015-01-01

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

  18. Lien analytique entre les systèmes de référence géocentriques relativistes.

    NASA Astrophysics Data System (ADS)

    Moisson, X.

    The general relativity theory is of practicle importance in astronomy. For instance, it does introduce new reference systems, the hierarchie of which has been elaborated for the barycentric, geocentric and topocentric levels. Four dimensional transformations are performed between these levels. This paper is devoted to the computation of the geometrical link between the dynamically and kinematically non-rotating reference systems (DGRS and KGRS respectively) based on the expression of the three dynamical Euler angles. The differences between the rotation vector of the International Terrestrial Reference system, as seen in DGRS and KGRS is investigated.

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

    ERIC Educational Resources Information Center

    Bailleul, Marc; Bodergat, Jean-Yves

    2001-01-01

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

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

    Cancer.gov

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

  1. Pertes de charge des fluides non newtoniens thermodependants en écoulement entre deux plaques parallèles

    NASA Astrophysics Data System (ADS)

    Nguyen, Van Tuan; Lebouche, Michel

    2007-01-01

    In this Note, the pressure drop of non-Newtonian thermodependent fluids flowing between two parallel plates is considered. The effects of different parameters on the evolution of local friction factor are numerically investigated in two heating cases and correlations are proposed to compute the pressure drop. To cite this article: V.T. Nguyen, M. Lebouche, C. R. Mecanique 335 (2007).

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

    ERIC Educational Resources Information Center

    Zenone, Anna

    1981-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

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

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

    ERIC Educational Resources Information Center

    Pellus Perez, Elena

    2012-01-01

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

  5. Relación entre distribuciones de colisiones de baja energía y trayectorias de escape

    NASA Astrophysics Data System (ADS)

    Zoppetti, F. A.; Leiva, A. M.; Briozzo, C. B.

    In the restricted three-body problem; the impact distributions on the secondary mass originated by low-energy trajectories exhibit peculiar properties concerning the positions and directions of the impacts. In particular; for low energies there are regions on the surface of the secondary mass where no collisions happen. On the other hand; similar surface distributions can be obtained when only considering those test particles whose low-energy trajectories satisfy the escape condition. In this work; taking into account the Earth-Moon problem; we analyze the relations between these two distributions and discuss their possible applications. FULL TEXT IN SPANISH

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

    NASA Astrophysics Data System (ADS)

    Le Guet Tully, Francoise

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

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

    PubMed

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

    2008-01-01

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

  8. Entre le zero et l'infini...l'environnement (Between Zero and the Infinite...the Environment).

    ERIC Educational Resources Information Center

    Cortes, Jacques

    1982-01-01

    Envisages the environment as that which surrounds, conditions, opposes, and allows one to understand, identify, and attain a series of objectives. The relationship of this understanding of environment to second language learning is explored, with particular emphasis on recent methodologies that see language as a culture's mode of expression. (AMH)

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

    NASA Astrophysics Data System (ADS)

    Boulais, Etienne

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

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

    PubMed Central

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

    2015-01-01

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

  11. Supra and infralevator neurovascular pathways to the penile corpora cavernosa

    PubMed Central

    BENOIT, G.; DROUPY, S.; QUILLARD, J.; PARADIS, V.; GIULIANO, F.

    1999-01-01

    The aim of this study was to provide a comprehensive description of both penile innervation and vascularisation. Eighty-five male cadavers were examined through gross and microscopic anatomical analysis. The pelvic nerve plexus had both parasympathetic and sympathetic roots. It was distributed to the external urethral sphincter giving rise to cavernous nerves which anastomosed in 70% of the cases with the pudendal nerve in the penile root. Accessory pudendal arteries were present in the pelvis in 70% of the cases, anastomosing in 70% of the cases with the cavernous arteries that originated from the pudendal arteries. Transalbugineal anastomoses were always seen between the cavernous artery and the spongiosal arterial network. There were 2 venous pathways, 1 in the pelvis and 1 in the perineum with a common origin from the deep dorsal penile vein. It is concluded that there are 2 neurovascular pathways destined for the penis that are topographically distinct. One is located in the pelvis and the other in the perineum. We were unable to determine the functional balance between these 2 anastomosing pathways but experimental data have shown that they are both involved in penile erection. These 2 neurovascular pathways, above and below the levator ani, together with their anastomoses, form a neurovascular loop around the levator ani. PMID:10634698

  12. Experience with the use of the circular stapler in rectal surgery.

    PubMed

    Kyzer, S; Gordon, P H

    1992-07-01

    This report provides our personal experience along with a general overview of the use of the circular stapler in rectal surgery. To determine the results of our experience with the use of the circular stapler for construction of anastomoses following resection, a series of 215 anastomoses performed in 214 patients was reviewed. The patients ranged in age from 33 to 88 years. There were 116 men and 98 women. Indications for operation included malignancy, diverticular disease, villous adenoma, Crohn's disease, and rectal procidentia. The types of operation performed included removal of varying portions of the large bowel. The anastomosis was performed in a uniform manner with the EEA (United States Surgical Corp., Norwalk, CT) and more recently the CEEA (United States Surgical Corp., Norwalk, CT). The operative mortality was 0.47 percent, with the death being unrelated to the anastomosis. Intraoperative complications encountered included bleeding, difficult extraction, instrument failure, incomplete doughnuts, deficient anastomoses, and miscellaneous problems. Early postoperative complications included one leak and a number of complications unrelated to the anastomoses. Anastomotic stenosis developed in 27 patients, but only 8 were permanent and only 3 of these were symptomatic. Two of these patients were treated with balloon dilatation. Anastomotic recurrences developed in 13.1 percent of patients. Our experience gained with the circular stapling device and that reported in the literature have shown it to be a reliable method of performing anastomoses to the rectum in a safe and expeditious manner. PMID:1611960

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

    PubMed Central

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

    2010-01-01

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

  14. [Anatomic orthotopic heart transplantation: the surgical characteristics and the advantages of the method].

    PubMed

    Dzemeshkevich, S L; Ivanov, A S; Rykunov, I E; Kuznetsova, L M; Trekova, N A; Poplavskiĭ, I V; Belous, A E; Zhidkov, I L; Koseros, Kh; Eremenko, A A; Chaus, N I

    1998-01-01

    Standard technique of establishment of interatrial anastomoses allows to carry out orthotopic transplantation of the heart quickly and reliably. However the accumulation of collective experience evidences about a number of unavoidable shortcomings of such operation: rhythm disturbances, worsening of hemodynamics in discordant atrial contractions of recipient and donor, atrio-ventricular valve insufficiency, thromboembolism, coronary fistulas. Since 1990 in RRCS 25 operations were carried out with the use of standard technique and we also met with the risk of developing the above complications. In experiment on 30 mongrel dogs the technique of anatomical, truly orthotopic transplantation of the heart with six anastomoses was developed: left pulmonary veins with a common cuff, separate anastomoses of the superior and inferior caval veins, anastomoses of aorta and pulmonary artery. Particular attention was paid to developing of original surgical modes for prophylaxis of stenoses in the area of anastomoses of pulmonary and caval veins. In 1997 the anatomical technique of heart transplantation was successfully introduced by us into clinical practice. Clinical electrophysiological, echocardiographic and functional examinations have confirmed the results of the experiments and have evidenced for substantial advantages of the anatomical technique of orthotopic transplantation of the heart. By reliability the new operation is not inferior to standard method of N. Shumway.

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

    PubMed Central

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

    2015-01-01

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

  16. Anatomy of diaphragmatic circulation.

    PubMed

    Comtois, A; Gorczyca, W; Grassino, A

    1987-01-01

    The diaphragmatic circulation was studied in 48 mongrel dogs weighing 10-35 kg by injecting acrylic coloring into the arteries and veins of the diaphragm. The phrenic arteries and internal mammary arteries were found to anastomose head to head, forming an internal arterial circle around the medial leaflet of the diaphragm tendon. This arterial circle emitted vascular branches that traveled between muscle fibers toward the periphery of the diaphragm. These branches anastomosed with vessels of the intercostal arteries to form costophrenic arcades all along the fibers of the crural and costal diaphragms. The intercostal arteries were anastomosed to one another by small vessels within the muscular diaphragm, thus forming an arterial ring around the insertions of the diaphragm on the ribs. The venous drainage has an anatomic distribution similar to that observed on the arterial side, but with the additional presence of valves that could play a role in directing blood flow.

  17. A catheter-based suture-free approach to bilioenteric anastomosis: a pilot study.

    PubMed

    Seal, John B; Stern, Jordan R; Vanha, Thuong; Alverdy, John C; Testa, Giuliano

    2013-04-01

    Bilioenteric anastomoses are commonly performed during liver transplantation, reconstruction following tumor resection, and repair of bile duct injury. Ischemia plays an important role in both short- and long-term complications related to biliary anastomoses. The authors describe a catheter-based, suture-free approach to bilioenteric anastomosis that aims to reduce or eliminate tissue trauma and foreign material that contribute to anastomotic ischemia. The device uses a novel "umbrella" anchoring mechanism to approximate bowel to the transected bile duct over a percutaneously placed transhepatic catheter. The authors performed an open choledochojejunostomy using the device in 7 pigs. The anastomosis was assessed with cholangiography, gross inspection, and histology at the time of necropsy. The procedure was well tolerated, with no evidence of anastomotic leak in any of the study animals. This alternative catheter-based approach to bilioenteric anastomoses is safe and effective, offers potential advantages over traditional approaches, and can be easily adapted to a minimal access surgery.

  18. Sutureless end-to-end ureteral anastomosis using a new albumin stent and diode laser

    NASA Astrophysics Data System (ADS)

    Xie, Hua; Shaffer, Brian S.; Prahl, Scott A.; Gregory, Kenton W.

    1999-09-01

    Sutureless end to end ureteral anastomoses was successfully constructed in acute and chronic experiments. A photothermal sensitive hydrolyzable (PSH) albumin stent played roles as solder and intraluminal supporter to adhesion and position the anastomosed ureter by end to end fashion. The anastomosis seam was lased with 810 nm diode laser energy supplied through hand- held 600 micrometers noncontact optical fiber. A continuous 1 watt wave of power was applied for laser anastomosis. Integrity, welding strength, bursting pressures of anastomosis and histological reaction, and radiological phenomena were compared to those of anastomoses constructed using a liquidity soldering technique. The acute results of two methods were equivalent at welding strengths, but the liquid soldering showed more energy consumption. At chronic study, the radiological and histological studies were performed to evaluate the complications of the anastomosis. Excellent heating and varied degrees of complications were observed. We conclude that PSH stent showed great promise for ureteral anastomosis using laser welding.

  19. Unequal but monozygous: a history of twin-twin transfusion syndrome.

    PubMed

    Obladen, Michael

    2010-03-01

    Twin-twin transfusion is the major cause of mortality and morbidity in monochorionic twins. Its pathogenesis has been gradually elucidated over the last three centuries. Among obstetricians, there was a long-lasting controversy on the existence of placental anastomoses and whether or not to tie the placental end of the firstborn infant's cord. However, a twin pregnancy practically never could be excluded. Stalpart van der Wiel described a twin-twin vessel connection in 1687. Studies on interfetal anastomoses using injection of placental vessels were published by Smellie in 1752, Osiander in 1781, and Brachet in 1821. Different types of anastomoses, and their associated fetal disorders were classified by Schatz in a series of papers at the end of the 19(th) century. With the advent of ultrasound and laser techniques, prenatal diagnosis and treatment became available in the last decade of the 20(th) century.

  20. [Intraoperative graft assessment using fluorescent imaging system (SPY)].

    PubMed

    Kawashima, T; Naraoka, S; Kakizaki, T

    2009-07-01

    We investigated the efficacy of intraoperative fluorescent imaging system for the assessment of coronary artery bypass grafting (CABG). We used SPY imaging system in 100 CABG (57 off-pump and 43 on-pump CABG), totalling 287 distal anastomoses. The total graft patency rate on postoperative angiography in this series was 96.2% (276/287). Graft revision was done in 10 cases (10.0%) and 13 anastomoses (4.5%) by SPY imaging, which all resulted in good patency at postoperative angiography. On the other hand, 7 distal anastomoses and 1 mammary graft (2.8%) appeared to be successful on intraoperative SPY imaging, but were revealed to be occluded by postoperative angiography. SPY imaging system is useful for graft validation, and may contribute to improvement of coronary bypass graft patency.

  1. Placental characteristics of monochorionic diamniotic twin pregnancies in relation to perinatal outcome.

    PubMed

    Hack, K E A; Nikkels, P G J; Koopman-Esseboom, C; Derks, J B; Elias, S G; van Gemert, M J C; Visser, G H A

    2008-11-01

    To study placental characteristics in relation to perinatal outcome in 150 pairs of monochorionic diamniotic (MCDA) twins. Between January 1998 and January 2007 150 pairs of MCDA twins were delivered in the University Medical Center, Utrecht, The Netherlands. Mortality, neonatal morbidity and birth weight discordancy were studied in relation to type of anastomoses, type and distance between cord insertions and placental sharing. From 14 weeks onwards, there were 45 (15.0%) perinatal deaths. We found no clear relationship between perinatal mortality and type of anastomoses, distance between cord insertions and placental sharing. Perinatal mortality was significantly increased in the presence of velamentous cord insertion (OR 3.65, 95% CI 1.83-7.28). Data concerning neonatal morbidity were similar. TTTS occurred predominantly in the presence of AV-anastomoses without compensating superficial AA-anastomoses (p=0.005) and occurred more frequently in the presence of velamentous cord insertion (OR 1.79, 95% CI 0.94-3.44). Twins with unequal shared placentas had significantly more often severe birth weight discordancy, although only in the presence of AA-anastomoses (OR 4.09, 95% CI 1.74-9.63). If AA-anastomoses were absent in the unequally shared placenta, there was no relation between severe birth weight discordancy and unequal sharing of the placenta (OR 1.06, 95% CI 0.08-13.52). In MCDA twins, placental characteristics determine perinatal outcome, occurrence of TTTS and fetal growth. Prenatal identification of these characteristics by ultrasound may alter counselling and intensity of pregnancy surveillance.

  2. Evaluation of microvascular anastomosis using real-time ultrahigh resolution Fourier domain Doppler optical coherence tomography

    PubMed Central

    Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Mao, Qi; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

    2014-01-01

    Background Evolution and improvements in microsurgical techniques and tools have paved the way for super-microsurgical anastomoses with vessel diameters often approaching below 0.8 mm in the clinical realm and even smaller (0.2–0.3 mm) in murine models. Several imaging and monitoring devices have been introduced for post-operative monitoring but intra-operative guidance, assessment and predictability have remained limited to binocular optical microscope and surgeon’s experience. We present a high-resolution real time 3D imaging modality for intra-operative evaluation of luminal narrowing, thrombus formation and flow alterations. Methods An imaging modality that provides immediate, in-depth high resolution 3D structure view and flow information of the anastomosed site called phase resolved Doppler optical coherence tomography (PRDOCT) was developed. 22 mouse femoral artery anastomoses and 17 mouse venous anastomoses were performed and evaluated with PRDOCT. Flow status, vessel inner lumen 3D structure, and early thrombus detection were analyzed based on PRDOCT imaging results. Initial PRDOCT based predictions were correlated with actual long term surgical outcomes. Eventually four cases of mouse orthotopic limb transplantation were carried out and PRDOCT predicted long term patency were confirmed by actual results. Results PRDOCT was able to provide high-resolution 3D visualization of the vessel flow status and vessel inner lumen. The assessments based on PRDOCT visualization shows a 92% sensitivity and 90% specificity for arterial anastomoses and 90% sensitivity and 86% specificity for venous anastomoses. Conclusions PRDOCT is an effective evaluation tool for microvascular anastomosis. It can predict the long term vessel patency with high sensitivity and specificity. PMID:25811583

  3. The vascular pattern and viability of microvascularized rib grafts based on periosteal circulation--an experimental study

    SciTech Connect

    Papanastasiou, V.W.; Lalonde, D.H.; Williams, H.B.

    1984-11-01

    Previous reports have stressed the importance of the nutrient blood supply in rib grafts transferred by microvascular anastomoses. In the present experimental study, we have demonstrated that a rib graft transferred by microvascular anastomoses based on periosteal vessels can survive; vascular clearing studies demonstrated that the vascularity of these grafts extends not only into the cortex but the medulla as well. The relative facility of harvesting these grafts (compared with those based on nutrient vessels) should make them the favored choice. Technetium bone scintigraphy proved accurate in the assessment of both vascular pattern and microanastomotic patency. Tetracycline labeling did not correlate well with the patency of a rib graft's pedicle blood supply.

  4. Collateral Pathways in Portal Hypertension

    PubMed Central

    Sharma, Malay; Rameshbabu, Chittapuram S.

    2012-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Sloboda, Zili; David, Susan L.

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Serafin, Ana Gil; Thompson, Eugene W.

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    ERIC Educational Resources Information Center

    Gajo, Laurent; Matthey, Marinette

    1998-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2003-08-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

  15. Relations structurales entre U 3O 8 et quelques fluorures mixtes de formules M2M' 3F 11, MM' 2F 7 et MM' 3F 10

    NASA Astrophysics Data System (ADS)

    Aléonard, S.; Le Fur, Y.; Champarnaud-Mesjard, J. C.; Frit, B.; Roux, M. Th.

    1983-01-01

    U 3O 8 oxide, as well as M2M' 3F 11, MM' 2F 7 and MM' 3F 10 fluorides, with M = Rb, Tl, Cs, NH 4 and M' = In, Lu, Yb, Tm, is described as the regular repetition according to the … A-A-A … sequence of identical and parallel sheets of edge-and corner-sharing M'F 7 or UO 7 pentagonal bipyramids and M'F 6 octahedra. M' and U atoms are systematically located at the lattice points of a pseudohexagonal network, but in the fluorides some of these lattice points are vacant, producing hexagonal tunnels in which M atoms are located. It is shown that in the two kinds of compounds the same linear chains and M' 3X17 groups of pentagonal bipyramids are present, and that the transformation of the U 3O 8 structure into the fluorides can be achieved by an ordered substitution of some linear … UOUO … chains by … M- M- M … chains. All these structures can be described with the same structural model based on the chemical twinning principle.

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

    ERIC Educational Resources Information Center

    Boethel, Martha

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    NASA Astrophysics Data System (ADS)

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

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

  19. Une experience de collaboration entre la BBC et des etablissements d'enseignement superieur britanniques (Collaboration Experiences between BBC and Some British Higher Education Institutions).

    ERIC Educational Resources Information Center

    Hill, Brian

    1980-01-01

    Describes the BBC French language program and the activities that have resulted from BBC's collaboration with institutions such as the Brighton Polytechnic. These activites include the organization of intensive courses, the publication of instructional materials for teachers, and the development of correspondence studies. (MES)

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

    PubMed Central

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

    2009-01-01

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

  1. Prevalence of high-risk egg-preparation practices in restaurants that prepare breakfast egg entrées: an EHS-Net study.

    PubMed

    Lee, Robin; Beatty, Mark E; Bogard, April K; Esko, Michael-Peter; Angulo, Frederick J; Selman, Carol

    2004-07-01

    Salmonella enterica serotype Enteritidis (SE) is a common cause of foodborne illness in the United States. Foods prepared with raw shell eggs have often been associated with SE outbreaks. The federal government published the Egg Safety Action Plan in December 1999 that called for reduction of egg-preparation practices that may contribute to the survival and proliferation of SE. In seven states, an interview and brief site evaluation of 153 restaurants that prepare eggs during all hours of operation was conducted by the Environmental Health Specialists Network to determine the prevalence of such practices. Fifty-four percent (83 of 153) of restaurants pooled raw shell eggs not intended for immediate service. These pooled eggs were held a median of 4 h for scrambled eggs, 5.5 h for omelets, and 6 h for pancakes and French toast. Nearly 26% (39 of 152) of restaurants reported storing eggs at room temperature, and 5% (7 of 152) stored eggs on ice or in cold-water baths before cooking. Generally, eggs were cooked to 72 to 83 degrees C, which is above the recommended final cook temperature of 63 to 68 degrees C. Employees reported sanitizing utensils used to prepare eggs less than once every 4 h in 42% (57 of 136) of restaurants. Several areas were identified in which further emphasis might reduce egg-associated SE infections in accordance with Healthy People 2010 goals.

  2. Evidence supporting a promotora-delivered entertainment education intervention for improving mothers' dietary intake: the Entre Familia: Reflejos de Salud Study.

    PubMed

    Ayala, Guadalupe X; Ibarra, Leticia; Horton, Lucy; Arredondo, Elva M; Slymen, Donald J; Engelberg, Moshe; Rock, Cheryl L; Hernandez, Erika; Parada, Humberto; Elder, John P

    2015-01-01

    Entertainment education and the promotora model are 2 evidence-based health communication strategies. This study examined their combined effect on promoting healthy eating among mothers in a family-based intervention. Participants were 361 Mexican-origin families living in Imperial County, California, who were randomly assigned to an intervention or delayed treatment condition. The intervention involved promotoras (community health workers) who delivered 11 home visits and 4 telephone calls. Home visits included a 12-minute episode of a 9-part situation comedy depicting a family struggling with making healthy eating choices; an accompanying family workbook was reviewed to build skills and left with the family. Baseline and immediate postintervention data were collected from the mothers, including the primary outcome of daily servings of fruits and vegetables. Other dietary and psychosocial factors related to healthy eating were examined. At postintervention, mothers in the intervention reported increases in daily vegetable servings (p ≤ .05); however, no changes were observed in fruit consumption. Improvements were observed in behavioral strategies to increase fiber (p ≤ .001) and to decrease fat intake (p ≤ .001), unhealthy eating behaviors (p ≤ .001), and individual (p ≤ .05) and family-related (p ≤ .01) perceived barriers to healthy eating. Entertainment education and promotoras engaged families and improved mothers' diets. Further research should examine the dose needed for greater changes.

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

    PubMed

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Cejudo, Javier

    2016-01-01

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

  5. Prevalence of high-risk egg-preparation practices in restaurants that prepare breakfast egg entrées: an EHS-Net study.

    PubMed

    Lee, Robin; Beatty, Mark E; Bogard, April K; Esko, Michael-Peter; Angulo, Frederick J; Selman, Carol

    2004-07-01

    Salmonella enterica serotype Enteritidis (SE) is a common cause of foodborne illness in the United States. Foods prepared with raw shell eggs have often been associated with SE outbreaks. The federal government published the Egg Safety Action Plan in December 1999 that called for reduction of egg-preparation practices that may contribute to the survival and proliferation of SE. In seven states, an interview and brief site evaluation of 153 restaurants that prepare eggs during all hours of operation was conducted by the Environmental Health Specialists Network to determine the prevalence of such practices. Fifty-four percent (83 of 153) of restaurants pooled raw shell eggs not intended for immediate service. These pooled eggs were held a median of 4 h for scrambled eggs, 5.5 h for omelets, and 6 h for pancakes and French toast. Nearly 26% (39 of 152) of restaurants reported storing eggs at room temperature, and 5% (7 of 152) stored eggs on ice or in cold-water baths before cooking. Generally, eggs were cooked to 72 to 83 degrees C, which is above the recommended final cook temperature of 63 to 68 degrees C. Employees reported sanitizing utensils used to prepare eggs less than once every 4 h in 42% (57 of 136) of restaurants. Several areas were identified in which further emphasis might reduce egg-associated SE infections in accordance with Healthy People 2010 goals. PMID:15270499

  6. Estatuto del Docente: Modificaciones Introducidas entre el Mes de Junio de 1967 y Setiembre de 1970 (Teacher Regulations: Changes Made between June 1967 and September 1970).

    ERIC Educational Resources Information Center

    Ministerio de Cultura y Educacion, Buenos Aires (Argentina). Centro National de Documentacion e Informacion Educativa.

    This booklet contains the modifications made in the regulations governing the teaching profession in Argentina between June 1967 and September 1970. Regulations cover the qualifications and requirements for certification, promotion, and retirement and the mechanics for classification and advancement. (VM)

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

    NASA Astrophysics Data System (ADS)

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

    1998-12-01

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

  8. La Linguistica Aplicada a la Relacion Paradigmatica entre los Verbos "Ser" y "Estar" (Linguistics Applied to the Paradigmatic Relationship between the Verbs "Ser" and "Estar")

    ERIC Educational Resources Information Center

    Marchetti, Magda Ruggeri

    1977-01-01

    Speakers of Italian often have problems mastering Spanish because they erroneously believe its great similiarity to Italian makes it easy to learn. One of the fundamental problems is the lack of ability to choose the correct verb, "ser" or "estar," both equivalents of the Italian "essere." (Text is in Spanish.) (CFM)

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

    ERIC Educational Resources Information Center

    International Reading Association, Newark, DE.

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

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

    NASA Astrophysics Data System (ADS)

    Galvão, Izabel

    1995-01-01

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

  11. Etudes sociales 30. Sujet B: Interaction entre nations. Cahier de l'eleve. Edition finale = Social Studies 30. Subject B: Interaction between Nations. Student Workbook. Final Edition.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton. Curriculum Branch.

    In this Alberta (Canada) student workbook, four history units are presented for study. These are: (1) Between Two Wars (1919-1936); (2) World War II; (3) The Emergence and Interaction of the Superpowers; and (4) Contemporary World Interactions. Advice is offered to students in each unit along with information about key events and issues during…

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

    ERIC Educational Resources Information Center

    Kontos, Susan; Wilcox-Herzog, Amanda

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

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

    ERIC Educational Resources Information Center

    Kimmel, Allan J.

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

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

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2013-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1990-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-07-01

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

  18. Diode laser anastemoses of medium-size arteries with indocyanine green dye-enhanced albumine

    NASA Astrophysics Data System (ADS)

    Weng, Guo-Xing; Williamson, Warren; Aretz, H. Thomas

    1998-11-01

    In order to achieve a better long-term patency result and solve the problem of tensile strength in laser artery anastomoses, diode laser and Indocyanine Green (ICG) enhanced albumin were applied to medium-size artery anastomoses with three different methods, that is, direct laser vascular anastomoses, direct method enforced with ICG albumin, and laser welding with ICG albumin as 'solder'. Internal mammary artery (IMA) harvested from patients undergoing coronary bypass procedures, in vivo rat abdominal artery, and in vitro swine heart and IMA were chosen as the experimental materials. The results revealed that only 3.15 +/- 0.36 minutes were required for each anastomosis; the bursting pressure and tensile strength were greater in the groups enforced with ICG albumin and laser welding than that with direct laser anastomoses. In the laser soldering group, the thermal damage was limited in the adventitial layer, only at a depth of 200 micrometers . There was also a satisfied result in the in vivo laser welding rat's abdominal adventitial layer, only at a depth of 200 micrometers . There was also a satisfied result in the in vivo laser welding rat's abdominal arteries. However, end-to-side laser welding of IMA soronary artery with ICG albumin needs further investigation about its tensile strength in an in vivo model.

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

    PubMed

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

    2014-02-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    EPA Science Inventory

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

  3. Cardiac retractor for coronary bypass operations.

    PubMed

    Rousou, J A; Engelman, R M; Flack, J E; Deaton, D W

    1991-10-01

    The Thompson retractor, used mainly for abdominal procedures, has been used to retract the heart and facilitate exposure for the performance of inferior wall or posterolateral wall coronary anastomoses. It has been found to be very effective and can replace a second assistant to retract the heart or avoid other cumbersome methods of cardiac retraction.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  5. Real-time mosaicing of fetoscopic videos using SIFT

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

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

    PubMed

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

    2014-02-01

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

  7. Retinal pigment epithelial hamartoma--unusual manifestations.

    PubMed Central

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

    1984-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. Operative considerations in implantation of the Perma-Flow graft.

    PubMed

    Emery, R W; Joyce, L D; Arom, K V; King, R M; Nicoloff, D M

    1994-12-01

    The Perma-Flow coronary bypass graft (Possis Medical, Inc, Minneapolis, MN) currently is undergoing expanded clinical trial. From November 1992 through June 1994 we have used this artificial conduit in 8 patients without autologous alternatives. These cases allowed the establishment of a technical basis for successful implantation of this graft. All studied coronary anastomoses are patent.

  10. [Complications of the anterior resection of the rectum].

    PubMed

    Gruttadauria, G; Foresta, G; Gruttadauria, S

    1990-05-01

    The Authors report their experience, referred to the last 10 years (1980-1989), concerning 169 cases of anterior resection of the rectum. Manual and mechanical anastomoses were performed in 83 and 86 cases, respectively. Immediate and long-term complications are evaluated considering the type of anastomosis used, while results are correlated to the stage of the tumor.

  11. Effect of Microvascular Anastomosis Technique on End Product Outcome in Simulated Training: A Prospective Blinded Randomized Controlled Trial.

    PubMed

    Kim, Eunsol; Singh, Masha; Akelina, Yelena; Shurey, Sandra; Myers, Simon R; Ghanem, Ali M

    2016-09-01

    Background The aim of this article is to evaluate the difference in skills acquisition of two end-to-end microvascular anastomosis techniques-the triangulation and biangulation-in early microsurgery training. Method In this study, 32 candidates ranging from medical students to higher surgical trainees underwent a 5-day basic microsurgery course. On days 3 and 5 of the course, candidates performed two end-to-end anastomoses on cryopreserved rat aortas. One anastomosis was performed using the biangulation technique and the other using the triangulation technique. Candidates were randomized to the order of technique performed. Structural patency, errors performed, and suture distribution were evaluated randomly by a blinded reviewer using the anastomosis lapse index score and ImageJ (U.S. National Institutes of Health, Bethesda, MD) Software. Results A total of 128 anastomoses were evaluated during the study period. A total of six anastomoses performed with the biangulation technique, and four anastomoses with the triangulation technique, were physically occluded on day 3 of the course. On day 5, two biangulation technique anastomoses and one triangulation technique produced a nonpatent outcome. There was a statistically significant difference of patency rate between the 2 days of evaluation confirming evidence of skill acquisition but no statistically significant difference between the two techniques in relation to anastomotic patency, errors performed, or suture placement quality. Conclusion The biangulation and triangulation techniques of microvascular anastomosis produce similar outcomes in relation to vessel structural patency and quality of anastomosis when taught in early stages of microsurgery training. Our results suggest that both techniques are equally suitable in training novices, basic microsurgical skills. PMID:27303937

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

    PubMed Central

    Kaji, Masahide; Kinoshita, Jun; Shimizu, Koichi

    2016-01-01

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

  13. [Low colorectal anastomosis: a comparison of manual and mechanical sutures].

    PubMed

    Del Gaudio, A; Boschi, L; Petrin, C; Berardi, M; Accorsi, D

    1993-01-01

    Sixty-three carcinomas of the lower third of the rectum operated of anterior resection with low colorectal or coloanal anastomosis are presented. Handsewn anastomoses were performed in 33 patients, while staplers were used in 30 cases. The average distance of the tumor from the anal verge is 10.8 cm. in hand sutured anastomoses and 7.8 cm. in stapled ones. Dehiscences, stenosis and temporary incontinence are observed more frequently after stapled anastomosis, while the incidence of neoplastic recurrences is higher in sutured anastomosis; hospital stay and mortality are similar in the two series. Our results and literature review show that both techniques are comparable though maintaining their own specific identity and precise indication.

  14. Temperature control during laser vessel welding.

    PubMed

    Springer, T A; Welch, A J

    1993-02-01

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

  15. Low anterior anastomotic dehiscence following preoperative irradiation with 6000 rads

    SciTech Connect

    Blake, D.P.; Bubrick, M.P.; Kochsiek, G.G.; Feeney, D.A.; Johnston, G.R.; Strom, R.L.; Hitchcock, C.R.

    1984-03-01

    Twenty mongrel dogs received 6000 rads of irradiation to the rectum and colon using the Nominal Standard Dosage Equation. Three weeks after irradiation each dog underwent anterior resection of the rectosigmoid with reconstruction randomized to either an EEA stapled or a two layer handsewn anastomosis. Each dog was studied digitally and by barium enema at the time of surgery, on the seventh postoperative day, and at autopsy. Five clinically significant leaks and three radiographic leaks occurred in the EEA stapled anastomoses. The handsewn anastomoses had five clinically significant leaks and two radiographic leaks. The data indicate that low anterior resection with either an EEA stapled or handsewn anastomosis cannot be done safely after 6000 rad preoperative irradiation.

  16. Laser welding with an albumin stent: experimental ureteral end-to-end anastomosis

    NASA Astrophysics Data System (ADS)

    Xie, Hua; Shaffer, Brian S.; Prahl, Scott A.; Gregory, Kenton W.

    2000-05-01

    Porcine ureters were anastomosed using an albumin stent and diode laser in vitro. The albumin stent provided precise apposition for an end to end anastomosis and enhanced welding strength. The anastomosis seam was lasered with an 810 nm diode laser using continuous wave and pulse light through a hand-held 600 micrometer noncontact optical fiber. Tensile strength, burst pressures, operative times, total energy and thermal damaged were measured in this study. The results demonstrated that using an albumin stent to laser weld ureteral anastomoses produces strong weld strengths. The liquid albumin solder also provided satisfactory welding strength. There were no significant differences of tissue thermal damage between the albumin stent alone, liquid solder alone and both combination groups. Thermal damage to tissue depended on laser setting and energy. This study determined the appropriate laser setting parameters to perform in vivo ureteral end to end anastomosis.

  17. A multiphase transitioning peptide hydrogel for suturing ultrasmall vessels

    NASA Astrophysics Data System (ADS)

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  19. A rat uterine horn model of genital tract wound healing.

    PubMed

    Schlaff, W D; Cooley, B C; Shen, W; Gittlesohn, A M; Rock, J A

    1987-11-01

    A rat uterine horn model of genital tract wound healing is described. Healing was reflected by acquisition of strength and elasticity, measured by burst strength (BS) and extensibility (EX), respectively. A tensiometer (Instron Corp., Canton, MA) was used to assess these characteristics in castrated and estrogen-supplemented or nonsupplemented animals. While the horn weights (HW), BS, and EX of contralateral horns were not significantly different, the intra-animal variation of HW was 7.2%, BS was 17.7% and EX was 38.2%. In a second experiment, one uterine horn was divided and anastomosed, and the animal given estrogen supplementation or a placebo pellet. Estrogen administration was found to increase BS and EX of anastomosed horns prior to 14 days, but had no beneficial effect at 21 or 42 days. The data suggest that estrogen may be required for optimal early healing of genital tract wounds.

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

    PubMed

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

    2002-10-01

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

  1. Anatomy of the Ophthalmic Artery: Embryological Consideration

    PubMed Central

    TOMA, Naoki

    2016-01-01

    There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures. PMID:27298261

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

    SciTech Connect

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

    1981-11-01

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

  3. [DESCRIPTION OF A RETROPERITONEAL ACCESS ROUTE TO THE VESSELS OF THE SPLEEN FOR SPLENORENAL ARTERIAL AND VENOUS ANASTOMOSIS].

    PubMed

    Gil-Vernet Vila, José María

    2014-01-01

    To perform arterial or venous spleno-renal anastomoses, surgeons have so far systematically used the transperitoneal way whic is burdened by a high mortality an morbility percentage. On the basis of anatomo-surgical considerations, a retroperitoneal approach has been found reaching the hilus of the spleen via the lumbar region; the first arterial spleno-renal anastomosis by this way was performed in 1972 and the first venous spleno-renal anastomosis due to portal hipertension also by this way was performed in 1974, the alter proving to be the least aggresive by avoiding damaging the páncreas, the most surgical and direct for reaching the splenic vessels thereby enabling a better exposure and an easier performing of the anastomoses. By being retroperitoneal, the loss or infección of the ascitic liquid in the cirrhotic patient is prevented.

  4. [Costs and benefits of mechanical sutures in esophageal surgery].

    PubMed

    Peracchia, A; Bardini, R

    1990-03-01

    The cost/benefit ratio of mechanical sutures is a controversial issue. Aim of this work was to compare the cost of esophago-visceral anastomoses performed with staplers versus the cost of conventional anastomoses. Not only the cost of the material, but also the economical impact of the hospital stay and operative complications was evaluated. Results show a statistically significant decrease of morbidity in patients treated with mechanical sutures (3.7% vs 18.8%, p = 0.0001). The overall cost of a single mechanical suture was markedly lower than that of a single manual suture (934.000 vs 2,209.000 Italian lira). We conclude that a significant decrease of hospital cost can be expected using mechanical sutures. It has to be noted, however, that in order to achieve such results, an adequate surgical training with staplers is mandatory.

  5. The dangers of using stapling devices for cystic duct closure in laparoscopic cholecystectomy.

    PubMed

    Belgaumkar, Ajay P; Carswell, Kirstin A; Chang, Avril; Patel, Ameet G

    2009-10-01

    Laparoscopic stapling devices are used widely in laparoscopic surgery, for division of vessels and creation of anastomoses. Their use in the division of a widened cystic duct at laparoscopic cholecystectomy has been reported earlier. We present 3 different complications occurring after division of the cystic duct using the EndoGIA stapling device. A review of the literature has been performed and safe alternative techniques for laparoscopic ligation of the cystic duct are proposed.

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

    NASA Technical Reports Server (NTRS)

    Baker, V. R.

    1978-01-01

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

  7. Palmar arch reconstruction using dorsal venous arch of foot for revascularisation of multiple digits

    PubMed Central

    Krishnakumar, K. S.; Petkar, Kiran; Lateef, Sameer; Rasalkar, Jyoti; Arun, T. J.; Suresh, V.

    2014-01-01

    A case of trauma causing total loss of superficial and deep palmar arches of hand with ischemia of all the digits was managed using dorsal venous arch of the foot to reconstruct the palmar arch. The ends of the venous arch were anastomosed to radial and ulnar arteries and the tributaries to the arch were coapted to the cut ends of the common digital vessels and princeps pollicis. The surgery yielded gratifying results, successfully revascularising all the digits. PMID:24987216

  8. [Our surgical heritage. Alexis Carrel (1873-1944)].

    PubMed

    Schmitt, W

    1983-01-01

    Carrel did fundamental research in many branches of experimental surgery. Starting with perfectioning vessel anastomoses in 1902, he began with the transplantation of organs as early as in the first decade of this century. Vessel bank, patch-technique, extracorporeal circulation and the artificial heart have their scientific basis in Carrel's investigations. Carrel was not only an outstanding but a visionary surgeon, far ahead of his time, now almost forgotten.

  9. Long term follow up results of sequential left internal thoracic artery grafts on severe left anterior descending artery disease

    PubMed Central

    2010-01-01

    Purpose Several alternative procedures have been proposed to achieve complete revascularization in the presence of diffuse left anterior descending coronary artery (LAD) disease. With the extensive use of internal thoracic artery grafts in coronary artery bypass procedures, sequential anastomosis of the left internal thoracic artery (LITA) to LAD has gained popularity in these challenging cases. The long term results of sequential LITA to LAD anstomosis were examined in this study. Patients and Methods In order to determine the long term results of the sequential revascularization of LAD by LITA graft, 41 out of 49 patients operated between January 2001 and December 2005 were selected for control coronary arteriography. The median period for control coronary arteriography was 64 months. Results Seventy five anastomoses were found to be fully patent (91,46%) among the 82 sequential LITA anastomoses (41 LITA grafts) on the LAD at a median follow-up period of 64 months (53 to 123 months). Among the 41 LITA grafts used for this purpose, 36 were found intact (complete patency of the proximal and distal anastomoses) (87,8%). Two LITA grafts (4 anastomoses) were found to be totally occluded (4,87%). The proximal anastomosis of the LITA graft was observed to be 90% stenotic in one patient (1,21%). In one patient tight stenosis of the distal anastomosis line was observed (1,21%), while in another patient 70% narrowing of LITA lumen after the proximal anastomosis was detected (1,21%). Conclusion We strongly beleive that sequential LITA grafting of LAD is a safe alternative in the presence of severe LAD disease to achieve complete revascularization of the anterior myocardium with patency rates not much differing from conventional single LITA to LAD anastomosis. PMID:20958964

  10. Evaluation of the Microvascular Research Center Training Program for Assessing Microsurgical Skills in Trainee Surgeons

    PubMed Central

    Yamada, Kiyoshi; Yamashita, Shuji; Sugiyama, Narushi; Tokuyama, Eijiro; Matsumoto, Kumiko; Takara, Ayumi; Kimata, Yoshihiro

    2013-01-01

    Background We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons. Methods Twenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4. Results The passing rates were 100% (22/22) for stages 1 and 2, 86.4% (19/22) for stage 3, 59.1% (13/22) for stage 4, and 55.0% (11/20) for stage 5. The number of anastomoses performed was 17.2±12.2 in stage 3 and 11.3±8.1 in stage 4. Conclusions Majority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons. PMID:23730596

  11. Ite Boerema--surgeon and engineer with a double-Dutch legacy to medical technology.

    PubMed

    Leopardi, Lisa N; Metcalfe, Matthew S; Forde, Allison; Maddern, Guy J

    2004-01-01

    Ite Boerema, 1902-1978: a Dutchman with a brilliant academic surgical career, and war hero, decorated for resistance to the Germans in World War II. As a man who regarded surgery as "engineering in medicine," we still feel his legacy in medical technology today, specifically with regard to his work on esophageal anastomoses and hyperbaric oxygen therapy. This biography places his major contributions to medicine in context of the man himself and of contemporary medicine.

  12. Complications following repair of extrahepatic bile duct injuries after blunt abdominal trauma.

    PubMed

    Rodriguez-Montes, J A; Rojo, E; Martín, L G

    2001-10-01

    Extrahepatic bile duct traumatic injuries are extremely rare and their treatment is difficult and with several controversies. The aim of this study was to offer some more clinical information on their surgical repair and outcome. We present seven patients with extrahepatic biliary tract lesions after blunt abdominal trauma, (isolated gallbladder lesions were excluded) four males and three females from 23 to 51 years of age (mean age 35.1 years). All patients had suffered high-energy blunt abdominal trauma and presented associated injuries, mostly liver trauma and lung contusions. Six gallbladder lesions and six common bile duct injures were identified; a right hepatic duct laceration and a left hepatic duct transection were also present. Injuries were treated either with primary repair or with duct-jejunal anastomoses with Roux-en-Y reconstruction. Principal complications were postoperative anastomotic leakage (1 case) and recurrent cholangitis (3 cases) with or without stricture. Not-diagnosed injuries caused substantial morbidity. We prefer and recommend the use of primary repair in partial ruptures with no significant tissue loss and biliary-enteric anastomoses in large injuries and complete transections because they offer the best long-term drainage with less risk of stricture formation than end-to-end anastomoses. We defend the use of long duration (6 to 9 months) transanastomotic stents. PMID:11596896

  13. Low anterior resection without defunctioning stoma.

    PubMed

    Kanellos, I; Zacharakis, E; Christoforidis, E; Demetriades, H; Betsis, D

    2002-12-01

    The aim of our study was to determine the anastomotic leakage rate after the performance of low anterior resection without protective stoma. During the time period from 1989 to 2001, 82 consecutive patients underwent low anterior resection for rectal carcinoma without protective stoma. Thirteen anastomoses were hand sewn (15.8%) and the remaining 69 (84.2%) were constructed with the use of a circular stapling gun. The mean distance of the anastomoses from the anal margin was 6.2 cm (range, 3-9 cm). None of the 82 low anterior resections was covered by a defunctioning stoma. Clinical anastomotic leakage occurred in 4 patients (4.9%) and 4 other patients presented radiologically detected leakage (4.9%). No death occurred in the 8 patients that presented anastomotic dehiscence. Non-specific complications were detected in 11 (13.4%) of 82 patients. In conclusion, the low leakage rate of the anastomoses in our patients allows us to recommend low anterior resection without defunctioning stoma.

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

    USGS Publications Warehouse

    Suping, P.; Flores, R.M.

    1996-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  16. The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries.

    PubMed

    Amirzargar, Mohammad Ali; Babolhavaeji, Hooshang; Hosseini, Shahriar Amir; Bahar, Habibmousavi; Gholyaf, Mahmood; Dadras, Farahnaz; Khoshjoo, Farhad; Yavangi, Mahnaz; Amirzargar, Nasibeh

    2013-03-01

    The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA), which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient's main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

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

    PubMed

    Mutafchiev, Yasen; Kinsella, John M

    2012-10-01

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

  18. Incomplete restoration of homeostatic shear stress within arteriovenous fistulae.

    PubMed

    McGah, Patrick M; Leotta, Daniel F; Beach, Kirk W; Eugene Zierler, R; Aliseda, Alberto

    2013-01-01

    Arteriovenous fistulae are surgically created to provide adequate access for dialysis patients suffering from end-stage renal disease. It has long been hypothesized that the rapid blood vessel remodeling occurring after fistula creation is, in part, a process to restore the mechanical stresses to some preferred level, i.e., mechanical homeostasis. We present computational hemodynamic simulations in four patient-specific models of mature arteriovenous fistulae reconstructed from 3D ultrasound scans. Our results suggest that these mature fistulae have remodeled to return to ''normal'' shear stresses away from the anastomoses: about 1.0 Pa in the outflow veins and about 2.5 Pa in the inflow arteries. Large parts of the anastomoses were found to be under very high shear stresses >15 Pa, over most of the cardiac cycle. These results suggest that the remodeling process works toward restoring mechanical homeostasis in the fistulae, but that the process is limited or incomplete, even in mature fistulae, as evidenced by the elevated shear at or near the anastomoses. Based on the long term clinical viability of these dialysis accesses, we hypothesize that the elevated nonhomeostatic shear stresses in some portions of the vessels were not detrimental to fistula patency. PMID:23363216

  19. Reducing the number of animals used for microsurgery training programs by using a task-trainer simulator.

    PubMed

    Guerreschi, P; Qassemyar, A; Thevenet, J; Hubert, T; Fontaine, C; Duquennoy-Martinot, V

    2014-01-01

    To master the skills needed for microsurgery techniques, residents must enrol in a long and complex training program that includes manipulations on simulators, on ex vivo tissues and finally in vivo training. This final step consists of performing vascular anastomoses on murine models. We propose here a simulation program designed to decrease the number of rats used during the final in vivo training. Our study presents the materials used, the various exercises proposed and their evaluations. Two identical student groups were compared in the framework of the University Diploma of Microsurgery. Group A (seven students) followed a classic training program, all of whom achieved permeable vascular anastomoses. A total of 149 rats were needed for this group. Group B (seven students) first validated their manipulations on the task-trainer simulation program. A mean of 6 h was necessary to obtain this validation. All these students achieved the required permeable vascular anastomoses but only 77 rats were used for this group. This simulation program spared 72 rats, abiding by the Russell and Burch concept of a humane experimental technique, namely the 3R principles. This home-made, cost-efficient and easy-to-use task trainer included various exercises with increasing difficulty levels and a progressive scoring system. We believe that microsurgery training needs to include both simple and sophisticated tools in order to reduce the number of animals used to master these surgical skills.

  20. Crevassing and capture by floodplain drains as a cause of partial avulsion and anastomosis (lower Rio Pastaza, Peru)

    NASA Astrophysics Data System (ADS)

    Bernal, Carolina; Christophoul, Frédéric; Darrozes, José; Laraque, Alain; Bourrel, Luc; Soula, Jean-Claude; Guyot, Jean-Loup; Baby, Patrice

    2013-07-01

    Avulsion is the main process at the origin of anastomosing rivers. This study illustrates 3 examples of avulsions resulting from crevasse splays evolving in anastomosed channels along the Rio Pastaza, a tropical humid river sourced in the Ecuadorian Andean Cordillera and flowing into the Amazonian foreland. The Lower Pastaza flows in an alluvial plain, with no tectonic influence and an average monthly rainfall equally distributed throughout the year. Based on the analysis of satellite image recorded over the period 1977-2008, three cases have been studied. The first one began in 1990 with crevassing of natural levees of the right bank of the Pastaza main channel and the formation of a small channel linking up with a pre-existing tributary to this main channel. A splay formed at the confluence beheaded the tributary which became an anabranch of the main river. Downstream, two other avulsions developed from crevasse splays on a low gradient floodplain. In both cases, capture of one of the distributary channels flowing on the splay by a pre-existing drain of the floodplain and consecutive headward erosion arrives to disconnect the other drains and capture their flow into a single-thread channel. As this channel rejoins the Pastaza main channel downstream, this process gives rise to the larger-scale anastomosing system which characterizes the lower reach of the Rio Pastaza.

  1. Avulsion and anastomosis in the panhandle region of the Okavango Fan, Botswana

    NASA Astrophysics Data System (ADS)

    Smith, Norman D.; McCarthy, Terence S.; Ellery, W. N.; Merry, Charles L.; Rüther, Heinz

    1997-09-01

    GPS water-surface elevation data from the panhandle region of the Okavango Fan (northwestern Botswana) show that a prominent anastomosed reach occurs within a relative valley-gradient depression inferred to represent a small graben structure. The Okavango River undergoes an abrupt change in pattern as it approaches the upstream fault zone of the graben, developing small meander loops and higher sinuosity in response to increased valley slope induced by faulting. Four channels split from and ultimately rejoin the Okavango trunk channel to define the anastomosed reach. The oldest (Filipo channel) diverted from the Okavango on the upstream horst block, rejoining the trunk channel 26 km downstream within the graben. The younger channels B, C and D all developed subsequent to the Filipo avulsion by forming linkages between the Okavango trunk and floodplain tributaries that had evolved by headward extension and incorporation of older abandoned channel segments. Diversion of the three younger anastomosed channels was likely abetted by increased aggradation of the trunk channel following down-faulting. Neotectonic movement, although involving only slight displacement, is seen to be the underlying cause of avulsion, anastomosis, and certain channel pattern changes in the Okavango panhandle. This contrasts with other parts of the Okavango Fan system where avulsion appears to result more from autogenic in-channel sedimentation conditioned by various roles of vegetation.

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

    NASA Astrophysics Data System (ADS)

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

    2011-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2005-07-01

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

  4. Vegetative compatibility and anastomosis formation within and among individual germlings of tropical isolates of arbuscular mycorrhizal fungi (Glomeromycota).

    PubMed

    de Novais, Cândido Barreto; Sbrana, Cristiana; Saggin Júnior, Orivaldo José; Siqueira, José Oswaldo; Giovannetti, Manuela

    2013-05-01

    Hyphal anastomoses which play a key role in the formation of interconnected mycorrhizal networks and in genetic exchange among compatible individuals have been studied in a limited number of species and isolates of arbuscular mycorrhizal fungi (AMF), mainly in symbiotic mycelium. In this work, the occurrence and frequency of anastomosis between hyphae of the same and different germlings were assessed in tropical isolates belonging to Acaulospora, Claroideoglomus, Gigaspora, Glomus, Rhizophagus and Scutellospora. Germlings belonging to Acaulospora, Claroideoglomus, Glomus and Rhizophagus formed perfect hyphal fusions, with frequencies ranging from 9.29 ± 3.01 to 79.84 ± 4.39 % within the same germling and from 14.02 ± 7.36 to 91.41 ± 3.92 % between different germlings. Rare fusions, occurring within the same hypha, were detected in Gigaspora species, and no anastomoses were observed in Scutellospora species. The consistent detection of nuclei in perfect fusions suggests that nuclear migration is active both within and between germlings. Present data on anastomosis formation, nuclear migration and germling viability in tropical isolates of AMF widen our knowledge on the extensive and consistent occurrence of successful hyphal fusions in this group of beneficial symbionts. The ability to anastomose and establish protoplasm flow, fundamental for the maintenance of physiological and genetic continuity, may produce important fitness consequences for the obligately biotrophic AMF.

  5. The stapled functional end-to-end anastomosis following colonic resection.

    PubMed

    Kyzer, S; Gordon, P H

    1992-09-01

    To determine the results of our experience with the use of staples for construction of anastomoses following colonic resection, a series of 223 anastomoses performed in 205 patients was reviewed. Indications for operation included malignancy, benign neoplasms, inflammatory bowel disease, and several miscellaneous entities. A functional end-to-end anastomosis using the standard GIA cartridge and the TA 55 instruments was performed. The operative mortality was 1.5% with none of the deaths related to the anastomosis. Intraoperative complications encountered included bleeding (21), leak (1), tissue fracture (1), instrument failure (4), and technical error (3). Early postoperative complications related or potentially related to the anastomosis included bleeding (5), pelvic abscess (1), fistula (1), peritonitis (2), ischemia of anastomosis (1). Late complications included five patients with small bowel obstruction, two of whom required operation. Anastomotic recurrences developed in 5.9% of patients. Our experience gained with stapling instruments has shown them to be a reliable method for performing anastomoses in the colon in a safe and expeditious manner. PMID:1402308

  6. Use of the Konnyaku Shirataki noodle as a low fidelity simulation training model for microvascular surgery in the operating theatre.

    PubMed

    Prunières, G J-C; Taleb, C; Hendriks, S; Miyamoto, H; Kuroshima, N; Liverneaux, P A; Facca, S

    2014-04-01

    The aim of this study was to test the feasibility of a type of Japanese noodle, named "shirataki konnyaku", for microsurgery training in the operating room. Thirteen surgical residents without experience in microsurgery had to perform two microsurgical anastomoses: one on a model of a femoral artery of a rat (control) and one on a model of a konnyaku shirataki. Two quantitative variables (time in minutes and number of stitches to perform the anastomosis) and two qualitative variables (patency and tightness of the anastomosis) were measured. Sixty anastomoses were performed with the control model and 62 anastomoses with the konnyaku model. The time of the anatomosis was significantly higher in the control group. The number of stitches was similar in both groups. The patency of the anastomosis was significantly lower in the control group. The tightness (no leak) of the anastomosis was significantly higher in the control group. The "konnyaku shirataki" model could improve the teaching of microsurgery due to its availability, low cost and structural similarity to the animal model.

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

    PubMed Central

    Rutegård, Martin; Rutegård, Jörgen

    2015-01-01

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

  8. A comprehensive review with potential significance during skull base and neck operations, Part II: glossopharyngeal, vagus, accessory, and hypoglossal nerves and cervical spinal nerves 1-4.

    PubMed

    Shoja, Mohammadali M; Oyesiku, Nelson M; Shokouhi, Ghaffar; Griessenauer, Christoph J; Chern, Joshua J; Rizk, Elias B; Loukas, Marios; Miller, Joseph H; Tubbs, R Shane

    2014-01-01

    Knowledge of the possible neural interconnections found between the lower cranial and upper cervical nerves may prove useful to surgeons who operate on the skull base and upper neck regions in order to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections between the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized into two parts. Part I discusses the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches and other nerve trunks or branches in the vicinity. Part II deals with the anastomoses between the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or between these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part II is presented in this article. Extensive and variable neural anastomoses exist between the lower cranial nerves and between the upper cervical nerves in such a way that these nerves with their extra-axial communications can be collectively considered a plexus.

  9. A simple fluid-structure coupling algorithm for the study of the anastomotic mechanics of vascular grafts.

    PubMed

    Schiller, N K; Franz, T; Weerasekara, N S; Zilla, P; Reddy, B D

    2010-12-01

    Vascular anastomoses constitute a main factor in poor graft performance due to mismatches in distensibility between the host artery and the graft. This work aims at computational fluid-structure investigations of proximal and distal anastomoses of vein grafts and synthetic grafts. Finite element and finite volume models were developed and coupled with a user-defined algorithm. Emphasis was placed on the simplicity of the coupling algorithm. An artery and vein graft showed a larger dilation mismatch than an artery and synthetic graft. The vein graft distended nearly twice as much as the artery while the synthetic graft displayed only approximately half the arterial dilation. For the vein graft, luminal mismatching was aggravated by development of an anastomotic pseudo-stenosis. While this study focused on end-to-end anastomoses as a vehicle for developing the coupling algorithm, it may serve as useful point of departure for further investigations such as other anastomotic configurations, refined modelling of sutures and fully transient behaviour.

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

    ERIC Educational Resources Information Center

    American Association of School Administrators, Arlington, VA.

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Kohout-Diaz, Magdalena

    2008-07-01

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

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

    PubMed

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

    1999-01-01

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

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

    PubMed

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

    1999-01-01

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

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

    ERIC Educational Resources Information Center

    Méndez, Tatiana; García, Andrea

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Manteca, Ivan Alhama

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

  17. Irradiations y Jusqu'a 109 Rads De Fibres Toute Silice Comparaisons Avec Des Fibres Pcs Et Des Echantillons Massifs Entre 0,4 Et 2,5 Microns

    NASA Astrophysics Data System (ADS)

    Boisde, G.; Bonnejean, C.; Perez, J. J.; Neumann, V.; Wurier, B.; Boucher, D.

    1984-03-01

    The effect of y radiation (Co60 ) on optical fibers is studied for investigations to remote measurement in irradiating environments. The spectral characteristics of PCS and AS silica fibers, PCS "Wet" and AS "wet" and "superwet" are compared. An automatic computerized system for measurement "in situ" is used between 0,4 and 1,1 micron. Radiation-induced effects are examinated at 840 nm on PCS, AS with silicone, AS with epoxy (200 and 400/6004m) up to 5.108 rads.Samples of "dry", "wet", "superwet" and "doped fluor" silica are studied up to 1,3.109 rads between 0,3 and 2,5μm. The photobleaching, the radiation hardening and the breakeage of PCS and AS-silicone after 107 rads are recognized. The spectral characte-ristics of a band at 610-630 nm, a spectral deformation at 945 nm for "wet" fibers and a peak of the radiation-induced attenuation are observed. The kinetic of the 630 nm defect in silica fibers and silica samples is also investigated.

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

    NASA Astrophysics Data System (ADS)

    Zeitoun, Valery

    2000-01-01

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

  19. La Mamora, charnière entre la Meseta et le Rif : son importance dans l'évolution géodynamique post-paléozoïque du Maroc

    NASA Astrophysics Data System (ADS)

    Zouhri, Lahcen; Lamouroux, Christian; Buret, Christophe

    The Mamora area (Morocco) is located in the northern part of the Meseta and the southern part of Rharb. The recent formations (Mesozoic to Quaternary) lie unconformably on a Paleozoic basement. This study based on hydrogeological, sedimentological, drilling data and seismic reflection profiles interpretation, proposes new interpretations of geodynamical evolution of this area particularly in terms of tectonic patterns. The most ancient formations recognized in this region are Paleozoic schists and quartzites in the Tiflete sector. They represent the basement of the basin on which Triassic conglomerates and red mudstones associated with basalts lie unconformably. Jurassic and Cretaceous sediments are limestones and marls. The Mio-pliocene formations are open marine blue marls. Plio-quaternary sediments are limestones and sands containing gravel and pebbles. Miocene to Pliocene blue marls facies corresponds to deep marine marls (bathyal as indicated by planctonic foraminifers) with an attributed age from upper Miocene 〚9〛 to middle Pliocene 〚7〛. A facies distribution map of the top of the blue marls has been realized where four main facies - conglomerate, shelly sandstone, limestone and marls - indicate a major regression in the Mamora basin. The datation of the formations was mostly realized by Wernli 〚22, 23, 24, 25〛, and Cirac 〚10〛. In the Mamora area, Hercynian faults show two main structural directions, N020°E-N040°E (Agadir-Rabat), N120°E (Rabat-Tiflète) 〚5〛, and a new major Hercynian fault (K2S). The seismic profiles have been studied between Sidi Slimane and Sidi Yahia area, to illustrate the structure of the Mamora, and to replace it, in the geodynamical evolution. The seismic reflection lines and drilling data show that the eastern Mamora was subdivided into two sectors : i) the southern sector is affected by Hercynian faults which create horsts and grabens in the Paleozoic. Mio-Pliocene formations infill these depressions and are covered by Quaternary sediments ; ii) the northern sector is constituted by various formations : 1. Paleozoic formation as basement covered by autochthonous Mesozoic to Miocene, 2. Prerifain nappes (marls and evaporites), 3. Mio-Plio-Pleistocene formations as subautochthonous to autochthonous. These two sectors are separated by a major fault (K2S). On the other hand, in the occidental Mamora, the facies distribution and the Plio-Pleistocene thickening seem to be induced by faults with a NE-SW and NW-SE trends which affect the Paleozoic basement. Then, between the Meseta domain and the septentrional Rharb basin, two major Hercynian initially dextral shear zones, Rabat-Tiflete and K2S, have been recognised. During the Atlantic Ocean opening, they are probably senestral shear zones. At the same time the subsidence in Rharb basin is active, major action of these faults is normal. Therefore, Mamora represents a real hinge between stable Meseta and unstable septentrional Rharb basin.

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

    ERIC Educational Resources Information Center

    Michaud, Claude

    1996-01-01

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

  1. Estudi de la dependéncia energética de les diferéncies entre jets de quarks i gluons utilitzant el detector DELPHI de LEP

    NASA Astrophysics Data System (ADS)

    Garcia, S. Marti i.

    1995-11-01

    Three jet events arising from decays of the Z^0 boson, collected by the DELPHI detector at LEP, were used to measure differences in the properties of quark and gluon jet fragmentation. Gluon jets were anti-tagged in bbar{b}g events, by identifiying b quark jets with high purities. Unbiased quark jets came from events qbar{q}γ with two jets plus one photon. A comparison of quark and gluon jet properties in different energy ranges was performed for the first time and within the same detector. The average value of the ratio of the mean charged multiplicities of gluon and quark jets was measured to be [ 1.232 ± 0.026 ({esta.}) ± 0.018 ({sist.}) ] where the fraction of b-quark initiates jets was 11% and the Durham jet finding algorithm has been used for the selection of three jet events. In agreement with QCD an increase of this ratio with energy was observed at a 3sigma level. A further dependence of this ratio related with the angular acceptance of the algorithm used to reconstruct jets was also measured. Gluon jets have a broader energy and particle flow around its jet axis than quark jets of equivalent energy. The string effect has been observed in fully symmetric three-jet events. The ratio R_γ of the charged particles flow in the qbar{q} inter-jet region of the qbar{q}g and qbar{q}γ samples was measured in agreement with the perturbative QCD expectation [ frac{(N_{qq})_{qbar{q}g}}{(N_{qq})_{qbar{q}γ}} = 0.058 ± 0.06 ({stat.+sist.}) ] The dependence of the mean charged multiplicity on the hadronic center-of-mass energy was analysed in photon plus n-jet events. A value for

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Paulu, Nancy

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

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

    ERIC Educational Resources Information Center

    Gómez Lobatón, July Carolina

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Keranen, Nancy; Encinas Prudencio, Fátima

    2014-01-01

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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

    Valle, Victor M.

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

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

    ERIC Educational Resources Information Center

    Lopez, Maria I. Hernandez; And Others

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

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

    ERIC Educational Resources Information Center

    Marson, Izabel Andrade

    1998-01-01

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

  10. Étude numérique de l'écoulement d'un fluide non newtonien thermodépendant entre deux plaques parallèles

    NASA Astrophysics Data System (ADS)

    Van Tuan, Nguyen; Lebouche, Michel

    2005-04-01

    In this study, the heat transfer of a non Newtonian thermodependent fluid flowing between two parallel plates is considered. The effects of different parameters on the evolutions of thermal boundary layer and of Nusselt number are numerically investigated in two heating cases and correlations are proposed to compute the heat transfer. To cite this article: N. Van Tuan, M. Lebouche, C. R. Mecanique 333 (2005).

  11. Lien entre le référentiel dynamique et l'ICRS à l'aide des petites planètes Hipparcos: analyse methématique du modèle d'estimation.

    NASA Astrophysics Data System (ADS)

    Bange, J.-F.; Bec-Borsenberger, A.; Bougeard, M. L.; Caquineau, C. D.

    Eighty-eight minor planets have been observed by the satellite Hipparcos. The precise positions obtained allow to position the dynamical reference system to the Hipparcos reference system (ICRS). Due to a multicollinearity phenomena, the system is ill-conditioned. Thus the global least squares fit gives unstable numerical estimations and large values of the Variance Inflation Factors (VIF). In this paper, the authors are presenting results obtained by using algorithms (implemented on the Connexion Machine CM5) based on the least absolute value and the Huber M-estimators.

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Thanh, Nguyen Cao

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    NASA Astrophysics Data System (ADS)

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

    2000-12-01

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

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

    ERIC Educational Resources Information Center

    Buendía Arias, Ximena Paola

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

    Association of Universities and Colleges of Canada, 2006

    2006-01-01

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

  19. Etudes sociales 30. Sujet B: Interactions entre nations. Unite d'enseignement--Guide. Edition finale = Social Studies 30. Subject B: Interactions between Nations. Teaching Unit--Guide. Final Edition.

    ERIC Educational Resources Information Center

    Alberta Dept. of Education, Edmonton. Curriculum Branch.

    In this Alberta (Canada) teacher's guide, four history units are outlined. These are: (1) Between Two Wars (1919-36); (2) World War II; (3) The Emergence and Interaction of the Superpowers; and (4) Contemporary World Interactions. At the end of each unit, questions are provided for discussion and there is a final synthesis at the end of the…

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  1. [Pedicled versus free TRAM flap for breast reconstruction].

    PubMed

    Galla, T J; Lukas, B; Feller, A M

    1999-03-01

    In breast reconstruction, the free TRAM-flap offers many advantages over the pedicled TRAM-flap. Due to its superior perfusion, the free flap rarely develops necrosis. Shaping of the flap is easier due to the lack of the thick muscle pedicle. Because the rectus muscle is spared, there is minimal donor site morbidity. However, the necessary microvascular anastomoses reduced the acceptance of the free TRAM-flap. During a 13-months period, 51 breast reconstructions were performed in 41 patients, 31 unilateral and ten bilateral. 45 flaps served for delayed reconstruction and six flaps for immediate reconstruction. The operations were performed by two teams working simultaneously. The average operating time was 3.9 hours for unilateral and 6.9 hours for bilateral delayed reconstruction. For immediate reconstruction, 6.2 and 6.3 hours were required for uni- and bilateral procedures, respectively. In 38 flaps, the thoracodorsal vessels served as recipient vessels; 13 flaps were anastomosed to the internal mammary artery and vein. Postoperative complications were observed in 13 patients. Three vessel anastomoses had to be revised. In one flap, a partial necrosis occurred; in two flaps hematoma evacuation was necessary. Two patients suffered from fat necroses at the abdomen and one umbilicus was lost. Skin irritations and seromas at the abdomen occurred in five patients. Pulmonary embolism was diagnosed in one patient three weeks postoperatively. Abdominal hernias or bulging in the epigastric area were not observed up to 15 months after reconstruction. These results reveal a low complication rate for breast reconstruction with the free TRAM-flap. The advantages of this technique as compared to the pedicled technique are discussed.

  2. Laser-assisted vascular anastomosis

    NASA Astrophysics Data System (ADS)

    Kao, Race L.; Tsao-Wu, George; Magovern, George J.

    1990-06-01

    The milliwatt CO2 laser and a thermal activated binding compound (20% serum albumin) were used for microvascular anastomoses. Under general anesthesia, the femoral arteries (0.7 to 1.0 mm diameter) of 6 rats were isolated. After the left femoral artery in each rat was clamped and transected, the vessel was held together with 3 equidistant 10-0 Xomed sutures. The cut edges were coated 3 to 4 times with the albumin solution and sealed with the CO2 laser (power density = 120 W/cm2). The binding compound solidified to a translucent tensile substance which supported the anastomosis until self healing and repair were achieved. The right femoral artery was used as sham operated control. Complete hemostasis and patency were observed in every case immediately and at 1, 3, and 6 months following surgery. The binding compound absorbed most of the laser energy thus minimizing thermal injury to the underlying tissue. Mongrel dogs weighing 28 to 33 kg were anesthetized and prepared for sterile surgical procedures. In 5 dogs, the femoral and jugular veins were exposed, transected, and anastomosed using a CO2 laser (Sharplan 1040) with the binding compound. In another 12 dogs, cephalic veins were isolated and used for aortocoronary artery bypass procedures. The Sharplan 1040 CO2 laser and 20% albumin solution were utilized to complete the coronary anastomoses in 6 dogs, and 6 dogs were used as controls by suturing the vessels. Again, hemostasis, patency, and minimal tissue damage were observed immediately and 6 weeks after the procedures. Improved surgical results, reduced operating time, minimized tissue damage, and enhanced anastomotic integrity are the advantages of laser assisted vascular anastomosis with a thermal activated binding compound.

  3. Functioning pancreas graft with thromboses of splenic and superior mesenteric arteries after simultaneous pancreas-kidney transplantation: a case report.

    PubMed

    Matsumoto, I; Shinzeki, M; Asari, S; Goto, T; Shirakawa, S; Ajiki, T; Fukumoto, T; Ku, Y

    2014-04-01

    Graft thrombosis is the most common cause of early graft loss after pancreas transplantation. The grafted pancreas is difficult to salvage after complete thrombosis, especially arterial thrombosis, and graft pancreatectomy is required. We describe a patient presenting with a functioning pancreas graft with thromboses of the splenic artery (SA) and superior mesenteric artery (SMA) after simultaneous pancreas-kidney transplantation (SPK). A 37-year-old woman with a 20-year history of type 1 diabetes mellitus underwent SPK. The pancreaticoduodenal graft was implanted in the right iliac fossa with enteric drainage. A Carrel patch was anastomosed to the recipient's right common iliac artery, and the graft gastroduodenal artery was anastomosed to the common hepatic artery using an arterial I-graft. The donor portal vein was anastomosed to the recipient's inferior vena cava. Four days after surgery, graft thromboses were detected by Doppler ultrasound without increases in the serum amylase and blood glucose levels. Contrast enhanced computed tomography revealed thromboses in the SA, splenic vein and SMA. Selective angiography showed that blood flow was interrupted in the SA and SMA. However, pancreatic graft perfusion was maintained by the I-graft in the head of the pancreas and the transverse pancreatic artery in the body and tail of the pancreas. We performed percutaneous direct thrombolysis and adjuvant thrombolytic therapy. However, we had to stop the thrombolytic therapy because of gastrointestinal hemorrhage. Thereafter, the postoperative course was uneventful and the pancreas graft was functioning with a fasting blood glucose level of 75 mg/dL, HbA1c of 5.1%, and serum C-peptide level of 1.9 ng/mL at 30 months post-transplantation.

  4. Anomalous median nerve associated with persistent median artery.

    PubMed Central

    Sañudo, J R; Chikwe, J; Evans, S E

    1994-01-01

    A right human forearm showed persistence of the median artery in combination with anomalies of the median nerve and of the palmar circulation. The median nerve formed a ring enclosing the median artery, gave off its 3rd palmar digital branch in the forearm, and had a high palmar cutaneous nerve origin and a double thenar supply. The superficial palmar arch was incomplete. The median artery extended into the hand, providing the 2nd common palmar digital artery and the artery to the radial side of the index finger. It anastomosed with the radial artery in the 1st web space. Images Fig. 1 Fig. 2 PMID:7961153

  5. Systemic Artery to Pulmonary Artery Fistula Associated with Mitral Regurgitation: Successful Treatment with Endovascular Embolization

    SciTech Connect

    Iwazawa, Jin; Nakamura, Kenji; Hamuro, Masao; Nango, Mineyoshi; Sakai, Yukimasa; Nishida, Norifumi

    2008-07-15

    We present the case of a 60-year-old woman with symptomatic mitral regurgitation caused by a left-to-right shunt via anastomoses consisting of microfistulae, most likely of inflammatory origin, between the right subclavian artery and the right pulmonary artery. The three arteries responsible for fistulous formation, including the internal mammary, thyrocervical, and lateral thoracic arteries, were successfully occluded by transcatheter embolization using superabsorbent polymer microsphere (SAP-MS) particles combined with metallic coils. No complications have been identified following treatment with SAP-MS particles. This approach significantly reduced the patient's mitral regurgitation and she has remained asymptomatic for more than 4 years.

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

    PubMed

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

    2015-08-15

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

  7. [Topographo-anatomic interrelationships between the branches of the lumbar arteries and the spinal ganglia, nerves and roots].

    PubMed

    Kravchuk, V N

    1975-01-01

    By using a complex of investigation methods variants of branchingout of the spinal cord and spinal ganglia blood supply sources and their anatomo-topographic interrelations were discerned in 140 preparations of lumbar spinal ganglia obtained from human cadavers of both sexes and different age. With the help of anastomoses these sources form a specific arterial circle around the ganglion. The radicular arteries are noted to be non-equivalent. The annular architectonics of the blood vessels is considered as a morphological manifestation of a functionally reliable blood supply to the border area between the central and peripheral divisions of the nervous system.

  8. [Application of a device for determination of the transplant length during operation of the aorta-coronary bypass].

    PubMed

    Volkov, A M; Khubulava, G G; Paĭvin, A A; Liubimov, A I; Kravchuk, V N

    2012-01-01

    Determination of the necessary length of the bypass is one of the principal stages of operation of the aorta-coronary bypass. The greatest difficulty of the determination of the bypass length is the first-priority applying of proximal anastomoses. It requires the surgeon to have great experience, the operation to be longer. It also makes it necessary to prepare a conduit of deliberately excessive length. A device is proposed for the determination of the necessary bypass length during operation of aorta-coronary bypass consisting of a crocodile grip with a fixed to it polymer tube.

  9. Meconium peritonitis in both fetuses with early twin-to-twin transfusion syndrome.

    PubMed

    Marcellin, Louis; Quintana, Andrea; Essaoui, Mohamed; Anselem, Olivia; Beaudoin, Sylvie; El Ayoubi, Mayas; Boujenah, Laurence; Salhi, Houria; Tsatsaris, Vassili

    2012-08-01

    Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin bloodflow through placental vascular anastomoses. We present a TTTS case treated with fetoscopic laser photocoagulation (FLP) that was complicated by perinatal meconium peritonitis in both twins. Ten weeks following laser treatment, the two fetuses showed intra-abdominal hyperechogenicity and ascites. After birth, the two newborns were surgically managed for peritonitis. We discuss the pathogenesis of this double insult. The present case highlights the role of end-circulation bowel thrombi as the potential cause of subsequent intestinal perforation. PMID:22853881

  10. [Encephalopathy in the rat following partial portosystemic anastomosis].

    PubMed

    Stella, G D; Vassanelli, P; Gonzato, P; Rizzi, B; Pelizzo, M R

    1973-01-01

    Gamma-aminobutyric acid (GABA) values were determined in 4 groups of Sprague-Dawley rats 45-50 days after end-to-side porto-cava (PC), mesentericosplenic-cava (MSC) and mesenteric-cava (MC) anastomosis, and a false operation (FO) respectively. Values were significantly increased in the anastomosed animals. If, as may be supposed, this finding points to altered cerebral metabolism, its observation in the MSC and MC groups militates against the general view that encephalopathy in the experimental animal only occurs as a result of total deviation of the portal flow.

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

    SciTech Connect

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

    2010-02-15

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

  12. A new 'enterocompressor' to facilitate rectal anastomosis.

    PubMed

    Barraza, R P

    1990-02-01

    A newly devised enterocompressor facilitates low rectal anastomosis in children with Hirschsprung's disease. This simple surgical instrument, composed of two semicylindrical valves, a hinge, and a regulating screw, maintains intestinal anastomoses properly placed and produces spur crushing. In addition, it is inexpensive and reusable. The enterocompressor, used in 33 primary and 15 secondary Duhamel operations, and applied to normalize intestinal transit in 10 colectomies, provided adequate anastomosis and prevented leakage of intestinal contents. This enterocompressor can be used safely in children as young as six months of age. PMID:2298104

  13. Comment by J.P. Figueiredo, & Hoorn, C. on 'Late Miocene sedimentary environments in south-western Amazonia (Solimões Formation; Brazil)' by Martin Gross, Werner E. Piller, Maria Ines Ramos, Jackson Douglas da Silva Paz

    NASA Astrophysics Data System (ADS)

    Figueiredo, Jorge Jesus Picanço

    2012-04-01

    In their paper Gross et al., 2011 present an excellent description of a series of outcrops from the Eirunepe region in western Amazonia (Brazil). The authors interpret these sediments as relics of a Late Miocene anastomosing fluvial system and conclude that the paleogeography of the entire western Amazon region must have been characterized by this environmental setting. They also imply that therefore a long-lived lake system - or megawetland - never existed. We contend this assumption for some reasons, amongst them, the most important are: (1) this is an inconsistent overgeneralized conclusion; (2) The authors make references to previous scientific works we published which we consider incorrect, and therefore can mislead their readers.

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

    PubMed

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

    2016-02-01

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

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

    SciTech Connect

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

    2008-07-15

    We report a case of a ruptured para-anastomotic aortic aneurysm treated with implantation of a bifurcated stent-graft. A 72-year-old patient, who had undergone aortobifemoral bypass for aortoiliac occlusive disease 16 years ago, presented with a ruptured para-anastomotic aortic aneurysm. A bifurcated stent-graft was successfully deployed into the old bifurcated graft. This is the first report of a bifurcated stent-graft being placed through an 'end-to-side' anastomosed old aortobifemoral graft. Endovascular treatment of ruptured para-anastomotic aortic aneurysms can be accomplished successfully, avoiding open surgery which is associated with increased mortality and morbidity.

  16. Late-Onset Primary Intestinal Lymphangiectasia Successfully Managed with Octreotide: A Case Report

    PubMed Central

    Suehiro, Kotaro; Morikage, Noriyasu; Murakami, Masanori; Yamashita, Osamu; Hamano,, Kimikazu

    2012-01-01

    We report a case of a patient with late-onset primary lymphangiectasia whose persistent diarrhoea was successfully managed with octreotide. A 63 year-old man visited our clinic with a complaint of worsening general edema. Gastrointestinal endoscopy revealed typical whitish jejunal villi, which suggested primary intestinal lymphangiectasia. Despite a diet, supplemented with medium-chain triglycerides; antiplasmin therapy; oral corticosteroids; and surgery, including pericardial window and lymphaticovenous anastomoses; his symptoms, including watery diarrhoea, showed no improvement. After administration of octreotide, his persistent diarrhoea resolved within a couple of days. Octreotide was continued for 2 months. Thereafter, his diarrhoea has not recurred for 6 months. PMID:23555496

  17. [Total laryngopharyngectomy and reconstruction with a jejunum speech siphon : A case report].

    PubMed

    Seidel, D U; Sheppard, K; Dogan, Z A; Remmert, S

    2014-06-01

    Advanced laryngeal and hypopharyngeal carcinomas are associated with a poor prognosis and a pronounced loss of quality of life due to impairment of the swallowing and voice function. The fundamental therapeutic challenge is successful tumor control with concomitant rehabilitation of swallowing and voice functions. Further objectives are a low complications rate (fistula, aspiration) and prompt transfer to the adjuvant radio-oncologic therapy. With these factors in mind, the microvascular anastomosed jejunum speech siphon with a biventer rein has proven to be an effective method of reconstruction following extensive circular laryngopharyngeal resections. In this case report, a typical operative and postoperative course is presented, as are the functional results.

  18. The question of the fusion of neuron processes.

    PubMed

    Sotnikov, O S; Rybakova, G I; Solov'eva, I A

    2008-10-01

    The authors, whilst accepting the neuron theory, present data indicating the possibility that neuronal syncytia exist when myelin-coated ring-like structures form in the dendritic field, in nerve arcades close to neuron bodies, and on formation of thick, straight anastomoses between neuron bodies. Studies using computerized time-lapse videomicroscopy in cultures of isolated neurons demonstrated the mechanism by which these structures form. This report provides the first evidence of the time parameters of the fusion of the processes of a single live neuron; the fusion of fragments of an isolated glial-free fiber was demonstrated. PMID:18802755

  19. Abnormal Origin and Course of the Accessory Phrenic Nerve: Case Report.

    PubMed

    Paraskevas, George; Koutsouflianiotis, Konstantinos; Kitsoulis, Panagiotis; Spyridakis, Ioannis

    2016-01-01

    In the current cadaveric study an unusual sizeable accessory phrenic nerve (APN) was encountered emerging from the trunk of the supraclavicular nerves and forming a triangular loop that was anastomosing with the phrenic nerve. That neural loop surrounded the superficial cervical artery which displayed a spiral course. The form of a triangular loop of APN involving the aforementioned artery and originating from the supraclavicular nerve to the best of our knowledge has not been documented previously in the literature. The variable morphological features of the APN along with its clinical applications are briefly discussed. PMID:27526310

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

    NASA Technical Reports Server (NTRS)

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

    1980-01-01

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

  1. Twin anemia polycythemia sequence: a single center experience and literature review.

    PubMed

    Moaddab, Amirhossein; Nassr, Ahmed A; Espinoza, Jimmy; Ruano, Rodrigo; Bateni, Zhoobin H; Shamshirsaz, Amir A; Mandy, George T; Welty, Stephen E; Erfani, Hadi; Popek, Edwina J; Belfort, Michael A; Shamshirsaz, Alireza A

    2016-10-01

    Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS. In this article, three cases of TAPS are described and we review the literature on this uncommon pregnancy complication.

  2. A Proposed Anatomic Typing of the Right Internal Spermatic Vein: Importance for Percutaneous Sclerotherapy of Varicocele

    SciTech Connect

    Siegel, Yoel Gat, Yigal; Bacher, Gil N.; Gornish, Michael

    2006-04-15

    Purpose. To classify the anatomic types of the right internal spermatic vein (ISV). Methods. We evaluated venograms obtained in 150 consecutive patients with idiopathic varicocele referred for transfemoral sclerotherapy .Results. Six anatomic types of the right internal spermatic vein (ISV) were recognized. These were classified by the location of their orifices and the tributary venous patterns. In roughly half the patients (53%), the ISV appeared as a simple vein with no remarkable retroperitoneal interconnections. In the remainder, complex retroperitoneal anastomoses were encountered. Conclusion. By understanding these anatomic variations, the angiographer can approach treatment of right-sided varicocele with foreknowledge of the nature of these types and the presence of valves and collaterals.

  3. Internal carotid occlusion: assessment, by Tc-99m-tagged microspheres, of bypass from superficial temporal to middle cerebral artery

    SciTech Connect

    Etani, H.; Kimura, K.; Iwata, Y.; Yoneda, S.; Imaizumi, M.; Nukada, T.

    1981-01-01

    The assessment of regional blood perfusion through the STA-MCA anastomosis was performed by the method of intracarotid injection of Tc-99m-labeled human albumin microspheres (HAM scintigraphy). This study included 11 anastomoses in 10 cases with occlusion of the internal carotid artery, who were treated by bypass surgery. The area of intracranial perfusion through the bypass was well defined in all cases by HAM scintigraphy. This method is excellent for imaging the regional blood perfusion through the anastomotic vessel, and the scintigraphic findings agree well with those of postoperative angiography. HAM scintigraphy will partially replace postoperative angiography because of its simplicity and low invasiveness.

  4. Radionuclide evaluation of free vascularized bone graft viability. [/sup 99m/Tc-methylene diphosphonate

    SciTech Connect

    Lisbona, R.; Rennie, W.R.J.; Daniel, R.K.

    1980-02-01

    Free vascularized bone grafting is a new technique applied to the reconstructive surgery of long bones affected by aggressive benign or malignant processes, as well as traumatic deficiencies. These bone lesions may be treated by en bloc excision and replacement with fibular segments or osteocutaneous flaps from the groin isolated on their vascular pedicle. Microvascular anastomosis of the pedicle at the recipient site is necessary. Radionuclide bone imaging is unique in the assessment of the free vascularized bone graft because postoperative graft uptake of radiopharmaceutical reflects patent anastomoses and segmental bone viability.

  5. Internal carotid occlusion: assessment, by Tc-99m-tagged microspheres, of bypass from superficial temporal to middle cerebral artery

    SciTech Connect

    Etani, H.; Kimura, K.; Iwata, Y.

    1981-10-01

    The assessment of regional blood perfusion through the STA-MCA anastomosis was performed by the method of intracarotid injection of Tc-99m-labeled human albumin microspheres (HAM scintigraphy). This study included 11 anastomoses in 10 cases with occlusion of the internal carotid artery, who were treated by bypass surgery. The area of intracranial perfusion through the bypass was well defined in all cases by HAM scintigraphy. This method is excellent for imaging the regional blood perfusion through the anastomotic vessel, and the scintigraphic findings agree well with those of postoperative angiography. HAM scintigraphy will partially replace postoperative angiography because of its simplicity and low invasiveness.

  6. Mechanism of aneurysm formation after 830-nm diode-laser-assisted microarterial anastomosis

    NASA Astrophysics Data System (ADS)

    Tang, Jing; Godlewski, Guilhem; Rouy, Simone

    1998-01-01

    A series of 830 nm diode laser assisted longitudinal aortorrhophy with a condition of 400 to 500 J/mm2 for one cm length of anastomosis versus conventional manual anastomoses were performed in 90 Wistar rats. With comparing with normal media process, a histologic examination of aneurysm formation was conducted. The results show that there are two important factors to cause aneurysm formation after laser assisted anastomosis: (1) vessel wall is damaged by laser heating; (2) proliferation of collagen fiber at adventitia is absent when media reconstruction.

  7. Surgical Treatment of Abdominal Aortic Aneurysm with Congenital Solitary Pelvic Kidney and Superior Mesenteric Artery Stenosis

    PubMed Central

    Saito, Takaaki; Tanaka, Hiroki; Yamamoto, Naoto; Inuzuka, Kazunori; Sano, Masaki

    2016-01-01

    We report the rare case of a 54-year-old man with uncontrolled renovascular hypertension, who was found to have an abdominal aortic aneurysm with congenital solitary pelvic kidney and superior mesenteric artery stenosis. A single renal artery branched from aneurysmal aortic bifurcation, and both the renal artery and the superior mesenteric artery (SMA) had severe stenosis at their origins. The aneurysm was repaired with a bifurcated Dacron graft, to which the renal artery was anastomosed. SMA bypass was created between the graft’s left limb and the SMA using another Dacron graft. The operation was successful, with improvement in renal functions and control of hypertension. PMID:27738466

  8. Creative Use of Contralateral Combined Myocutaneous Free Flap for Empyema Cavity.

    PubMed

    Tan, Hannah B; Mohan, Anita T; Coonar, Aman S; Malata, Charles M

    2016-01-01

    Treatment of chronic postpneumonectomy empyema is a reconstructive problem that is always complicated by previous thoracic surgical procedures. Free flaps may be used because they effectively obliterate remaining pleural cavity dead space. Combined muscle free flaps with common vascular pedicles are viable alternatives when single muscle flaps do not possess adequate bulk. This case describes a contralateral combined latissimus dorsi-serratus anterior myocutaneous free flap with anastomoses to thoracodorsal vessels used for correction of chronic empyema. We also describe successful correction of a posterolateral chest wall defect using the adjacent axillary system as a recipient vessel. An accompanying skin paddle also enabled reliable cutaneous coverage of the external defect. PMID:26694302

  9. Pseudoangio-matous stromal hyperplasia: A rare tumor of the breast.

    PubMed

    Shahi, Kedar Singh; Bhandari, Geeta; Gupta, Rakesh Kumar; Sawai, Malvika

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast entity described first by Vuitch et al., in 1986. PASH is a benign stromal lesion containing complex anastomosing channels lined by slender spindle cells. It can be mistaken with fibroadenoma on ultrasound examination and histologically with low-grade angiosarcoma and phyllodes tumor. Here, presented is a case report of a 30-year-old female who presented with huge palpable lump in left breast. Ultrasonography revealed the lesion as giant fibroadenoma and fine needle aspiration cytology report was suggestive of cystosarcoma phyllodes. Excision and reduction mammoplasty was done and histopathology report was suggestive of PASH. PMID:26881624

  10. Response to ‘Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”’

    NASA Astrophysics Data System (ADS)

    McClenagan, J. Donald

    2014-03-01

    A response is given to 'Discussion: “Streamlined erosional residuals and drumlins in central British Columbia, Canada”'. Emphasis is made that the main purpose of the paper under discussion is to present the recognition of a distinctive landscape pattern in central British Columbia that appears to be an immense anastomosing channel network. A channel network of the magnitude described requires a large magnitude of flowing water to form it. Thus, that recognizable landscape pattern and associated upland landform shapes can be explained as products of water erosion. Such landscape patterns are observed being formed by water today.

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

    PubMed

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

    2016-08-01

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

  12. Tertiary resurfacing after one of the first free flaps in Europe, a reflection on 30 years of microsurgical progress.

    PubMed

    Hart, A M; Tollan, C J; Dabernig, J; Acland, R; Taggart, I

    2007-01-01

    Free flaps have been used for over 30 years. During this period, improved anatomical understanding has increased donor options and available pedicle lengths, permitting safer, single-stage reconstructions with simpler anastomoses. Refinements, such as perforator flaps in particular, have greatly improved donor morbidity, recipient site cosmesis, and the ability to replace 'like with like' while retaining options for innervation. This case highlights the evolution from one of Europe's first free tissue transfers, effectively a perforator flap, through the advent of free muscle flaps to the current generation of contourable perforator flaps. Free flap transfer has become increasingly sophisticated, safer, and more predictable, yet the potential quality of reconstructive outcome has changed little.

  13. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms

    NASA Astrophysics Data System (ADS)

    Umur, Asli; van Gemert, Martin J. C.; Ross, Michael G.

    2002-06-01

    Clinical evidence suggests that increased amniotic fluid volume due to polyhydramnios increases placental vascular resistance. We have sought to model the possible effects of an increased amniotic fluid volume on the net fetofetal transfusion in monochorionic twin pregnancies. We wanted to compare these effects with the results of previous simulations, which aimed to explain why the twin-twin transfusion syndrome (TTTS) placentas more often include bidirectional arteriovenous (AV) rather than AV plus arterioarterial (AA) anastomoses. We extended our mathematical model of TTTS by simulating two different mechanisms that increase the placental vascular resistance as a consequence of polyhydramnios. First, there is an increase in the placental capillary resistance and hence in deep AV and opposite AV (denoted as VA) resistances due to polyhydramnios. Second, there is an increase in the resistance of chorionic veins due to polyhydramnios, assuming that these veins act as Starling resistors. We then simulated the effects of polyhydramnios on different placental anastomotic patterns. The results were as follows. In the first mechanism (polyhydramnios affects AV-VA resistances), an increased amniotic fluid volume hardly affected bidirectional AV, but slightly decreased fetofetal transfusion in AV plus AA anastomoses. However, for these effects to change the natural development of the pregnancy, polyhydramnios needed to persist for approximately 4 weeks, and by comparing the effects of polyhydramnios with the effects of amnioreduction, amnioreduction was more beneficial for normalizing the donor amniotic fluid volume. Therefore, these beneficial effects due to polyhydramnios have no practical clinical significance. In the second mechanism (Starling resistor for chorionic veins), polyhydramnios slightly increased fetofetal transfusion and hence slightly increased TTTS severity in bidirectional AV and AV plus VV, but did not affect AV plus AA anastomoses. In conclusion, we

  14. Compliant model of a coupled sequential coronary arterial bypass graft: effects of vessel wall elasticity and non-Newtonian rheology on blood flow regime and hemodynamic parameters distribution.

    PubMed

    Kabinejadian, Foad; Ghista, Dhanjoo N

    2012-09-01

    We have recently developed a novel design for coronary arterial bypass surgical grafting, consisting of coupled sequential side-to-side and end-to-side anastomoses. This design has been shown to have beneficial blood flow patterns and wall shear stress distributions which may improve the patency of the CABG, as compared to the conventional end-to-side anastomosis. In our preliminary computational simulation of blood flow of this coupled sequential anastomoses design, the graft and the artery were adopted to be rigid vessels and the blood was assumed to be a Newtonian fluid. Therefore, the present study has been carried out in order to (i) investigate the effects of wall compliance and non-Newtonian rheology on the local flow field and hemodynamic parameters distribution, and (ii) verify the advantages of the CABG coupled sequential anastomoses design over the conventional end-to-side configuration in a more realistic bio-mechanical condition. For this purpose, a two-way fluid-structure interaction analysis has been carried out. A finite volume method is applied to solve the three-dimensional, time-dependent, laminar flow of the incompressible, non-Newtonian fluid; the vessel wall is modeled as a linearly elastic, geometrically non-linear shell structure. In an iteratively coupled approach the transient shell equations and the governing fluid equations are solved numerically. The simulation results indicate a diameter variation ratio of up to 4% and 5% in the graft and the coronary artery, respectively. The velocity patterns and qualitative distribution of wall shear stress parameters in the distensible model do not change significantly compared to the rigid-wall model, despite quite large side-wall deformations in the anastomotic regions. However, less flow separation and reversed flow is observed in the distensible models. The wall compliance reduces the time-averaged wall shear stress up to 32% (on the heel of the conventional end-to-side model) and somewhat

  15. Basic Vascular Neuroanatomy of the Brain and Spine: What the General Interventional Radiologist Needs to Know

    PubMed Central

    Prince, Ethan A.; Ahn, Sun Ho

    2013-01-01

    This article is intended to provide a review of clinically relevant neurovascular anatomy. A solid understanding of the vascular anatomy of the brain and spine are essential for the safe and effective performance of neurointerventional radiology. Key concepts to master include collateral pathways and anastomoses between the external and internal carotid circulation, the Circle of Willis as a route to otherwise inaccessible intracranial vascular distributions, and the origin of spinal arterial blood supply. These concepts will be highlighted using clinical angiographic examples with discussion of relevant embryology and pathology as needed. PMID:24436544

  16. A preliminary assessment of the fluid erosional processes that shaped the Martian outflow channels

    NASA Technical Reports Server (NTRS)

    Baker, V. R.

    1978-01-01

    Catastrophic floods may be the mechanism which created Martian outflow channels and the distinctive assemblage of channel landforms, including regional and local anastomosing patterns, expanding and contracting reaches correlated with flow constrictions, streamlined uplands, inner channels with recessional headcuts, pendant forms on the downcurrent sides of flow obstacles, and scour marks around the obstacles. A terrestrial landscape which contains analogs to all the Martian outflow features is the Channeled Scabland of eastern Washington, formed by catastrophic flooding across differentially resistant basalt, loess and sedimentary rock. Both hydrodynamic theory and the properties of the boundary undergoing deformation need to be considered in studying the forms that result from catastrophic flooding.

  17. An impending rupture of a celiac artery aneurysm in a patient with Behçet's disease -- extra-anatomic aorto-common hepatic artery bypass: report of a case.

    PubMed

    Maeda, Hideaki; Umezawa, Hisaki; Goshima, Masakazu; Hattori, Tsutomu; Nakamura, Tetsuya; Negishi, Nanao; Oinuma, Toshinori; Sugitani, Masahiko; Nemoto, Norimichi

    2008-01-01

    A celiac artery aneurysm associated with Behçet's disease is extremely rare. We herein present the case of successful surgical treatment for an impending rupture of a large celiac artery aneurysm with a wide proximal neck in a patient associated with Behçet's disease. To our knowledge, this is the first report of a procedure involving extra-anatomic aorto-common hepatic artery (CHA) bypass through the retroperitoneal space implanting a 6-mm expanded polytetrafluoroethylene graft. An 18-month postoperative magnetic resonance angiography scan showed a good patency of the aorto-CHA graft without an anastomotic pseudoaneurysm in a closure of aorta and anastomoses.

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

    USGS Publications Warehouse

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

    1988-01-01

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

  19. Compliant model of a coupled sequential coronary arterial bypass graft: effects of vessel wall elasticity and non-Newtonian rheology on blood flow regime and hemodynamic parameters distribution.

    PubMed

    Kabinejadian, Foad; Ghista, Dhanjoo N

    2012-09-01

    We have recently developed a novel design for coronary arterial bypass surgical grafting, consisting of coupled sequential side-to-side and end-to-side anastomoses. This design has been shown to have beneficial blood flow patterns and wall shear stress distributions which may improve the patency of the CABG, as compared to the conventional end-to-side anastomosis. In our preliminary computational simulation of blood flow of this coupled sequential anastomoses design, the graft and the artery were adopted to be rigid vessels and the blood was assumed to be a Newtonian fluid. Therefore, the present study has been carried out in order to (i) investigate the effects of wall compliance and non-Newtonian rheology on the local flow field and hemodynamic parameters distribution, and (ii) verify the advantages of the CABG coupled sequential anastomoses design over the conventional end-to-side configuration in a more realistic bio-mechanical condition. For this purpose, a two-way fluid-structure interaction analysis has been carried out. A finite volume method is applied to solve the three-dimensional, time-dependent, laminar flow of the incompressible, non-Newtonian fluid; the vessel wall is modeled as a linearly elastic, geometrically non-linear shell structure. In an iteratively coupled approach the transient shell equations and the governing fluid equations are solved numerically. The simulation results indicate a diameter variation ratio of up to 4% and 5% in the graft and the coronary artery, respectively. The velocity patterns and qualitative distribution of wall shear stress parameters in the distensible model do not change significantly compared to the rigid-wall model, despite quite large side-wall deformations in the anastomotic regions. However, less flow separation and reversed flow is observed in the distensible models. The wall compliance reduces the time-averaged wall shear stress up to 32% (on the heel of the conventional end-to-side model) and somewhat

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

    PubMed

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

    2015-08-15

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

  1. Off-pump coronary artery bypass grafting for a left main lesion due to cardiac allograft vasculopathy in Japan: first report of a case.

    PubMed

    Fujita, Tomoyuki; Kobayashi, Junjiro; Hata, Hiroki; Murata, Yoshihiro; Seguchi, Osamu; Yanase, Masanobu; Shimahara, Yusuke; Sato, Shunsuke; Nakatani, Takeshi

    2014-10-01

    Cardiac allograft vasculopathy (CAV) is a major cause of mortality after transplantation. We treated a 44-year-old female with off-pump coronary artery bypass grafting (OPCAB) 4 years after heart transplantation. Annual examinations, including coronary angiography and intravenous ultrasound (IVUS), revealed a severe lesion in the left main trunk. The left internal mammary artery was successfully anastomosed to the left anterior descending artery in an off-pump manner. To ensure that patients have a good long-term outcome after heart transplantation, routine examinations, including IVUS, are crucial, because of the nature of CAV. OPCAB is a good option for a left main trunk lesion due to CAV.

  2. [Cerebellar stroke].

    PubMed

    Paradowski, Michał; Zimny, Anna; Paradowski, Bogusław

    2015-01-01

    Cerebellar stroke belongs to a group of rare diseases of vascular origin. Cerebellum, supplied by three pairs of arteries (AICA, PICA, SCA) with many anastomoses between them is less susceptible for a stroke, especially ischemic one. Diagnosis of the stroke in this region is harder due to lower sensibility of commonly used CT of the head in case of stroke suspicion. The authors highlight clinical symptoms distinguishing between vascular territories or topographical locations of the stroke, diagnostic procedures, classical and surgical treatment, the most common misdiagnoses are also mentioned. The authors suggest a diagnostic and therapeutic algorithm development, including rtPA treatment criteria for ischemic cerebellar stroke. PMID:26181157

  3. Covered stent in the superior gluteal artery in a hybrid approach to treat internal iliac artery aneurysm: a technical note.

    PubMed

    Noël-Lamy, Maxime; Teng Tan, Kong; Lindsay, Thomas

    2015-07-01

    This brief report describes a hybrid endovascular and open procedure to treat internal iliac artery (IIA) aneurysms and preserve pelvic blood flow. A covered stent was deployed before surgery in the superior gluteal artery, extending across the IIA aneurysm, with the proximal end in the common iliac artery lumen. During open aortoiliac aneurysm repair, the stent graft was anastomosed in an end-to-side manner to the surgical graft. Four aneurysms were treated in 3 patients. Technical success was achieved in all cases. There were no complications or repeat interventions. Stents were all patent at imaging follow-up (range, 6-25 mo). Patients were free from buttock claudication. PMID:26095271

  4. Massive amebic liver abscess--an unusual presentation.

    PubMed

    Kaur, N; Gupta, S; Minocha, V R; Singh, U R

    2001-01-01

    A 40-year-old woman presented with a huge lump in the right half of the abdomen and irregular menses. Ultrasonography showed a cystic lump with septations, extending from the upper abdomen to the pelvis; the right ovary was not seen. On exploration, there was a large cyst arising from the right lobe of the liver; the aspirate was bilious. Since the cyst wall was adherent to retroperitoneal structures, complete excision was not possible. A roux-en-Y loop of jejunum was anastomosed to the cyst wall. Biopsy of the wall showed inflammatory granulation tissue with trophozoites of Entamoeba histolytica. She was treated with metronidazole, and recovered uneventfully.

  5. Anomalous Feeding of the Left Upper Lobe.

    PubMed

    Hazzard, Christopher; Itagaki, Shinobu; Lajam, Fouad; Flores, Raja M

    2016-09-01

    We report the case of a 53-year-old woman who presented with massive hemoptysis. Computed tomographic angiography revealed an anomalous vessel arising from the abdominal aorta, coursing anteriorly and through the diaphragm, and feeding the left upper lobe. At operation the vessel was found to anastomose to the left upper lobe lingula, which contained multiple vascular abnormalities and arteriovenous fistulas. The vessel was ligated, and the affected portion of the left upper lobe was resected. Anomalous systemic arterial supply of an upper lobe is an especially rare form of a Pryce type 1 abnormality. Recognition of these unusual anatomic variants is crucial to successful treatment and avoidance of adverse events.

  6. Restoration of the pelvic circulation in patients with abdominal aortic aneurysms receiving aortobifemoral grafts.

    PubMed

    Cardia, G; Tumolo, R; Cafagna, L

    1998-04-01

    When operating on abdominal aortic aneurysms associated with stenoses or occlusions of iliac vessels, surgeons may face the problem of reestablishing circulation to pelvic or gluteal territories. A new technique consists of anastomosing a posterior opening in the body or one of the branches of a bifurcated graft, distally sutured to the femoral artery, to the distal aortic stump, which contains all the patent vessels arising from the end of the aorta, such as inferior mesenteric and lumbar arteries. This technique, successfully performed in two cases, has the advantages of avoiding closure of the distal aortic stump and a possible backflow leak and of ensuring adequate pelvic circulation. PMID:9576094

  7. Retroperitoneal robotic-assisted laparoscopic reimplantation of a ureter into an ileal conduit.

    PubMed

    Durbin, Jason M; Bejma, Jeffrey; Auge, Brian K; L'Esperance, James O

    2012-06-01

    A novel technique for managing ureteroenteric strictures is robotic-assisted retroperitoneal laparoscopic reimplantation. A 63-year-old morbidly obese male underwent a left nephroureterectomy and cystoprostatectomy after neoadjuvant chemotherapy for transitional cell carcinoma of both the bladder and left kidney. His single right ureter was anastomosed to the ileal conduit. Postoperatively, he developed acute renal failure and hydronephrosis. An antegrade pyelogram demonstrated a distal stricture that failed two attempts at endoscopic management. In an effort to avoid the morbidity of an open repair, we present a minimally invasive option that replicates the steps of an open reimplantation. PMID:27628283

  8. Distinct expression profiles of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (MMP-12), and tissue inhibitor of metalloproteinases-3 (TIMP-3) in intestinal ulcerations.

    PubMed Central

    Vaalamo, M.; Karjalainen-Lindsberg, M. L.; Puolakkainen, P.; Kere, J.; Saarialho-Kere, U.

    1998-01-01

    Programmed expression of matrix metalloproteinases is involved in wound healing in various organs. We have previously demonstrated enhanced expression of collagenase-1, stromelysin-1, matrilysin, and tissue inhibitor of metalloproteinases (TIMP-1) in gastrointestinal ulcerations. To further define the role of matrix-degrading enzymes and their inhibitors in intestinal inflammation and ulcerations, the expression of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (HME, MMP-12), and TIMP-3 mRNAs was studied using in situ hybridization and immunohistochemistry in 38 samples representing ulcerative colitis, Crohn's disease, ischemic colitis, and normal intestine. As controls for normally healing intestinal wounds, 12 postoperative samples of rat experimental jejunal anastomoses were also examined. The colitis types studied did not essentially differ in their MMP expression. We found stromelysin-2 mRNA in laminin-5-positive and Ki-67-negative enterocytes bordering the ulcerations. HME was abundantly expressed by macrophages in the vicinity of shedding mucosal epithelium and beneath the necrotic surface of the ulcers. Collagenase-3 and TIMP-3 were expressed by fibroblast-like cells deeper in the remodeling intestinal wall. Expression for stromelysin-2 and collagenase-3 was observed in granulation tissue, but not the epithelium, of the rat anastomoses. Our results suggest a role for stromelysin-2 in epithelial migration and for metalloelastase in macrophage movement and epithelial cell shedding. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:9546361

  9. Temporary Ectopic Implantation of a Single Finger Using a Perforator as a Feeding Vessel, and Subsequent Prefabricated Chimeric Flap Transplantation

    PubMed Central

    Takumi, Yamamoto; Hisako, Hara; Yusuke, Yamamoto; Azusa, Oshima; Kazuki, Kikuchi; Harunosuke, Kato; Kumiko, Sata; Kentaro, Doi; Takeshi, Todokoro; Jun, Araki; Makoto, Mihara; Takuya, Higashino; Takuya, Iida; Isao, Koshima

    2012-01-01

    Objective: Ectopic implantation was first reported by Godina in 1986. We herein present 2 cases in which amputated fingers were salvaged and reconstructed by means of temporary ectopic implantation utilizing perforator anastomoses and chimeric flaps. Methods: Case 1. A 30-year-old man injured his right hand. All of the fingers were completely crushed with the exception of the little finger. We performed an ectopic implantation by using the superficial circumflex iliac artery perforator. Three months later, the little finger was transplanted with the superficial circumflex iliac artery perforator flap, vascularized nerve, and the 2nd metacarpal bone. Case 2. A 29-year-old man suffered a degloving injury of the index finger. The digital artery was anastomosed to deep inferior epigastric artery perforator. One month later, a deep inferior epigastric artery perforator flap containing the ectopically transplanted index finger was transplanted, but the index fingertip became pale and necrotized. After debridement, a hemipulp transplantation was performed. Results/Conclusions: As the diameter of perforators is similar to that of digital arteries, and perforators are capable of supplying large areas of tissue, they can be used as recipient vessels for ectopic implantation in finger salvage procedures. Another advantage of perforators as feeding vessels in ectopic implantation is the possibility of forming an ectopic chimera; the finger can be incorporated as a part of the chimeric reconstructive flap. With respect to these advantages, the perforator can be used as a feeder in an ectopic implantation of single finger.

  10. Transvaginal Route for Kidney Extraction in Laparoscopic Donor Nephrectomy

    PubMed Central

    Berber, Ibrahim; Cakir, Ulkem; Gurkan, Alihan

    2014-01-01

    Background and Objectives: The aim of this retrospective study was to compare conventional laparoscopic living-donor nephrectomy with transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy in terms of feasibility and reproducibility. Methods: A total of 115 consecutive female patients who underwent laparoscopic living-donor nephrectomy (n = 70) or transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy (n = 45) were included and compared in terms of operative characteristics, as well as donor and recipient outcomes. Results: No significant difference was observed between the laparoscopic living-donor nephrectomy and transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy groups in terms of mean duration of warm and cold ischemia, operation time, length of hospital stay, arterial anastomoses, visual analog scale pain scores, serum creatinine levels, and receiver outcomes, whereas a significantly higher number of venous anastomoses was noted in the laparoscopic living-donor nephrectomy group than in the transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy group (P = .029). Conclusions: Transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy seems to be a feasible and reproducible alternative to conventional laparoscopic living-donor nephrectomy in female donors provided the viability of the vagina as an organ retrieval route. PMID:25419107

  11. Optimal line of hepatotomy for left lateral living donor liver transplantation according to the anatomical variations of left hepatic duct system.

    PubMed

    Kiss, Mátyás; Deshpande, Rahul R; Nemeskéri, Ágnes; Nguyen, Tien T; Kürti, Zsuzsanna; Kovács, Sándor; Pápai, Zsolt; Németh, Károly; Szuák, András; Dudás, Ibolyka; Kóbori, László

    2015-08-01

    Multiple duct anastomoses during LLS transplantation increase the incidence of biliary complications. The optimal plane of hepatotomy that results in the least number of bile ducts at the surface was investigated according to LHD variations. Ducts of 30 human livers were injected with resin and LHD branching on 3D-CT reconstructions were analyzed. Ducts on the virtual hepatotomy surface were estimated in three splitting lines. Variations with subtypes were described. Ia (66.7%): ducts from segments (S.) II-III form a common trunk and S.IV duct joins it. Ib (10%): common trunk formed by ducts from S.II-S.III while S.IV duct joins the common hepatic duct. IIa (16.67%): S.IV duct drains into S.III duct. IIc (3.33%): S.IV duct drains into both S.II and S.III ducts. III (3.33%): trifurcation of S.II, S.III and S.IV ducts. When the virtual hepatotomy line was on the FL, there was a single duct for the anastomosis in 30% of cases but two, three, or four ducts in 53.3%, 10%, and 3.3%, respectively. Division 1 cm to the right of the FL resulted in one duct (70%), but S.IV duct injury may occur. LLS hepatotomy should not necessarily be performed along the FL. Variations must be taken into consideration to minimize the number of biliary anastomoses during liver implantation.

  12. Pathology of twin placentas with special attention to monochorionic twin placentas.

    PubMed

    Nikkels, P G J; Hack, K E A; van Gemert, M J C

    2008-12-01

    The risk of perinatal morbidity and mortality in twins is 3-7 times higher than in singletons. In comparison to dichorionic twins, monochorionic twins are at increased risk for perinatal mortality and serious morbidity. In both type of twins growth discordance can occur. Discordant growth of dichorionic twins could be due to differences in placental mass or differences in placental parenchymal lesions, whereas birth weight discordancy in monochorionic twins is caused by placental vascular anastomoses. In this review the different types of complications (acardiac twins, acute and chronic twin-twin transfusion syndrome) due to different combinations of vascular anastomoses are discussed in relation to a computer model developed to gain more insight into the development of the twin-twin transfusion syndrome. The angioarchitecture of 395 monochorionic twin placentas was studied. Mortality was highest in the absence of an arterio-arterial anastomosis (42%) and lowest in the presence of an arterio-arterial anastomosis (15%). If mortality occurred, pregnancies with double mortality usually had an arterio-arterial anastomosis. If pregnancies were complicated by one death, a veno-venous anastomosis is more likely to be present. In conclusion, monochorionic twin pregnancies are a high risk pregnancy with a high chance of both mortality and morbidity; placental characteristics are a major contributor to adverse outcome in these pregnancies.

  13. Systematization and description of the internal carotid arteries and their main ramifications at the brain base in turtles (Trachemys scripta elegans).

    PubMed

    Voll, Juliana; Campos, Rui

    2016-08-01

    Thirty turtle brains (Trachemys scripta elegans) were injected with latex to systematize and describe the internal carotid arteries and their main ramifications at the brain base. The internal carotid arteries had one intercarotid anastomosis. At the level of the tuber cinereum, the internal carotid artery bifurcated into its terminal branches, the rostral and the caudal branches. The rostral branch emitted the rostral choroid artery, the orbital artery, and a series of middle cerebral arteries. After giving off the last middle cerebral artery, the rostral branch continued as the rostral cerebral artery in the cerebral longitudinal fissure, and had one anastomosis with its contralateral homologous artery, the rostral communicating artery, making the first rostral closure of the cerebral arterial circle. Next, the rostral cerebral arteries anastomosed forming a rostral interhemispheric artery, making the second rostral closure of the cerebral arterial circle. The internal carotid artery, after emitting its rostral branch, continued caudally as the caudal branch. The caudal branch ran caudally along the ventral surface of the mesencephalic tegmentum, emitted the caudal cerebral artery and the mesencephalic artery, and continued caudomedially while progressively narrowing, and anastomosed with its contralateral homologous artery, forming the basilar artery. The narrower portion also emitted the trigeminal artery. The anastomosis of the caudal branches closed the cerebral arterial circle caudally. The internal carotid arteries exclusively supplied the cerebral arterial circle of the turtle. Anat Rec, 299:1090-1098, 2016. © 2016 Wiley Periodicals, Inc. PMID:27145530

  14. Different ophthalmic artery origins: Embryology and clinical significance.

    PubMed

    Louw, Louise

    2015-07-01

    This retrospective study gives a summary of ophthalmic artery (OA) variations to serve as guidelines for surgical interventionists and trainees. Pubmed and Medline searches were conducted. The OA usually arises intradurally (superomedial, anteromedial, or rarely superolateral) from the internal carotid artery (ICA). Rare extradural origin (primitive dorsal OA) (PDOA) remnant and extremely rare interdural origin (primitive ventral OA) (PVOA) remnant are of significance when sectioning the dural ring. Rarely, a persistent PDOA with ICA origin, or a PDOA remnant with inferolateral trunk origin, enters the orbit via the superior orbital fissure (SOF) for sole or partial orbital supply. Extremely rare, the PDOA and PVOA persist and form double OAs that arise from the ICA and run via the SOF and optic foramen. Occasionally, the OA arises from the middle meningeal artery (MMA), when both the PDOA and VDOA regress and enter the orbit via the SOF. Sole orbital supply via the external carotid artery (ECA), i.e. meningo-ophthalmic artery and/or MMA branches, or dual OAs (ECA and ICA origins) may occur. Other rare OA origins include anterior or posterior communicating artery; anterior or middle cerebral artery; basilar artery; posterior inferior cerebellar artery; and the carotid bifurcation. Primitive arteries (persistent or remnant), and/or abnormal anastomoses play pivotal roles in manifestations of OA variations. Of clinical importance are orbital collateral routes and dangerous extracranial-intracranial anastomoses. Awareness of OA origins and collateral routes is imperative for transarterial embolizations or infusion chemotherapy in the ECA territory to prevent visual complications.

  15. Delayed endoluminal vacuum therapy for rectal anastomotic leaks after rectal resection in a swine model: a new treatment option.

    PubMed

    Rosenberger, Laura H; Shada, Amber; Ritter, Lane A; Mauro, David M; Mentrikoski, Mark J; Feldman, Sanford H; Kleiner, Daniel E

    2014-04-01

    Anastomotic leaks are a dreaded surgical complication following colorectal operations. Creation of a temporary proximal diverting ileostomy is used in high-risk anastomoses, however, additional surgical risk is accumulated with its creation and reversal. Endoluminal vacuum therapy has been shown to seal anastomotic defects in the prophylactic setting in a pig model and we hypothesized it could be utilized in a delayed fashion to rescue subjects with an active anastomotic leak. Yorkshire pigs underwent rectal resection, intentional leak confirmed by fluoroscopy, and endoluminal vacuum therapy device placement to low continuous suction. Following treatment, a contrast enema and necropsy was performed for gross and histopathology. Pigs underwent 2 (or 5) days of free intraperitoneal leak prior to device placement and 5 (or 7) subsequent days of endoluminal vacuum therapy. Six of seven early-treated pigs sealed their anastomotic defect, while two of the four treated pigs in this extended group sealed the defect. Endoluminal vacuum therapy is feasible and well tolerated in a pig model, and it has been shown to seal a significant number of freely leaking anastomoses in the early period (86%). This technology warrants further study as it may provide a noninvasive means to treatment of anastomotic leaks.

  16. Tooth serration morphologies in the genus Machimosaurus (Crocodylomorpha, Thalattosuchia) from the Late Jurassic of Europe.

    PubMed

    Young, Mark T; Steel, Lorna; Brusatte, Stephen L; Foffa, Davide; Lepage, Yves

    2014-11-01

    Machimosaurus was a large-bodied durophagous/chelonivorous genus of teleosaurid crocodylomorph that lived in shallow marine and brackish ecosystems during the Late Jurassic. Among teleosaurids, Machimosaurus and its sister taxon 'Steneosaurus' obtusidens are characterized by having foreshortened rostra, proportionally enlarged supratemporal fenestrae and blunt teeth with numerous apicobasal ridges and a shorter anastomosed ridged pattern in the apical region. A recent study on 'S.' obtusidens dentition found both true denticles and false serrations (enamel ridges which contact the carinae). Here, we comprehensively describe and figure the dentition of Machimosaurus, and find that Machimosaurus buffetauti and Machimosaurus hugii have four types of serration or serration-like structures, including both denticles and false denticles on the carinae. The denticles are irregularly shaped and are not always discrete units, whereas the false denticles caused by the interaction between the superficial enamel ridges and the carinae are restricted to the apical region. Peculiarly, the most 'denticle-like' structures are discrete, bulbous units on the apicobasal and apical anastomosed ridges of M. hugii. These 'pseudo-denticles' have never, to our knowledge, previously been reported among crocodylomorphs, and their precise function is unclear. They may have increased the surface area of the apical region and/or strengthened the enamel, both of which would have been advantageous for a durophagous taxon feeding on hard objects such as turtles. PMID:26064563

  17. Reflectance spectrometry of placental vessels in cases of twin-twin transfusion syndrome: experiments and modeling

    NASA Astrophysics Data System (ADS)

    Lines, Collin; Kim, Oleg; McMurdy, John; Luks, Francois; Alber, Mark; Crawford, Greg

    2013-03-01

    A stochastic photon transport model in multilayer skin tissue combined with reflectance spectroscopy measurements is used to study placental vessels in cases of twin-twin transfusion syndrome (TTTS). TTTS occurs in about 12% of monozygotic (identical) twin pregnancies wherein flow within placental vessels linking the twins together becomes unbalanced, leading to dual mortality. Endoscopic laser ablation can halt the syndrome by occluding the anastomoses connecting the two fetuses. The objective of this study is to develop a technique to determine hemoglobin (Hb) content through spectral analysis of diffuse reflectance spectra of placental vessels to aid in identification of the anastomoses. Previous work by researchers at Brown University has shown that the reflectance spectra of the donor twin and recipient twin are considerably different in the wavelengths for Hb absorbance. This presentation will give preliminary results for a Monte Carlo model adapted to fit the physiology of the placenta that can be used to quantitative determine the Hb levels. The reflectance spectra of the vessels are simulated for different values of Hb as well oxygenation and water concentration with the vessel and placental mass. The preliminary results will be shown to be in good approximation with the prior experimental data. The combination of modeling with spectroscopic measurement will provide a new tool for detailed prenatal study.

  18. Optimization of the Outflow Graft Position and Angle in a Left Ventricular Assist Device

    NASA Astrophysics Data System (ADS)

    McGah, Patrick; Prisco, Anthony; Beckman, Jennifer; Mokadam, Nahush; Mahr, Claudius; Aliseda, Alberto

    2015-11-01

    The placement of the outflow graft in the aorta plays a key role in the hemodynamics of Left Ventricle Assist Devices (LVAD), a medical device with a growing importance in the treatment of end-stage heart failure. We use a patient-specific computational model of the VAD and the ascending aorta to investigate the impact of VAD outflow graft configuration on the residence time and wall shear stresses along the ascending aorta and the ostia of the upper branches. The flow induced by the combination of VAD output through the graft anastomosed to the aorta and the limited cardiac output through intermittent opening of the aortic valve is studied to determine the nature of thrombogenic flow patterns. Outflow grafts are virtually anastomosed along the ascending aorta or subclavian artery of the patient-specific model at different positions and angles that are surgically-informed. Detailed markers of thrombosis, such as cell residence time, wall shear stress, and shear stress gradients are analyzed and compared for the different configurations. The angle of incidence of the outflow graft critically influences the volume of recirculating flow between aortic valve and anastomosis, and the aortic pressure acting against aortic valve opening.

  19. Skeletonization of the internal thoracic artery: a randomized comparison of harvesting methods.

    PubMed

    Urso, Stefano; Alvarez, Luis; Sádaba, Rafael; Greco, Ernesto

    2008-02-01

    We performed a randomized study to compare internal thoracic artery (ITA) flow response to two harvesting methods used in the skeletonization procedure: ultrasonic scalpel and bipolar electrocautery. Sixty patients scheduled for CABG were randomized to receive either ultrasonically (n=30 patients) or electrocautery (n=30 patients) skeletonized ITAs. Intraoperative ITA graft mean flows were obtained with a transit-time flowmeter. ITA flows were evaluated at the beginning (Time 1) and at the end (Time 2) of the harvesting procedure. Post-cardiopulmonary bypass (CPB) flow measurement (Time 3) was obtained in the ITA grafts anastomosed to the left anterior descending artery. Intraoperative mean flow decreased significantly within ultrasonic group (Group U) and electrocautery group (Group E) at the end of the harvesting procedure (P<0.0001 in both cases). Within both groups the final mean flow measured on anastomosed ITAs (Time 3) was significantly higher than the beginning ITA flow value (Time 1). No statistical difference was noted comparing ITA flows between the two groups at any time of evaluation. Skeletonization harvesting of the ITA produces a modification of the mean flow. The quantity and the reversibility of this phenomenon, probably related to vasospasm, are independent from the energy source used in the skeletonization procedure. PMID:17998305

  20. Halstedian technique revisited. Innovations in teaching surgical skills.

    PubMed

    Barnes, R W; Lang, N P; Whiteside, M F

    1989-07-01

    This paper reviews the laboratory models used to teach fundamental surgical skills in our general surgery residency. The laboratory modules allow supervision and self-instruction, practice, and videotape monitoring of the following techniques: skin incision, suturing, knot tying, hemostasis, vascular anastomosis, and intestinal anastomosis. Pigs' feet simulate human skin for exercises in skin incision, lesion excision, suturing, and basic plastic surgical techniques. Latex tubing and penrose drains allow experience in suturing, knot tying, and hemostasis. Polytetrafluoroethylene vascular prostheses permit quantification of the precision of needle passage and suturing by measurement of leakage of water through a vascular anastomosis. Reconstituted, lyophilized, irradiated bovine arteries and ileum provide models of biologic tissue for creating handsewn vascular anastomoses and sutured or stapled gastrointestinal anastomoses. A headlamp videocamera allows unobstructive recording of the resident's technical performance and provides subsequent visual feedback for self-improvement when compared to reference instructional videotapes. We feel that these innovations may enhance surgical dexterity of residents without the need for animal sacrifice. Our goal is to foreshorten the learning curve for basic surgical skills and improve performance in the clinical operating room.

  1. Inhomogeneous vasodilatory responses of rat tail arteries to heat stress: evaluation by synchrotron radiation microangiography.

    PubMed

    Kuwabara, Eriko; Furuyama, Fujiya; Ito, Kunihisa; Tanaka, Etsuro; Hattan, Naoichiro; Fujikura, Hisanori; Kimura, Koji; Goto, Takako; Hayashi, Takashi; Taira, Hiroyuki; Shinozaki, Yoshiro; Umetani, Keiji; Hyodo, Kazuyuki; Tanioka, Kenkichi; Mochizuki, Ryo; Kawai, Toshiaki; Koide, Shirosaku; Mori, Hidezo

    2002-10-01

    Tail blood flow is crucial for dissipating body heat in rats. Angiographies are convenient tools to evaluate tail circulation. However, conventional angiographies do not have sufficient sensitivity or spatial resolution for small vessels. Recently, we developed a novel microangiographic system using monochromatic synchrotron radiation and a high-definition video camera system. Here, we report an evaluation of rat tail circulation under heat stress using the synchrotron radiation microangiographic system. We performed an experiment using the microangiography of the caudal artery before and after heating up WKAH/HkmSlc rats to rectal temperature of 39 degrees C. The images were digitized and temporal subtraction was performed, and the diameters of caudal arteries were evaluated. After heating, the medial caudal artery was markedly dilated (320 +/- 53 to 853 +/- 243 micro m in diameter, p<0.001), while no significant change was observed in the lateral caudal arteries (139 +/- 42 to 167 +/- 73 micro m) and segmental anastomosing vessels. The heat stress allowed for visualization of the superficial caudal arteries with a diameter of approximately 60 micro m, not visible prior to heating. Thus, synchrotron radiation microangiography demonstrated that the rat tail possessed dual sets of arteries; one set was highly sensitive to heat-induced vasodilation (medial caudal artery and superficial caudal arteries) and the other set was less sensitive (lateral caudal arteries and segmental anastomosing vessels).

  2. Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum

    SciTech Connect

    Hoskins, W.J.; Burke, T.W.; Weiser, E.B.; Heller, P.B.; Grayson, J.; Park, R.C.

    1987-02-01

    Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland. All patients had previously undergone an abdominal operation and three patients had irradiation utilizing extended fields. In all cases, right hemicolectomy and extended ileal resection were performed with primary anastamosis of the ileum to the ascending colon or the transverse colon. Operating time averaged 4 1/2 hr utilizing hand closure anastomoses and 2 1/2 hr with stapled anastomoses. All patients received postoperative hyperalimentation and six of eight patients received preoperative hyperalimentation. One operative death occurred in a patient with intestinal perforation who required multiple resections. The remaining seven patients experienced no serious complications and had rapid return of bowel function. Our experience indicates that wide ileal resection with right hemicolectomy and primary reanastomosis is an acceptable alternative to intestinal bypass for the treatment of severe irradiation injury, especially when performed with gastrointestinal stapling devices.

  3. Surgical management of radiation enteritis

    SciTech Connect

    Galland, R.B.; Spencer, J.

    1986-02-01

    Seventy patients (17 men and 53 women) were seen with radiation-injured gut between 1958 and 1984. The median age at treatment with radiotherapy was 54 years. External radiotherapy was used in all cases, combined with internal treatment for cervical cancer. Ninety-seven gastrointestinal lesions were produced. There were 63 strictures, 14 fistulas, 12 perforations, and eight bleeds. The period between radiotherapy and clinical manifestation of the lesion was approximately 2 years, being longest for strictures. The majority of the lesions were in the rectosigmoid or mid and distal small bowel. Sixty-one patients required one or more operations, and review of the operative results up to 1977 showed a high incidence of anastomotic leak and death after resection and primary anastomosis. However, we noticed that the ascending, transverse, and descending colon were relatively free of radiation-induced disease. Since then we have used a nonirradiated part of the colon for one end of the anastomosis. Thus terminal ileal resection has been followed by an ileotransverse anastomosis and rectosigmoid resection by mobilization of the splenic flexure to bring it down for anastomosis. With these techniques there has been one leak in 14 anastomoses and none of the 12 patients have died. These results are significantly better (p less than 0.02) than our previous figures when 14 of 27 anastomoses leaked, with 10 deaths. We conclude that use of nonirradiated bowel for at least one end of an anastomosis significantly improves the results of resection of irradiated bowel.

  4. Radionuclide studies in postoperative evaluation of the Fontan procedure

    SciTech Connect

    Brendel, A.J.; Wynchank, S.; Choussat, A.; Barat, J.L.; Deville, C.; Ducassou, D.; Fontan, F.

    1984-10-01

    Radionuclide studies were performed on 12 patients who had had a Fontan operation for cyanotic congenital heart disease, six of whom had undergone a prior palliative Glenn procedure. The patients without prior Glenn anastomoses were studied by radionuclide first-pass angiocardiography, using a right antecubital vein injection of /sup 99m/Tc pertechnetate. The patients with Glenn anastomoses required two injections, one by femoral vein to study the Fontan procedure, using bolus injection of /sup 99m/Tc pertechnetate or microspheres, and the second by right anetcubital vein to study the Glenn anastomosis and right lung, using a bolus of microspheres. Noninvasive radionuclide methods seem to be dependable in the postoperative evaluation of patients after the Fontan procedure. First-pass angiocardiography is most helpful in evaluating the dynamics and distribution of blood flow, especially the right atrial output, and gated blood-pool scintigraphy offers a better evaluation of right atrial and left ventricular contraction, so both supply complementary information.

  5. Proposal for classification of the circumaortic renal collar's morphology.

    PubMed

    Natsis, Konstantinos; Tsitouridis, Ioannis; Totlis, Trifon; Levva, Sofia; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2008-12-01

    In the present study, we propose a classification of the different forms of the circumaortic renal collar based on the findings of 319 patients and on a literature review. The patients underwent a CT angiography scan of the abdomen for various diagnostic reasons. The different forms in which the circumaortic renal collar may appear were categorized. The renal collar was observed in eight of the 319 (2.5%) patients. The classification we propose is the following: Type I, one left renal vein splitting into two branches, a preaortic and a retroaortic, draining into the inferior vena cava; Type II, two different left renal veins, the one preaortic and the other retroaortic, draining into the inferior vena cava; and Type III, either anastomoses between the preaortic and retroaortic vein, being multiple or not, or multiple preaortic or retroaortic renal veins without anastomoses. Although the circumaortic renal collar is usually asymptomatic, the knowledge of this variation is useful, mainly before abdominal aortic aneurysm surgery and renal transplantation. Failure to recognize the collar's retroaortic component may lead to hemorrhage and death during retroperitoneal surgery. We believe that our classification contributes to recognize the circumaortic renal collar's morphology both preoperatively and intraoperatively.

  6. Quantification of sympathetic vascular responses in skin by laser Doppler flowmetry.

    PubMed

    Khan, F; Spence, V A; Wilson, S B; Abbot, N C

    1991-05-01

    An improved physiological test of focal sympathetic nervous function using a laser Doppler flowmeter is presented. The test evaluates rapid reflex changes in skin blood flow at the finger tip where there are abundant arteriovenous anastomoses with dense sympathetic innervation. Indirect body heating was employed in all subjects to induce central vasodilation and to obtain stable comparable finger tip blood flows prior to stimulus. The reflex vasoconstriction which occurs following inspiratory gasp and contralateral hand cold challenge was quantified and its reproducibility investigated on three separate occasions in 20 young subjects. The variability in responses both within and between young subjects was small. The test was applied to 10 diabetic patients with autonomic neuropathy and to 10 age-matched control subjects. Vasoconstrictor reflexes were significantly lower in the diabetic group (p less than 0.005) with responses lower than 2 SD from the mean for age-matched controls. In conclusion, the test provides an assessment of focal autonomic damage which can be applied to other regions of the body rich in arteriovenous anastomoses and may have application in clinical studies investigating autonomic activity. PMID:2060997

  7. Anatomical variation of arterial supply to the rabbit stomach

    PubMed Central

    IKEGAMI, Reona; TANIMOTO, Yoshimasa; KISHIMOTO, Miori; SHIBATA, Hideshi

    2015-01-01

    Gastric stasis is common in rabbits, and gastrotomy may be performed to cure this pathological condition. Detailed descriptions of the arterial supply to the stomach are essential for this surgical operation, but published descriptions are limited. Here, we investigated anatomical variations of the arterial supply to the stomach in 43 New Zealand White rabbits by injecting colored latex into arteries. We observed that the left gastric artery that arose as the second branch from the celiac artery provided 1–3 parietal and 1–3 visceral branches to the stomach, with various branching patterns depending on the case. In 34 of 43 cases, the left gastric artery ended upon entering the gastric wall at the lesser curvature, whereas in the remaining cases, the artery continued as the hepatic artery without entering the gastric wall. The right gastric artery that branched off from the gastroduodenal artery also supplied the lesser curvature sinistrally but did not anastomose with the left gastric artery. In 40 cases, the hepatic artery provided 1–4 pyloric branches. In the fundic region, the short gastric arteries arose from the splenic artery and varied in number from 2 to 6. The right and left gastroepiploic arteries anastomosed to give 2–7 branches to the greater curvature. The results showed that many variations occurred in the arteries supplying the rabbit stomach, suggesting that such variations should be considered when performing veterinary surgical treatments in rabbits. PMID:26615866

  8. The structure of the Temsamane fold-and-thrust stack (eastern Rif, Morocco): Evolution of a transpressional orogenic wedge

    NASA Astrophysics Data System (ADS)

    Jabaloy-Sánchez, Antonio; Azdimousa, Ali; Booth-Rea, Guillermo; Asebriy, Lahcen; Vázquez-Vílchez, Mercedes; Martínez-Martínez, José Miguel; Gabites, Janet

    2015-11-01

    The structure of the Temsamane fold-and-thrust stack corresponds to four units limited by anastomosing ductile shear zones cutting a trend of south verging recumbent folds. This ductile stack was formed in an inclined left-handed transpressional zone at the North African paleomargin during Chattian to Langhian times producing two main deformational events. The first event (Dp) produced a Sp/Lp planar linear fabric generated in a non-coaxial deformation with a top-to-the-WSW sense of movement and was associated to metamorphic P-T conditions varying from late diagenesis in the southernmost Temsamane outcrops to epizone in the north. According to the 40Ar/39Ar ages, this deformation occurred at Chattian-Aquitanian times. The second deformational event (Dc event) generated ENE-WSW trending folds with SSE vergence and a set of anastomosing shear zones with Sm/Lm planar linear fabric. The latter units were generated at around 15 Ma (Langhian), and indicate a strong localization of the simple shear component of the transpression. Moreover, this orientation is compatible with the kinematics of the Temsamane detachment, which can explain most of the uplift of the Temsamane rocks from the middle to the uppermost crust. The described evolution indicates that collision between the western Mediterranean terranes and the North African paleomargin and the formation of the Rifean orogenic wedge occurred at Chattian to Langhian times.

  9. Intussusception causing postoperative intestinal obstruction following free jejunum transfer in adults: two case reports and review of the literature.

    PubMed

    Matsumoto, Akira; Watanabe, Masayuki; Shigaki, Hironobu; Okumura, Yasuhiro; Nishida, Koujiro; Mine, Shinji; Yamada, Kazuhiko; Yanaga, Katsuhiko; Sano, Takeshi

    2015-12-01

    Intussusception is a rare cause of postoperative intestinal obstruction in adults. We experienced two cases of bowel obstruction due to the jejuno-jejunal intussusception after harvest of a free jejunum graft for reconstruction after cervical esophagectomy. Bowel obstruction occurred early in the postoperative course, and reoperations were needed in both cases. In both case, the anastomotic site was resected and re-anastomosed in a side-to-side fashion. Recurrence of intussusception has not been observed. In the literature, such a complication has been documented in two case series and a case report. The reported incidence of postoperative intussusception of the case series was 2.8% and 7.4%, respectively. The jejuno-jejunal anastomoses were performed with end-to-end fashion by two layered hand-sewn suture (Albert-Lembert method) in all cases reported. In order to prevent the occurrence of postoperative intussusception, we recommend to harvest a free jejunal graft as far from the Treitz ligament as possible and to avoid reconstruction by an Albert-Lembert end-to-end anastomosis. PMID:26943396

  10. Viscoelasticity of repaired sciatic nerve by poly(lactic-co-glycolic acid) tubes

    PubMed Central

    Piao, Chengdong; Li, Peng; Liu, Guangyao; Yang, Kun

    2013-01-01

    Medical-grade synthetic poly(lactic-co-glycolic acid) polymer can be used as a biomaterial for nerve repair because of its good biocompatibility, biodegradability and adjustable degradation rate. The stress relaxation and creep properties of peripheral nerve can be greatly improved by repair with poly(lactic-co-glycolic acid) tubes. Ten sciatic nerve specimens were harvested from fresh corpses within 24 hours of death, and were prepared into sciatic nerve injury models by creating a 10 mm defect in each specimen. Defects were repaired by anastomosis with nerve autografts and poly(lactic-co-glycolic acid) tubes. Stress relaxation and creep testing showed that at 7 200 seconds, the sciatic nerve anastomosed by poly(lactic-co-glycolic acid) tubes exhibited a greater decrease in stress and increase in strain than those anastomosed by nerve autografts. These findings suggest that poly(lactic-co-glycolic acid) exhibits good viscoelasticity to meet the biomechanical require-ments for a biomaterial used to repair sciatic nerve injury. PMID:25206634

  11. [Multiple free transplants in microsurgery for cervicofacial reconstruction].

    PubMed

    Germain, M A; Demers, G; Parent, F; Giguere, P; Julieron, M; Luboinski, B; Mamelle, G; Marandas, P; Schwaab, G; Hureau, J

    Microsurgical techniques open the way for much creativity and originality for cervicofacial reconstruction and tumoral repair. Between 1976 and 1994, we performed 481 free transplants for cervico-facial reconstruction. A recently developed strategy has been the use of multiple free transplants, either simultaneously or successively. Between 1990 and 1994, we operated and reconstructed 9 patients using multiple free cervico-cephalic transplants after multitissular and agressive exeresis for tumoral or traumatic lesions. In 3 cases, the transplants were made simultaneously and in the 6 others successively. Three patients received 3 free transplants and 6 patients had 2. In 8 cases, each of the transplants was micro-anastomosed on different vessels. In one case, the two transplants were anastomosed in series, the most distal portion being connected to the most proximal portion (in comparison with the cervical vessels). One death occurred at 6 weeks due to infectious complications. The final result for the 8 other patients was good both morphologically and functionally. Indications for multiple free transplants include: complex tissue loss, multiple and massive tissue loss of the cervicocephalic region. This situation occurs particularly in case of voluminous tumours invading several structures, in multiple tumours and in firearm wounds. These series of patients allowed a definition of recommended techniques in case of difficulties in these very elaborate surgical procedures and confirmed that if the strategy is correctly planned, it is possible to greatly improve the quality of survival in these patients in terms of aesthetics, morphology and function.

  12. Contribution of the vertebral artery to cerebral circulation in the rat snake Elaphe obsoleta

    NASA Technical Reports Server (NTRS)

    Zippel, K. C.; Lillywhite, H. B.; Mladinich, C. R.; Hargens, A. (Principal Investigator)

    1998-01-01

    Blood supplying the brain in vertebrates is carried primarily by the carotid vasculature. In most mammals, cerebral blood flow is supplemented by the vertebral arteries, which anastomose with the carotids at the base of the brain. In other tetrapods, cerebral blood is generally believed to be supplied exclusively by the carotid vasculature, and the vertebral arteries are usually described as disappearing into the dorsal musculature between the heart and head. There have been several reports of a vertebral artery connection with the cephalic vasculature in snakes. We measured regional blood flows using fluorescently labeled microspheres and demonstrated that the vertebral artery contributes a small but significant fraction of cerebral blood flow (approximately 13% of total) in the rat snake Elaphe obsoleta. Vascular casts of the anterior vessels revealed that the vertebral artery connection is indirect, through multiple anastomoses with the inferior spinal artery, which connects with the carotid vasculature near the base of the skull. Using digital subtraction angiography, fluoroscopy, and direct observations of flow in isolated vessels, we confirmed that blood in the inferior spinal artery flows craniad from a point anterior to the vertebral artery connections. Such collateral blood supply could potentially contribute to the maintenance of cerebral circulation during circumstances when craniad blood flow is compromised, e.g., during the gravitational stress of climbing.

  13. Primary anastomosis in the treatment of acute disease of the unprepared left colon.

    PubMed

    Trillo, C; Paris, M F; Brennan, J T

    1998-09-01

    Between June 1, 1990 and December 31, 1996, 58 consecutive patients with unprepared colons were urgently explored for nontraumatic disease with intent to proceed with primary left-sided colonic anastomosis. Unprotected anastomoses were not attempted in 15 patients. The causes of exclusion included preoperative and intraoperative shock in three patients, and three patients were on long-term high-dose steroids, four had gross fecal contamination of the peritoneal cavity, four had large pelvic abscesses, and one had ischemic colitis. All 43 patients undergoing anastomosis without protective colostomy had stapled anastomoses. Indications included complicated diverticular disease in 32 cases. There were nine cases of obstruction from colorectal carcinoma and one obstruction due to sigmoid volvulus. There was one case of perforation from pseudomembranous enterocolitis. The most common complications were: atelectasis in nine cases, wound infection in two cases, and prolonged ileus in two cases. Pelvic abscess occurred in one case. There was one wound dehiscence. There was one anastomotic dehiscence, and there was no mortality. Operative time averaged 85 minutes and hospital length of stay 9.7 days. Primary anastomosis of the unprepared left colon is safe in most urgent and emergent situations, thus avoiding the significant morbidity and cost of colostomy closure. PMID:9731807

  14. [Robot-assisted Coronary Artery Bypass Grafting].

    PubMed

    Ishikawa, Norihiko; Watanabe, Go

    2016-07-01

    The application for robot-assisted coronary surgery ranges from internal thoracic artery (ITA) harvesting with hand-sewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB), either on- or off-pump. The bilateral IMA can be harvested with the aid of a surgical robot and then multivessel bypass grafting can follow. Such robot-assisted minimally invasive direct coronary artery bypass grafting is called "ThoraCAB". Surgical robots cannot only endoscopically harvest the ITA but they can also anastomose the coronary artery in TECAB. But TECAB still has the difficulties, such as narrow surgical field in Japanese patients. Both procedures have the significant advantages of minimizing surgical trauma, such as reduced comlications, faster return back to normal activities and being improved cosmesis, and which have resulted in the development of minimally invasive surgery. Robot-assisted cardiac surgery for structural heart disease has been approved by the Ministry of Health, Labour and Welfare (MHLW) since December 2015, however, robot-assisted cardiac surgery for TECAB has not been approved yet in Japan. PMID:27440015

  15. A case report of emergency off-pump CABG in an aged patient with ACS renewing ventricular fibrillation.

    PubMed

    Masuhara, Hiroshi; Watanabe, Yoshinori; Shiono, Noritsugu; Kawasaki, Muneyasu; Yokomuro, Hiroki; Fujii, Takeshiro; Koyama, Nobuya

    2006-06-01

    An emergency off-pump coronary artery bypass (OPCAB) was performed successfully in an aged patient with acute coronary syndrome (ACS). The patient, an 80-year-old woman residing in a nursing home, suddenly lost consciousness during lunch. The electrocardiogram (ECG) showed ventricular fibrillation (Vf) but defibrillation successfully recovered the sinus rhythm. The patient was brought to our hospital as an emergency. She underwent emergency cardiac catheterization. Coronary angiography demonstrated severe three vessel disease with left main coronary trunk (LMT) stenosis. Even during intra-aortic balloon pumping (IABP), the hemodynamic state was unstable, with repeated development of ventricular tachycardia and fibrillation. An emergency coronary artery bypass without a cardiopulmonary bypass was performed. Saving her life was of primary importance and revascularization of the left anterior descending artery (LAD) branch, was performed. Thanks to the advances made in various devices, safe and reliable anastomoses have become possible in OPCAB applied to ACS. OPCAB for ACS have become safe and reliable anastomoses following development of various devices. We think that OPCAB is an effective surgical technique for coronary revascularization for emergency or serious cases involving elderly patients. PMID:16823341

  16. High resolution sequence stratigraphy of Scythian-early Anisian continental deposits of east of Paris basin: Applications to gas storage

    SciTech Connect

    Roselyne, F.; Guillocheau, F.; Wicquart, E.

    1995-08-01

    Continental facies of Scythian-early Anisian age (Buntsandstein) of East of the Paris Basin form the underground gas storage reservoir exploited by Gaz de France in the area of Nancy (east of France). An accurate sedimentological study and the application of Genetic Stratigraphy principles lead to the understanding of the deposition of fluvial, which form the reservoirs, and to the reconstruction of their geometries. The subsurface data are calibrated on outcrops. Three types of fluvial systems (braided, sinuous to straight and anastomosed) are defined. A special focus on anastomosed channels permits to differentiate a proximal and a distal facies. Study of laterally continuous outcrops induces recurrent cycles of thickness, velocity and time variations (few tens to hundred ka). These correspond to the highest frequence stratigraphic units, i.e. parasequences or genetic units. Maximum of channel and levee presentation occurs during base-level rise: base-level fall is characterised by amalgamation of sets, by-pass and erosion. This method is applied to subsurface data by an accurate calibration of well logs on cores. Thus the electric expression of genetic units corresponding to different environments is determined as well as the expression of base-level variations. The correlation of these units using stacking pattern method leads to a very fine subdivision of reservoir between timelines. Different orders of depositional sequences are pointed out, resulting in reservoir geometry characterization and permeability barrier distribution.

  17. Alteration-weakening leading to localized deformation in a damage aureole adjacent to a dormant shear zone

    NASA Astrophysics Data System (ADS)

    Backeberg, Nils R.; Rowe, Christie D.; Barshi, Naomi

    2016-09-01

    Deformation adjacent to faults and shear zones is traditionally thought to correlate with slip. Inherited structures may control damage geometry, localizing fluid flow and deformation in a damage aureole around structures, even after displacement has ceased. In this paper we document a post-shearing anastomosing foliation and fracture network that developed to one side of the Mesoarchean Marmion Shear Zone. This fracture network hosts the low-grade, disseminated Hammond Reef gold deposit. The shear zone juxtaposed a greenstone belt against tonalite gneiss and was locked by an intrusion that was emplaced during the final stages of suturing. After cessation of activity, fluids channeled along fault- and intrusion-related fractures led to the pervasive sericitization of feldspars. Foliated zones resulted from flattening in the weaker sericite-rich tonalite during progressive alteration without any change in the regional NW-SE shortening direction. The anastomosing pattern may have been inherited from an earlier ductile fabric, but sericite alteration and flattening fabrics all formed post-shearing. Thus, the apparent foliated fracture network adjacent to the Marmion Shear Zone is a second-order effect of shear-related damage, distinct in time from shear activity, adjacent to an effectively dormant shear zone. This phenomenon has implications for understanding the relative timing of fault zone activity, alteration and (in this case) gold mineralization related to long-term fault zone permeability.

  18. N-butyl Cyanoacrylate Glue Embolization of Arterial Networks to Facilitate Hepatic Arterial Skeletonization before Radioembolization

    SciTech Connect

    Samuelson, Shaun D.; Louie, John D.; Sze, Daniel Y.

    2013-06-15

    Purpose. Avoidance of nontarget microsphere deposition via hepatoenteric anastomoses is essential to the safety of yttrium-90 radioembolization (RE). The hepatic hilar arterial network may remain partially patent after coil embolization of major arteries, resulting in persistent risk. We retrospectively reviewed cases where n-butyl cyanoacrylate (n-BCA) glue embolization was used to facilitate endovascular hepatic arterial skeletonization before RE. Methods. A total of 543 RE procedures performed between June 2004 and March 2012 were reviewed, and 10 were identified where n-BCA was used to embolize hepatoenteric anastomoses. Arterial anatomy, prior coil embolization, and technical details were recorded. Outcomes were reviewed to identify subsequent complications of n-BCA embolization or nontarget RE. Results. The rate of complete technical success was 80 % and partial success 20 %, with one nontarget embolization complication resulting in a minor change in treatment plan. No evidence of gastrointestinal or biliary ischemia or infarction was identified, and no microsphere-related gastroduodenal ulcerations or other evidence of nontarget RE were seen. Median volume of n-BCA used was <0.1 ml. Conclusion. n-BCA glue embolization is useful to eliminate hepatoenteric networks that may result in nontarget RE, especially in those that persist after coil embolization of major vessels such as the gastroduodenal and right gastric arteries.

  19. Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique

    PubMed Central

    Kofler, Markus; Ritschl, Paul; Oellinger, Robert; Aigner, Felix; Sucher, Robert; Schneeberger, Stefan; Pratschke, Johann; Brandacher, Gerald; Maglione, Manuel

    2014-01-01

    Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are available to perform mechanistic in vivo studies. While heart transplantation models using a suture technique were first successfully developed in rats, the translation into an equally widespread used murine equivalent was never achieved due the technical complexity of the microsurgical procedure. In contrast, non-suture cuff techniques, also developed initially in rats, were successfully adapted for use in mice1-3. This technique for revascularization involves two major steps I) everting the recipient vessel over a polyethylene cuff; II) pulling the donor vessel over the formerly everted recipient vessel and holding it in place with a circumferential tie. This ensures a continuity of the endothelial layer, short operating time and very high patency rates4. Using this technique for vascular anastomosis we performed more than 1,000 cervical heart transplants with an overall success rate of 95%. For arterial inflow the common carotid artery and the proximal aortic arch were anastomosed resulting in a retrograde perfusion of the transplanted heart. For venous drainage the pulmonary artery of the graft was anastomosed with the external jugular vein of the recipient5. Herein, we provide additional details of this technique to supplement the video. PMID:25350682

  20. Arterial Vascularization of the Gastrointestinal Tract of the Pampas Deer (Ozotoceros bezoarticus, Linnaeus, 1758).

    PubMed

    Pérez, W; Vazquez, N; Ungerfeld, R

    2016-06-01

    Based on gross dissection of fifteen adult animals (11 females, 4 males), we described the arterial supply of the stomach and intestines of the pampas deer (Ozotoceros bezoarticus), a South American endangered species. The coeliac artery emitted the splenic, left gastric and hepatic arteries. The splenic artery directed towards the spleen, and the right ruminal artery, which is its only collateral directed towards the stomach, being the main artery of the rumen. The left gastric artery gave origin to the left ruminal, the reticular and the left gastroepiploic arteries. The left gastroepiploic artery originated the reticular accessory artery. Both arteries, gastric and left gastroepiploic, anastomosed their right counterparts derived from the hepatic artery on the curvatures of the abomasum. The cranial mesenteric artery irrigated the second half of the duodenum until the beginning of the descending colon. The thickest branch emitted by the cranial mesenteric artery was the ileocolic artery, which was destined to the ascending colon, caecum and ileum. The colic branches and the right colic arteries were irradiated on the right surface of the spiral loop of the ascending colon and distributed to both centripetal and centrifugal coils of the ascending colon; the colic branches were also anastomosed with the last jejunals and ileals and with the right colic arteries. There were no variations in the origin of any of the main branches derived from the coeliac and cranial mesenteric arteries. This species had a basic pattern of arterial distribution similar to small domestic ruminants.

  1. The first simultaneous kidney-adrenal gland-pancreas transplantation: outcome at 1 year.

    PubMed

    Vouillarmet, J; Buron, F; Houzard, C; Carlier, M C; Chauvet, C; Brunet, M; Thivolet, C; Morelon, E; Badet, L

    2013-07-01

    Adrenal insufficiency is a rare but life-threatening disease. Replacement therapy sometimes fails to prevent an acute adrenal crisis and most often does not lead to restoration of well-being. We report here the 1-year outcome of the first simultaneous kidney-adrenal gland-pancreas transplantation in a 33-year-old patient with type 1 diabetes and concomitant autoimmune adrenal insufficiency. En bloc left adrenal gland and kidney grafts were anastomosed on the left iliac vessels in normal vascular conditions and the pancreas graft was anastomosed on the right iliac vessels. The immunosuppressive regimen was not modified by the addition of the adrenal gland. We observed no additional morbidity due to the adrenal gland transplantation, as there were no surgical complications. One-year kidney and pancreas graft functions were satisfactory (estimated glomerular filtration rate: 55 mL/min/1.73 m(2) and HbA1c: 4.8%). The adrenal graft functioned well at 12 months with a normalization of cortisol and aldosterone baseline levels. Functional imaging at 3 months showed good uptake of [(123) I]-metaiodobenzylguanidine by the adrenal graft. Transplantation of the adrenal gland en bloc with the left kidney appears to be a good therapeutic option in patients with adrenal insufficiency awaiting kidney or kidney-pancreas transplantation.

  2. Surgical techniques in short bowel syndrome.

    PubMed

    Waag, K L; Heller, K

    1990-01-01

    An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a Bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition. PMID:2105523

  3. NOTE: Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning

    NASA Astrophysics Data System (ADS)

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

    2004-07-01

    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin.

  4. Microvascular anastomosis guidance and evaluation using real-time three-dimensional Fourier-domain Doppler optical coherence tomography

    PubMed Central

    Ibrahim, Zuhaib; Tong, Dedi; Zhu, Shan; Mao, Qi; Pang, John; Andrew Lee, Wei Ping; Brandacher, Gerald; Kang, Jin U.

    2013-01-01

    Abstract. Vascular and microvascular anastomoses are critical components of reconstructive microsurgery, vascular surgery, and transplant surgery. Intraoperative surgical guidance using a surgical imaging modality that provides an in-depth view and three-dimensional (3-D) imaging can potentially improve outcome following both conventional and innovative anastomosis techniques. Objective postoperative imaging of the anastomosed vessel can potentially improve the salvage rate when combined with other clinical assessment tools, such as capillary refill, temperature, blanching, and skin turgor. Compared to other contemporary postoperative monitoring modalities—computed tomography angiograms, magnetic resonance (MR) angiograms, and ultrasound Doppler—optical coherence tomography (OCT) is a noninvasive high-resolution (micron-level), high-speed, 3-D imaging modality that has been adopted widely in biomedical and clinical applications. For the first time, to the best of our knowledge, the feasibility of real-time 3-D phase-resolved Doppler OCT (PRDOCT) as an assisted intra- and postoperative imaging modality for microvascular anastomosis of rodent femoral vessels is demonstrated, which will provide new insights and a potential breakthrough to microvascular and supermicrovascular surgery. PMID:23856833

  5. A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply

    PubMed Central

    Menshawi, Khaled; Mohr, Jay P

    2015-01-01

    The anatomy of the arterial system supplying blood to the brain can influence the development of arterial disease such as aneurysms, dolichoectasia and atherosclerosis. As the arteries supplying blood to the brain develop during embryogenesis, variation in their anatomy may occur and this variation may influence the development of arterial disease. Angiogenesis, which occurs mainly by sprouting of parent arteries, is the first stage at which variations can occur. At day 24 of embryological life, the internal carotid artery is the first artery to form and it provides all the blood required by the primitive brain. As the occipital region, brain stem and cerebellum enlarge; the internal carotid supply becomes insufficient, triggering the development of the posterior circulation. At this stage, the posterior circulation consists of a primitive mesh of arterial networks that originate from projection of penetrators from the distal carotid artery and more proximally from carotid-vertebrobasilar anastomoses. These anastomoses regress when the basilar artery and the vertebral arteries become independent from the internal carotid artery, but their persistence is not uncommon in adults (e.g., persistent trigeminal artery). Other common remnants of embryological development include fenestration or duplication (most commonly of the basilar artery), hypoplasia (typically of the posterior communicating artery) or agenesis (typically of the anterior communicating artery). Learning more about the hemodynamic consequence that these variants may have on the brain territories they supply may help understand better the underlying physiopathology of cerebral arterial remodeling and stroke in patients with these variants. PMID:26060802

  6. MICROSURGICAL TRANSFER OF THE GRACILIS MUSCLE FOR ELBOW FLEXION IN BRACHIAL PLEXUS INJURY IN ADULTS: RETROSPECTIVE STUDY OF EIGHT CASES

    PubMed Central

    Kimura, Luiz Koiti; do Nascimento, Alexandre Tadeu; Capócio, Roberto; Mattar, Rames; Rezende, Marcelo Rosa; Wei, Teng Hsiang; Torres, Luciano Ruiz; Moya, Fernando Munhoz

    2015-01-01

    Objective: Treating brachial plexus injuries is a major challenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed patients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. Methods: Eight patients were included, divided into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was performed directly on the spinal accessory nerve, with anastomosis in thoracoacromial vessels. Results: We found a significant difference between the groups. A greater number of satisfactory results (75% M4) were found among patients who underwent direct neurorrhaphy, whereas the procedure using grafts for neurorrhaphy was less successful (25% M4). Conclusion: Patients who underwent microsurgical functional transfer of the gracilis muscle in which vascular anastomoses were performed in thoracoacromial vessels presented better functional outcomes than shown by those whose anastomoses were in the brachial artery with subsequent use of a nerve graft. PMID:27027050

  7. Systematization and description of the internal carotid arteries and their main ramifications at the brain base in turtles (Trachemys scripta elegans).

    PubMed

    Voll, Juliana; Campos, Rui

    2016-08-01

    Thirty turtle brains (Trachemys scripta elegans) were injected with latex to systematize and describe the internal carotid arteries and their main ramifications at the brain base. The internal carotid arteries had one intercarotid anastomosis. At the level of the tuber cinereum, the internal carotid artery bifurcated into its terminal branches, the rostral and the caudal branches. The rostral branch emitted the rostral choroid artery, the orbital artery, and a series of middle cerebral arteries. After giving off the last middle cerebral artery, the rostral branch continued as the rostral cerebral artery in the cerebral longitudinal fissure, and had one anastomosis with its contralateral homologous artery, the rostral communicating artery, making the first rostral closure of the cerebral arterial circle. Next, the rostral cerebral arteries anastomosed forming a rostral interhemispheric artery, making the second rostral closure of the cerebral arterial circle. The internal carotid artery, after emitting its rostral branch, continued caudally as the caudal branch. The caudal branch ran caudally along the ventral surface of the mesencephalic tegmentum, emitted the caudal cerebral artery and the mesencephalic artery, and continued caudomedially while progressively narrowing, and anastomosed with its contralateral homologous artery, forming the basilar artery. The narrower portion also emitted the trigeminal artery. The anastomosis of the caudal branches closed the cerebral arterial circle caudally. The internal carotid arteries exclusively supplied the cerebral arterial circle of the turtle. Anat Rec, 299:1090-1098, 2016. © 2016 Wiley Periodicals, Inc.

  8. Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast.

    PubMed

    Marginean, Felicia; Rakha, Emad A; Ho, Bernard C; Ellis, Ian O; Lee, Andrew H S

    2010-10-01

    Medullary carcinomas have a better prognosis than other grade 3 mammary carcinomas, but they typically show basal-like biological features, which are associated with a poor prognosis. In this study we examined the associations and prognostic relevance of medullary histological features in a series of 165 invasive carcinomas with a basal-like phenotype: triple-negative (oestrogen receptor, progesterone receptor, HER2) and expressing at least one basal marker (CK5/6, CK14, CK17 or EGFR). The following histological features were associated with each other: prominent inflammation, anastomosing sheets, absence of fibrosis, absence of infiltrative margin and absence of gland formation. Prominent inflammation and anastomosing sheets in at least 30% of the tumour were associated with a better prognosis on univariate analysis. The combination of these two features (a simplified definition of medullary-like type) was present in 17% of tumours and was an independent prognostic factor on multivariate analysis. This simplified definition had good inter-observer reproducibility (κ=0.61) and is worthy of more detailed assessment in an unselected group of mammary carcinomas. A fibrotic focus was present in 36% of carcinomas. Only 3% of tumours with a fibrotic focus had features of medullary-like carcinomas. Fibrotic focus of greater than 30% of the tumour was associated with a poor prognosis. This study emphasizes the heterogeneity of morphology and behaviour of triple-negative basal-like carcinomas.

  9. Viscoelasticity of repaired sciatic nerve by poly(lactic-co-glycolic acid) tubes.

    PubMed

    Piao, Chengdong; Li, Peng; Liu, Guangyao; Yang, Kun

    2013-11-25

    Medical-grade synthetic poly(lactic-co-glycolic acid) polymer can be used as a biomaterial for nerve repair because of its good biocompatibility, biodegradability and adjustable degradation rate. The stress relaxation and creep properties of peripheral nerve can be greatly improved by repair with poly(lactic-co-glycolic acid) tubes. Ten sciatic nerve specimens were harvested from fresh corpses within 24 hours of death, and were prepared into sciatic nerve injury models by creating a 10 mm defect in each specimen. Defects were repaired by anastomosis with nerve autografts and poly(lactic-co-glycolic acid) tubes. Stress relaxation and creep testing showed that at 7 200 seconds, the sciatic nerve anastomosed by poly(lactic-co-glycolic acid) tubes exhibited a greater decrease in stress and increase in strain than those anastomosed by nerve autografts. These findings suggest that poly(lactic-co-glycolic acid) exhibits good viscoelasticity to meet the biomechanical require-ments for a biomaterial used to repair sciatic nerve injury.

  10. Overview of the influence of syn-sedimentary tectonics and palaeo-fluvial systems on coal seam and sand body characteristics in the Westphalian C strata, Campine Basin, Belgium

    USGS Publications Warehouse

    Dreesen, Roland; Bossiroy, Dominique; Dusar, Michiel; Flores, R.M.; Verkaeren, Paul; Whateley, M. K. G.; Spears, D.A.

    1995-01-01

    The Westphalian C strata found in the northeastern part of the former Belgian coal district (Campine Basin), which is part of an extensive northwest European paralic coal basin, are considered. The thickness and lateral continuity of the Westphalian C coal seams vary considerably stratigraphically and areally. Sedimentological facies analysis of borehole cores indicates that the deposition of Westphalian C coal-bearing strata was controlled by fluvial depositional systems whose architectures were ruled by local subsidence rates. The local subsidence rates may be related to major faults, which were intermittently reactivated during deposition. Lateral changes in coal seam groups are also reflected by marked variations of their seismic signatures. Westphalian C fluvial depositional systems include moderate to low sinuosity braided and anastomosed river systems. Stable tectonic conditions on upthrown, fault-bounded platforms favoured deposition by braided rivers and the associated development of relatively thick, laterally continuous coal seams in raised mires. In contrast, rapidly subsiding downthrown fault blocks favoured aggradation, probably by anastomosed rivers and the development of relatively thin, highly discontinuous coal seams in topogenous mires.

  11. Fetal cardiovascular hemodynamics in twin-twin transfusion syndrome.

    PubMed

    Wohlmuth, Christoph; Gardiner, Helena M; Diehl, Werner; Hecher, Kurt

    2016-06-01

    Twin-twin transfusion syndrome (TTTS) complicates 10-15% of monochorionic-diamniotic (MCDA) pregnancies. It originates from unbalanced transfer of fluid and vasoactive mediators from one twin to its co-twin via placental anastomoses. This results in hypovolemia in the donor and hypervolemia and vasoconstriction in the recipient twin. Consequently, the recipient demonstrates cardiovascular alterations including atrioventricular valve regurgitation, diastolic dysfunction, and pulmonary stenosis/atresia that do not necessarily correlate with Quintero-stages. Selective fetoscopic laser photocoagulation of placental vascular anastomoses disrupts the underlying pathophysiology and usually improves cardiovascular function in the recipient with normalization of systolic and diastolic function within weeks after treatment. Postnatal studies have demonstrated early decreased arterial distensibility in ex-donor twins, but 10-year follow up is encouraging with survivors showing normal cardiovascular function after TTTS. However, prediction and appropriate early management of TTTS remain poor. Assessment of the cardiovascular system provides additional insight into the pathophysiology and severity of TTTS and may permit more targeted early surveillance of MCDA pregnancies in future. It should form an integral part of the diagnostic algorithm. PMID:26872246

  12. Anastomotic dehiscence (AD) in colorectal cancer surgery: mechanical anastomosis versus manual anastomosis

    PubMed Central

    Oprescu, C; Beuran, M; Nicolau, AE; Negoi, I; Venter, MD; Morteanu, S; Oprescu-Macovei, AM

    2012-01-01

    disease, anastomotic dehiscence incidence was of 13.8% (4/29) when using mechanical suture and 8.3% (1/12) when using manual suturing. The period required for postoperative resumption of intestinal transit was of 3.12 days for mechanical suturing and 3.93 days in case of manual suture. The mean time (MT) to perform the ileocolic and colocolic mechanical anastomosis is 9 ± 2 minutes. If anastomosis is “cured" with surjet wire or separate threads, MT is 11 ± 5 minutes. MT to perform the ileocolic and colocolic manual anastomosis is 9 ± 3 minutes for surjet wire and 18 ± 5 minutes for separate threads. MT to perform the colorectal mechanical anastomosis is 15 ± 4 minutes. MT to perform the colorectal manual anastomosis is 30 ± 7 minutes (using separate threads). Detailing the nature of the surgical reinterventions, we have found: 7 reinterventions for AD post mechanical anastomoses (1 case of suture defect, 2 cases of resection and re-anastomoses, 4 cases with external branching stoma); 5 reinterventions for AD post manual anastomoses (0 cases of suture defect, 1 case of resection with re-anastomosis, 4 cases of external shunt stoma). In the analyzed group, we recorded a total of 57 deaths from a total of 714 cases resulting in a mortality rate of 7.98%. Conclusions: Mechanical suture technique is not ideal for making digestive sutures. With the exception of low colorectal anastomoses where mechanical sutures are preferable, we cannot claim the superiority of mechanical anastomoses over those manually made, for colorectal neoplasia. PMID:23346248

  13. [The EMECAM protocol: an analysis of the short-term effect of air pollution on mortality. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica u la Mortalidad].

    PubMed

    Pérez-Hoyos, S; Sáez Zafra, M; Barceló, M A; Cambra, C; Figueiras Guzmán, A; Ordóñez, J M; Guillén Grima, F; Ocaña, R; Bellido, J; Cirera Suárez, L; López, A A; Rodríguez, V; Alcalá Nalvaiz, T; Ballester Díez, F

    1999-01-01

    The aim of this study is to Mortality show the protocol of analysis which was set out as part of the EMECAM Project, illustrating the application thereof to the effect of pollution has on the mortality in the city of Valencia. The response variables considered will be the daily deaths rate resulting from all causes, except external ones. The explicative variables are the daily series of different pollutants (black smoke, SO2, NO2, CO, O3). As possible confusion variables, weather factors, structural factors and weekly cases of flu are taken into account. A Poisson regression model is built up for each one of the four deaths series in two stages. In the first stage, a baseline model is fitted using the possible confusion variables. In the second stage, the pollution variables or the time legs thereof are included, controlling the residual autocorrelation by including mortality time lags. The process of fitting the baseline model is as follows: 1) Include the significant sinusoidal terms up to the sixth order. 2) Include the significant temperature or temperature squared terms with the time lags thereof up to the 7th order. 3) Repeat this process with the relative humidity. 4) Add in the significant terms of calendar years, daily tendency and tendency squared. 5) The days of the week as dummy variables are always included in the model. 6) Include the holidays and the significant time lags of up to two weeks of flu. Following the reassessment of the model, each one of the pollutants and the time lags thereof up to the fifth order are proven out. The impact is analyzed by six-month periods, including interaction terms.

  14. Les Differences dans l'emploi de la construction possessive "N1"+"DE"+"N2" entre le XIX et le XX s. dans la prose litteraire francaise (Differences in the Use of the Possessive Construction "N1"+"de"+"N2" between 19th and 20th Century French Literature).

    ERIC Educational Resources Information Center

    Roglic, Vera

    1991-01-01

    Study looks at frequency of noun1 + de + noun2 possessive in French prose. Researchers used chi-square and Pearson test to analyze results of syntagmatic possessive construction in works by Hugo, Stendahl, Balzac, Zola, Gide, Malraux, St. Exupery, and Sartre. Findings indicate that syntagmatic genitive possessive is more commonly found in…

  15. Efectos Especiales de Anclaje (Estudio sobre Regresiones de Juicios Condicionales). Parte 1: Distincion entre Efectos Aditivos y Efectos Multiplicativos en el Fenomeno de Anclaje (Special Effects of Anchoring (Study on Regression of Conditional Judgements) Part 1: Distinction Between Additive Effects and Multiplicative Effects in the Phenomenon of Anchoring). Publication No. 17.

    ERIC Educational Resources Information Center

    Lopez Alonso, A. O.

    A linear relationship was found between judgements given by 160 subjects to 7 objects presented as single stimuli (alpha judgements) and judgements given to the same objects presented with a condition (gamma judgements). This relationship holds for alpha judgements and the gamma judgements that belong to a family of constant stimulus and varying…

  16. Construyendo un Puente entre la Educacion del Dotado y el Mejoramiento Escolar Integral. Resumen. La Serie de Decision Basada en la Investigacion (Building a Bridge between Gifted Education and Total School Improvement. Summary. Talent Development Research-Based Decision Making Series).

    ERIC Educational Resources Information Center

    Renzulli, Joseph S.

    This monograph addresses the role of gifted education in total school improvement by describing three service delivery components (the Total Talent Portfolio, Curriculum Modification Techniques, and Enrichment Learning and Teaching) and several organizational components of the Schoolwide Enrichment Model (SEM). The report describes how the SEM can…

  17. Tensions entre rationalité technique et intérêts politiques : l’exemple de la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux au Québec

    PubMed Central

    Contandriopoulos, D.; Hudon, Raymond; Martin, Elisabeth; Thompson, Daniel

    2013-01-01

    Sommaire L’objet de cet article est constitué par les processus décisionnels entourant la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux (Loi 25). Nous entendons mettre en lumière les stratégies des groupes ou institutions de diverses natures qui ont fait valoir leurs préférences et ont tenté, avec un succès inégal, d’influencer les décisions relatives à cette réforme majeure de la structure du système de santé québécois. Au plan théorique, nous nous appuyons principalement sur les modèles d’analyse du lobbying qui, depuis les travaux fondateurs de Milbrath (1960, 1963), présentent cette pratique comme un processus fondamental d’échange d’information. Selon les données colligées dans les retranscriptions d’entrevues, les stratégies observées correspondent effectivement aux caractéristiques constitutives du lobbying et, dans quelques situations, à celles du patronage. La combinaison de ces divers éléments révèle que la mise en œuvre de la Loi 25 s’avère être avant tout un processus proprement politique. Ainsi, furent relégués au second plan les arguments techniques qui composaient initialement les objectifs de la Loi. PMID:23509412

  18. Linking: Today's Libraries, Tomorrow's Technologies. Report of the Bibliographic and Communications Network Pilot Project. Canadian Network Papers Number 7 = Le Lien entre les Bibliotheques d'Aujourd'hui et les Technologies de Demain. Rapport du Projet Pilote du Reseau de Services Bibliographiques et de Communications. Documents sur les Reseaux Canadiens Numero 7.

    ERIC Educational Resources Information Center

    National Library of Canada, Ottawa (Ontario).

    A pilot project was conducted from May 1980 to November 1983 to test the application of iNet--a decentralized, packet-switched telecommunications network--to bibliographic data interchange in Canada. The principal components of the project were participation of the Bibliographic Common Interest Group (BCIP), a group of libraries with stand-alone,…

  19. Human Relations Activities for the Single Parent To Develop More Effective Parent/Child Relations. Bilingual Guide = Actividades sobre relaciones humanas para ayudar al padre-soltero o madre-soltera a desarrollar una relacion efectiva entre padre e hijo Guia bilingue.

    ERIC Educational Resources Information Center

    Peterson, Susan

    Written in English and Spanish, this bilingual guide offers 10 activities which single parents can use to improve their relationships with their children. Objectives of activities include: (1) developing children's responsibility for work tasks in the home; (2) improving sibling relationships; (3) discussing emergencies with children; (4)…

  20. En sus marcas--Listos--A leer! Para las familias: Actividades de lenguaje para la primera infancia y ninez entre el nacimiento y los 5 anos. El reto: A leer, America! (Ready--Set--Read! For Families: Early Childhood Language Activities for Children from Birth through Age Five. America Reads Challenge).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This Ready--Set--Read Kit includes an activity guide for families, a 1997-98 early childhood activity calendar, and an early childhood growth wallchart. The activity guide presents activities and ideas that families (adults who have nurturing relationships with a child--a mother, father, grandparent, other relative, or close friend) can use to…

  1. El juego entre el nacimiento y los 7 anos: Un manual para ludotecarias. Investigacion-accion sobre la Familia y la Primera Infancia. UNESCO Sector de Educacion Monografia (Play between Birth and 7 Years: A Manual for Preschool Teachers. Action Research in Family and Early Childhood. UNESCO Education Sector Monograph).

    ERIC Educational Resources Information Center

    Grellet, Carolina

    The purpose of this Spanish-language manual is to help preschool teachers better understand theoretical concepts related to children's play. Following a preface that discusses UNESCO's activities related to early childhood education, the two main sections of the manual discuss children's play between 0-2 years and 2-7 years. Each section includes…

  2. En sus marcas--Listos--A leer! Para los cuidadores de ninos pequenos: Actividades de lenguaje para la primera infancia y ninez entre el nacimiento y los 5 anos. El reto: A leer, America! (Ready--Set--Read! For Caregivers: Early Childhood Language Activities for Children from Birth through Age Five. America Reads Challenge).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This Ready--Set--Read Kit includes an activity guide for caregivers, a 1997-98 early childhood activity calendar, and an early childhood growth chart. The activity guide presents activities and ideas that caregivers (family child care providers and the teachers, staff, and volunteers in child development programs) can use to help young children…

  3. How To Talk to Your Doctor (and Get Your Doctor To Talk to You!). An Educational Workshop on Doctor Patient Communication = Como Hablarle a su Doctor (iY que su doctor le hable a usted!). Un seminario educativo sobre la comunicacion entre el doctor y el paciente.

    ERIC Educational Resources Information Center

    Baylor Coll. of Medicine, Houston, TX.

    This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should communicate…

  4. Mitigation of Disagreement in Peer Review among L2 Learners and Native Speakers in a College Writing Class (Mitigación del Impacto de las Opiniones de Desacuerdo en el Proceso de Revisión por Pares entre Estudiantes de una Segunda Lengua y Hablantes Nativos en una Clase de Escritura a Nivel Universitario)

    ERIC Educational Resources Information Center

    Christoffersen, Katherine O'Donnell

    2015-01-01

    Peer review is now a commonplace practice in process-oriented writing instruction. A crucial aspect of peer review is assessing another classmate's work, which encompasses the act of disagreement. Given its prevalence in the classroom, it is necessary to analyze how L2 learners mitigate disagreement in the context of peer review with other L2…

  5. Global Professional Identity in Deterretorialized Spaces: A Case Study of a Critical Dialogue between Expert and Novice Nonnative English Speaker Teachers (Identidad profesional global en espacios desterritorializados: un estudio de caso de los diálogos críticos entre profesores de inglés no nativos)

    ERIC Educational Resources Information Center

    Guerrero Nieto, Carmen Helena; Meadows, Bryan

    2015-01-01

    This study analyzes the online, peer-peer dialogue between two groups of nonnative English-speaking teachers who are attending graduate programs in Colombia and the United States. Framed by the theoretical concepts of critical pedagogy and global professional identity, a qualitative analysis of the data shows that their expert vs. novice roles…

  6. L'impact de l'enseignement de la biologie sur la construction de la distinction entre normal et pathologique chez les eleves du secondaire Marocain (The Impact of Teaching Biology on the Way Moroccan High School Students Construe the Difference between Normal and Pathological).

    ERIC Educational Resources Information Center

    Khzami, Salah-Eddine; Favre, Daniel

    2002-01-01

    Study of the distinction between the notions of the normal and the pathological among Moroccan high school students and their teachers of biology found that students confused the registers of the normal/abnormal with the healthy/pathological, a fact that is at odds with current teaching in biology. It also found a possible link to the values held…

  7. Contamination par le nickel et d'autres métaux lors de la manipulation des pièces de monnaie comparaison entre francs français et eurosContamination by nickel and other metals resulting from the manipulation of coins comparison between French francs and euros

    NASA Astrophysics Data System (ADS)

    Fournier, P.-G.; Govers, T. R.; Fournier, J.; Abani, M.

    The introduction of the euro has revived the interest for potential nickel allergies. We show that the handling of a single used nickel coin releases an average of 0.45 μg of nickel, 0.26 μg of copper and 0.08 μg of zinc, whereas a euro coin composed of nickel alloys releases 0.25 μg of nickel, 1.3 μg of copper and 0.17 μg of zinc. These levels of contamination, favored by friction during handling, differ from those obtained on the basis of the EN 1811 test applicable to solubilisation in artificial sweat. The evaluation of allergy risks following the introduction of the euro may require the consideration of potential synergies between the metals mentioned above. To cite this article: P.-G. Fournier et al., C. R. Physique 3 (2002) 749-758.

  8. An Early Pennsylvanian threshold for the influence of vegetation on fluvial landscapes, based on the geological record of Atlantic Canada

    NASA Astrophysics Data System (ADS)

    Gibling, Martin; Ielpi, Alessandro; Bashforth, Arden; Davies, Neil

    2015-04-01

    Vegetation profoundly influences modern fluvial systems, depending on plant life-history strategies, tolerance to disturbance, and habitat drainage. However, direct evidence for these dynamic relationships is cryptic and has commonly been overlooked in ancient deposits. We report evidence for profound interactions between channels, in situ and transported vegetation in Lower Pennsylvanian formations of Atlantic Canada (~310 Ma), attributed to braided, meandering and fixed-channel (anastomosing) systems. Plant groups include lycopsids that preferred stable wetland settings, disturbance-tolerant calamitaleans, and deeply rooted cordaitaleans (early gymnosperms) that originated in the late Mississippian and colonised both wetland and dryland settings. For the meandering and anastomosing channel deposits, upright vegetation was observed within channel-based bedforms and bars and on channel margins. Lycopsids and calamitalean groves colonized the channel bed and bank-attached bars during periods of reduced flow, nucleating bar growth after flow resumed. Upright lycopsids and cordaitaleans are common along channel cutbanks and are locally tilted towards the channel, implying involvement in bank stabilization. Rhizoconcretions that formed around deep cordaitalean roots may have aided bank reinforcement. Tetrapod and arthropod trackways in the channel deposits indicate a close linkage between riparian and aquatic ecosystems. In the braided systems, sediments that contain abundant cordaitalean logs constitute nearly 20% of channel deposits, and the logs form channel-base lags, fill channels up to 6 m deep, and form nuclei for shallow sandbars. Log accumulations overlain by shale lenses imply a contribution to channel avulsion. Rooted channel-sandstones containing upright trees are interpreted as vegetated islands in an island-braided system. Anastomosing systems are abundant in these Lower Pennsylvanian formations but rare in older strata, and the multi-channel island

  9. Experimental study of pancreaticojejunostomy completed using anastomotic chains

    NASA Astrophysics Data System (ADS)

    Pan, Wei-Dong; Xu, Rui-Yun; Li, Nan; Fang, He-Ping; Pan, Cu-Zhi; Tang, Zhao-Feng

    2010-07-01

    The most difficult, time-consuming, and complication-prone step in pancreaticoduodenectomy is the pancreaticojejunostomy step. The largest disadvantage of this kind of anastomosis is the high incidence of postoperative anastomotic leakage. Once pancreatic leakage occurs, the patient death rate can be very high. The aim of this study was to design a pancreaticojejunostomy procedure using anastomotic chains, which results in the cut end of the jejunum being attached to the pancreatic stump without suturing, and to evaluate the safety and efficacy of this procedure in domestic pigs. The pancreaticojejunal anastomotic chains had the following structures: the chains consisted of two braceletlike chains made of titanium, named chain A and chain B. The function of chain A was to attach the free jejunal end onto the pancreatic stump, whereas the function of chain B was to tighten the contact between the jejunal wall and the surface of the pancreatic stump to eliminate gaps between the two structures and ensure tightness that is sufficient to guarantee that there is no leakage of jejunal fluid or pancreatic juice. The following procedure was used to assess the safety and efficacy of the procedure: pancreaticojejunostomies were performed on ten domestic pigs using anastomotic chains. The time required to complete the pancreaticojejunal anastomoses, the pressure tolerance of the pancreaticojejunal anastomoses, the pig death rate, and the histopathological examinations of the pancreaticojejunostomy tissues were recorded. The average time required to complete the pancreaticojejunal anastomosis procedure was 13±2 min. The observed tolerance pressure of the pancreaticojejunal anastomoses was more than 90 mm H2O. All ten domestic pigs that underwent operations were still alive four weeks after the operations. Pathological examinations showed that the anastomotic surfaces were completely healed, and the pancreatic cutting surfaces were primarily epithelialized. In conclusion, the

  10. Mechanical evaluation of anastomotic tension and patency in arteries.

    PubMed

    Zhang, F; Lineaweaver, W C; Buntic, R; Walker, R

    1996-02-01

    This study quantified arterial anastomotic tension, evaluated subsequent patency rates, and examined the degree of tension reduction with vessel mobilization. The study was divided into two components. In part I, a mechanical analysis was undertaken to evaluate tension, based on the determination of the force required to deflect a cable (vessel) laterally, and its resulting lateral displacement. Six Sprague-Dawley rats with 12 femoral arteries were divided into two subgroups: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. The tension of femoral arterial anastomoses was calculated in vessels with no segmental defect and with 1.5-, 3-, 4.5-, 6-, and 7.5-mm defects. In part II, patency was evaluated. Fifty-five rats with 110 femoral arteries were divided into two sub-groups as defined in part I: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. Microvascular anastomoses were performed with no segmental defect and with 1-, 2-, 3-, 4-, 5-, 6-, 7-, 8-, 9-, and 10-mm segmental vessel defects. Patency was evaluated 24 hr postoperatively. Part I of the study revealed that anastomotic tension gradually increased along with an increase in the length of the vessel defect, from 1.9 to 11.34 g in the no-mobilization group and from 1.97 to 8.44 g in the axial-mobilization group. Comparison of tension linear regression coefficient showed a significant difference between the two groups (p < 0.05). In part II of the study, the maximum length of femoral artery defects still able to maintain 100 percent patency of anastomoses was 4 mm (tension approximately 6 g) in the no-mobilization group and 6 mm in the axial-mobilization group (tension approximately 6.48 g). Microanastomotic tension was related to the size of the vessel defect, with increasing tension leading to thrombosis. Axial mobilization significantly reduced

  11. Study on shallow-water delta characteristics by utilizing seismic sedimentologic methods in Zilaitun Oilfield, Huanghua Depression, East China

    NASA Astrophysics Data System (ADS)

    Liu, Shan; Wang, Jiahao

    2015-04-01

    Shallow-water delta is characterized by widely distributed distributary channels from plentiful previous studies. But how to tenuously depict its planar geomorphology remains a difficult problem at present. This paper discussed the feasibility of seismic sedimentologic methods to interpret distributary channels distribution and summarized shallow-water delta characteristics. Huanghua Depression of Bohai Bay Basin is the Cenozoic rift basin in east China. Zilaitun Oilfield lies in the Kongdian buried-hill belt of Huanghua Depression. The oil layer is mainly distributed in the Paleocene Kongdian Formation. From core samples, 1st member of Kongdian Formation mainly consists of finer grain-size sandstone and amaranth mudstone, revealing a shallow-water environment. In the sandstone of distributary channels, sedimentary structures such as erosional surface, lag deposit, parallel bedding and trough cross-bedding are developed, illustrating an intensive hydrodynamic condition. Combining logging data, shallow-water delta mainly developed delta front subfacies. Microfacies of the delta front include subaqueous distributary channel, mouth bar and interdistributary bay in study area. A vertical discontinuous sequence was formed on account of the lack of distal bar. Subaqueous distributary channels are characterized by cylinder and conical well log curves. By extraction of RMS amplitudes from 3-D seismic data, seismic strata slices reveal banding distribution of sand bodies. Cylinder and conical logging curves demonstrated that these sand bodies are developed in distributary channels. The NE-trending anastomosing and dendritic distributary channels are widely developed in 1st member of Kongdian Formation. When the lake expanded, the river frequently bifurcated and diverted due to the rise of the relative lake-level, forming deep and wide anastomosing distributary channels. These channels extended as far as 13.2 km. The width is from 600 m to 1000 m. The average thickness of

  12. Experimental study of pancreaticojejunostomy completed using anastomotic chains.

    PubMed

    Pan, Wei-Dong; Xu, Rui-Yun; Li, Nan; Fang, He-Ping; Pan, Cu-Zhi; Tang, Zhao-Feng

    2010-07-01

    The most difficult, time-consuming, and complication-prone step in pancreaticoduodenectomy is the pancreaticojejunostomy step. The largest disadvantage of this kind of anastomosis is the high incidence of postoperative anastomotic leakage. Once pancreatic leakage occurs, the patient death rate can be very high. The aim of this study was to design a pancreaticojejunostomy procedure using anastomotic chains, which results in the cut end of the jejunum being attached to the pancreatic stump without suturing, and to evaluate the safety and efficacy of this procedure in domestic pigs. The pancreaticojejunal anastomotic chains had the following structures: the chains consisted of two braceletlike chains made of titanium, named chain A and chain B. The function of chain A was to attach the free jejunal end onto the pancreatic stump, whereas the function of chain B was to tighten the contact between the jejunal wall and the surface of the pancreatic stump to eliminate gaps between the two structures and ensure tightness that is sufficient to guarantee that there is no leakage of jejunal fluid or pancreatic juice. The following procedure was used to assess the safety and efficacy of the procedure: pancreaticojejunostomies were performed on ten domestic pigs using anastomotic chains. The time required to complete the pancreaticojejunal anastomoses, the pressure tolerance of the pancreaticojejunal anastomoses, the pig death rate, and the histopathological examinations of the pancreaticojejunostomy tissues were recorded. The average time required to complete the pancreaticojejunal anastomosis procedure was 13+/-2 min. The observed tolerance pressure of the pancreaticojejunal anastomoses was more than 90 mm H(2)O. All ten domestic pigs that underwent operations were still alive four weeks after the operations. Pathological examinations showed that the anastomotic surfaces were completely healed, and the pancreatic cutting surfaces were primarily epithelialized. In conclusion

  13. Single-born marmosets without hemopoietic chimerism: naturally occurring and induced.

    PubMed

    Gengozian, N; Batson, J S

    1975-01-01

    Marmosets have a high frequency of fraternal twinning, and placental vascular anastomoses between the twin fetuses invariably lead to hemopoietic chimerism. The occasional finding of chimerism in single-born marmosets suggested that in a twin pregnancy one fetus had undergone resorption after contributing hemopoietic stem cells to its twin. In this study non-chimeric single-born marmosets were produced by fallopian tube ligation or surgical relocation of one ovary in breeding females. Further, in an examination of hemopoietic cells from over 50 single-born young from nonoperated females, chimerism occurred less frequently than what one would expect if resorption of a co-twin had occurred after a functional anastomosis had been established. PMID:808628

  14. Flood surge through the Lunae Planum Outflow Complex, Mars

    NASA Technical Reports Server (NTRS)

    De Hon, R. A.; Pani, E. A.

    1992-01-01

    It is shown that the Maja outflow on Mars was released as a catastrophic outburst from Juventae Chasma. The flood surge traveled the first two-thirds of its length as a semiconfined sheetflood in a broad trough formed by the eastward-sloping Lunae Planum surface and the Xanthe Terra highlands to the east. At its northernmost extent, the flow ponded on the northern Lunae Planum surface. As the flow impounded on the upper Maja lake, waters rose to spill over the Xanthe Terra revetment onto the lower Chryse Planitia surface. The initial spillover crossed Xanthe Terra as sheetflood flow that muted topography over which it passed. The sheetflood was rapidly broken by the irregular topography to cut a complex series of anastomosing channels. A few main channels on eventually captured most of the drainage and local ponds formed in breached craters and irregular basins. The Maja Valles canyon eventually captured the remaining flow at the expense of all other channels.

  15. Assessment of arterial collateralization and its relevance to intra-arterial therapy for acute ischemic stroke.

    PubMed

    Ramaiah, Siva Seeta; Mitchell, Peter; Dowling, Richard; Yan, Bernard

    2014-03-01

    Evidence from recent randomized controlled studies comparing intra-arterial (IA) therapy with intravenous tissue plasminogen activator highlighted the mismatch between recanalization success and clinical outcomes in patients presenting with acute ischemic stroke. There is emerging interest in the impact of arterial collateralization, as determined by leptomeningeal anastomoses (LMAs), on the treatment outcomes of IA therapy. The system of LMA constitutes the secondary network of cerebral collateral circulation apart from the Circle of Willis. Both anatomic and angiographic studies confirmed significant interindividual variability in LMA. This review aims to outline the current understanding of arterial collateralization and its impact on outcomes after IA therapy for acute ischemic stroke, underpinning the possible role of arterial collateralization assessment as a selection tool for patients most likely to benefit from IA therapy.

  16. Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia

    PubMed Central

    Tielemans, Hanneke J.P.; Ulrich, Dietmar J.O.

    2016-01-01

    Summary: In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema. PMID:27622088

  17. Taxonomic and Molecular Identification of Mesocriconema and Criconemoides Species (Nematoda: Criconematidae)

    PubMed Central

    Cordero, Marco A.; Robbins, Robert T.; Szalanski, Allen L.

    2012-01-01

    Populations of Mesocriconema curvatum, M. kirjanovae, M. onoense, M. ornatum, M. sphaerocephala, M. surinamense, M. vadense, M. xenoplax, and Criconemoides informis from different geographical areas in the continental United States were characterized morphologically and molecularly. A new ring nematode from Washington County, Arkansas, is also described and named Mesocriconema ozarkiense n. sp., This new species is characterized by females with small flattened submedian lobes, lower than or at the same level as the labial disc, vagina straight, very well developed spermatheca without sperm, no more than one anastomoses, L=379-512 μm, V=89-93, stylet length = 49-61 μm, R=107-119, annuli with slightly crenate margins on tail portion and a simple anterior vulval lip. The molecular characterization of M. ozarkiense n. sp. using the ITS rRNA gene sequence and the phylogenesis relationship of this new species with the ring nematodes included in this study are provided. PMID:23482878

  18. Anomalous Feeding of the Left Upper Lobe.

    PubMed

    Hazzard, Christopher; Itagaki, Shinobu; Lajam, Fouad; Flores, Raja M

    2016-09-01

    We report the case of a 53-year-old woman who presented with massive hemoptysis. Computed tomographic angiography revealed an anomalous vessel arising from the abdominal aorta, coursing anteriorly and through the diaphragm, and feeding the left upper lobe. At operation the vessel was found to anastomose to the left upper lobe lingula, which contained multiple vascular abnormalities and arteriovenous fistulas. The vessel was ligated, and the affected portion of the left upper lobe was resected. Anomalous systemic arterial supply of an upper lobe is an especially rare form of a Pryce type 1 abnormality. Recognition of these unusual anatomic variants is crucial to successful treatment and avoidance of adverse events. PMID:27549539

  19. Thoracic aorta to popliteal artery bypass for bilateral lower-extremity critical limb ischemia.

    PubMed

    Jayaraj, Arjun; Starnes, Benjamin W; Tran, Nam T; Hatsukami, Thomas

    2012-08-01

    Thoracic aortic to infrainguinal arterial bypasses are rare in the literature, even more so when the outflow is the popliteal artery bilaterally. The case of a patient presenting with critical limb ischemia, chronic infrarenal aortic occlusion, and recurrent thrombosis of a unilateral axillobifemoral graft managed with thoracoretroperitoneal bitransobturator bipopliteal bypass is presented. The patient's vascular history was significant for multiple previous groin procedures for thrombectomy of her axillobifemoral graft, aortomesenteric bypass, redo aortomesenteric bypass for graft thrombosis, and multiple bowel resection procedures for acute mesenteric ischemia. The thoracic aorta and popliteal arteries were selected as sites for proximal and distal anastomoses, respectively, given anticipated difficulty in exposing the supraceliac aorta and femoral arteries. The technique of this operative approach is discussed. PMID:22794339

  20. Some remarks on a re-do urinary diversion by converting the ileal conduit to an Indiana pouch.

    PubMed

    Maffezzini, Massimo; Campodonico, Fabio

    2006-06-01

    Although the ileal conduit is a wide accepted urinary diversion with a low rate of long way postoperative complications, some patients are not satisfied with the change of body image and the need to wear an external bag inherent to the Bricker's diversion. We report on a patient who underwent cystectomy and Bricker's diversion for bladder cancer which afterwards was converted to an Indiana pouch due to patient preference. The use of the proximal portion of the preexisting ileal conduit facilitated the pouch construction, minimizing the bowel requirement and the need for redoing the ureteral anastomoses. The conversion from ileal-conduit to a catheterizable pouch is technically feasible and involves a better perception of the body image, and a less cumbersome management of the diversion. Before any surgical reconstruction, a realistic discussion with the patient, explaining the potential physical and life-style changes, and problems encountered postoperatively, is the crucial issue. PMID:16929606

  1. The Superior Rectal Artery as a Recipient Vessel for Free Flap Transfer After Partial Sacrectomy in Patients With Chordoma.

    PubMed

    Miyamoto, Shimpei; Arikawa, Masaki; Fujiki, Masahide; Kawai, Akira; Kobayashi, Eisuke; Sakuraba, Minoru

    2016-03-01

    Free flaps have rarely been used to reconstruct lumbosacral defects, primarily because of the lack of suitable recipient vessels in this region. We propose the novel use of the superior rectal artery as a recipient vessel for free flap transfer after partial or total sacrectomy. We transferred free flow-through latissimus dorsi musculocutaneous flaps, with the superior rectal vessels as recipient vessels, to reconstruct defects after partial sacrectomy in 2 patients with sacral chordoma. The flaps survived completely, and the wounds healed uneventfully in both patients. The superior rectal artery is easier to dissect and anastomose than are gluteal vessels and is less affected by patients' postoperative postural change than are extraperitoneal vessels. We believe that the superior rectal artery is a versatile recipient vessel for free flap transfer to reconstruct sacrectomy defects.

  2. Ductile duplexing at a bend of a continental-scale strike-slip shear zone: example from NE Brazil

    NASA Astrophysics Data System (ADS)

    Corsini, Michel; Vauchez, Alain; Caby, Renaud

    1996-04-01

    During the Pan-African orogeny, the Borborema Province in NE Brazil developed a continental-scale shear-zone system that comprises NE- and EW-trending ductile strike-slip shear zones. Remote sensing and structural mapping has revealed a pattern of arcuate anastomosing strike-slip shear zones separating sigmoidal lenses of less deformed material, located at the western end of the EW-trending Patos shear zone, which is one of the largest shear zones of the Province. This structure of imbricate shear zones was initiated under high-temperature deformation conditions. It is interpreted as a ductile strike-slip duplex and may represent a kinematic pattern for strain accommodation in response to a bend of a ductile mega-shear zone.

  3. Emergency off-pump complete arterial revascularization in a patient with dextrocardia.

    PubMed

    Yamashiro, Satoshi; Iha, Kiyoshi; Akasaki, Mitsuru; Uezu, Toru; Ikemura, Ryo; Nishijima, Isao

    2009-11-01

    We describe complete emergency arterial coronary artery bypass grafting performed on the beating heart of a 73-year-old man with situs inversus totalis and triple-vessel disease. The right internal mammary artery was anastomosed to the left anterior descending artery in situ. The first and second obtuse marginal branches of the circumflex coronary and the posterior descending branch of the right coronary artery were sequentially revascularized using the left internal mammary and radial arteries in situ. The only abnormality was that the position of the heart mirrored that of a normal heart. Beating heart surgery appears to be as safe in patients with dextrocardia as in the general population. However, the position of the surgeon must be reconsidered for optimal handling of stabilizers and to facilitate access to anastomosis sites. Understanding mirror-image coronary arterial anatomy is important for successful surgical outcomes among patients with dextrocardia.

  4. [Detubularized U-shaped enterocystoplasty after cystoprostatectomy].

    PubMed

    el Mrini, M; Aboutaieb, R; el Fatimi, A; Sarf, I; Joual, A; Bennani, S; Elmoussaoui, A; Benjelloun, S

    1996-01-01

    We reviewed the charts of 58 patients who underwent orthotopic bladder replacement after total cystoprostatectomy for muscle invasive bladder cancer. Mean age was 56 years. As described by Camey, 60 centimetres of small bowel, are isolated, detubularised then folded upon itself to form a U shaped reservoir, which is anastomosed to the urethra. Death occurred in 5%. Urologic complications observed were: urinary leakage (15%), ureteral reflux (6.8%), ureteral stenosis (8.6%) and stones of the neobladder (5.1%). 64.2% of the patients were immediately continent during the day. Nocturnal continence was obtained for 50% immediately and for 80% three months postoperatively. Detubularised and U shaped cystoplasty achieve a low pressure reservoir, with protection of the upper urinary tract, and a diurnal continence. Nocturnal continence is achieved later.

  5. Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation.

    PubMed

    Teixeira, Uirá Fernandes; Machry, Mayara Christ; Goldoni, Marcos Bertozzi; Kruse, Cristine; Diedrich, João Alfredo; Rodrigues, Pablo Duarte; Giacomazzi, Caroline Becker; Negri, Estéfano Aurélio; Koop, Matheus; Gomes, Carlos Gustavo Spode; Sampaio, José Artur; Fontes, Paulo Roberto Ott; Waechter, Fábio Luiz

    2016-01-01

    Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation. The vein was dissected and sectioned near the cardia; the proximal segment was ligated with suture and the distal segment was anastomosed to the donor portal vein. Gastroportal anastomosis is an excellent option for portal reconstruction in the presence of thrombosis or hypoplasia. It allows an adequate splanchnic drainage and direction of hepatotrophic factors to the graft. PMID:27595034

  6. [US-guided transhepatic drainage of a mediastinal abscess].

    PubMed

    Simón-Yarza, I; Viteri-Ramírez, G; García-Lallana, A; Benito, A

    2014-01-01

    Anastomoses often leak after esophageal surgery; if they are not detected in time, leaks can give rise to complications like fluid collections, superinfections, and mediastinitis. Although these complications usually require surgical treatment, different series of patients successfully treated with conservative or minimally invasive approaches have been reported. We present the case of a patient who developed a mediastinal abscess after epiphrenic diverticulectomy. We treated the abscess with US-guided percutaneous transhepatic drainage to avoid surgical reintervention. Although other cases of a transhepatic approach to thoracic lesions have been reported, to our knowledge this is the first report of this technique in mediastinal abscesses. We recommend that transhepatic drainage be considered a therapeutic option in the management of these complications. PMID:22464798

  7. Vanishing Venous Coronary Artery Bypass Grafts after Sepsis

    PubMed Central

    Park, Soo Jin; Park, Ji Ye; Jung, Joonho; Hong, You Sun; Lee, Cheol Joo; Lim, Sang Hyun

    2016-01-01

    The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication. PMID:27734001

  8. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    PubMed Central

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  9. Isostatic uplift, crustal attenuation, and the evolution of an extensional detachment system in southwestern Nevada

    SciTech Connect

    Scott, R.B.

    1987-12-31

    Geological and geophysical evidence supports the existence of extensional detachments, between the Sheep Range and Death Valley. It is proposed that geographically separated pieces of detachments between Death Valley and the Sheep Range are parts of a regional detachment system that has evolved since the Miocene, and that the system consists of lenses of strata separated by an anastomosing network of low- and high-angle normal faults. This manuscript emphasizes the probability that isostatic uplift within the region of greatest crustal attenuation in this system, the Bullfrog Hills core complex, controlled the evolution of the detachment system between the breakaway zone a the Sheep Range and the core complex. Features in this system are described from east to west, which is the apparent direction of tectonic transport.

  10. Ice sculpture in the Martian outflow channels

    NASA Technical Reports Server (NTRS)

    Lucchitta, B. K.

    1982-01-01

    Viking Orbiter and terrestrial satellite images are examined at similar resolution to compare features of the Martian outflow channels with features produced by the movement of ice on earth, and many resemblances are found. These include the anastomoses, sinuosities, and U-shaped cross profiles of valleys; hanging valleys; linear scour marks on valley walls; grooves and ridges on valley floors; and the streamlining of bedrock highs. Attention is given to the question whether ice could have moved in the Martian environment. It is envisaged that springs or small catastrophic outbursts discharged fluids from structural outlets or chaotic terrains. These fluids built icings that may have grown into substantial masses and eventually flowed like glaciers down preexisting valleys. An alternative is that the fluids formed rivers or floods that in turn formed ice jams and consolidated into icy masses in places where obstacles blocked their flow.

  11. Repair of congenital 'disconnected uterus': a new female genital anomaly?

    PubMed

    Kisu, Iori; Tanaka, Kyoko; Banno, Kouji; Okuda, Shigeo; Aoki, Daisuke

    2015-01-01

    Congenital uterine anomaly is a female genital disorder caused by developmental anomaly of the Müllerian ducts. In this report, we present a case of repair of congenital 'disconnected uterus' between the cervix and the body of the uterus. The case did not correspond to the consensus classifications that have been proposed for congenital uterine anomaly. The patient was a young woman whose chief complaints were not having first menstruation and experiencing monthly severe lower abdominal pain. Magnetic resonance imaging showed that the uterine body was separated from the uterine cervix. Uteroplasty was conducted to anastomose the separated uterus. Periodic menstruation started 1 month after surgery and abdominal pain was improved. Performance of uteroplasty in this case was extremely significant and greatly improved the quality of life of the patient.

  12. At the Root of the Wood Wide Web

    PubMed Central

    Avio, Luciano; Fortuna, Paola; Pellegrino, Elisa; Sbrana, Cristiana; Strani, Patrizia

    2006-01-01

    Arbuscular mycorrhizal (AM) fungi are mutualistic symbionts living in the roots of 80% of land plant species, and developing extensive, below-ground extraradical hyphae fundamental for the uptake of soil nutrients and their transfer to host plants. Since AM fungi have a wide host range, they are able to colonize and interconnect contiguous plants by means of hyphae extending from one root system to another. Such hyphae may fuse due to the widespread occurrence of anastomoses, whose formation depends on a highly regulated mechanism of self recognition. Here, we examine evidences of self recognition and non-self incompatibility in hyphal networks formed by AM fungi and discuss recent results showing that the root systems of plants belonging to different species, genera and families may be connected by means of anastomosis formation between extraradical mycorrhizal networks, which can create indefinitely large numbers of belowground fungal linkages within plant communities. PMID:19521468

  13. Wound repair in Pocillopora.

    PubMed

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry Martin; Calderon-Aguilera, Luis Eduardo

    2016-09-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals. PMID:27397755

  14. Palliation of biliary and duodenal obstruction in patients with unresectable pancreatic cancer: endoscopy or surgery?

    PubMed

    Maire, F; Sauvanet, A

    2013-06-01

    Patients with unresectable pancreatic adenocarcinoma often develop biliary and/or duodenal obstruction during the course of their disease. Jaundice, pruritis, nausea and vomiting impact negatively on the quality of life and chemotherapy must often be withheld until these symptoms are resolved. In the past, an open surgical palliative bypass was proposed, but the development of endoprosthetic stents has changed the management of these patients. The success rate for placement of duodenal and biliary stents is greater than 90% with low morbidity. Classical surgical bypass surgery includes biliary-digestive and gastro-jejunal anastomoses. Many studies have compared endoscopic and surgical treatment, and there is a clear advantage to endoscopic treatment in terms of quality of life and cost.

  15. Impact of surgical shape on blood flow pattern for patient specific coronary artery bypass graft (CABG) surgery

    NASA Astrophysics Data System (ADS)

    Sankaran, Sethuraman; Marsden, Alison

    2010-11-01

    We present a numerical framework for studying blood flow patterns in patients who have undergone coronary artery bypass surgeries. We use a stabilized finite element framework for performing blood flow simulations. Specialized lumped parameter boundary conditions for the coronary arteries, aorta and its branches are utilized. Computational models of CABG patients are constructed from CT scan images. A comprehensive study of how surgical shape affects hemodynamics in patient-specific CABG surgery has not been performed till date. The objective of this work is to study the effect of surgical geometry on blood flow pattern, especially downstream and in the proximity of the suture locations of the bypass graft. Quantities such as energy efficiency, wall shear stresses and its gradients and oscillatory shear index are extracted and compared for different surgical shapes in a systematic fashion. A framework and results for robust optimization of bypass graft anastomoses in unsteady flow will be presented. Implications of surgical geometry on graft patency will be discussed.

  16. Reticular and myxoid non-keratinizing nasopharyngeal carcinoma: an unusual case mimicking a salivary gland carcinoma.

    PubMed

    Petersson, Fredrik; Vijayadwaja, Desai; Loh, Kwok Seng; Tan, Kong-Bing

    2014-01-01

    We present a case of non-keratinizing carcinoma of the nasopharynx (NK-NPC) with an unusual histopathological pattern. The neoplastic cells were arranged in anastomosing cords embedded in a stroma which contained a significant component of alcian blue-positive myxoid substance forming a reticular pattern. These histopathological features gave an initial impression of a salivary gland-type carcinoma. On immunohistochemistry the tumor cells were strongly and diffusely positive for cytokeratins (AE1-3 and 5/6) and p63 and there was strong and diffuse nuclear positivity for Epstein-Barr virus-encoded small RNA on in situ hybridization. This case highlights the histomorphological variability of NK-NPC. Awareness of the histological spectrum of NK-NPC is important in clinical practice and this is not always adequately highlighted in currently used standard textbooks of Head and Neck Pathology. PMID:24323539

  17. Evaluation of a training course on open vascular surgical techniques in aortoiliac pathology - 5 years of experience

    PubMed Central

    STANCU, BOGDAN; BETEG, FLORIN; MIRONIUC, AUREL; MUSTE, AUREL; GHERMAN, CLAUDIA

    2015-01-01

    Introduction The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008–2012), and to verify the viability and the feasibility of vascular anastomoses. Material and method The vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. The endpoints of the study were the surgical skills and the technical quality, assessed on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants. Results A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a significant statistical association between the quality of the suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05). Conclusions Our course contributed to the improvement of the technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment of human patients. PMID:26528071

  18. Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses

    PubMed Central

    Anderson, Stacy L.; Blackford, James T.; Kelmer, S. Gal

    2012-01-01

    This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at least 1 year after surgery. The survival times and incidence of post-operative ileus compared favorably with published results for other types of small intestinal resection and anastomoses. A COSFE JIA is a viable surgical procedure to correct lesions of the distal jejunum and proximal ileum. PMID:23450864

  19. Fibrinogen-fibrin conversion and inhibition of fibrinolysis.

    PubMed

    Stemberger, A; Blümel, G

    1982-08-01

    The fibrin adhesion technique is the imitation of the last step of the coagulation system. Fibrinogen is converted by thrombin into fibrin and stabilized by factor XIII. Fibrin sticks to the tissue and the tissue is adapted by syneresis. Local application of aprotinin to the thrombin solution is necessary in order to inhibit premature lysis of the fibrin film. This technique is now used in some selected cases in man such as fixation of cartilage, tendon, sealing of colonic anastomoses and preclotting of vessel grafts. An excellent hemostyptic effect of the fibrin glue in combination with absorbable collagen tampons was found. This combination technique is now used to seal parenchymatous organs and to stop hemorrhage in patients with defective hemostasis particularly those undergoing open heart surgery.

  20. In vitro fabrication of functional three-dimensional tissues with perfusable blood vessels

    PubMed Central

    Sekine, Hidekazu; Shimizu, Tatsuya; Sakaguchi, Katsuhisa; Dobashi, Izumi; Wada, Masanori; Yamato, Masayuki; Kobayashi, Eiji; Umezu, Mitsuo; Okano, Teruo

    2013-01-01

    In vitro fabrication of functional vascularized three-dimensional tissues has been a long-standing objective in the field of tissue engineering. Here we report a technique to engineer cardiac tissues with perfusable blood vessels in vitro. Using resected tissue with a connectable artery and vein as a vascular bed, we overlay triple-layer cardiac cell sheets produced from coculture with endothelial cells, and support the tissue construct with media perfused in a bioreactor. We show that endothelial cells connect to capillaries in the vascular bed and form tubular lumens, creating in vitro perfusable blood vessels in the cardiac cell sheets. Thicker engineered tissues can be produced in vitro by overlaying additional triple-layer cell sheets. The vascularized cardiac tissues beat and can be transplanted with blood vessel anastomoses. This technique may create new opportunities for in vitro tissue engineering and has potential therapeutic applications. PMID:23360990

  1. [The super extended sub-mental flap or combo sub-mental flap].

    PubMed

    Martin, D

    2014-08-01

    The author presents a technical variation of the sub-mental flap including in a conventional pedicled flap both sub-mental axes and their anastomoses on the midline. The assessment of the first flaps raised according to this method confirms the improvement of the distal blood supply. It allows the possibility to harvest "super extended" flaps reaching the contralateral auricular lobula. This variation can be considered as an axial flap which only the tip, located beyond the mandibular angle, is at random. The evolution of the sub-mental flap from its original description to this variation called "combo sub-mental flap" is then presented. Its reliability and the technical simplification it provides will have to be assessed in the future. PMID:24840945

  2. Reticular and myxoid non-keratinizing nasopharyngeal carcinoma: an unusual case mimicking a salivary gland carcinoma.

    PubMed

    Petersson, Fredrik; Vijayadwaja, Desai; Loh, Kwok Seng; Tan, Kong-Bing

    2014-01-01

    We present a case of non-keratinizing carcinoma of the nasopharynx (NK-NPC) with an unusual histopathological pattern. The neoplastic cells were arranged in anastomosing cords embedded in a stroma which contained a significant component of alcian blue-positive myxoid substance forming a reticular pattern. These histopathological features gave an initial impression of a salivary gland-type carcinoma. On immunohistochemistry the tumor cells were strongly and diffusely positive for cytokeratins (AE1-3 and 5/6) and p63 and there was strong and diffuse nuclear positivity for Epstein-Barr virus-encoded small RNA on in situ hybridization. This case highlights the histomorphological variability of NK-NPC. Awareness of the histological spectrum of NK-NPC is important in clinical practice and this is not always adequately highlighted in currently used standard textbooks of Head and Neck Pathology.

  3. Clathria (Thalysias) (Poecilosclerida: Demospongiae: Porifera) from Brazil:
    New species and redescription of Clathria (Thalysias) basiarenacea (Boury-Esnault, 1973).

    PubMed

    Galindo, Helcy; Hooper, John N A; Pinheiro, Ulisses

    2014-10-30

    The subgenus Clathria (Thalysias) Duchassaing & Michelotti, 1864 has 97 valid species, of which 27 are recorded in the Atlantic Ocean. However, only three species are known from Brazil so far. Here we provide the redescription of Clathria (Thalysias) basiarenacea (Boury- Esnault, 1973), based on the discovery of new characters (additional category of auxiliary styles, and details of spicules), and describe a new species of Clathria (Thalysias) repens sp. nov., that differs from sister species in having a live orange color, a massively encrusting repent growth form with lamellate folds and anastomosed projections, and three categories of structural styles, of which the two auxiliary styles have microspined heads. We also invalidate the record of Clathria (Thalysias) procera (Ridley, 1884) for Brazil. 

  4. The Tapestry of Life: Lateral Transfers of Heritable Elements - Scientific Meeting

    SciTech Connect

    Claire M. Fraser, Ph.D.

    2005-12-31

    The Sackler Colloquium The Tapestry of Life: Lateral Transfers of Heritable Elements was held on December 12-13, 2005. What Darwin saw as a tree of life descending in a linear fashion, is now more accurately seen as a tapestry of life, an anastomosing network, with important lateral transfers of heritable elements among parallel lines of descent These transfers range in complexity from small insertion sequences, to whole genes, gene islands, and portions of whole genomes which may be combined in symbiogenesis. The colloquium brought together researchers, empirical and theoretical, working at all levels on genomics, comparative genomics, and metagenomics to identify common and differentiating features of lateral gene transfer and to examine their implications for science and for human concerns.

  5. Cancer développé sur dilatation kystique de la voie biliaire: à propos d’un cas

    PubMed Central

    Soufi, Mehdi; Lahlou, Mohammed Khalid; Chad, Bouziane

    2014-01-01

    Les auteurs rapportent un cas de dilatation kystique du cholédoque intra- pancréatique découvert chez une femme de 46 ans et compliqué d'un carcinome tubulo-papillaire n'envahissant pas le pancréas. Le traitement a consisté en une duodénopancréatectomie céphalique avec un curage ganglionnaire et anastomose hépatico-jéjunale; la survie était de 30 mois; les auteurs abordent les aspects radiologiques, anatomopathologiques, thérapeutiques et pronostiques de ces cancers développé sur dilatation kystique de la voie biliaire et discutent la place d'une radiothérapie complémentaire de la chirurgie susceptible d'améliorer la survie. PMID:25922635

  6. Wound repair in Pocillopora

    USGS Publications Warehouse

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguileraa, Luis Eduardo

    2016-01-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40 days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40 d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  7. [Causes, diagnosis and surgical treatment of strictures of lobar and segmental hepatic ducts].

    PubMed

    Gal'perin, E I; Diuzheva, T G; Chevokin, A Iu; Garmaev, B G

    2005-01-01

    Causes of strictures of lobar and segmental ducts after their injuries during open and laparoscopic cholecystectomy in 53 patients were analyzed. For correction of bile outflow precision non-wireframe (n=22) and wireframe (n=20) anastomoses were used. In 10 patients a combined anastomosis was established. In 1 patient the external drainage of hepatic ducts was performed. After surgery 3 patients died. 1-15 year long-term results were studied in 48 (96%) patients. Good results were achieved in 29 (60.5%), satisfactory -- in 13 (27%) patients. Recurrences of the strictures were diagnosed in 6 patients. It is concluded that dynamic control is necessary in patients operated on for bile ducts injuries. Underestimation of remittent cholangitis leading to biliary cirrhosis worsens prognosis of the disease.

  8. Laser therapy for twin-to-twin transfusion syndrome (TTTS).

    PubMed

    Chalouhi, G E; Essaoui, M; Stirnemann, J; Quibel, T; Deloison, B; Salomon, L; Ville, Y

    2011-07-01

    Monochorionic twins are subjected to specific complications which originate in either imbalance or abnormality of the single placenta serving two twins including twin-to-twin transfusion syndrome. The diagnosis is well established in overt clinical forms with the association of polyuric polyhydramnios and oliguric oligohydramnios. The best treatment of cases presenting before 26 weeks of gestion is fetoscopic laser ablation of the intertwin anastomoses on the chorionic plate. Although subjected to subtle variations, the core technique follows robust guidelines which could help understanding and acquiring the required skills and experience to perform this procedure. However appropriate and tailored hands-on training and appropriate perinatal set-up are critical not only for surgical management but also for the follow-up and management of related complications.

  9. Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.

    PubMed

    Zembala, Michal O; Irimie, Vadim; Urbanski, Paul P

    2016-04-01

    A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful. PMID:27002017

  10. Collateral Circulation in Chronic Total Occlusions - An Interventional Perspective

    PubMed Central

    Choo, Gim-Hooi

    2015-01-01

    Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to the myocardial segment at risk. This mitigates the ischemic injury. Clinical outcome of coronary occlusion ie. severity of myocardial infarction/ischemia, impairment of cardiac function and possibly survival depends not only on the acuity of the occlusion, extent of jeopardized myocardium, duration of ischemia but also to the adequacy of collateral circulation. Adequacy of collateral circulation can be assessed by various methods. These coronary collateral channels have been used successfully as a retrograde access route for percutaneous recanalization of chronic total occlusions. Factors that promote angiogenesis and further collateral remodeling ie. arteriogenesis have been identified. Promotion of collateral growth as a therapeutic target in patients with no suitable revascularization option is an exciting proposal.

  11. [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.

  12. Viscous Moment, Mechanism of Slow Slip, and Subduction Megathrust Viscosity

    NASA Astrophysics Data System (ADS)

    Fagereng, A.

    2015-12-01

    Slow slip events (SSEs) represent transient slip velocities slower than earthquakes but faster than steady, average plate motion. SSEs repeating at the same location have characteristic slip magnitude and duration. Contrary to earthquakes, however, average slip relates to neither duration nor area. Variations in duration, slip, and slip rate can instead be tied to variations in effective viscosity, calculated from a viscous definition of moment. In this paradigm, the observation that deep slow slip events are slower and longer, implies a higher effective viscosity than in shallower, colder SSEs. Observed variations in effective viscosity and slip rate can be interpreted in terms of differences in driving stress and shear zone width, and likely arise in anastomosing shear zones containing a heterogeneous mixture of materials.

  13. [The symptoms and surgical tactics for complicated forms of the abdominal cavity tuberculosis].

    PubMed

    Kosul'nikov, S O; Kravchenko, K V; Tarnopol'skiĭ, S A; Besedin, A M

    2012-01-01

    The results of treatment of 12 patients, suffering complicated forms of abdominal tuberculosis and external intestinal fistulas, were presented. Late diagnosis of abdominal tuberculosis in the patients, suffering the complications phase of the disease, is caused by unclear symptoms presence in early stages of the disease. Clinical and laboratory indices in peritonitis of a phthisis origin are nonspeciphic. In 91% of patients, admitted to the hospital for complicated forms of abdominal tuberculosis and external intestinal fistulas, the operative treatment was indicated. Surgical intervention (more frequently right-sided hemicolectomy, enterostomy, the abscesses opening, the caseously-changed lymph nodes excision, formation of anastomosis) was performed in 11 patients for peritonitis and external intestinal fistulas. The method of a secure invagination anastomoses formation was elaborated, permitting to perform primary restoration operations. An early diagnosis, early effective therapy and radical surgical intervention conduction for complicated abdominal tuberculosis promote the patients to survive.

  14. Vascularization of hollow channel-modified porous silk scaffolds with endothelial cells for tissue regeneration.

    PubMed

    Zhang, Wenjie; Wray, Lindsay S; Rnjak-Kovacina, Jelena; Xu, Ling; Zou, Duohong; Wang, Shaoyi; Zhang, Maolin; Dong, Jiachen; Li, Guanglong; Kaplan, David L; Jiang, Xinquan

    2015-07-01

    Despite the promise for stem cell-based tissue engineering for regenerative therapy, slow and insufficient vascularization of large tissue constructs negatively impacts the survival and function of these transplanted cells. A combination of channeled porous silk scaffolds and prevascularization with endothelial cells was investigated to test the ability of this tissue engineering strategy to support rapid and extensive vascularization process. We report that hollow channels promote in vitro prevascularization by facilitating endothelial cell growth, VEGF secretion, and capillary-like tube formation. When implanted in vivo, the pre-established vascular networks in the hollow channel scaffolds anastomose with host vessels and exhibit accelerated vascular infiltration throughout the whole tissue construct, which provides timely and sufficient nutrients to ensure the survival of the transplanted stem cells. This tissue engineering strategy can promote the effective application of stem cell-based regeneration to improve future clinical applications.

  15. Pan-nitinol occluder and special delivery device for closure of patent ductus arteriosus: a canine-model feasibility study.

    PubMed

    Jiang, Hai-bin; Bai, Yuan; Zong, Gang-jun; Han, Lin; Li, Wei-ping; Lu, Yang; Qin, Yong-wen; Zhao, Xian-xian

    2013-01-01

    The aim of this study was to evaluate a new type of occluder for patent ductus arteriosus. Patent ductus arteriosus was established in a canine model by anastomosing a length of autologous jugular vein to the descending aorta and the left pulmonary artery in an end-to-side fashion. Transcatheter closure of each patent ductus arteriosus was performed on 10 dogs, which were then monitored for as long as 6 months with aortography, echocardiography, and histologic evaluation. Transcatheter closure with use of the novel pan-nitinol device was successful in all canine models. Postoperative echocardiography showed that the location and shape of the occluders were normal, without any residual shunting. Further histologic evaluation confirmed that the occluder surface was completely endothelialized 3 months after implantation. Transcatheter patent ductus arteriosus closure with the pan-nitinol occluder can be performed safely and successfully in a canine model and shows good biological compatibility and low mortality rates.

  16. Post-granulite facies fluid infiltration in the Adirondack Mountains

    SciTech Connect

    Morrison, J.; Valley, J.W.

    1988-06-01

    Granulite facies lithologies from the Adirondack Mountains of New York contain alteration assemblages composed dominantly of calcite +/- chlorite +/- sericite. These assemblages document fluid infiltration at middle to upper crustal levels. Cathodoluminescence of samples from the Marcy anorthosite massif indicates that the late fluid infiltration is more widespread than initially indicated by transmitted-light petrography alone. Samples that appear unaltered in transmitted light show extensive anastomosing veins of calcite (< 0.05 mm wide) along grain boundaries, in crosscutting fractures, and along mineral cleavages. The presence of the retrograde calcite documents paleopermeability in crystalline rocks and is related to the formation of high-density CO/sub 2/-rich fluid inclusions. Recognition of this process has important implications for studies of granulite genesis and the geophysical properties of the crust.

  17. The description of Centrorhynchus globirostris n. sp. (Acanthocephala: Centrorhynchidae) from the pheasant crow, Centropus sinensis (Stephens) in Pakistan, with gene sequence analysis and emendation of the family diagnosis.

    PubMed

    Amin, Omar M; Heckmann, Richard A; Wilson, Eric; Keele, Brianna; Khan, Aly

    2015-06-01

    A new species of Centrorhynchus (Centrorhynchidae) with receptacle insertion at the posterior third of the proboscis is described from the pheasant crow Centropus sinensis (Stephens) (Cuculidae) in Pakistan. Centrorhynchu sglobirostris n. sp. is similar to the 98 other known species of Centrorhynchus Lühe, 1911 in having long cylindrical trunk with anterior dilation and transverse anastomoses of the secondary lacunar vessels. However, specimens of C. globirostris differ from all other species of the genus by having a unique globular proboscis not divided into anterior proboscis with rooted hooks and posterior proboscis with rootless spines. Posterior hooks of C. globirostris emerge at the level of the receptacle insertion and are uniquely fully rooted. Sequencing and phylogenetic analysis of C. globirostris 18S and 28S ribosomal RNA genes reveals the genetic and evolutionary relationships between C. globirostris and other members of Centrorhynchidae which have representative orthologs in public databases. Comparison to known acanthocephalans confirms appropriate inclusion in the genus Centrorhynchus. PMID:25804972

  18. False aneurysm on distal part of coarctation of the aorta in a parous Turner syndrome patient.

    PubMed

    Oi, Keiji; Yoshida, Tetsuya; Takeshita, Masashi; Tsuruta, Goro

    2013-09-01

    False aneurysm associated with untreated coarctation of the aorta (CoA) is an uncommon vascular complication. We present a 41-year-old woman with mosaic Turner syndrome who had CoA complicated with a small false aneurysm on descending aorta just distal to the coarctation. The patient had not been diagnosed with Turner syndrome despite several physical characteristics of the syndrome because she had histories of natural childbirth. The false aneurysm was resected with the coarctation through a thoracotomy and proximal aorta was directly anastomosed to distal aorta. Endovascular therapy has become preferred method in recent years in treatment for coarctation of the aorta. However, careful consideration should be given to the irregularities on the aorta with the coarctation for diagnosis of false aneurysm.

  19. [Duodenojejunostomy in the symptomatic treatment of neoplastic obstruction of the duodenum--clinical observations].

    PubMed

    Górka, Z; Lesiecka, M; Kuśnierz, K; Mrowiec, S; Leidgens, M

    1997-01-01

    The aim of the study was to evaluate the value of duodenojejunostomy and gastrojejunostomy in the treatment of neoplastic obstruction in the distal part of the duodenum. From 1992-1996, 37 patients (15 women, 22 men, aged 31-76 years) underwent a palliative operation for pancreatic cancer infiltrating the distal part of duodenum. Roux-en-Y procedure was used to create anastomoses between the duodenal bulb and jejunal loop. In 13 patients only alimentary by-pass was made whereas in the remaining 24 biliary decompression was also performed. The results were compared with the outcome in 26 patients in whom gastrojejunal side-to-side anastomosis been made. The advantage of Roux-en-Y duodenojejunostomy is that it does not interfere with gastric emptying and thus prevents jejuno biliary reflux and the consequent complications. Improvement of nutrition and quality of life in patients with inoperable pancreatic cancer, were noticed with this method.

  20. NICE guidance for off-pump CABG: keep the pump primed.

    PubMed

    Pepper, John R

    2011-11-01

    Because of a desire to reduce the morbidity of a well-established and effective procedure for coronary artery disease, up to 30% of coronary bypass operations are being performed without the use of a heart-lung pump. Concerns remain about the quality of the coronary anastomoses and the completeness of revascularisation. Randomised trials have not disclosed the significant reduction in morbidity or mortality that the early enthusiasts had hoped for. Yet a number of non-randomised studies have shown clinical benefit with the avoidance of an extracorporeal circulation, but these studies have been criticised for potential bias in patient selection and management. Most surgeons have not yet adopted this technique and are waiting for more evidence.

  1. Effect of octreotide acetate on pancreatic exocrine and endocrine functions after pancreatoduodenal resection.

    PubMed

    Petrin, P; Antoniutti, M; Zaramella, D; Da Lio, C; Basso, D; Plebani, M; Panozzo, M P; Costantino, V; Pedrazzoli, S

    1995-01-01

    In view of forecasting the effect of octreotide acetate (Sandostatin) in preventing fistula formation after pancreatic surgery, 9 patients, who had pancreatoduodenectomy 8-12 days before, underwent a 2-day study. The first day, by means of a catheter located in the jejunal loop separately anastomosed to the pancreatic remnant, basal and after secretin stimulation pancreatic secretion was evaluated. During the 2nd day the possible inhibitory effect of octreotide on basal and stimulated secretion was investigated. Under the experimental conditions of the study Sandostatin showed little effect on the water and bicarbonate increase as stimulated by secretin. A greater hormone inhibitory effect on amylase production and pancreatic endocrine function was seen. On the basis of these results the use of Sandostatin can hardly be seen as useful in preventing fistula formation after pancreatic resection.

  2. Wound repair in Pocillopora.

    PubMed

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry Martin; Calderon-Aguilera, Luis Eduardo

    2016-09-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  3. Percutaneous Selective Embolectomy using a Fogarty Thru-Lumen Catheter for Pancreas Graft Thrombosis: A Case Report

    SciTech Connect

    Izaki, Kenta Yamaguchi, Masato; Matsumoto, Ippei; Shinzeki, Makoto; Ku, Yonson; Sugimura, Kazuro; Sugimoto, Koji

    2011-06-15

    A 57-year-old woman with a history of diabetes mellitus underwent simultaneous pancreas-kidney transplantation. The pancreaticoduodenal graft was implanted in the right iliac fossa. The donor's portal vein was anastomosed to the recipient's inferior vena cava (IVC). Seven days after the surgery, a thrombus was detected in the graft veins. Percutaneous thrombolysis was immediately performed; however, venous congestion was still present. We therefore attempted selective embolectomy using a Fogarty Thru-Lumen Catheter. Thrombi were directed from the graft veins toward the IVC and captured in the IVC filter with complete elimination of the thrombus without any major complications. We present our technique for the successful treatment of pancreas graft thrombosis within a short time period by percutaneous selective embolectomy using a Fogarty Thru-Lumen Catheter.

  4. A Technique for Localizing Perforated Duodenal Ulcer During Laparoscopic Repair.

    PubMed

    Philip, Sujith; Varma, Deepak

    2015-12-01

    Laparoscopic repair of duodenal ulcer perforation has certain advantages over open repair. However, the conversion rate to open surgery is still high. The most common reason for conversion is inadequate localization of the ulcer perforation site during laparoscopy. Here, a technique is described which will aid in localizing the perforation, make suturing and repair easier, and helps in checking the integrity of the repair at the end of the procedure. This is done by compressing the gall bladder with an instrument like a laparoscopic fan retractor and simultaneously depressing the first part of the duodenum with another instrument. This results in bile flowing out through the perforation and simultaneously depressing the duodenum downward, making it more easily visible and making identification easier. Suturing is easier due to the liver also getting retracted simultaneously and more space being available consequently. Integrity of the anastomoses is also easily ascertained by this maneuver. PMID:27011591

  5. [Malignant mediastinal lesions with invasion to the superior vena cava].

    PubMed

    Kitada, M; Kubo, Y; Hirata, S; Yatsuyanagi, E; Nosaka, T; Sugimoto, S; Moriyama, H; Koshigo, S; Muraki, S; Sasajima, T

    1995-11-01

    Four patients underwent resection of mediastinal malignant tumors with invasion to the superior vena cava. Two patients had invasive thymoma, one seminoma, and one metastatic mediastinal lymph nodes of unknown origin. Prior to resection of the tumor, an ePTFE graft was anastomosed between the innominate vein and the right atrium to maintain the venous drainage from the brain and the upper extremities. In two patients, the superior vena cava was reconstructed by patch angioplasty after the tumor with a part of the vena cava was safely resected. One patient died of acute respiratory failure, but the other three are alive and well without any evidence of graft obstruction. This safe and useful method in order to prevent cerebral congestion during and after resection of the tumor.

  6. Monozygotic twins discordant for trisomy 13.

    PubMed

    Ramsey, K Wong; Slavin, T P; Graham, G; Hirata, G I; Balaraman, V; Seaver, L H

    2012-04-01

    Monozygotic twins with discordant karyotypes are rare. We report a case of monozygotic twins discordant for trisomy 13 by amniocyte karyotypes. Ultrasound revealed multiple congenital anomalies in Twin A (47,XY,+13), none in Twin B (46,XY), and monochorionic-diamniotic placentation. Zygosity testing performed both prenatally and after birth supported monozygosity. Twin A died in the neontal period. Twin B survived and had normal physical examination, but peripheral blood karyotype revealed 20% mosaicism for trisomy 13. Monochorionic-diamniontic placentation with vascular anastomoses was confirmed by pathological examination. In this paper, we discuss the various mechanisms by which monozygotic twins may have discordant karyotypes. The surviving twin, structurally and developmentally normal at 6 months of age, will be monitored for potential complications of uniparental disomy of chromosome 13 and trisomy 13 mosaicism.

  7. Lymphatic drainage in patients after replantation of extremities

    SciTech Connect

    Smith, A.R.; van Alphen, W.A.; van der Pompe, W.B.

    1987-02-01

    Lymph drainage was studied by means of lymph scintigraphy in eight patients in whom successful replantation of a totally or subtotally amputated extremity had been performed. Scintigrams were made after subcutaneous injection of technetium-99m in the replanted part of the patient and the contralateral, normal extremity. In all scintigrams, axillary or inguinal lymph node activity is seen, implying drainage of lymph by means of the lymph vessels. Retention of colloid in the replanted part (79 to 94 percent) shows no significant difference with the contralateral, normal side (86 to 94 percent). Unquestionable evidence of regeneration of lymphatics in humans is delivered in the three patients, in whom lymph node activity and normal retention percentages are seen on the scintigrams after total amputation of an extremity followed by replantation without anastomosing of interrupted lymph vessels.

  8. The Fetal Heart in Twin-to-Twin Transfusion Syndrome

    PubMed Central

    Van Mieghem, Tim; Lewi, Liesbeth; Gucciardo, Léonardo; DeKoninck, Philip; Van Schoubroeck, Dominique; Devlieger, Roland; Deprest, Jan

    2010-01-01

    Twin-to-twin transfusion syndrome is a severe complication occurring in 10% of monochorionic twin pregnancies. The disease is usually explained as due to an intrauterine imbalance in intertwin blood exchange, which leads to a volume depleted-donor twin and an overfilled recipient twin. The recipient has signs of cardiac dysfunction, which can be measured using echocardiography or blood and amniotic fluid derived biomarkers. Whereas cardiac dysfunction typically progresses in pregnancies treated with amniodrainage, it usually disappears within a few weeks after fetoscopic laser coagulation of the connecting intertwin anastomoses. Nevertheless, recipients remain at a increased risk of pulmonary stenosis. In this paper, we summarize the cardiac alterations in twin-to-twin transfusion syndrome, describe the changes seen after fetal therapy, list the newly proposed staging systems based on fetal cardiac function, and make recommendations about the use of fetal echocardiography in the evaluation and followup of pregnancies complicated by twin-to-twin transfusion syndrome. PMID:20811613

  9. Laser-induced tissue fluorescence in radiofrequency tissue-fusion characterization

    NASA Astrophysics Data System (ADS)

    Su, Lei; Fonseca, Martina B.; Arya, Shobhit; Kudo, Hiromi; Goldin, Robert; Hanna, George B.; Elson, Daniel S.

    2014-01-01

    Heat-induced tissue fusion is an important procedure in modern surgery and can greatly reduce trauma, complications, and mortality during minimally invasive surgical blood vessel anastomosis, but it may also have further benefits if applied to other tissue types such as small and large intestine anastomoses. We present a tissue-fusion characterization technology using laser-induced fluorescence spectroscopy, which provides further insight into tissue constituent variations at the molecular level. In particular, an increase of fluorescence intensity in 450- to 550-nm range for 375- and 405-nm excitation suggests that the collagen cross-linking in fused tissues increased. Our experimental and statistical analyses showed that, by using fluorescence spectral data, good fusion could be differentiated from other cases with an accuracy of more than 95%. This suggests that the fluorescence spectroscopy could be potentially used as a feedback control method in online tissue-fusion monitoring.

  10. Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia

    PubMed Central

    Tielemans, Hanneke J.P.; Ulrich, Dietmar J.O.

    2016-01-01

    Summary: In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema.

  11. Endometriosis presenting as carcinoma colon in a perimenopausal woman

    PubMed Central

    Muthyala, Tanuja; Sikka, Pooja; Aggarwal, Neelam; Suri, Vanita; Gupta, Rajesh; Nahar, Uma

    2015-01-01

    Endometriosis is a common benign disease of reproductive age women, and can involve the intestinal tract. Inconsistent clinical presentation, similar features on radiological imaging and colonoscopy with other inflammatory and malignant lesions of the bowel makes the preoperative diagnosis of bowel endometriosis difficult. We present a case of a 42-year-old perimenopausal female clinically presented, investigated and managed in the lines of carcinoma of sigmoid colon. She underwent terminal ileac resection with end to end anastomoses, Hartmann's procedure and total hysterectomy with bilateral salpingoophorectomy. The histopathological report revealed endometriosis of small intestine, large intestine, mesentery, right ovary and adenomyoma of uterus. Thus, bowel endometriosis should also be considered as differential diagnosis in reproductive age women with gastrointestinal symptoms or intestinal mass of uncertain diagnosis. PMID:26538989

  12. Endometriosis presenting as carcinoma colon in a perimenopausal woman.

    PubMed

    Muthyala, Tanuja; Sikka, Pooja; Aggarwal, Neelam; Suri, Vanita; Gupta, Rajesh; Nahar, Uma

    2015-01-01

    Endometriosis is a common benign disease of reproductive age women, and can involve the intestinal tract. Inconsistent clinical presentation, similar features on radiological imaging and colonoscopy with other inflammatory and malignant lesions of the bowel makes the preoperative diagnosis of bowel endometriosis difficult. We present a case of a 42-year-old perimenopausal female clinically presented, investigated and managed in the lines of carcinoma of sigmoid colon. She underwent terminal ileac resection with end to end anastomoses, Hartmann's procedure and total hysterectomy with bilateral salpingoophorectomy. The histopathological report revealed endometriosis of small intestine, large intestine, mesentery, right ovary and adenomyoma of uterus. Thus, bowel endometriosis should also be considered as differential diagnosis in reproductive age women with gastrointestinal symptoms or intestinal mass of uncertain diagnosis.

  13. Coarctation repair in children with Turner's syndrome.

    PubMed

    Beder, S D; Driscoll, D J; McNamara, D G; Cooley, D A

    1982-03-01

    Ravelo recently reported the results of surgical repair of coarctation of the aorta in eight patients with Turner's syndrome. Three of these patients had serious hemorrhagic complications. At Texas Children's Hospital, we have operated on four patients with Turner's syndrome and coarctation of the aorta without complications. Of the 12 patients in both series, nine patients had uncomplicated courses when they had Dacron aortoplasty (4/12) or end-to-end anastomosis (5/12). The three other patients with end-to-end anastomoses had significant perioperative hemorrhage. Whereas Ravelo reported serious complications in 38% (3/8), the combined series suggest that only about 25% (3/12) of patients with Turner's syndrome undergoing repair of coarctation of the aorta may experience significant perioperative hemorrhage. We conclude, as did Ravelo, that attention to technical details should keep surgical morbidity in these patients to a minimum.

  14. Basaloid follicular hamartoma: a case report and review of the literature.

    PubMed

    Huang, Shu-Han; Hsiao, Tien-Fa; Lee, Chin-Cheng

    2012-01-01

    Basaloid follicular hamartoma (BFH) is a rare, benign, skin adnexal tumor. Several clinical patterns have been reported, but they all share the same histopathological features. BFH may be hereditary or nonhereditary and can be accompanied by systemic diseases. Microscopic examination of BFH shows branching cords and anastomosing strands of basaloid cells in a loose, fibrous stroma. The most important pathological differential diagnosis is infundibulocystic basal cell carcinoma. These two lesions must be differentiated carefully based on clinical presentation and histopathological picture, and even molecular studies may be needed. We present a report of a 78-year-old woman with a solitary, asymptomatic, slow-growing skin tumor on her left scalp. No associated systemic disorders were found. On the basis of an excisional biopsy performed on the tumor, a pathological diagnosis of sporadic BFH was made. PMID:22226063

  15. Renal transplantation with venous drainage through the superior mesenteric vein in cases of thrombosis of the inferior vena cava.

    PubMed

    Aguirrezabalaga, Javier; Novas, Serafín; Veiga, Francisco; Chantada, Venancio; Rey, Ignacio; Gonzalez, Marcelino; Gomez, Manuel

    2002-08-15

    Renal transplantation usually is performed by placing the graft in the iliac fossa, anastomosing the renal vein to the iliac vein or, when this is not possible, to the vena cava. When vascular complications occur, particularly on the venous side, the position of the graft may have to be changed. This report describes orthotopic renal grafts and positioning of the organ with anastomosis to the splenic vessels. Venous drainage was established directly into the mesenteric-portal territory, with two cases to the portal vein and one to the inferior mesenteric vein. A new technique for the venous drainage of the renal graft is shown. We have used this model in two cases of infrarenal inferior vena cava thrombosis. The kidney was located in a retroperitoneal position, with venous drainage to the superior mesenteric vein through an orifice in the posterior peritoneum.

  16. Lymphovenous Anastomosis and Secondary Resection for Noonan Syndrome with Vulvar Lymphangiectasia.

    PubMed

    Winters, Harm; Tielemans, Hanneke J P; Ulrich, Dietmar J O

    2016-08-01

    In this case report we describe the use of a 2-stage approach to treat severe recurrent vulvar lymphangiectasia in a patient with Noonan syndrome. First, 3 functional lymphatic vessels were identified and anastomosed to venules in an end-to-end fashion. Then, in a second surgical procedure, the vulvar lesions were resected as much as possible and the vulva was reconstructed. By the 12-month follow-up the patient had recovered well. Although there were still some small vesicles on the left labia there was no more ooze, itch, and pain. Lymphatic mapping using indocyanine green showed improvement of the edema of her vulva region and patent LVA. In addition to the demonstration of this 2-stage approach, this case report also demonstrates the benefits of preemptive LVA before performing surgery that may be at high risk for postoperative lymph edema. PMID:27622088

  17. On how whales avoid decompression sickness and why they sometimes strand.

    PubMed

    Blix, Arnoldus Schytte; Walløe, Lars; Messelt, Edward B

    2013-09-15

    Whales are unique in that the supply of blood to the brain is not by the internal carotid arteries, but by way of thoracic and intra-vertebral arterial retia. We found in the harbor porpoise (Phocoena phocoena) that these retia split up into smaller anastomosing vessels and thin-walled sinusoid structures that are embedded in fat. The solubility of nitrogen is at least six times larger in fat than in water, and we suggest that nitrogen in supersaturated blood will be absorbed in the fat, by diffusion, during the very slow passage of the blood through the arterial retia. Formation of nitrogen bubbles that may reach the brain is thereby avoided. We also suggest that mass stranding of whales may be due to disturbances to their normal dive profiles, resulting in extra release of nitrogen that may overburden the nitrogen 'trap' and allow bubbles to reach the brain and cause abnormal behavior.

  18. Rapid elongation of arteries and veins in rats with a tissue expander.

    PubMed

    Stark, G B; Hong, C; Futrell, J W

    1987-10-01

    The saphenous arteries and veins of 40 rats were elongated with 20-cc tissue expanders underlying the leg adductor muscles. The mean rate of successful elongation of the vessels was 84 +/- 47 percent SD, with a maximum gain of 140 percent. The fastest mean elongation velocity reached 45 percent per day. Thrombosis occurred only with stretching velocities of more than 10 percent per day, which seemed to be a safe margin. Distribution of the volume into many intervals was safer than infrequent high-volume injections. Histology showed no reduction in vessel wall diameter or loss intimal integrity. Subendothelial cellular proliferation was an indicator of this rapid regeneration. Microvascular anastomoses performed in elongated arteries and veins had the same patency rate (90 percent) as in controls.

  19. Novel extracellular matrix and microtubule cables associated with pseudopodia of Astrammina rara, a carnivorous Antarctic foraminifer.

    PubMed

    Bowser, S S; DeLaca, T E; Rieder, C L

    1986-02-01

    Astrammina rara is a benthic foraminiferan protozoan which uses an extensive network of fine, branching, and anastomosing pseudopodia to capture and digest metazoans up to 12 mm long. During such predation the pseudopodia appear remarkably elastic and tensile. Electron microscopy has revealed a novel extracellular matrix of thin branching fibers associated with A. rara's pseudopodia, which are otherwise typical in appearance. These fibers are structurally associated with the pseudopodial glycocalyx. Cytoplasmic microtubules are often found in close juxtaposition to the plasma membrane and overlying extracellular fibers. In the main pseudopodial trunks bundles of 30-300 microtubules are surrounded by a lightly staining matrix and linked by occasional bridges. The microtubules follow straight trajectories in distal filopodia, but in pseudopodial trunks they appear to coil around one another to form cables. These microtubular cables and extracellular fibers are novel features of A. rara's pseudopodia and may provide the structural basis for their tensile strength.

  20. Molecular evidence that Reticulomyxa filosa is a freshwater naked foraminifer.

    PubMed

    Pawlowski, J; Bolivar, I; Fahrni, J F; De Vargas, C; Bowser, S S

    1999-01-01

    Reticulomyxa filosa is a freshwater protist possessing fine granular, branching and anastomosing pseudopodia and therefore traditionally placed in the class Granuloreticulosea, order Athalamida, as a sister group to the order Foraminiferida. Recent studies have revealed remarkable similarities in pseudopodial motility and ultrastructure between R. filosa and foraminifera (e.g. Allogromia laticollaris), prompting us to conduct a molecular phylogenetic analysis of these seemingly disparate organisms. We sequenced the complete small-subunit of the ribosomal DNA of the cultured strain of R. filosa and compared it to the corresponding sequences of other protists including 12 species of foraminifera. We also sequenced and analyzed the actin coding genes from R. filosa and two species of foraminifera, Allogromia sp. and Ammonia sp. The analysis of both data sets clearly shows that R. filosa branches within the clade of foraminifera, suggesting that R. filosa is in fact a freshwater naked foraminiferan.