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Sample records for entre anastomoses intestinais

  1. Free Grafts and Microvascular Anastomoses.

    PubMed

    Scharf, Valery F

    2017-08-09

    Skin grafts and free skin flaps are useful options for closure of wounds in which primary closure or use of traditional skin flaps is not feasible. Grafts are classified by their morphology and host-donor relationship. Free skin flaps with microvascular anastomoses are developed from previously described axial pattern flaps and have the added advantage of reestablishing robust vascular supply to the flap, but require specialized equipment and a high degree of technical expertise. Despite intensive perioperative care and the risk of graft or flap failure, skin grafts and free skin flaps can serve as rewarding methods of closing difficult wounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. New techniques of gastrointestinal anastomoses with the EEA stapler.

    PubMed

    Nance, F C

    1979-05-01

    A new instrument for accomplishing inverted stapled anastomoses in the gastrointestinal tract is described. Side-to-side, end-to-side and end-to-end anastomoses can be performed. Techniques developed for utilization of the instrument in virtually all gastrointestinal anastomoses are described. In most instances a proximal or distal enterotomy is required. Experience with 57 anastomoses in 42 patients is reported. One leak occurred; no other complications not recognized intraoperatively were observed. Anastomoses completed included gastroduodenostomy, gastrojejunostomy, cholecystojejunostomy, colocolostomy and ileocolostomy. Hazards and complications associated with the use of the instrument are described. It should be used only after the surgeon has acquired the skills to operate the instrument properly. The instrument saves time, creates better anastomoses than can be obtained by hand sewing and is extremely versatile. It may permit safer anastomoses in adverse conditions, such as in obstruction and peritonitis. The instrument opens new horizons in gastrointestinal surgery.

  4. [Microvascular anastomoses in cervical esophageal reconstruction].

    PubMed

    Takushima, A; Harii, K; Asato, H

    2001-09-01

    Ischemia or hemostasis in the gastric, jejunal, and colonic pedicle after esophagectomy is believed to contribute significantly to postoperative complications. With the advent of microvascular anastomoses, many surgeons have adopted vascular augmentation (supercharge) as a means of avoiding these difficulties. Microsurgical free tissue transfer represented by the free jejunum and forearm flap also plays an important role in esophageal reconstruction. In this paper, the authors introduce the technical points important for successful revascularization including the choice of recipient vessels, setting up of the reconstructive materials, and postoperative monitoring. In cases of gastric pull-up elevated via posterior mediastinum, the left gastroduodenal vessels are anastomosed to the cervical transverse or superior thyroidal vessels. In cases of duodenal or colonic pull-up elevated via the anterosternal route, the vascular pedicles are anastomosed to the internal mammary vessels which are dissected by resecting the costal cartilage. When the free jejunum flap is used, the cervical transverse or superior thyroidal vessels are most frequently used as recipients. Postoperative monitoring of free flaps is performed using Doppler ultrasound or through a small skin incision made above the transferred tissue. Although gastric or colonic pull-up is difficult to monitor, color Doppler sonography permits quantitative analysis of blood flow and may be a useful option.

  5. Compression anastomoses in colorectal surgery: a review.

    PubMed

    Zbar, A P; Nir, Y; Weizman, A; Rabau, M; Senagore, A

    2012-06-01

    The main serious risks of anastomotic construction in the colon and rectum include dehiscence and stricture formation. There is a resurgence of interest in sutureless anastomoses formed by compression elements since the introduction of shape memory alloy (SMA) systems, which evoke minimal early inflammatory response whilst maintaining anastomotic integrity. Currently, the most commonly used SMA is the nickel-titanium (NiTi) alloy that is highly biocompatible, returning to its pre-deformed stable (austenite) shape under different mechanical and thermal loads for use in humans. Pre-clinical data for shape memory alloy systems in colorectal anastomoses are limited, but it appears to be safe in porcine and canine models with limited leakage and reduced stricture formation. There does not appear to be any difference in tissue biochemistry of inflammatory markers when compared with conventional stapled techniques, although the few studies available show a markedly reduced early inflammatory response at the anastomotic site with the NiTi device. The majority of the clinical data concerning compression anastomoses are derived from the biofragmentable anastomotic ring device. This device has fallen out of use because of reported leaks, instrumental failure and problems with device expulsion. A novel SMA device, the NiTi anastomotic ring, permits construction of a low rectal anastomosis construction during open or laparoscopic procedures. The preliminary data demonstrate a safety comparable to conventional staple technology. This device also provides the potential of benefit of reduced anastomotic inflammation, because the compression ring results in direct serosa-to-serosa (or alternatively serosa-to-muscularis propria) apposition without the persistence of residual foreign material. This type of construction could lead to a reduced incidence of early anastomotic leakage and/or the development of anastomotic stenosis. Randomized clinical trials employing a NiTi arm for

  6. Omental transposition for low pelvic anastomoses.

    PubMed

    Topor, B; Acland, R D; Kolodko, V; Galandiuk, S

    2001-11-01

    Surgeons' opinions differ regarding the role of the omentum in low pelvic intestinal anastomoses. This study was undertaken to define the anatomy and surgical technique of omental transposition to the pelvis. We studied 45 cadavers to elucidate surgical aspects of omental mobilization, lengthening, and transposition into the pelvic cavity. In addition, intraoperative studies of omental transposition to the pelvis were performed in 20 patients with chronic ulcerative colitis, familial adenomatous polyposis, and rectal cancer who were undergoing ileal J-pouch anal anastomosis or low anterior resection. The most important anatomic variables for omental transposition are three variants of arterial blood supply: (1) In 56% of patients, there is one right, one (or two) middle, and one left omental artery. (2) In 26% of patients, the middle omental artery is absent. (3) In the remaining 18% of patients, the gastroepiploic artery is continued as a left omental artery but with various smaller connections to the right or middle omental artery. The first stage of omental lengthening is detachment of the omentum from the transverse colon mesentery. This must be performed carefully, as the omentum is closely adherent to the right transverse mesocolon. The second stage is the actual lengthening of the omentum. The third stage is placement of the omental flap into the pelvis. Creation of an omental pedicle is a simple surgical procedure. This procedure can be performed quickly, does not involve significant blood loss, and may reduce the frequency of complications after low pelvic anastomoses.

  7. Vascular Clips in Anastomoses of Femoropopliteal Arterial Reconstruction.

    PubMed

    Aarnio; Järvinen; Varjo

    2000-03-01

    The vascular anastomoses are usually made with sutures. Some mainly experimental studies have been published about a new method of doing the vascular anastomoses with metal clips. We studied the suitability of vascular closure staple (VCS) clip applier system for making the anastomoses in femoropopliteal and femorotibial arterial reconstruction. During an 11-month period, VCS clips were used in 17 out of 27 patients who were operated due to severe claudication or incipient gangrena of the foot. Altogether 26 anastomoses were made with VCS clips using either great saphenous vein or PTFE graft. The making of anastomosis was easy and reliable. No postoperative bleeding was noticed. All anastomoses were patent 4-6 weeks postoperatively studied by palpation and measured by ankle brachial pressure index (mean 0.96). In Duplex Doppler examination all studied patients had well patent anastomoses on an average 11 months after the operation. With VCS clip applier system, it is possible to do anastomoses in arteriosclerotic arteries like in femoropopliteal reconstructions. This method helps making reliable anastomoses more easily.

  8. Anastomosing haemangioma of liver: A case report

    PubMed Central

    Peng, Xiuhua; Li, Jin; Liang, Zonghui

    2017-01-01

    Anastomosing haemangioma (AH) is a recently described, unusual variant of capillary hemangioma that appears to be unique to the genitourinary system, with a particular proclivity for the kidney. AH is a subtype of capillary haemangioma, which is rarely encountered in clinical practice, particularly in the liver. We herein present the case of a 57-year-old woman with an incidental finding on magnetic resonance imaging of a local lesion in the liver, sized 3.3×3.0 cm. The patient underwent hepatectomy with a good postoperative recovery. The histopathological diagnosis was AH of the liver. To the best of our knowledge, this is the first case report of hepatic AH. PMID:28808574

  9. New techniques of gastrointestinal anastomoses with the EEA stapler.

    PubMed Central

    Nance, F C

    1979-01-01

    A new instrument for accomplishing inverted stapled anastomoses in the gastrointestinal tract is described. Side-to-side, end-to-side and end-to-end anastomoses can be performed. Techniques developed for utilization of the instrument in virtually all gastrointestinal anastomoses are described. In most instances a proximal or distal enterotomy is required. Experience with 57 anastomoses in 42 patients is reported. One leak occurred; no other complications not recognized intraoperatively were observed. Anastomoses completed included gastroduodenostomy, gastrojejunostomy, cholecystojejunostomy, colocolostomy and ileocolostomy. Hazards and complications associated with the use of the instrument are described. It should be used only after the surgeon has acquired the skills to operate the instrument properly. The instrument saves time, creates better anastomoses than can be obtained by hand sewing and is extremely versatile. It may permit safer anastomoses in adverse conditions, such as in obstruction and peritonitis. The instrument opens new horizons in gastrointestinal surgery. Images Fig. 1. Fig. 2. Figs. 3 and 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. PMID:443911

  10. Early Experience with Stapled Gastrointestinal Anastomoses in a Nigerian Hospital

    PubMed Central

    Adisa, AO; Olasehinde, O; Arowolo, OA; Alatise, OI; Agbakwuru, EA

    2015-01-01

    Background: Hand-sewn gastrointestinal anastomoses has been the traditional approach to gastrointestinal anastomosis in Nigeria while stapled anastomoses are infrequently performed in few centers. Objectives: To describe the outcome of our initial experience with stapled gastrointestinal anastomoses in a semi-urban patient population. Patients and Methods: Consecutive patients who had stapled gastrointestinal anastomoses between January 2011 and June 2014 in a Nigerian tertiary hospital were prospectively evaluated. Indications for operation, procedures performed and anastomoses constructed and postoperative outcome of each patient were documented. Results: Nineteen patients including seven males and 12 females had stapled anastomoses within the period. Their ages ranged between 41 and 68 (mean 52.5) years. Six (31.6%) Roux-en-Y gastrojejunostomies, 6 (31.6%) ileo-colic, 3 (15.8%) ileo-ileal, 2 (10.5%) colo-colic, and 2 (10.5%) colo-anal anastomoses were performed. Indications include antral gastric cancer in 4 (21.1%), right colon cancer 4 (21.1%), ileal perforations in 3 (15.8%) while 2 (10.5%) each had left colon cancer, common bile duct obstruction, rectal cancer and ruptured appendix. Mean duration of operation was 108 ± 46 min and mean duration of postoperative stay was 5 ± 2.6 days. No intraoperative complications were recorded and no anastomotic leakage occurred. At a median follow-up of 5 months no staple related stricture had occurred. Conclusions: Stapled gastrointestinal anastomoses are associated with a good outcome in our center. We propose a prospective, large-population randomized comparison of the technique with hand-sewn anastomoses. PMID:26425069

  11. Antenatal detection of arteriovenous anastomoses in monochorionic twin pregnancy.

    PubMed

    Sau, A; Weber, M; Shennan, A H; Maxwell, D

    2008-01-01

    To revalidate the detection technique for arteriovenous anastomoses in an unselected group of monochorionic twins, and to make recommendations about its applicability for more widespread use. Women with monochorionic diamniotic (MCDA) twins were recruited and underwent placental mapping by color Doppler ultrasound. Images of placental maps showing the location and type of anastomoses were saved as digital video clips. After delivery, dye injection study of all the placentas was performed to delineate the site and type of anastomoses. A digital photograph of each injection study was taken and saved. The antenatal ultrasound images and postnatal dye injection studies were compared. 18 sets MCDA twins were evaluated. In 3 cases there was evidence of twin-to-twin transfusion syndrome. Dye injection of 18 placentas revealed 21 arterio-arterial anastomoses (AAA), 21 arteriovenous anastomoses (AVA) and 4 veno-venous anastomoses (VVA). Of these, 10 (48%) AAAs and 5 (24%) AVAs were detected antenatally by color Doppler. In all cases, where an AVA was detected, the placenta was located anteriorly. Antenatal detection of AVA was feasible when the placenta was located anteriorly, but proved difficult in posteriorly situated placentas.

  12. Healing of colonic ischemic anastomoses in the rat: role of superoxide radicals.

    PubMed

    Garcia, J G; Criado, F J; Persona, M A; Alonso, A G

    1998-07-01

    The aim of this study was to evaluate the role of superoxide radicals in the healing of ischemic colonic anastomoses in the rat. Adult male Wistar rats were used in a factorial design with two factors (normal or ischemic colonic anastomoses) each having two levels (treatment with saline or allopurinol). Colonic anastomoses were performed either in normal or previously devascularized colons (ischemic anastomoses) at identical locations, using the same technique. On the fourth postoperative day, animals were killed, and specimens were taken for determinations. Ischemic anastomoses displayed significant increases in superoxide radical (assayed as superoxide anion), superoxide dismutase, and glutathione peroxidase concentrations. Bursting strength and hydroxyproline levels were also significantly lower in these anastomoses. Allopurinol administration elicited a significant decrease in superoxide anions and raised both bursting strength and hydroxyproline levels only in ischemic anastomoses. Superoxide radicals are involved in the delay in healing of ischemic anastomoses. Allopurinol lowers superoxide anion production and has beneficial effects on the cicatrization of ischemic anastomoses.

  13. Scintiscanning in the evaluation of biliary enteric anastomoses

    SciTech Connect

    Tidmore, H.; Ram, M.D.

    1985-03-01

    The evaluation of symptomatic patients who have undergone biliary enteric anastomoses, particularly when the diversion was into the jejunum, is difficult. Conventional techniques for evaluation, such as oral cholecystography (OCG), intravenous cholangiography (IVC), ultrasonography (US), computer-assisted tomography scanning (CT scanning), or endoscopy are not adequate to provide definitive information on the patency of the anastomoses. Hepatobiliary scintiscanning using /sup 99m/Tc-HIDA and BIDA (iminodiacetic acid derivatives) was performed on 12 patients. The patients were from 11 to 72 years of age and included ten men and two women. The scan results were correlated with US, CT scan, percutaneous transhepatic cholangiography (PTC), operative findings, and final diagnosis. Scanning was highly accurate in this group and could be performed successfully even in jaundiced patients (total serum bilirubin level up to 20.0 mg/dl). In patients in whom dilated bile ducts were demonstrated (by US, CT scan, or scintiscan), only the scintiscan revealed the true patency of the anastomoses. The advantages of the technique are that it is simple and noninvasive. Delayed transit of bile (scanning agent) to bowel is a very reliable indication of partial or complete obstruction. Scintiscanning is the only technique that demonstrated the functional state of biliary secretion and excretion into bowel in patients with previous biliary enteric anastomoses.

  14. 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.

  15. Myopericytoma proliferating in an unusual anastomosing multinodular fashion.

    PubMed

    Inoue, Takuya; Misago, Noriyuki; Asami, Akihiko; Tokunaga, Osamu; Narisawa, Yutaka

    2016-05-01

    We herein describe a case of myopericytoma that proliferated in an unusual fashion. Myopericytoma is described as a group of rare, benign, dermal or subcutaneous tumors that are characterized histologically by a striking, concentric, perivascular proliferation of spindle cells and showing apparent differentiation towards perivascular myoid cells. Myopericytoma forms a morphological continuum with myofibroma/myofibromatosis, glomus tumor and angioleiomyoma. The patient was a 64-year-old woman who demonstrated a recurrent ulcer on an atrophic plaque on her left shin. A histopathological examination of the plaque demonstrated that tumor cells proliferated in an anastomosing multinodular fashion along the vessels in the dermis and subcutaneous tissue. In those nodules, there were numerous, small, concentric proliferations of myoid-appearing spindle cells around small vascular lumina. The present case is an unusual example of myopericytoma, manifesting in a characteristic anastomosing, multinodular, infiltrating fashion.

  16. [Microvascular anastomoses in reconstructive head and neck surgery].

    PubMed

    Remmert, S

    1995-04-01

    At the ENT Department of the University of Lübeck, 57 microvascular tissue transplants with 129 anastomoses (61 arterial and 68 venous) have been performed in the last three years. Arteries have always been anastomosed end to end. The venous anastomoses have primarily been performed as end-to-side unions with the jugular vein. In nine patients, great distances between the donor and recipient vessel had to be connected with venous interponates. In two cases in which veins were lacking in the neck after radical neck dissection or radiation fibrosis, we used the cephalic vein or veins of the capsule of the thyroid gland as recipient vessels. The jejunal or osteomyocutaneous transplants were first fitted into the defect before performing the anastomosis. The jejunal peristalsis and the required freedom of movement in shaping the bone necessitated this technique. Microvascular anastomosis was first performed on the transplant of the radialis flap and the neurovascular infrahyoid muscular flap, and then they were integrated into the defect. We lost two transplants postoperatively because of venous thrombosis. In this article wie describe our anastomosis technique, the frequency distribution of recipient vessels, and the rules and characteristics of microvascular anastomosis after radiation and neck dissection.

  17. 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.

  18. 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

  19. 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.

  20. Intestinal anastomoses after radiation therapy by surgical stapling instruments.

    PubMed

    Photopulos, G J; Delgado, G; Fowler, W C; Walton, L A

    1979-10-01

    The use of automated stapling instruments in 17 patients requiring intestinal surgery following irradiation therapy for gynecologic malignancies has been reviewed. Fifteen of these patients also had other medical problems thought to inhibit optimal anastomotic healing: malnutrition, persistent intraabdominal cancer, uremia, hypoalbuminemia, and recent antineoplastic chemotherapy. Although these conditions severely test a method of intestinal anastomosis, no patient had a complication involving the intestinal anastomosis. The use of these stapling instruments reduced both the operating time and the contamination of the peritoneal surfaces by bowel content, thereby improving the postoperative recovery of these patients. The favorable results and the secure anastomoses justify the continued use of stapling instruments in gynecologic oncology patients with prior irradiation therapy.

  1. Papillary carcinoma thyroid with anastomosing channels: An unusual morphology

    PubMed Central

    Dalal, Varsha; Kaur, Manveen; Bansal, Anju

    2017-01-01

    Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for 70%–80% of all thyroid malignancies. It is biologically indolent and has an excellent prognosis. Variations in histopathologic patterns are known to influence prognosis and often result in a diagnostic dilemma. We report an unusual case of a 35-year-old female with papillary carcinoma of a thyroid isthmus showing anastomosing channels on histopathology, a distinctive pattern that has not been described in PTC. Similar to tumor cells, the lining cells of these channels were also positive for thyroid transcription factor 1, thyroglobulin, and cytokeratin-19 and negative for CD34 and CD31. The diagnosis of PTC should rely on nuclear morphology rather than architecture. Pathologists should be aware of different variants because some of these variants show aggressive behavior and poor outcome. The present report highlights the distinctive pattern of PTC, recognition of which is important to avoid any diagnostic pitfall. PMID:28367032

  2. 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

  3. [Healing of tubal anastomoses--microsurgery vs. fibrin gluing: morphologic aspects].

    PubMed

    Gauwerky, J F; Klose, R P; Forssmann, W G

    1994-01-01

    The healing of anastomoses either by microsurgical suture technique or by fibrin sealant technique has been examined in an experimental morphological study. With view to morphological criteria the healing of tubal anastomoses after one month is completed. Afterwards only little areas of regeneration could be found in the region of the anastomosis. These statements are valid for both types of anastomoses. In single cases a more progressive regeneration of the mucosa could be demonstrated. Using fibrin glue a more pronounced fibrosis could not be seen.

  4. Accurate and simple evaluation of vascular anastomoses in monochorionic placenta using colored dye.

    PubMed

    Lopriore, Enrico; Slaghekke, Femke; Middeldorp, Johanna M; Klumper, Frans J; van Lith, Jan M; Walther, Frans J; Oepkes, Dick

    2011-09-05

    The presence of placental vascular anastomoses is a conditio sine qua non for the development of twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS)(1,2). Injection studies of twin placentas have shown that such anastomoses are almost invariably present in monochorionic twins and extremely rare in dichorionic twins(1). Three types of anastomoses have been documented: from artery to artery, from vein to vein and from artery to vein. Arterio-venous (AV) anastomoses are unidirectional and are referred to as "deep" anastomoses since they proceed through a shared placental cotyledon, whereas arterio-arterial (AA) and veno-venous (VV) anastomoses are bi-directional and are referred to as "superficial" since they lie on the chorionic plate. Both TTTS and TAPS are caused by net imbalance of blood flow between the twins due to AV anastomoses. Blood from one twin (the donor) is pumped through an artery into the shared placental cotyledon and then drained through a vein into the circulation of the other twin (the recipient). Unless blood is pumped back from the recipient to the donor through oppositely directed deep AV anastomoses or through superficial anastomoses, an imbalance of blood volumes occurs, gradually leading to the development of TTTS or TAPS. The presence of an AA anastomosis has been shown to protect against the development of TTTS and TAPS by compensating for the circulatory imbalance caused by the uni-directional AV anastomoses(1,2). Injection of monochorionic placentas soon after birth is a useful mean to understand the etiology of various (hematological) complications in monochorionic twins and is a required test to reach the diagnosis of TAPS(2). In addition, injection of TTTS placentas treated with fetoscopic laser surgery allows identification of possible residual anastomoses(3-5). This additional information is of paramount importance for all perinatologists involved in the management and care of monochorionic twins

  5. Preliminary results with sutured colonic anastomoses reinforced with dye-enhanced fibrinogen and a diode laser

    NASA Astrophysics Data System (ADS)

    Libutti, Steven K.; Williams, Matthew R.; Oz, Mehmet C.; Forde, Kenneth A.; Bass, Lawrence S.; Weinstein, Samuel; Auteri, Joseph S.; Treat, Michael R.; Nowygrod, Roman

    1991-07-01

    A common cause of morbidity in patients recovering from bowel surgery is leakage from colonic anastomoses. A technique utilizing a laser activated protein solder to strengthen colonic anastomoses in a canine model was evaluated. Following creation of six single-layer interrupted suture anastomoses in four dogs, a protein solder consisting of indocyanine green dye and fibrinogen was topically appied to the serosal surface and exposed to 808 nm continuous wave diode laser energy. Immediately following anastomosis, the mean leakage pressure of sutures alone was 129 +/- 14 mm hg (n equals 6), while the mean leakage pressure of sutures reinforced with the laser welded solder was 312 +/- 32 mm hg (n equals 6) (p <0.001). Histologic examination of sections take through the anastomosis demonstrated a layer of fibrinogen across the anastomotic gap without evidence of thermal injury. Laser activated protein solder significantly enhances the immediate strength of sutured colonic anastomoses without causing appreciable thermal injury to surrounding tissues.

  6. 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

  7. Is there a haemodynamic advantage associated with cuffed arterial anastomoses?

    PubMed

    Cole, J S; Watterson, J K; O'Reilly, M J G

    2002-10-01

    The development of intimal hyperplasia at arterial bypass graft anastomoses is a major factor responsible for graft failure. A revised surgical technique, involving the incorporation of a small section of vein (vein cuff) into the distal anastomosis of PTFE grafts, results in an altered distribution of intimal hyperplasia and improved graft patency rates, especially for below-knee grafts. Numerical simulations have been conducted under physiological conditions to identify the flow behaviour in a typical cuffed bypass model and to determine whether the improved performance of the cuffed system can be accounted for by haemodynamic factors. The flow patterns at the cuffed anastomosis are significantly different to those at the conventional end-to-side anastomosis. In the former case, the flow is characterised by an expansive, low momentum recirculation within the cuff. Separation occurs at the graft heel, and at the cuff toe as the blood enters the recipient artery. Wall shear stresses in the vicinity of the cuff heel are low, but high shear stresses and large spatial gradients in the shearing force act on the artery floor during systole. In contrast, a less disturbed flow prevails and the floor shear stress distribution is less adverse in the conventional model. In conclusion, aspects of the anastomotic haemodynamics are worsened when the cuff is employed. The benefits associated with the cuffed grafts may be related primarily to the presence of venous material at the anastomosis. Therefore, caution is advised with regard to the use of PTFE grafts, pre-shaped to resemble a cuffed geometry.

  8. Effects of metoclopramide on healing of colonic anastomoses in a rat model of abdominal sepsis.

    PubMed

    Marques e Silva, Silvana; Carneiro, Fabiana Pirani; Ferreira, Vânia Maria Moraes; Oliveira, Paulo Gonçalves de; Sousa, João Batista de

    2013-10-01

    Metoclopramide is often used in the treatment of postoperative nausea and vomiting, but a literature review failed to find reports on the influence of this drug on the healing of bowel anastomoses in the setting of abdominal sepsis. The aim of this study was to evaluate the effects of metoclopramide on the healing of left colonic anastomoses in rats with induced abdominal sepsis. Forty rats were divided into two groups of 20 animals each to receive either metoclopramide (experimental group: E) or saline (control group: C). Each group was further divided into subgroups of 10 animals each to be killed on the third (E3 and C3) or seventh postoperative day (E7 and C7). A segmental resection of the left colon was performed, followed by end-to-end anastomosis. Sepsis was induced by cecal ligation and puncture. On the day of reoperation, the total number of adhesions was assessed and the anastomosed bowel segment was removed for tensile strength testing, histopathological analysis, measurement of hydroxyproline levels, and histomorphometric evaluation of collagen. Intraoperative findings, number of intra-abdominal adhesions in the anastomosed area, and tensile strength before anastomosis rupture were similar among all subgroups at all assessments. On the third postoperative day, the anastomoses of animals treated with metoclopramide showed significantly lower hydroxyproline levels (p = 0.01) when compared with controls. Collagen content was similar among all subgroups. Metoclopramide does not have deleterious effects on the healing of bowel anastomoses in rats subjected to experimental abdominal sepsis.

  9. 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

  10. Sutureless anastomoses using magnetic rings in canine liver transplantation model.

    PubMed

    Liu, Shi-Qi; Lei, Peng; Cui, Xiao-Hai; Lv, Yi; Li, Jian-Hui; Song, Yu-Long; Zhao, Ge

    2013-12-01

    anastomoses formed with magnetic rings. In group C, gross observation, histologic staining, and scanning electron microscopy were used to evaluate the vessels and bile ducts 12 wk postoperatively. In group A, the total operation time, inferior vena cava, and portal vein anastomosis times were significantly shortened, and the anhepatic phase was reduced to about one-fifth that of group B, which was a significant difference between the two groups (P < 0.01). The mean total operative time was 2.54 ± 0.45 h. In order to maintain adequate blood pressure, the mean fluid volume infused was 800.56 ± 60.56 mL in the recipients of group A, which was lower than that in group B (2241.67 ± 390.78 mL, P < 0.01). Use of a pressor agent in group A was unnecessary. After operation, five of eight animals in group A survived more than 7 d after operation. The main cause of death was acute rejection. Only three of eight animals in group B survived more than 1 wk after operation due to chronic anastomotic bleeding, kidney failure, heart failure, and gastrointestinal bleeding. There was a statistically significant difference (P < 0.01) between the short-term survival rate in the two groups (75.0% versus 37.5%). The ALT (1544.46 ± 286.27) U/L and AST (1710.74 ± 252.27) U/L levels after operation in the animals with hand suturing were significantly higher than those in the sutureless group (ALT = 1116.41 ± 210.55 U/L; AST = 1176.95 ± 248.25) U/L after reperfusion (P < 0.01). The serum tumor necrosis factor α levels (45.56 ± 10.78) ng/L in group B were significantly higher than those of group A (26.64 ± 10.84) ng/L after reperfusion (P < 0.01). Re-endothelialization was confirmed in all vessels in group C, with neither formation of aneurysms nor thickening of the vascular wall noted after 12 wk. The bile duct anastomoses also healed well. The magnetic pinning-ring device offers a simple, fast, reliable, and efficacious technique for nonsuturing vascular and bile duct

  11. Testing of a new prototype surgical stapler that automates the rollover sleeve technique for venous anastomoses.

    PubMed

    Carroll, Patricia B; Defaria, Werviston; Gandia, Carlos; Berho, Mariana; Misiakos, Evangelos; Tzakis, Andreas G

    2006-01-01

    The creation of successful vascular anastomoses is of primary importance in many surgical fields. Numerous attempts to automate this process have been made. These techniques have slowly gained acceptance, but their use is still limited. This report details feasibility testing of a new prototype stapler that automates the rollover sleeve technique for venous vascular anastomoses. Male and female mongrel dogs (n=7) (25-32 kg) were used. A segment of the right (n=5) or left (n=2) iliac vein was harvested for interposition grafts after the contra lateral side was transected. In each dog, two end-to-end venous anastomoses at the interposition grafts were performed. The standard anastomosis employed continuous mattress sutures. The experimental anastomosis was performed with a new prototype surgical stapler. The stapled anastomosis was proximal and the sutured was distal. In all experiments, it was possible to perform the experimental anastomosis with the stapler. Complications included two small leaks, one due to misfiring of a single pin in one experimental site. These leaks required suture reinforcement. One dog died of hemorrhage due to a slipped suture at the vein harvest site. One vein had thrombus seen at the sutured site although no technical abnormalities at either of the anastomoses could be found. After two weeks, grafts were inspected grossly and histologically. Healing appeared normal. There was a trend for less inflammatory cells infiltrating stapled sites; however, this was not statistically significant. The experiments demonstrate that this device can automate the rollover sleeve technique for venous anastomoses.

  12. 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.

  13. 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.

  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. 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.

  16. Success of free flap anastomoses performed within the zone of trauma in acute lower limb reconstruction.

    PubMed

    Bendon, Charlotte L; Giele, Henk P

    2016-07-01

    Traditionally, in free flap cover of lower limb injuries, every attempt is made to perform anastomoses proximal to the zone of injury. We report on the success of anastomoses within the zone of trauma, at the level of the fracture, avoiding further dissection and exposure. The records of free flap reconstructions for fractures of the lower extremity at a tertiary trauma centre between 2004 and 2010 were retrospectively reviewed. A total of 48 lower limb fractures required free flap reconstruction, performed at 28 days post injury (0-275 days). Anastomoses were proximal (21), distal (5) or within the zone of trauma (22). There was no significant difference (p > 0.05) in return to theatre, revision of anastomosis or flap survival between groups. Of the 22 performed within the zone of injury, five returned to theatre but only two for revision of anastomosis and 20 (91%) of these flaps survived. Of the 48 free flaps, arterial anastomoses were end to end in 34 (71%) and end to side in 14 (30%). There was no significant difference (p > 0.05) in return to theatre, revision of anastomosis or flap survival between the end-to-end and end-to-side groups. There was a tendency for arterial anastomoses to be performed end to end outside the zone of trauma (23/26) compared to within the zone of trauma (11/22). Our data suggest that free flap anastomoses can be performed safely in the zone of trauma in lower limb injuries.

  17. Venous Complications in One Versus Two Vein Anastomoses in Head and Neck Free Flaps.

    PubMed

    Khaja, Sobia F; Rubin, Nathan; Bayon, Rodrigo

    2017-10-01

    The purpose of this study was to compare rates of reexploration and flap failure in patients with 1- and 2-vein anastomoses in free flap reconstructions. Retrospective chart review of 300 patients undergoing free flap reconstruction to head and neck defects from 2010 to 2014. One venous anastomosis was performed in 229 patients, and 2 venous anastomoses were performed in 71 patients. The 1-vein group had significantly more reexplorations in the operating room (36/229, 15.7%) compared with the 2-vein group (4/71, 5.6%; P = .028), even when controlling for flap type ( P = .022). This finding remained true among radial forearm flaps (17/81, 21% vs 3/53, 5.7%; P = .024). The number of venous anastomoses was not significantly associated with flap failure, though patients with flap failure did have a significantly greater proportion of venous issues ( P < .001). Two-vein anastomoses do not appear to reduce rates of flap failure or postoperative venous thrombosis but are associated with a lower number of reexplorations in the operating room even after accounting for differences in flap types and surgeons.

  18. Significance of establishing collateral circulation by leptomeningeal anastomoses in the occlusion of arteriae cerebri mediae.

    PubMed

    Kulenović, Amela; Dilberović, Faruk

    2004-05-01

    We have investigated establishment of collateral circulation in patients with cerebral circulation disorder. Thirty angiograms of patients treated at Neurological Department of Hospital Centre in Sarajevo suffering from arteriae cerebri mediae occlusion were used for this study. Cerebral anastomoses that included connections between arteriae cerebri anterior and arteriae cerebri mediae over leptomeningeal anastomoses occurred in some patients suffering from occlusion of this arteriae. It was concluded that the majority of anastomoses existed between big leptomeningeal branches of postcommunicant segment of a. cerebri anterior and branches of cerebri mediae. These collaterals are of great significance as their functional ability is sometimes of a high degree in cases of occlusion of one or the other artery. It can be concluded that anastomosing of the blood vessels increases their volume in the whole and therefore more blood can be provided, although physiological factors should not be neglected, as functional effectiveness of collateral circulation in postocclusive states depends also on the state of the whole cerebrovascular system, then on the speed of creation of occlusion (thrombosis or embolism), systemic arterial pressure, volume and viscosity of the blood.

  19. [Colonoscopy in the long-term follow-up of surgical anastomoses of the large intestine].

    PubMed

    Rossini, F P; Ferrari, A; Roatta, L; Presti, F; Boido, C

    1976-10-15

    On the bases of personal experience the importance of endoscopic examination of the colon in the follow-up of patients who have been subjected to resection of the large intestine is emphasized. Fibercoloscopy permits direct observation of "high" surgical anastomoses, which are inaccessible for examination with rigid rectosigmoidoscope, and thus opens the way to precise diagnosis and a correct therapeutic approach.

  20. Venous Thrombosis in Handsewn versus Coupled Venous Anastomoses in 857 Consecutive Breast Free Flaps.

    PubMed

    Kulkarni, Anita R; Mehrara, Babak J; Pusic, Andrea L; Cordeiro, Peter G; Matros, Evan; McCarthy, Colleen M; Disa, Joseph J

    2016-03-01

    The anastomotic coupling device has demonstrated safety and efficacy; however, the coupler has never been compared directly to handsewn venous anastomoses exclusively in breast reconstruction. We hypothesized that rates of venous thrombosis would be lower using the coupler versus handsewn anastomoses in free flap breast reconstruction. We performed a retrospective review utilizing clinic records, hospital records, and operative reports for 857 consecutive breast free flaps at a single institution from 1997 to 2012. Data were collected on reconstruction type, recipient vessels, timing, laterality, preoperative radiation, chemotherapy, venous thrombosis, and flap outcome. We compared rates of venous thrombosis between handsewn and coupled anastomoses for breast free flaps. Chi-square test was used to calculate statistical significance. A total of 857 consecutive free flaps were performed for breast reconstruction in 647 patients over 16 years. The venous anastomosis was handsewn in 303 flaps, and the anastomotic coupler was used in 554 flaps. The rate of venous thrombosis requiring anastomotic revision in the handsewn group was 0.04% (12/303), compared with 0.01% in the coupled group (8/554; p = 0.02). The anastomotic coupler was more effective in preventing venous thrombosis than handsewn anastomoses in our series. While our study demonstrates improved patency rates using the venous coupler in breast reconstruction, we were unable to definitively separate this finding from potential confounding variables due to the low rates of thrombosis in both the groups. Our data are consistent with current literature, which suggests that the coupler is a safe and effective alternative to hand sutured anastomoses. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Maxon is an Optimal Suture for Bile Duct Anastomoses in Pigs

    PubMed Central

    Jeans, Phil; Hall, Pauline; Liu, Yong-Feng; Baker, Robert A.; Holt, Andrew; Saccone, Gino T. P.; Harvey, John R.; Scicchitano, Jan

    1993-01-01

    Background. Three commonly used sutures were tested in a pig model of bile duct anastomosis to assess their relative contributions to inflammation and scarring. Methods. Thirty pigs were randomised to bile duct division and anastomosis with either polyglyconate (Maxon), polyglactin 910 (Vicryl) or polypropylene (Prolene). Half the animals were sacrificed at two weeks and the remainder at 23 weeks. Anastomoses were assessed by cholangiography, scanning electron microscopy and light microscopy. Results. There was less short term histological reaction with the two monofilament materials, Prolene and Maxon, compared to the braided suture Vicryl. Maxon was associated with less long term inflammation than Prolene, was found to handle better, and has an advantage over Prolene by being absorbable. Conclusion. Maxon is an optimal suture for bile duct anastomoses. Its long term absorption characteristics make it suitable for situations where bile duct healing may be delayed. PMID:8268103

  2. [Clinico-endoscopic classification of acute anastomositis after resection of the stomach].

    PubMed

    Zhizhin, F S; Kapustin, B B

    2002-01-01

    The authors have analyzed the results of resection of the stomach in 106 patients with a complicated course of ulcer disease of the stomach and duodenum. Based on a complex investigation of regeneration of the gastrointestinal anastomoses formed by different methods and a comparison of the endoscopic picture with the clinical course of the early postoperative period the authors propose a clinico-endoscopic classification of acute postgastroresectional anastomosites. Comparison of the frequency and severity of the anastomosites has shown advantages of a one-raw seroserous musculo-submucous suture in the resectional surgery of the stomach when forming gastro-intestinal anastomoses. The classification of acute anastomosites allows the timely detection and correction of the operation complications.

  3. [Clinical experiences in the use of lymphovenous anastomoses in secondary lymphedema].

    PubMed

    Ingianni, G; Holzmann, T

    1985-01-01

    Secondary lymphedema of the arm after therapy for breast cancer has a frequency of about 30% in the Federal Republic of Germany. Many authors have performed lympho-venous anastomoses to release lymphostatic edema, most using microsurgical technique. In this paper the authors present microlympho-venous anastomoses done in a telescope-like manner and using fibrin glue. First this technique was applied to dogs, later to patients. Measurement of the limb and of the limb volume at different levels were done pre- and postoperatively. Investigations with radionucleides were undertaken in some cases to measure lymphatic clearance. The operations were performed under local anaesthesia with perioperative antibiotic prophylaxis. The procedure was well tolerated by the patients, achieving a reduction of the swelling of about 30%. Despite the short follow-up of only six months and the limited number of cases we feel that this type of therapy should be offered to patients with secondary lymphedema.

  4. 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

  5. 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.

  6. Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System.

    PubMed

    Koshima, Isao; Narushima, Mitsunaga; Mihara, Makoto; Yamamoto, Takumi; Hara, Hisako; Ohshima, Azusa; Kikuchi, Kazuki; Todokoro, Ken; Seki, Yukio; Iida, Takuya; Nakagawa, Masahiro

    2016-01-01

    Collecting lymphatics have lymph-drainage function with contraction of smooth muscle cells. Patients with edema have lost this drainage function due to degeneration of smooth muscle cells. Lymphaticovenular (LV) anastomosis salvages smooth muscle cells from reversible degeneration (mild edema), but muscle cells cannot be recovered from irreversible degeneration (severe edema). Therefore, in severe edema, LV anastomoses cannot reestablish the drainage function of the lymphatic system.To overcome this weakness of LV bypass methods for severe edema, new methods were instituted for repair of this missing drainage function using a lymphadiposal flap from the contralateral foot for hemilateral edema, or transfer of lateral thoracic lymph nodes for bilateral edema. A total of 13 cases were repaired with lymphadiposal flaps and additional LV anastomoses. These cases have frequent phlegmon or cellulitis or resisted to previous LV anastomoses and/or compression therapy. The ages ranged from 15 to 75 years. There were four cases of primary edema and nine cases of secondary edema. Regarding the lymphadiposal flap (n = 8), three cases showed an excellent response (37.5%; no need for compression therapy), four cases had a good response (50%; improvement with compression), one case showed no change (12.5%; no improvement), and there were no cases of deterioration. Regarding the lateral thoracic lymph nodes transfer (n = 5), two cases had a good response (40%), three showed no improvement (60%), and there were no cases of deterioration. It is concluded that lymphadiposal flap or lymph nodes transfer is suitable for severe edema having frequent cellulitis in unilateral or bilateral lower extremities resisting previous LV anastomoses and/or compression therapy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. A prospective randomised study of drains in infra-peritoneal rectal anastomoses.

    PubMed

    Brown, S R; Seow-Choen, F; Eu, K W; Heah, S M; Tang, C L

    2001-08-01

    Although increasing evidence suggests that prophylactic drainage after intra-peritoneal colorectal anastomoses is unnecessary, drains for infra-peritoneal rectal anastomoses, where the leak rate is higher, are widely employed still. The aim of this study was to assess the effect of prophylactic drainage after anastomosis below the peritoneal reflection. All patients attending one specialist unit over an 8-month period for elective rectal cancer resection with an infra-peritoneal anastomosis were randomised to drainage or no drainage. The incidence of anastomotic leak and complications specific to the drain as well as other complications were compared. Fifty-nine patients were analysed (31 with drain). Twenty-five of the drained and 16 of the no-drain patients had a defunctioning stoma (p=ns). The groups were comparable for demographic data, operation and anastomotic height from the anal verge. There were three leaks (10%) in the drain group and five leaks (18%) in the no-drain group (p=ns). There were 2 (7%) patients in each group with a clinical leak. There were no specific drain complications and the incidence of other complications was similar in both groups. In conclusion, this study supports the contention that there is no difference in morbidity with or without the use of a drain for infra-peritoneal anastomoses.

  8. Prenatal diagnosis of spontaneous twin anemia-polycythemia sequence and postnatal examination of placental vascular anastomoses

    PubMed Central

    Bae, Jin Young; Oh, Jin Ju

    2016-01-01

    Twin anemia-polycythemia sequence (TAPS) is characterized by a wide discrepancy of hemoglobin between two monochorionic fetuses without sign of twin oligo-polyhydramnios sequence. A primiparous woman with monochorionic diamniotic twin transferred for preterm labor. Ultrasonographic evaluation at 32+3 weeks of gestation revealed increased middle cerebral artery-peak systolic velocity (77.4 cm/sec, 1.69 multiples of median) in donor and decreased in recipient twin (36.4 cm/sec, 0.79 multiples of median), the twin was diagnosed with TAPS. Repeated cesarean section was performed at 32+5 weeks of gestation following preeclampsia and preterm labor. After delivery, TAPS was confirmed through neonatal hematologic examination. There were no signs of acute hemorrhagic shock or brain injury. Placental evaluation via dye infusion and barium angiogram revealed one arterioarterial anastomoses with six arteriovenous anastomoses of placenta. We report a prenatally diagnosed case of spontaneous TAPS with arterioarterial and arteriovenous anastomoses and suggest careful monitoring of monochorionic twin and opinion on placenta vascular architecture. PMID:27896259

  9. Colour oscillations in arterioarterial anastomoses reflect natural differences in donor and recipient oxygenation and hematocrit.

    PubMed

    de Vries, H R; Aalders, M C G; Faber, D J; van den Wijngaard, J P H M; Nikkels, P G J; van Gemert, M J C

    2006-01-01

    Our aim was to show that the colour difference between brighter and darker red, occasionally observed as an oscillating boundary in the recipient and donor parts of an arterioarterial anastomosis in severe twin-twin transfusion syndrome (TTTS), is a consequence of natural differences in blood oxygenation and hematocrit developing between donor and recipient twins. As method we defined a theoretical model of the placenta with dimensions from pathology examination. From literature we determined the optical absorption and scattering properties of all tissue components, and hematocrit and oxygen saturation values for donor and recipient twins. From our placental model we simulated the spectrum of back-scattered light by standard Monte Carlo photon propagation computations and calculated the colour of chorionic arterial and venous blood vessels by applying the physics theory of colour perception. Our computations demonstrate that recipient arterial blood is somewhat brighter red than donor arterial blood. The strong colour differences seen after laser coagulation of all anastomoses but the arterioarterial were explained from an angiotensin II cut-off in the recipient due to obliteration of arteriovenous anastomoses, causing a temporary increase in recipient placental perfusion and hence in blood oxygenation. In conclusion, natural differences in recipient versus donor blood oxygen saturation and hematocrit in severe TTTS explain the observed colour differences between brighter and darker red observed in the recipient and donor parts of arterioarterial anastomoses.

  10. Single Superficial versus Dual Systems Venous Anastomoses in Radial Forearm Free Flap: A Meta-Analysis

    PubMed Central

    Bai, Shuang; Xu, Zhong-Fei; Duan, Wei-Yi; Liu, Fa-Yu; Huang, Dong-Hui; Sun, Chang-Fu

    2015-01-01

    Background The radial forearm free flap (RFFF) has been widely used with increasing frequency in head and neck reconstruction following extirpative surgery. The controversy of the venous anastomoses patterns still exists. Thus, we conducted a meta-analysis to assess the relationship between the venous anastomoses patterns and venous compromise. Methods MEDLINE, PubMed, Web of Science, and Wanfang databases were searched for studies reporting the different venous anastomoses patterns of the RFFF. A meta-analysis was conducted using the random effects models. Publication bias and sensitivity analysis were also assessed. Results 6 studies with 992 cases were included in this meta-analysis. The dual anastomosis group tended to have a lower incidence of venous compromise (RR = 1.39). However, the difference was not statistically significant (95%CI: 0.59, 3.24). Conclusions This meta-analysis indicated that performing dual venous anatomoses consisting of superficial and deep systems conferred a tendency of the reduction with regard to venous compromise. PMID:26270854

  11. Vascular Nature and Existence of Anastomoses of Extrinsic Postauricular Fascia: Application for Staged Auricular Reconstruction.

    PubMed

    Lohasammakul, Suphalerk; Turbpaiboon, Chairat; Chompoopong, Supin; Ratanalekha, Rosarin; Aojanepong, Chongdee

    2017-01-18

    A staged auricular reconstruction in microtia patients was developed by using superficial mastoid fascia (as part of extrinsic postauricular fascia) to cover the cartilagenous framework due to its highly vascularized nature. Three branches of external carotid artery (superficial temporal artery, posterior auricular artery and occipital artery) were found to supply this fascia, this study was therefore aimed to investigate the dimension of blood supply from each vessel and also to demonstrate the existence of anastomoses among these arteries. Thirty-eight pinnas and postauricular fascias from Thai fresh adult cadavers were included to document the anastomoses by showing both perfused dye connection (10 dissections) and visible anastomotic branches (8 dissections) among them. Distribution of each vessel trunk and its branches were demonstrated using superimposed illustration in the other 20 dissections with dye injection into each artery to designate 3 zones of anastomotic area between each arterial pair. Maximal size of viable postauricular fascial flap for staged reconstruction according to this vascular study was thus estimated to be at least 5 cm above and 3 cm below the Frankfurt horizontal plane and about 6 cm posterior to external acoustic meatus owing to the course of posterior auricular artery and its anastomoses. In addition, greater size of flap with dual blood supply from both superficial temporal and posterior auricular arteries can be raised by harvesting beyond 5 cm above external acoustic meatus.

  12. Distal end side-to-side anastomoses of sequential vein graft to small target coronary arteries improve intraoperative graft flow

    PubMed Central

    2014-01-01

    Background End-to-side anastomoses to connect the distal end of the great saphenous vein (GSV) to small target coronary arteries are commonly performed in sequential coronary artery bypass grafting (CABG). However, the oversize diameter ratio between the GSV and small target vessels at end-to-side anastomoses might induce adverse hemodynamic condition. The purpose of this study was to describe a distal end side-to-side anastomosis technique and retrospectively compare the effect of distal end side-to-side versus end-to-side anastomosis on graft flow characteristics. Methods We performed side-to-side anastomoses to connect the distal end of the GSV to small target vessels on 30 patients undergoing off-pump sequential CABG in our hospital between October 2012 and July 2013. Among the 30 patients, end-to-side anastomoses at the distal end of the GSV were initially performed on 14 patients; however, due to poor graft flow, those anastomoses were revised into side-to-side anastomoses. We retrospectively compared the intraoperative graft flow characteristics of the end-to-side versus side-to-side anastomoses in the 14 patients. The patient outcomes were also evaluated. Results We found that the side-to-side anastomosis reconstruction improved intraoperative flow and reduced pulsatility index in all the 14 patients significantly. The 16 patients who had the distal end side-to-side anastomoses performed directly also exhibited satisfactory intraoperative graft flow. Three-month postoperative outcomes for all the patients were satisfactory. Conclusions Side-to-side anastomosis at the distal end of sequential vein grafts might be a promising strategy to connect small target coronary arteries to the GSV. PMID:24884776

  13. 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

  14. Experience of General Surgery Residents in the Creation of Small Bowel and Colon Anastomoses.

    PubMed

    Nemeth, Zoltan H; Lazar, Eric L; Paglinco, Samantha R; Hicks, Addison S; Lei, Jason; Barratt-Stopper, Patricia A; Rolandelli, Rolando H

    2016-01-01

    With the introduction of stapling devices (SDs), the proportion of hand-sewn (HS) intestinal anastomoses (IAs) has declined. As more IAs are constructed with SDs, there are fewer opportunities for general surgery residents (GSRs) to acquire the skills for HS techniques during their training. Data for this study were extracted from an existing database of all IAs performed at the Department of Surgery of the Morristown Medical Center since 2003. For the purposes of this study, a 5.5-year timeframe was used between July 2006 and 2011, which contained 1659 IA operations on adult patients with resident involvement. GSRs of the 5-year general surgery residency program were grouped by postgraduate year (PGY) for further analysis. The number of all IAs created by each resident during the 5-year training was 67.2 on average. Most of these operations were done in the last 2 years of the training: 45.1% of all IAs in PGY5 and 37.3% of all IAs in PGY4. Of all, 1659 IAs performed in the study period, 711 (42.9% of total) were done laparoscopically and 948 (57.1% of all IAs) were done as open operations. Laparoscopic operations had a proportionally higher rate of SD use when compared to open cases (90.9% vs 82.4%). On average, each resident constructed 9.4 HS IAs (13.98% of all IAs) and 57.8 SD IAs (86.02% of total). Out of all anastomoses, ostomy reversals (30.7%) had the highest percentage of HS suturing followed by right colectomies (27.5%), ileal pouch-anal anastomoses and total colectomies and proctocolectomies (23.3%), small bowel resection (17.0%), and left colectomies (5.5%). Regardless of the location of the operation, stapled and sutured anastomoses had similar outcomes measured by the rate of anastomotic leaks. Residents used significantly more SDs in the creation of anastomoses than HS suturing in the PGY3, PGY4, and PGY5 years. We also documented that attending surgeons who are older more often used HS suturing than their younger colleagues when creating IAs. The

  15. Preliminary results of laser-assisted sealing of hand-sewn canine esophageal anastomoses

    NASA Astrophysics Data System (ADS)

    Auteri, Joseph S.; Oz, Mehmet C.; Sanchez, Juan A.; Bass, Lawrence S.; Jeevanandam, Valluvan; Williams, Matthew R.; Smith, Craig R.; Treat, Michael R.

    1991-07-01

    Dehiscence rates of esophageal anastomoses range between 5 and 20%. Causative factors include ischemia, tension, foreign body reaction, microabscesses, and the negative pressure within the thoracic cavity. Laser assisted tissue sealing (LATS) has been shown to decrease anastomotic leakage rates in other tissues. Using a canine model the efficacy of LATS in enhancing single layer hand swen intrathoracic esophageal anastomoses was assessed. Via a left thoracotomy, paired two centimeter transverse incisions (one laser sealed, one control) were made in the proximal and distal esophagus in nine dogs. Both were sewn using a single layer of 4-0 polyglycolic acid. A combination of albumin (0.2 cc), sodium hyaluronate (0.4 cc), and indocyanine green (1 gtt) was applied to one of the randomly chosen hand sewn repairs. The albumin/hyaluronate combination is used to provide a protein matrix across the anastomosis for ingrowth of fibroblasts. Indocyanine green dye selectively absorbs at OM805 nm which matches the output of the diode laser (808 +/- 1 nm), thus improving uptake of laser energy by the targeted tissues. The anastomosis was then exposed to continuous wave diode laser energy for OM2 minutes at a power density of 9.6 W/cm2. The esophagus was recovered either at the time of sealing or two days postoperatively and infused with saline under pressure. Bursting pressures were considered the point of initial saline leakage. At time 0 there was no significant difference in bursting pressures between the LATS group and controls. However, at two days postoperatively controls burst at 121 +/- 14 mmHg while the laser assisted anastomoses burst at 295 +/- 35 mmHg (p < .005). HPS staining of uninjured portions of the laser sealed anastomoses revealed minimal thermal injury to the mucosal surface initially, with some regeneration of mucosal lining at two days postoperatively. No foreign body reaction to the solder was noted. Laser reinforcement of single layer hand sewn esophageal

  16. Pneumatose kystique intestinale révélée par une sténose d'une anastomose gastro-jéjunale: à propos d'un cas

    PubMed Central

    El Matiallah, Mohammed Amine; El Bouhaddouti, Hicham; Mouaqit, Ouadii; Benjelloun, El Bachir; Ousadden, Abdelmalek; Taleb, Khalid Ait

    2013-01-01

    La pneumatose kystique intestinale est la présence de bulles gazeuses dans la paroi et les séreuses du tube digestif. Il s'agit d'une pathologie bénigne, rare, de diagnostic radiologique et de traitement médical. Nous rapportons le cas d'un homme âgé de 42ans, opéré il y a 6ans pour une sténose du bulbe duodénal d'origine ulcéreuse, il avait bénéficié d'une gastro-entéro-anastomose avec bivagotomie tronculaire. Il a été hospitalisé pour des vomissements associés à des épigastralgies. le patient a bénéficié d'une fibroscopie oeso-gastro-duodénale qui a trouvé une stase gastrique gênant toute exploration, ce qui a conduit à la réalisation d'une tomodensitométrie abdominale qui a objectivé un énorme estomac de stase en amont d'une sténose de l'anastomose gastro jéjunale, une pneumatose kystique intestinale et un pneumopéritoine. Le patient a été opéré et l'exploration a trouvé une ascite, un volumineux estomac de stase et des adhérences entre le grêle et le colon droit, sièges de la pneumatose, provoquant un tour de spire (volvulus) de l'ancienne anastomose gastro-jéjunale. L'estomac était atone. Une gastrectomie des 2/3 emportant l'ancienne anastomose suivie d'une anastomose type Finsterer manuelle a été réalisée. Les suites post opératoires étaient simples. La pneumatose kystique intestinale est une affection bénigne, de diagnostic radiologique. Le scanner permet d’étudier la diffusion des gaz dans les séreuses digestives. Son traitement est habituellement médical alors que ses complications peuvent relever d'un traitement chirurgical comme pour notre patient. PMID:24255731

  17. The influence of nicotine in healing of small bowel anastomoses in rats: angiogenesis and miofibroblasts.

    PubMed

    Skinovsky, James; Malafaia, Osvaldo; Chibata, Mauricio; Tsumanuma, Fernanda; Panegalli, Flávio; Martins, Marcus Vinícius Dantas de Campos

    2016-01-01

    to know the effect of nicotine on angiogenesis and myofibroblast formation in anastomoses of the small bowel of rats. we randomly divided 60 Wistar rats into the groups Nicotine (N) and control (C), according to the proposed treatment. Each group was subdivided into three subgroups according to the time interval used for the evaluation (7, 14 or 28 days). The N group with 30 animals received nicotine subcutaneously at a dose of 2mg/kg body weight, diluted in 0.3ml of 0.9% saline, twice daily for 28 days prior to the operation, and for more 7, 14 or 28 days, depending on the subgroup. The C group (also 30 animals) received only saline on the same conditions and time intervals. After 28 days we carried out an end-to-end anastomosis 10cm distal to the duodenojejunal flexure in each rat. After 7, 14 or 28 days after surgery, we euthanized ten animals of each group, sent specimens of the anastomosis areas, 1cm proximal to 1cm distal, to counting of blood vessels and myofibroblasts through immunohistochemical staining by the application of monoclonal anti-factor VIII antibodies and anti-smooth muscle alpha-actin. the administration of nicotine led to the decrease in the number of blood vessels measured on the 28th postoperative day and the number of myofibroblasts measured on the seventh day following completion of the anastomoses. administration of nicotine was deleterious on angiogenesis and myofibroblast formation in rats' small intestine anastomoses. conhecer o efeito da nicotina sobre a angiogênese e formação de miofibroblastos em anastomoses do intestino delgado de ratos. sessenta ratos Wistar foram divididos de maneira aleatória em grupos Nicotina(N) e Controle (C), conforme o tratamento proposto. Cada grupo foi subdividido em três subgrupos, de acordo com o intervalo de tempo utilizado para a avaliação (7, 14 ou 28 dias). O grupo N, com 30 animais, recebeu nicotina por via subcutânea, na dose de 2mg/Kg de peso, diluída em 0,3ml de solução salina a 0

  18. 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.

  19. 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

  20. 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.

  1. Lymphoscintigraphy as an adjunctive procedure in the perioperative assessment of patients undergoing microlymphaticovenous anastomoses

    SciTech Connect

    Sacks, G.A.; Sandler, M.P.; Born, M.L.; Clanton, J.A.; Franklin, J.D.; Partain, C.L.

    1983-07-01

    Microlymphaticovenous anastomoses provide a potential for reducing lymphedema of the upper extremity complicating radical mastectomy or irradiation. Lymphoscintigraphy with technetium isotopes is a valuable investigative modality in the perioperative evaluation of patients undergoing this surgical procedure. The radionuclide studies provide information regarding structural change and physiologic derangement with a low radiation dose to the patient. It is a simple, painless procedure requiring minimal skill and no surgical intervention. In addition, a reproducible method for preparing a radiocolloid suitable for lymphatic imaging using an approved drug as a precursor has been developed.

  2. 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

  3. 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).

  4. PIV-validated numerical modeling of pulsatile flows in distal coronary end-to-side anastomoses.

    PubMed

    Xiong, F L; Chong, C K

    2007-01-01

    This study employed particle image velocimetry (PIV) to validate a numerical model in a complementary approach to quantify hemodynamic factors in distal coronary anastomoses and to gain more insights on their relationship with anastomotic geometry. Instantaneous flow fields and wall shear stresses (WSS) were obtained from PIV measurement in a modified life-size silastic anastomosis model adapted from a conventional geometry by incorporating a smooth graft-artery transition. The results were compared with those predicted by a concurrent numerical model. The numerical method was then used to calculate cycle-averaged WSS (WSS(cyc)) and spatial wall shear stress gradient (SWSSG), two critical hemodynamic factors in the pathogenesis of intimal thickening (IT), to compare the conventional and modified geometries. Excellent qualitative agreement and satisfactory quantitative agreement with averaged normalized error in WSS between 0.8% and 8.9% were achieved between the PIV experiment and numerical model. Compared to the conventional geometry, the modified geometry produces a more uniform WSS(cyc) distribution eliminating both high and low WSS(cyc) around the toe, critical in avoiding IT. Peak SWSSG on the artery floor of the modified model is less than one-half that in the conventional case, and high SWSSG at the toe is eliminated. The validated numerical model is useful for modeling unsteady coronary anastomotic flows and elucidating the significance of geometry regulated hemodynamics. The results suggest the clinical relevance of constructing smooth graft-artery transition in distal coronary anastomoses to improve their hemodynamic performance.

  5. The current evidence on stapled versus hand-sewn anastomoses in the digestive tract.

    PubMed

    Korolija, Dragan

    2008-01-01

    The innovation process and developments in technology have given surgeons new products which can improve their performance and benefit our patients. Before the era of laparoscopic surgery one of the most important applications in surgical practice was the introduction of staplers. In this article, the evidence supporting the decision whether to use a mechanical device (stapler) or to make a hand-sewn anastomosis is presented. A sytematic review of the literature was performed. The search included published meta-anaylses, randomized clinical trials and comparative studies. Key words for the initial search were: surgical anastomosis, stapler, hand-sewn. There was no language restriction. The reference lists from the selected articles were also checked by the author. Literature data on main outcomes concerning the application of one or the other surgical technique have been analysed. The literature search yielded published data on various procedures in digestive surgery. Most of the available high-quality evidence was for gastric and colorectal resections. Resection of the esophagus, use of staplers in emergency procedures and some initial reports on pancreatic surgery were also retrieved. The evidence from the literature shows that stapler anastomoses take less operative time and are more costly than hand-sewn anastomoses. Regarding the morbidity and leaks rate the staplers give equal or better results when compared with the hand-sewn technique. Nevertheless, proper handling of staplers and experience remain crucial issues if one wants to gain benefits when using these devices.

  6. Placental sharing, birthweight discordance, and vascular anastomoses in monochorionic diamniotic twin placentas.

    PubMed

    Lewi, Liesbeth; Cannie, Mieke; Blickstein, Isaac; Jani, Jacques; Huber, Agnes; Hecher, Kurt; Dymarkowski, Steven; Gratacós, Eduard; Lewi, Paul; Deprest, Jan

    2007-12-01

    The purpose of this study was to examine the relationship between placental territory and birthweight discordance and vascular anastomoses in monochorionic diamniotic twin placentas from pregnancies that were not complicated by twin-to-twin transfusion syndrome with 2 liveborn twins. Placentas originated from a prospective follow-up study of monochorionic diamniotic twins included in the first trimester. After injection with dyed barium sulphate, a digital x-ray angiography and high-resolution digital photograph were taken. The 2 venous territories were delineated on the angiogram. The diameter of each arterioarterial anastomosis and of each vein that participated in an arteriovenous anastomosis was measured on the digital photograph. Net transfusion over the arteriovenous anastomoses was calculated as the difference between the total venous diameters of the 2 placental parts. One hundred placentas were analyzed. Birthweight discordance increased with placental territory discordance (P < .0001). Arterioarterial diameter (P < .01), net arteriovenous transfusion (P < .001), and total anastomotic diameter (P < .01) increased with placental territory discordance. On the other hand, birthweight discordance for a given placental territory discordance decreased with increasing arterioarterial diameter (P < .01), net arteriovenous transfusion (P < .001), and total anastomotic diameter (P < .01). In unequally shared placentas, the 2 fetal circulations are more tightly linked than in equally shared placentas, which may reduce the birthweight discordance for a given placental territory discordance.

  7. Different techniques for creating oesophageal anastomoses. A historical review and personal experience.

    PubMed

    Csíkos, M; Baradnay, G

    1997-01-01

    Among the surgical techniques used to create a reliable oesophageal anastomosis, mention should be made of the handmade (in one or two layers, wire or Vicryl) and the different stapler anastomoses. 41 oesophageal anastomoses were performed by stapler technique between 4 March 1985 and 4 March 1991. The EEA stapler was used in 15, and the SPTU stapler in 26 patients. The average age was 56.8 years overall, 53.6 in the female (7 patients) and 57.4 years in the 34 male patients. Tumours in the middle and lower third of the oesophagus and on the cardia were the indications for resection in 30 instances. Total gastrectomy was performed in 9 patients and oesophageal resection for peptic stricture in 2 cases. Replacement with stomach was carried out after oesophageal resection (17 patients), and with Roux-loop in 24 cases. The EEA anastomoses were not covered by a hand-made layer of interrupted sutures as is compulsory in the case of the SPTU gun. The intraoperative complication rate was 12.2%--two severe complications with the SPTU and 3 mild ones with the EEA (2 cases) and SPTU (1 case) machines. The postoperative complication rate was 17%--the severe ones with the SPTU gun. The only fatal anastomosis insufficiency was observed in this group. 3 of the 41 patients died--a mortality rate of 7.3%--but only one of them was due to technical failure in the SPTU group: 2.4%. Both the intra- and postoperative complications were more severe with the SPTU technique. The early postoperative complications are closely related to the intraoperative ones. Mortality due to technical failure was only observed in the SPTU group. The EEA stapler gun is superior in every respect to the SPTU sewing-machine. The future belongs to the even more sophisticated bent and modifiable devices. These were used in our Department Between 1992 and 1997, with practically no morbidity and no mortality. Although they are the most expensive of all the possibilities, the low morbidity and mortality rates pay

  8. Novel concave-convex electrode for colonic anastomoses by radiofrequency thermo-fusion.

    PubMed

    Zhao, Lingxi; Song, Chengli; Wang, Zhigang; Zhou, Yu; Li, Xinxiang; Zhu, Wei; Cuschieri, Alfred

    2015-07-01

    Successful vascular sealing by radiofrequency (RF)-induced tissue fusion is well established. The present study reports on a novel electrode structure design together with its experimental assessment for RF thermo-fusion of porcine colonic segments. Two types of electrode were constructed and used in the present study: one with a conventional smooth surface (S) and the other with a novel reciprocating concave-convex (CC) configuration. Finite element modeling was used to study the thermal distribution profile of the CC electrode. Ex vivo porcine colonic segments were used to create end-to-end serosa-to-serosa colonic anastomoses by applying a pulse of 160 W RF power for 20 s. Different compression pressures (S1, S2, S3) and (C1, C2, C3, C4, C5), were applied, via specially designed ring carriers, to the S and CC electrodes, respectively. Assessment was based on anastomotic burst pressures and histological appearances using light microscopy of paraffin sections. In total, 22 RF-induced circular anastomoses were performed. Similar burst pressures were observed for anastomoses created by the two types of electrodes (S, CC) performed under the same compression pressure. In contrast, significant differences were observed on histological examination of tissue anastomotic site. In particular, fusion areas between gaps of the CC electrode showed normal histological appearance, while the S electrode produced a completely flat featureless appearance. Furthermore, the CC electrode produced significantly different burst pressures depending on the applied compression pressure during thermo-fusion: compression pressures C1 vs. C4 produced circular anastomotic fusions with burst pressures of 21.9 ± 9.3 vs. 44.6 ± 8.9 mmHg, (p = 0.034); but the burst pressure beyond C4, declined significantly, with C4 vs. C5, burst pressures of 44.6 ± 8.9 vs. 24.7 ± 8.0 mmHg, (p = 0.034). The CC electrode exhibits larger and faster thermal diffusion profiles resulting in normal histological

  9. Challenging Pitfalls and Mimickers in Diagnosing Anastomosing Capillary Hemangioma of the Kidney: Case Report and Literature Review

    PubMed Central

    Al-Maghrabi, Haneen Adnan; Rashed, Abdullatif Sami Al

    2017-01-01

    Patient: Female, 55 Final Diagnosis: Anastomosing capillary hemangioma in the left kideny Symptoms: Left flank pain Medication: — Clinical Procedure: Partial nephrectomy Specialty: Diagnostics • Laboratory Objective: Rare disease Background: Vascular tumors of the kidney are rare tumors that are usually diagnosed and confirmed by histopathological examination due to the difficulty in definitive diagnosis by clinical and radiological examination. Anastomosing hemangioma is a rare variant of capillary hemangioma that mimics angiosarcoma. Case Report: Here, we present a case of a 55-year-old female with a history of partial nephrectomy due to clear cell renal cell carcinoma three years earlier, who presented with a contralateral anastomosing capillary hemangioma. The diagnosis was confirmed by histopathology and immunohistochemistry studies. Conclusions: Anastomosing hemangioma is a rare variant of capillary hemangioma. It has a sinusoidal growth pattern which resembles splenic parenchyma. It mimics malignant neoplasms, thus, clinical and radiological examination are not enough for accurate diagnosis. In this paper, we discuss the most crucial differential diagnoses and the pitfalls in diagnosing this rare variant of hemangioma. Furthermore, we present a literature review of all cases reported in the English-language literature. PMID:28286335

  10. [Branches of the perforating portions of the internal carotid arteries and their commissural anastomoses].

    PubMed

    Smirnov, V E

    1984-01-01

    By means of injection methods allowing microscopic preparation of vessels 0.015 mm and less in diameter the author examined 25 block-specimens of the base of the skull which contained the left and right cavernous parts of the internal carotid arteries and structures adjacent to them. The specimens were obtained in cases in which death was caused by the disease not associated with pathological conditions of the central nervous system. Arteries arising from the cavernous part of the internal carotid artery are described. The author determined the existence of a system of permanent commissural anastomoses between the cavernous parts of the left and right internal carotid arteries which is formed by the branches of the dorsal meningeal, inferior hypophyseal, and capsular arteries (McConnell arteries). The importance of the system in the diagnosis and treatment of pathological processes of parasinus and parasellar localization, particularly arteriosinus malformations of this region, is pointed out.

  11. Histological characteristics of collagen denaturation and injuries in bipolar radiofrequency-induced colonic anastomoses.

    PubMed

    Zhao, Lingxi; Zhuo, Changhua; Song, Chengli; Li, Xinxiang; Zhou, Yu; Shi, Debing

    2015-03-01

    Bipolar radiofrequency-induced thermo-fusion has been explored as an advanced surgical method for intestinal anastomoses; however, the histological characteristics of collagen denaturation and injuries arising from this process remain unclear. The aim of this study was to investigate the microcosmic changes and tissue damage of fusion regions with various parameters of injury. Ex vivo colons of pigs were fused serosa-serosa on two carrier rings, which were installed on a homemade anastomotic device. Five levels of compressive pressure from 171 to 313 kPa were applied for 5s to fuse the colons under radiofrequency power of 160 W, and then the collagen denaturation of the fused region was examined by transmission electron microscopy. Light microscopy was utilized to observe histological slices that were stained with picrosirius red in order to visualize the tissue injuries under two levels of radiofrequency power (120 vs. 140 W) and operation time (5 vs. 10s). Transmission electron micrographs showed that increased compressive pressure led to thicker denatured collagen fibrils and wider gaps between each collagen fibril. Serosa adhesion regions appeared abundant in collagen. No histological differences were observed when 120 W of power was applied for 5 and 10s. Significant muscle cracking occurred when colons were fused using 140 W for 5s. When the operation time was extended to 10s, 140 W led to tight fusion and less splitting on muscles. These results suggest that higher compressive pressure results in more severe collagen unfolding and also reduces collagen crosslinking in fused colons. Improved radiofrequency power along with operation time could avoid tissue injury upon radiofrequency-induced colonic anastomoses. Copyright © 2014 Elsevier GmbH. All rights reserved.

  12. 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)

  13. Reliability of near-infrared angiography and micro-Doppler sonography for evaluating microvascular anastomoses.

    PubMed

    Mücke, Thomas; Wolff, Klaus-Dietrich; Wagenpfeil, Stefan; Hölzle, Frank; Scholz, Martin

    2010-11-01

    Intraoperative fluorescence angiography has been reported to be a promising method, with rapid and high-quality image production at low cost when used for the detection of microvascular complications. The purpose of this study was to evaluate the reliability of intraoperative near-infrared indocyanine green angiography compared with microvascular Doppler testing in a standardized model in the rat with different vessel patencies. The carotid, aorta, and femoral vessels of 23 Wistar rats were used. Indocyanine green angiography and microvascular Doppler sonographic testing were performed to assess microanastomosis with a vessel patency randomly narrowed at the anastomosis to an outer patency of 100, 75, 50, 25, and 0 percent. A total of 424 investigations were performed for 68 anastomoses, including both indocyanine green videoangiographic and microvascular Doppler sonographic examinations. The overall sensitivity and specificity of the microvascular Doppler sonographic testing at different degrees of stenoses were 100 and 86.9 percent, respectively. The positive predictive value for all observations was 95.8 percent, and the corresponding negative predictive value was 100 percent. Indocyanine green angiography revealed an overall sensitivity of 95.3 percent and a specificity of 100 percent. The positive predictive value for these observations was 100 percent, and the negative predictive value was 84 percent. Indocyanine green angiography and microvascular Doppler sonography are quick and reliable methods for assessing blood flow in vessels in the laboratory model. The combined use of indocyanine green angiography and microvascular Doppler sonography can increase the accuracy of assessment of microvascular anastomoses intraoperatively. Indocyanine green can be used first, but followed by the microvascular Doppler in cases of a negative result to maximize accuracy.

  14. Efficacy of Early Superficial Temporal Artery-Middle Cerebral Artery Double Anastomoses for Atherosclerotic Occlusion in Patients with Progressing Stroke.

    PubMed

    Inoue, Akihiro; Kohno, Kanehisa; Iwata, Shinji; Ohue, Shiro; Ozaki, Saya; Ninomiya, Satoko; Tomita, Hitomi; Kamogawa, Kenji; Okamoto, Kensho; Fukumoto, Shinya; Ichikawa, Haruhisa; Onoue, Shinji; Nakamura, Yawara; Okuda, Bungo

    2017-04-01

    We investigated the efficacy of early superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses for patients with progressing stroke due to atherosclerotic occlusion. Nine consecutive patients who underwent early STA-MCA double anastomoses were enrolled. All patients presented with progressing stroke despite maximal medical treatment. Cerebral blood flow in 7 patients was analyzed by single-photon emission tomography. Clinical outcomes were investigated postoperatively, and we evaluated the utility of early STA-MCA double anastomoses. Nine patients in the present study included those with middle cerebral artery occlusion (n = 6) and internal carotid artery occlusion (n = 3). The mean age was 58.4 years. Subjects comprised 1 female (11.1%) and 8 males (88.9%). The cause was low perfusion ischemia due to atherosclerotic occlusion with a small infarct. The mean regional cerebral blood flow (rCBF) ratio in the middle cerebral artery territory compared to the normal side was 69.6 ± 5.3%. The duration from onset to surgery was 1-8 days (median, 3.11 days). All patients underwent early STA-MCA double anastomoses, and no reperfusion-induced hemorrhage occurred. All of them slowly achieved obvious remission compared to symptoms on admission and achieved a good functional outcome. Early STA-MCA double anastomoses were safe and effective, and early revascularization resulted in rapid neurological improvement. We recommend this procedure for patients with progressive ischemia due to main trunk artery occlusion, when the rCBF flow ratio with the normal side was 70 ± 10%, even at the subacute stage. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Wound healing enhancement of colonic anastomoses after endoscopic irradiation with low-power He-Ne laser: an experimental study after mechanical obstruction

    NASA Astrophysics Data System (ADS)

    Asencio-Arana, Francisco; Garcia-Fons, Vicente; Moloina-Andreu, E.

    1992-06-01

    We have tested the strength and collagen concentration of high-risk anastomoses of the rat colon after endoscopic irradiation by He-Ne laser. Repeated He-Ne laser irradiation (1.9 J/cm2) increases the bursting strength of the anastomoses by almost 100% on the fourth postoperative day. This effect is not observed by increasing the radiation dose (6.4 J/cm2). Differences in collagen (hydroxyproline) concentration did not reach statistical significance. Our study suggests that repeated endoscopic irradiation with He-Ne laser enhances the early phases of anastomotic healing in high risk colonic anastomoses.

  16. 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

  17. The significance of the extracranial-intracranial anastomoses of carotid system in occlusion of internal carotid artery.

    PubMed

    Kulenović, Amela; Dilberović, Faruk

    2004-05-01

    The existence of collateral circulation in patients with impaired intracranial circulation was studied. We analysed angiograms of 35 patients of the Neurology Clinic of Clinical Centre in Sarajevo with occlusion of internal carotid artery. In majority cases collateral circulation was not established. In patients with occlusion of internal carotid artery, extracranial-intracranial anastomoses were established in some cases, with results of surviving and patients recovery. Collateral circulation based on blood vessels which are formed in the early stages of fetal life. Some embryonal arteries undergo an involution process, while the other part of blood vessels stay unfunctional during life, until cerebrovascular disease appearence, when it comes to their activation. Establishing of the collateral circulation in post-occlusiv status depend on great number of factors: number of anastomoses, their calibre,velocity of occlusion and complete vascular status of patients.

  18. Analysis of Microvascular Free Flap Failure Focusing on the Microscopic Findings of the Anastomosed Vessels.

    PubMed

    Seo, Mi Hyun; Kim, Soung Min; Huan, Fan; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2015-10-01

    Microvascular flap reconstruction is known as successful technique, although vascular thrombosis can cause free flap failure. To analyze the histologic characteristics and causes of free flap failure, this clinical study examined failed free flaps, including the microanastomosed sites. This study included a total of 5 failed flaps, including 3 radial forearm free flaps, 1 latissimus dorsi free flap, and 1 fibular free flap, all performed with microvascular reconstruction surgery from 2009 to 2011 at Seoul National University Dental Hospital. At the resection surgeries of the failed nonviable flaps, histologic specimens including the microanastomosed vessels were acquired. For light microscope observation, the slides were stained with hematoxylin and eosin (HE), and also with Masson trichrome. Selected portions of graft tissue were also observed under transmission electron microscope (TEM). It was found that the cause of flap failure was the occlusion of vessels because of thrombi formation. During the microanastomosis, damage to the vessel endothelium occurred, followed by intimal hyperplasia and medial necrosis at the anastomosed site. In the TEM findings, some smooth muscle cells beneath endothelium were atrophied and degenerated. The formation of thrombi and the degeneration of the smooth muscle cells were coincident with vascular dysfunction of graft vessel. The damaged endothelium and the exposed connective tissue elements might initiate the extrinsic pathway of thrombosis at the microanastomotic site. Therefore, it is suggested that accurate surgical planning, adequate postoperative monitoring, and skillful technique for minimizing vascular injury are required for successful microvascular transfer.

  19. The functional outcomes of coloanal and low colorectal anastomoses with reservoirs after low rectal cancer resections.

    PubMed

    Rubin, François; Douard, Richard; Wind, Philippe

    2014-12-01

    Nearly half of patients undergoing low anterior rectal cancer resection have a functional sequelae after straight coloanal or low colorectal anastomoses (SA), including low anterior rectal resection syndrome, which combines stool fragmentation, urge incontinence, and incontinence. SA are responsible for anastomotic leakage rates of 0 to 29.2 per cent. Adding a colonic reservoir improves the functional results while reducing anastomotic complications. These colonic reservoir techniques include the colonic J pouch (CJP), transverse coloplasty (TC), and side-to-end anastomosis (STEA) procedures. The aim of this literature review was to compare the functional outcomes of these three techniques from a high level of evidence. CJP with a 4- to 6-cm reservoir is a good surgical option because it reduces functional impairments during the first year, and probably up to 5 years, but is not always feasible. TC appears to perform as well as CJP, is achievable in over 95 per cent of patients, but still with some doubts about a higher anastomotic leakage rate and worse functional outcomes. STEA appears equivalent to CJP in terms of morbidity and even better functional outcomes. STEA, with a terminal side segment size of 3 cm, is feasible in the majority of nonobese patients, combines good functional results, has low anastomotic leakage rates, and is easy to complete.

  20. Computational and experimental simulations of the haemodynamics at cuffed arterial bypass graft anastomoses.

    PubMed

    Cole, J S; Wijesinghe, L D; Watterson, J K; Scott, D J A

    2002-01-01

    The development of intimal hyperplasia at arterial bypass graft anastomoses is a major factor responsible for graft failure. A revised surgical technique, involving the incorporation of a small section of vein (vein cuff) into the distal anastomosis of polytetrafluoroethylene (PTFE) grafts, alters the distribution of intimal hyperplasia and improves graft performance. Numerical and in vitro flow visualization experiments have been conducted to identify the flow behaviour in the cuffed bypass model and to determine whether the improved performance of the cuffed system can be accounted for by haemodynamic factors. The flowfield at the cuffed anastomosis is characterized by an expansive recirculation. Separation occurs at the graft heel, and at the cuff toe as the blood enters the recipient artery. Wall shear stresses in the vicinity of the cuff heel are low, but high shear stresses and large spatial gradients in the shearing force act for a time on the artery floor. In the conventional model, a less disturbed flow prevails while the gradients of shear stress on the floor are smaller. Aspects of the anastomotic haemodynamics are worsened when the cuff is employed. The superior patency rates of cuffed bypasses may not be explained purely on the basis of local haemodynamic factors.

  1. Doppler detection of arterio-arterial anastomoses in monochorionic twins: feasibility and clinical application.

    PubMed

    Taylor, M J; Denbow, M L; Tanawattanacharoen, S; Gannon, C; Cox, P M; Fisk, N M

    2000-07-01

    The accuracy of in-vivo detection of arterio-arterial anastomoses (AAA) in monochorionic (MC) twins and its predictive value for twin-twin transfusion syndrome (TTTS) was assessed in 105 consecutive MC twins scanned at fortnightly intervals. AAA were sought using spectral and colour energy Doppler and ultrasound findings were compared with placental injection studies. AAA were identified in vivo in 59 (56%) pregnancies and at injection study in 68 (65%). The overall sensitivity and specificity was 85 and 97.3% respectively for the detection of AAA. Detection rates were higher at later gestations, with anterior placentae and with larger diameter AAA. The median insonation time to detect an AAA was 10 min (range 1-30). Where an AAA was identified, 15% of pregnancies (nine of 59) developed TTTS compared to 61% (28 of 46) when no AAA was seen (odds ratio 8.6). We conclude that AAA can be detected in vivo with high sensitivity and specificity without undue prolongation of scanning times and have a role in risk stratification in the antenatal assessment of MC twins.

  2. Placental markers of twin-to-twin transfusion syndrome in diamniotic-monochorionic twins: A morphometric analysis of deep artery-to-vein anastomoses.

    PubMed

    De Paepe, M E; Shapiro, S; Greco, D; Luks, V L; Abellar, R G; Luks, C H; Luks, F I

    2010-04-01

    Twin-to-twin transfusion syndrome (TTTS) is a multifactorial disorder that develops in 9-15% of diamniotic-monochorionic twin gestations. While the pathogenesis of TTTS remains poorly understood, unbalanced deep artery-to-vein (AV) anastomoses have traditionally been implicated in the gradual shift of blood from donor to recipient. The aim of this study was to define the placental markers of twin-to-twin transfusion syndrome, with special emphasis on the deep AV anastomoses. A prospective cohort of 284 consecutive diamniotic/monochorionic twin placentas was examined at Women and Infants Hospital between 2001 and 2008. Following exclusion of monoamniotic, multiple, disrupted and laser-treated placentas, 218 twin placentas (21 TTTS and 197 non-TTTS controls) formed the subject of this study. Placentas were injected with color-coded dyes. Anatomic characteristics and choriovascular anastomotic patterns of TTTS placentas were compared with non-TTTS controls. The TTTS placentas showed significantly higher frequencies of velamentous cord insertion, magistral vascular distribution patterns, uneven placental sharing, absence of AA anastomoses and presence of VV anastomoses. Deep AV anastomoses were identified in >or=95% of TTTS and non-TTTS placentas and were overall more abundant than previously reported. The total and net numbers of AV anastomoses were similar in both groups. However, the net cross-sectional area of AV anastomoses, which also takes into account the caliber of the vessels, was significantly smaller in TTTS placentas. There was no correlation between the direction of the AV imbalance and the twin donor/recipient status. In conclusion, TTTS has distinct placental characteristics, warranting their routine inclusion in the diamniotic-monochorionic placental pathology report. Our findings suggest imbalance of AV anastomoses is not required for the development for TTTS, although their presence, whether balanced or unbalanced, may contribute to the creation or

  3. [Bioelectrical activity and evacuation function of the gastric stump in an early period after different means of gastric resection and variations in the formation of anastomoses].

    PubMed

    Kapustin, B B; Khalimov, E V

    2003-01-01

    The results of the stomach resection on the occasion of stomach and duodenal ulcer were analyzed. Bioelectric activity of the stomach stump was studied in a comparative aspect, and early recovery of the motor function of the resected stomach after the formation of pyloroimitating gastroduodenal anastomoses was shown. Revealed roentgenologic mechanisms of the evacuator function of the stomach stump let us determine evacuation types for the early postoperative period. The formation of pyloroimitating gastroduodenal anastomoses is functionally advantageous.

  4. 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.

  5. 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

  6. Characterization and Optimal Management of High-Risk Pancreatic Anastomoses During Pancreatoduodenectomy.

    PubMed

    Ecker, Brett L; McMillan, Matthew T; Asbun, Horacio J; Ball, Chad G; Bassi, Claudio; Beane, Joal D; Behrman, Stephen W; Berger, Adam C; Dickson, Euan J; Bloomston, Mark; Callery, Mark P; Christein, John D; Dixon, Elijah; Drebin, Jeffrey A; Castillo, Carlos Fernandez-Del; Fisher, William E; Fong, Zhi Ven; Haverick, Ericka; Hollis, Robert H; House, Michael G; Hughes, Steven J; Jamieson, Nigel B; Javed, Ammar A; Kent, Tara S; Kowalsky, Stacy J; Kunstman, John W; Malleo, Giuseppe; Poruk, Katherine E; Salem, Ronald R; Schmidt, Carl R; Soares, Kevin; Stauffer, John A; Valero, Vicente; Velu, Lavanniya K P; Watkins, Amarra A; Wolfgang, Christopher L; Zureikat, Amer H; Vollmer, Charles M

    2017-06-07

    The aim of this study was to identify the optimal fistula mitigation strategy following pancreaticoduodenectomy. The utility of technical strategies to prevent clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreatoduodenectomy (PD) may vary by the circumstances of the anastomosis. The Fistula Risk Score (FRS) identifies a distinct high-risk cohort (FRS 7 to 10) that demonstrates substantially worse clinical outcomes. The value of various fistula mitigation strategies in these particular high-stakes cases has not been previously explored. This multinational study included 5323 PDs performed by 62 surgeons at 17 institutions. Mitigation strategies, including both technique related (ie, pancreatogastrostomy reconstruction; dunking; tissue patches) and the use of adjuvant strategies (ie, intraperitoneal drains; anastomotic stents; prophylactic octreotide; tissue sealants), were evaluated using multivariable regression analysis and propensity score matching. A total of 522 (9.8%) PDs met high-risk FRS criteria, with an observed CR-POPF rate of 29.1%. Pancreatogastrostomy, prophylactic octreotide, and omission of externalized stents were each associated with an increased rate of CR-POPF (all P < 0.001). In a multivariable model accounting for patient, surgeon, and institutional characteristics, the use of external stents [odds ratio (OR) 0.45, 95% confidence interval (95% CI) 0.25-0.81] and the omission of prophylactic octreotide (OR 0.49, 95% CI 0.30-0.78) were independently associated with decreased CR-POPF occurrence. In the propensity score matched cohort, an "optimal" mitigation strategy (ie, externalized stent and no prophylactic octreotide) was associated with a reduced rate of CR-POPF (13.2% vs 33.5%, P < 0.001). The scenarios identified by the high-risk FRS zone represent challenging anastomoses associated with markedly elevated rates of fistula. Externalized stents and omission of prophylactic octreotide, in the setting of

  7. 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

  8. Extracardiac to coronary anastomoses support regional left ventricular function in dogs.

    PubMed

    Unger, E F; Shou, M; Sheffield, C D; Hodge, E; Jaye, M; Epstein, S E

    1993-05-01

    Intramyocardial implantation of a systemic artery [the internal mammary artery (IMA)] causes angiogenesis, with formation of systemic to coronary anastomoses. In dogs, we assessed the magnitude of IMA-derived nutritive flow and determined its influence on regional contraction. We also sought to determine whether acidic fibroblast growth factor (FGF), an angiogenic peptide, could enhance myocardial neovascularization. Ameroid constrictors and hydraulic balloon occluders were placed on the left anterior descending coronary artery (LAD) of 23 dogs, and the left IMA was implanted in the LAD territory. Dogs were randomized to receive continuous infusions of acidic FGF with heparin, heparin alone, or placebo directly into the IMA for 8 wk. Regional myocardial blood flow was assessed in the conscious state 3 days and 8 wk after operation. Left ventricular function was determined in the anesthetized state at the 8-wk conclusion of treatment. In all dogs, IMA occlusion reduced mean maximal LAD zone perfusion by 28% (P < 0.001), without influencing regional contraction. When IMA occlusion was superimposed on left circumflex coronary artery (LCX) occlusion, LAD zone perfusion declined by 34% (relative to LCX occlusion alone), significantly impairing regional contraction. Treatment with either acidic FGF plus heparin or heparin alone improved IMA-derived collateral flow; however, addition of acidic FGF to heparin afforded no additional advantage over heparin by itself. We conclude that acidic FGF did not enhance myocardial angiogenesis in this model. IMA-derived collateral flow has significant functional importance; however, it is evident in the dog only when other sources of collateral flow are compromised.

  9. Exercise- and hypoxia-induced blood flow through intrapulmonary arteriovenous anastomoses is reduced in older adults.

    PubMed

    Norris, H Cameron; Mangum, Tyler S; Duke, Joseph W; Straley, Taylor B; Hawn, Jerold A; Goodman, Randy D; Lovering, Andrew T

    2014-05-15

    Mean pulmonary arterial pressure (Ppa) during exercise is significantly higher in individuals aged ≥50 yr compared with their younger counterparts, but the reasons for this are unknown. Blood flow through intrapulmonary arteriovenous anastomoses (IPAVA) can be detected during exercise or while breathing hypoxic gas mixtures using saline contrast echocardiography in almost all healthy young individuals. It has been previously hypothesized that a lower degree of exercise-induced blood flow through IPAVA is associated with high Ppa during exercise. This association may suggest that individuals who are known to have high Ppa during exercise, such as those ≥50 yr of age, may have lower blood flow through IPAVA, but the presence and degree of exercise-induced blood flow through IPAVA has not been specifically studied in older populations. Using transthoracic saline contrast echocardiography, we investigated the potential effects of age on exercise-induced blood flow through IPAVA in a cross-section of subjects aged 19-72 yr. To verify our findings, we assessed the effects of age on hypoxia-induced blood flow through IPAVA. Age groups were ≤41 yr (younger, n = 16) and ≥50 yr (older, n = 14). Qualitatively measured exercise- and hypoxia-induced blood flow through IPAVA was significantly lower in older individuals compared with younger controls. Older individuals also had significantly higher pulmonary arterial systolic pressure and total pulmonary resistance (TPR) during exercise. Low blood flow through IPAVA was independently associated with high TPR. The reasons for the age-related decrease in blood flow through IPAVA are unknown. Copyright © 2014 the American Physiological Society.

  10. Prominent Intrapulmonary Bronchopulmonary Anastomoses and Abnormal Lung Development in Infants and Children with Down Syndrome.

    PubMed

    Bush, Douglas; Abman, Steven H; Galambos, Csaba

    2017-01-01

    To determine the frequency of histologic features of impaired lung vascular and alveolar development and to identify the presence of intrapulmonary bronchopulmonary anastomoses (IBA) in infants and children who died with Down syndrome. A retrospective review of autopsy reports and lung histology from 13 children with Down syndrome (ages: 0-8 years) was performed. Histologic features of abnormal lung development were identified and semiquantified, including the presence of IBA. Three-dimensional reconstructions of IBA were also performed. Comparisons were made with 4 age-matched patients without Down syndrome with congenital heart defects who underwent autopsies during this time period. Of the 13 subjects with Down syndrome, 69% died from cardiac events, 77% had a congenital heart defect, and 46% had a clinical diagnosis of pulmonary hypertension. Lung histology from all subjects with Down syndrome demonstrated alveolar simplification, and 92% had signs of persistence of a double capillary network in the distal lung. The lungs from the subjects with Down syndrome frequently had features of pulmonary arterial hypertensive remodeling (85%), and prominent bronchial vessels and IBA were observed in all subjects with Down syndrome. These features were more frequent in subjects with Down syndrome compared with control subjects. Children with Down syndrome who died of cardiopulmonary diseases often have histologic evidence of impaired lung alveolar and vascular development, including the presence of prominent IBA and pulmonary hypertension. We speculate that children with Down syndrome are at risk for reduced lung surface area and recruitment of IBA, which may worsen gas exchange in subjects with Down syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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.

  12. [Effects of abdominal adhesion-preventing 4% icodextrin solution on healing of bowel anastomoses].

    PubMed

    Koç, Okay; Dağ, Ahmet; Ocal, Ahmet Koray; Dirlik, Mustafa Musa; Cömelekoğlu, Ulkü; Gümüş, Lülüfer Tamer; Serinsöz, Ebru; Kanık, Emine Arzu; Akça, Hamdi

    2013-07-01

    We aimed to introduce the efficiency of 4% icodextrin solution on preventing adhesions and its effect on anastomotic healing, together with biochemical parameters. In total, 40 rats were divided into four groups of 10 rats each as Group A (abrasion+icodextrin), Group B (abrasion), Group C (anastomosis+icodextrin), and Group D (anastomosis). Adhesion grade, anastomotic bursting pressure, histopathological analysis, tissue hydroxyproline level, and serum myeloperoxidase (MPO), nitric oxide (NO), and malondialdehyde (MDA) values were examined. Adhesion score was significantly lower in Group A than in Group B and significantly lower in Group C than in Group D (p=0.003577, p=0.001612). No difference in anastomoses healing was determined between Group C and Group D (p=0.816). Hydroxyproline level was significantly higher in Group A than in Group B and significantly higher in Group C than in Group D (p=0.001, p=0.0001). There were no differences in NO and MDA levels between Group A and Group B, but values were significantly lower in Group C than in Group D (p=0.434, p=0.001, p=0.116, p=0.018). MPO level was significantly lower in Group A than in Group B and significantly lower in Group C than in Group D (p=0.0001, p=0.0001). Based on our results, 4% icodextrin solution evidently decreased the formation of adhesion without negatively affecting the anastomotic healing. We also reported herein the biochemical and histopathological results and adhesion scores.

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

    PubMed Central

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

    2014-01-01

    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. PMID:25140813

  14. 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.

  15. Intertwin anastomoses in monochorionic placentas after fetoscopic laser coagulation for twin-to-twin transfusion syndrome: is there more than meets the eye?

    PubMed

    Lewi, Liesbeth; Jani, Jacques; Cannie, Mieke; Robyr, Romaine; Ville, Yves; Hecher, Kurt; Gratacos, Eduardo; Vandecruys, Hilde; Vandecaveye, Vincent; Dymarkowski, Steven; Deprest, Jan

    2006-03-01

    This study was undertaken to detect missed anastomoses on the chorionic surface as well as hidden connections in the depth of the cotyledons in placentas after laser coagulation for twin-to-twin transfusion syndrome (TTTS) and to correlate these findings to clinical outcome. All cord vessels were injected with dyed barium sulphate. A digital photograph of the chorionic surface angioarchitecture and single-shot digital X-ray (Rx) angiograms were made. The presence and diameter of any missed anastomoses on the chorionic surface and of any hidden angiographic connections were determined. Fifty placentas were analyzed, 7 of double intrauterine fetal death (IUFD) and 43 of double survivors. In 9 of 43 (21%) cases with double survival and in all 7 cases of double IUFD, missed anastomoses were identified that should have been ablated by laser coagulation (P < .001). There appeared to be a correlation between the type and diameter of missed anastomoses on the chorionic surface and the clinical outcome. Placentas with missed large arteriovenous/venoarterial anastomoses (AV/VA) (N = 8) were from cases with recurrent TTTS or double IUFD (unless compensated by a large arterioarterial anastomosis [AA]). Next, missed small AV/VA (N = 4) without AA resulted in isolated (ie, without TTTS) discordant hemoglobin levels requiring intrauterine transfusion. Finally, when there were no missed anastomoses (N = 34), TTTS had resolved in all cases and outcome was good, although 1 case had discordant hemoglobin values treated with a single intrauterine transfusion and 4 others had discordant hemoglobin at birth. On Rx angiography, potential hidden connections were present, all but 1 case. Coagulation of all anastomoses visible on the chorionic surface seems adequate to treat TTTS. However, hidden connections in the depth of the cotyledon could not be excluded and may be involved in lesser degrees of intertwin transfusion.

  16. International consensus statement regarding the use of animal models for research on anastomoses in the lower gastrointestinal tract.

    PubMed

    Bosmans, Joanna W A M; Moossdorff, Martine; Al-Taher, Mahdi; van Beek, Lotte; Derikx, Joep P M; Bouvy, Nicole D

    2016-05-01

    This project aimed to reach consensus on the most appropriate animal models and outcome measures in research on anastomoses in the lower gastrointestinal tract (GIT). The physiology of anastomotic healing remains an important research topic in gastrointestinal surgery. Recent results from experimental studies are limited with regard to comparability and clinical translation. PubMed and EMBASE were searched for experimental studies investigating anastomotic healing in the lower GIT published between January 1, 2000 and December 31, 2014 to assess currently used models. All corresponding authors were invited for a Delphi-based analysis that consisted of two online survey rounds followed by a final online recommendation survey to reach consensus on the discussed topics. Two hundred seventy-seven original articles were retrieved and 167 articles were included in the systematic review. Mice, rats, rabbits, pigs, and dogs are currently being used as animal models, with a large variety in surgical techniques and outcome measures. Forty-four corresponding authors participated in the Delphi analysis. In the first two rounds, 39/44 and 35/39 participants completed the survey. In the final meeting, 35 experts reached consensus on 76/122 items in six categories. Mouse, rat, and pig are considered appropriate animal models; rabbit and dog should be abandoned in research regarding bowel anastomoses. ARRIVE guidelines should be followed more strictly. Consensus was reached on several recommendations for the use of animal models and outcome measurements in research on anastomoses of the lower GIT. Future research should take these suggestions into account to facilitate comparison and clinical translation of results.

  17. Pharmacological evidence that α1- and α2-adrenoceptors mediate vasoconstriction of carotid arteriovenous anastomoses in anaesthetized pigs

    PubMed Central

    Willems, Edwin W; Trion, Marjo; De Vries, Peter; Heiligers, Jan P C; Villalón, Carlos M; Saxena, Pramod R

    1999-01-01

    Vasoconstriction of carotid arteriovenous anastomoses may be involved in the therapeutic action of acutely acting antimigraine agents, including the triptans and ergot alkaloids. While 5-HT1B/1D receptors mediate the effect of triptans, ergotamine and dihydroergotamine also interact with α-adrenoceptors. In the present study, we investigated the potential role of α1- and α2-adrenoceptors in mediating vasoconstriction of carotid arteriovenous anastomoses in anaesthetized pigs. Ten minute intracarotid infusions of phenylephrine (1, 3 and 10 μg kg−1 min−1) or BHT 933 (3, 10 and 30 μg kg−1 min−1) produced dose-dependent decreases in total carotid and arteriovenous anastomotic conductances; no changes were observed in the capillary fraction. The carotid vascular effects of phenylephrine and BHT 933 were selectively abolished by prazosin (100 μg kg−1, i.v.) and rauwolscine (300 μg kg−1, i.v.), respectively. The responses to phenylephrine and BHT 933 were not affected by the selective 5-HT1B/1D receptor antagonist GR127935 (500 μg kg−1, i.v.). These results show that both α1- and α2-adrenoceptors can mediate vasoconstriction of carotid arteriovenous anastomoses in anaesthetized pigs. Since vasoconstrictor activity in this in vivo model is predictive of anti-migraine activity, an agonist activity at particularly the α2-adrenoceptor subtypes, in view of their less ubiquitous nature, could provide migraine abortive potential. Thus, the present results may aid further understanding of the mode of action of some current anti-migraine agents and may eventually be helpful in the development of future treatment in migraine. PMID:10455274

  18. Identification of an anastomosing river system in the Early Cretaceous Khorat Basin, northeastern Thailand, using stratigraphy and paleosols

    NASA Astrophysics Data System (ADS)

    Horiuchi, Yu; Charusiri, Punya; Hisada, Ken-ichiro

    2012-11-01

    The Phu Kradung and Phra Wihan formations of the Early Cretaceous Khorat Group were investigated to characterize the depositional system and paleoclimate, based on stratigraphy, paleosol features, paleosol profiles, and reworked deposits. The sediments of both formations are classified into 12 facies on the basis of their primary depositional attributes, such as bedding, grain size, texture, and sedimentary structures. Furthermore, these facies are grouped into eight architectural elements based on stratigraphic relationships and outcrop-scale macroforms. The proportions of each architectural element indicate that the depositional system was that of an anastomosing river. The anastomosing river system in the studied section is characterized by a high rate of vertical floodplain aggradation and the development of a relatively stable crevasse channel. Paleosols are developed mainly in floodplain deposits, and are characterized by the development of calcretes. A semi-arid to sub-humid paleoclimate is deduced from the occurrence of the calcretes. In addition, their microstructures suggest that these calcretes were formed under several different conditions, with micritic carbonate precipitating under relatively arid climates, and alveolar septal structures under semi-arid to sub-humid conditions. Using the thicknesses of the calcrete horizons, we conclude that the difference in the amount of precipitation between the wet and dry periods was highly variable, without any order, during deposition of the studied section. The thicknesses of intervals between successive calcrete horizons indicate that the inflow of fine materials occurred randomly across the floodplain. Partly superimposed, multiple calcrete horizons were developed during periods of low sediment supply. A random deposition of floodplain sediments appears to characterize the anastomosing river system of the Khorat Basin.

  19. Endoscopic transanal vacuum-assisted rectal drainage (ETVARD): an optimized therapy for major leaks from extraperitoneal rectal anastomoses.

    PubMed

    Glitsch, A; von Bernstorff, W; Seltrecht, U; Partecke, I; Paul, H; Heidecke, C D

    2008-03-01

    A major leak from a rectal anastomosis is an important surgical complication. Endoscopic transanal vacuum-assisted rectal drainage (ETVARD) is a new method for treating nonseptic major anastomotic leaks after extraperitoneal rectal anastomoses. Between January 2002 and March 2007 a total of 17 patients (mean age 61.2 years) who developed anastomotic leakage after resection of the rectum or rectosigmoid colon were prospectively evaluated. Their treatment began with endoscopic debridement of the leak/cavity; nylon sponges were then endoscopically fitted into the cavity. Continuous suction was applied via suction tubes inserted into the sponges. Repeat endoscopies and sponge exchanges, including further debridement were essential. In 16/17 patients ETVARD was successful, relieving patients quickly from infectious symptoms and other complaints; one patient eventually required a Hartmann's procedure. Cavity sizes varied from 2 cm x 2 cm to 10 cm x 13 cm. The mean duration of drainage was 21.4 days, with a mean of 5.4 sponge exchanges and 10.7 endoscopies, and a mean total time to closure of the cavity of 53.1 days. The total time to closure of the cavity was directly dependent on the size of the cavity ( P< 0.015). Fifteen patients received additional intramural fibrin glue injections. In eight patients ETVARD was continued on an outpatient basis. There was no advantage demonstrated for patients with diverting loop ileostomies. Patients with anastomoses that were 6 cm or less from the anocutaneous line had considerably longer healing times. The healing time depended significantly on age ( P< 0.036). Follow-up endoscopies have shown only minor anastomotic changes in two patients. ETVARD is a well-tolerated and effective therapeutic option for the treatment of major leaks after extraperitoneal rectal anastomoses. In most cases ETVARD obviates the need for additional surgery, in particular diverting loop ileostomy.

  20. Opposite effects of interleukin-2 on normal and transfusion-suppressed healing of experimental intestinal anastomoses.

    PubMed Central

    Tadros, T; Wobbes, T; Hendriks, T

    1993-01-01

    OBJECTIVE: This study was done to investigate whether administration of interleukin-2 (IL-2) can abrogate the negative effects of blood transfusions on anastomotic healing. SUMMARY BACKGROUND DATA: Recently, the authors showed that blood transfusion severely impairs anastomotic repair and significantly increases the susceptibility to intra-abdominal septic complications in rats. It has been reported that blood transfusions suppress IL-2 production and that IL-2 may stimulate wound healing. METHODS: Lewis rats underwent resection and anastomosis of both the ileum and colon. Subsequently, they received either 3 mL of saline (control and IL-2 groups) or 3 mL of blood from brown Norway donors (transfusion and transfusion/IL-2 groups) intravenously. From the operation onward, the animals in the IL-2 and transfusion/IL-2 groups received daily injections of 5.4 x 10(5) IU of IL-2 in dextrose solution subcutaneously; the rats in the other groups received only the dextrose solution. The animals were killed 3 or 7 days after the operation and examined for septic complications and anastomotic repair. RESULTS: Transfusion led to an enhanced incidence of anastomotic abscesses, which was almost completely abrogated after IL-2 administration. The anastomotic strength was consistently and significantly reduced after transfusion. Seven days after surgery, the anastomotic strength was completely restored by IL-2 treatment. For instance, the average bursting pressure (+/- the standard deviation) of the ileal anastomoses in the control, transfusion, and transfusion/IL-2 groups were 86 +/- 15, 32 +/- 8,* and 63 +/- 10 mmHg* [symbol: see text] on day 3 and 293 +/- 36, 227 +/- 16,* and 299 +/- 19 mmHg on day 7, respectively (where * = significant vs. control group and [symbol: see text] = significant vs. transfusion group). In addition, IL-2 administration elevated the anastomotic hydroxyproline content, which was significantly decreased by transfusion alone, to the level found in the

  1. Differences between flow profiles of pulmonary vein anastomoses affected by peripheral atelectasis in cadaveric and bilateral living-donor lobar lung transplantations.

    PubMed

    Miyaji, Katsumasa; Matsubara, Hiromi; Nakamura, Kazufumi; Maruo, Takeshi; Morita, Hiroshi; Saito, Hironori; Kusano, Kengo F; Emori, Tetsuro; Goto, Keiji; Date, Hiroshi; Ohe, Tohru

    2004-09-01

    We report two cases of peripheral atelectasis during cadaveric and living-donor lobar lung transplantation, which had different effects on the flow profile of pulmonary vein (PV) anastomoses. In the patient who underwent living-donor lobar lung transplantation, we detected the increase in the velocity of blood flow through the left PV anastomosis by intraoperative transesophageal echocardiography. Then peripheral atelectasis occurred in the transplanted left lung lobe. On the other hand, in the patient who underwent cadaveric bilateral lung transplantation, peripheral atelectasis occurred, but no changes in velocities of blood flow through PV anastomoses were detected by intraoperative transesophageal echocardiography. This difference may have been caused by the difference in sizes of pulmonary beds of transplanted grafts. These findings indicate the necessity of careful monitoring of PV anastomoses, especially in cases of living-donor lobar lung transplantation.

  2. A systematic analysis of controlled clinical trials using the NiTi CAR™ compression ring in colorectal anastomoses.

    PubMed

    Tabola, R; Cirocchi, R; Fingerhut, A; Arezzo, A; Randolph, J; Grassi, V; Binda, G A; D'Andrea, V; Abraha, I; Popivanov, G; Di Saverio, S; Zbar, A

    2017-03-01

    Anastomotic leak following colorectal surgery can be a devastating adverse event. The ideal stapling device should be capable of rapid creation of an anastomosis with serosal apposition without the persistence of a foreign body or a foreign body reaction which potentially contribute to early anastomotic dehiscence or late anastomotic stricture. A systematic review was performed examining available data on controlled randomized and non-randomized trials assessing the NiTi compression anastomosis ring-(NiTi CAR™) (NiTi Solutions, Netanyah Israel) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards. A protocol for this meta-analysis has been registered on PROSPERO (CRD42016050934). The initial search yielded 45 potentially relevant articles. After screening titles and abstracts for relevance and assessment for eligibility, 39 of these articles were eventually excluded leaving 6 studies for analysis in the review. Regarding the primary outcome measure, the overall anastomotic leak rate was 2.2% (5/230) in the compression anastomosis group compared with 3% (10/335) in the conventional anastomosis group; this difference was not statistically significant (RR 0.75, 95% CI 0.25-2.24; participants = 565; studies = 6; I (2) = 0%). There were no statistically significant differences between compression and conventional anastomoses in any of the secondary outcomes. This review was unable to demonstrate any statistically significant differences in favor of the compression anastomosis technique over conventional manual or stapled mechanical anastomoses.

  3. Zygomatico-maxillary Reconstruction with Computer-aided Manufacturing of a Free DCIA Osseous Flap and Intraoral Anastomoses.

    PubMed

    Roy, Andrée-Anne; Efanov, Johnny I; Mercier-Couture, Geneviève; Chollet, André; Borsuk, Daniel E

    2017-02-01

    Craniomaxillofacial reconstruction using virtual surgical planning, computer-aided manufacturing, and new microsurgical techniques optimizes patient-specific and defect-directed reconstruction. A 3D customized free deep circumflex iliac artery (DCIA) flap with intraoral anastomoses was performed on a 23-year-old man with a posttraumatic right zygomatico-maxillary defect with failure of alloplastic implant reconstruction. An osseous iliac crest flap was sculpted based on a customized 3D model of the mirror image of the patient's unaffected side to allow for perfect fit to the zygomatico-maxillary defect. An intraoral dissection of the facial artery and vein was performed within the right cheek mucosa and allowed for end-to-end microvascular anastomoses. 3D preoperative planning and customized free DCIA osseous flap combined with an intraoral microsurgical technique provided restoration of facial esthetics and function without visible scars. In cases where zygomatico-malar reconstruction by alloplastic material fails, a customized free DCIA osseous flap can be designed by virtual surgical planning to restore facial appearance and function.

  4. 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.

  5. Comparison of continuous single layer polypropylene anastomosis with double layer and stapled anastomoses in elective colon resections.

    PubMed

    Ceraldi, C M; Rypins, E B; Monahan, M; Chang, B; Sarfeh, I J

    1993-03-01

    The documented leak rate of the continuous single layer polypropylene (CSLP) anastomosis in elective colon resection is 0-6 per cent. It is more cost effective than stapling (S), and should be faster and easier to perform than the double-layer (DL) technique. However, there have been no reported series comparing the outcome of the CSLP anastomosis with the DL and S techniques. We reviewed the charts of 100 patients with elective colon resections. Eighty-four had data sufficient for analysis. There were 44 CSLP, 21 DL, and 19 S. The groups were comparable with respect to 12 preoperative variables. Proportionately more large-small bowel anastomoses were performed in the S group, and no patient in the S group was actively taking steroids. Clinical outcome was assessed. All leaks were clinically apparent and documented with contrast enema or laparotomy. The leak rate for the CSLP was 6.8 per cent (3/44). Two of the three patients with leaks were taking steroids. There were two leaks in the DL group (9.5%), one of which was taking steroids, and no leaks in the S group. The difference in leak rate between the three groups was not statistically significant. The average cost for CSLP at our institution is $4.00 compared with $8.00 and $35.00 for the DL and S, respectively. We conclude that the CSLP is a reasonable and safe alternative to DL and S anastomoses.

  6. Zygomatico-maxillary Reconstruction with Computer-aided Manufacturing of a Free DCIA Osseous Flap and Intraoral Anastomoses

    PubMed Central

    Roy, Andrée-Anne; Efanov, Johnny I.; Mercier-Couture, Geneviève; Chollet, André

    2017-01-01

    Summary: Craniomaxillofacial reconstruction using virtual surgical planning, computer-aided manufacturing, and new microsurgical techniques optimizes patient-specific and defect-directed reconstruction. A 3D customized free deep circumflex iliac artery (DCIA) flap with intraoral anastomoses was performed on a 23-year-old man with a posttraumatic right zygomatico-maxillary defect with failure of alloplastic implant reconstruction. An osseous iliac crest flap was sculpted based on a customized 3D model of the mirror image of the patient’s unaffected side to allow for perfect fit to the zygomatico-maxillary defect. An intraoral dissection of the facial artery and vein was performed within the right cheek mucosa and allowed for end-to-end microvascular anastomoses. 3D preoperative planning and customized free DCIA osseous flap combined with an intraoral microsurgical technique provided restoration of facial esthetics and function without visible scars. In cases where zygomatico-malar reconstruction by alloplastic material fails, a customized free DCIA osseous flap can be designed by virtual surgical planning to restore facial appearance and function. PMID:28280668

  7. 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).

  8. Complications of rectal anastomoses with end-to-end anastomosis (EEA) stapling instrument. Clinical and radiological leak rates and some practical hints.

    PubMed Central

    Dorricott, N. J.; Baddeley, R. M.; Keighley, M. R.; Lee, J.; Oates, G. D.; Alexander-Williams, J.

    1982-01-01

    The complications and results of rectal anastomoses carried out with the end-to-end anastomosis (EEA) stapling instrument on 50 patients by 5 consultant surgeons are recorded. There was a clinical leakage rate of 6% and a radiological leakage rate of 20% assessed by water-soluble contrast enema. The technique has advantages compared with hand-suture by allowing low anastomoses and preservation of sphincters and is accompanied by an acceptably low leakage rate. Despite the cost of disposable cartridges these advantages make the technique economical because of the avoidance of colostomies and reduction in hospital stay. Images FIG. 1 FIG. 2 PMID:7044253

  9. 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.

  10. Heat-washout: a new method for measuring cutaneous blood flow rate in areas with and without arteriovenous anastomoses.

    PubMed

    Midttun, M; Sejrsen, P; Colding-Jorgensen, M

    1996-05-01

    A new method, the heat-washout method, for measuring total cutaneous blood flow rate is introduced. The measurements were performed with a transcutaneous (tc) PO2-electrode that is capable of heating and measuring local temperature, and it is constructed with a thermostatically controlled cap. The probe was heated electrically to a selected temperature 2-10 degrees above normal skin temperature. When the temperature was stable, the heating element was turned off, and the temperature was registered every 10 s until a stable baseline temperature, Tb, was obtained. Tb was subtracted from the registered temperatures giving deltaTs that were plotted in a semilogarithmic diagram. The heat-washout was monoexponential, and the slope was used for calculating blood flow rate in accordance with the principle of Kety, using a known partition coefficient. The method was applied to the forearm in two subjects, and the results were compared to blood flow rates obtained simultaneously by the 133Xe-washout method in the same area. The equation of the regression line was y = 2.5 + 0 x 968X and the correlation coefficient was 0 x 986 at temperature levels of 37-45 degrees C. In the pulp of the thumb, blood flow rates, in arteriovenous anastomoses, were estimated in two subjects by subtracting the capillary blood flow rate, measured by 133Xe-washout, from the total cutaneous blood flow rate, measured by heat-washout. Due to a relatively low diffusions coefficient for 133Xe compared to heat, 133Xe cannot be used for measurement of blood flow rate in arteriovenous anastomoses.

  11. Needle-to-suture ratio, as well as suture material, impacts needle-hole bleeding in vascular anastomoses.

    PubMed

    Sergeant, Paul; Kocharian, Richard; Patel, Bababhai; Pfefferkorn, Matthew; Matonick, John

    2016-06-01

    The purpose of this study was to examine the influence of material variables on needle-hole bleeding in vascular anastomoses. Material variables include suture size, needle-tip geometry and diameter, needle coating, suture material and coating and swage area. We attempted to determine whether particular suture material and a reduced needle-to-suture ratio (N:S ratio) could reduce the vessel wall defect and reduce needle-hole bleeding, without changing the suture diameter used for the anastomosis. A comparative analysis was made of the needle-hole leak rate in end-to-end anastomoses of an ePTFE®-ePTFE® vascular graft with a PROLENE® polypropylene suture with HEMO-SEAL™ technology (HS, 1.84:1 N:S ratio), standard PROLENE® polypropylene suture (polypropylene 1, 2.41:1 N:S ratio), an alternate standard PROLENE® polypropylene suture (polypropylene 2, 2.06:1 N:S ratio) and a GORE-TEX™ ePTFE® suture (ePTFE® suture, 1.4:1 N:S ratio) in an ex vivo cardiopulmonary bypass pulsatile flow loop model using heparinized porcine blood. Testing was completed within the model with an activated clotting time between 250 and 500 s, at near normothermia (33-35°C) and at normotensive pressure levels (120/80 mmHg). A sample size of n = 20 was completed for each group. The average total sample leak rate was 19.8 ± 4.5 ml/min for the HS suture, 57.2 ± 7.2 ml/min for polypropylene 1, 33.8 ± 4.1 ml/min for polypropylene 2 and 46.5 ± 10.3 ml/min for the ePTFE suture. The average needle-hole leak rates were 0.63 ± 0.13 ml/min for the HS suture, 1.94 ± 0.23 ml/min for polypropylene 1, 1.14 ± 0.14 ml/min for polypropylene 2 and 1.56 ± 0.34 ml/min for the ePTFE® suture. A two-sided 95% confidence interval for the difference in leak rates showed that there were significant differences (44-67% reduction) in favour of the HS suture when compared with the alternative needles with the same suture material and different N:S ratios, and also a reduction (59%) compared with the sample

  12. Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic Artery Embolization for Benign Prostatic Hypertrophy.

    PubMed

    Yu, Simon Chun Ho; Cho, Carmen; Hung, Esther; Wang, Defeng; Chiu, Peter; Yee, Chi Hang; Ng, Anthony

    2017-08-01

    It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH). A prospective study of 62 prostate sides in 31 consecutive patients (median age, 66 y; range, 60-71 y) with symptomatic BPH was undertaken. Median prostate volume was 72.4 mL (range, 48.8-85.8 mL), median International Prostate Symptom Score was 21 (range, 15-23), and median urine peak flow rate was 4 mL/s (range, 2-6 mL/s). The arterial anastomoses were classified as types I-III according to vascular morphology. Treatment safety was assessed in terms of adverse events and complications, and treatment effectiveness was assessed in terms of success rate of angiographic flow reversal. The PAE procedure was successfully completed in all 31 patients (100%). Adverse events in both groups were transient and mild and did not necessitate prolonged hospitalization. There was no clinical evidence of any significant nontarget ischemic complication in either group. Intraprostatic anastomosis was diagnosed in 19 of 31 patients (61.3%) and 22 of 62 prostate sides (35.5%). Success rates of verapamil treatment were 88.9% overall (20 of 22) and 100% (19 of 19) in type II and III anastomoses. There was no difference between the treatment group and the control group in clinical, urologic, and imaging outcomes of PAE. Intra-arterial verapamil treatment was probably safe and effective in causing flow reversal in type II and III intraprostatic anastomoses and in preventing ischemic complications in PAE for BPH without compromising PAE outcomes. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  13. Laparoscopic gastrointestinal anastomoses using knotless barbed absorbable sutures are safe and reproducible: a single-center experience with 242 patients

    PubMed Central

    Lee, Sang-Woong; Kawai, Masaru; Tashiro, Keitaro; Nomura, Eiji; Tokuhara, Takaya; Kawashima, Satoshi; Tanaka, Ryo; Uchiyama, Kazuhisa

    2016-01-01

    Objective Intracorporeal reconstruction of the digestive tract is technically challenging. The V-Loc 180 wound closure device (Covidien) is a self-anchoring unidirectional barbed suture that obviates the need for knot tying. The aim of this prospective cohort study was to investigate the use of the novel suture in gastrointestinal enterotomy closure. Methods The subjects comprised patients with malignant disease who were scheduled to undergo laparoscopic gastrectomy with curative intent. The barbed suture was used to close the entry hole for the linear stapler during intracorporeal reconstruction following laparoscopic gastric resection. The primary endpoint was the proportion of patients who developed anastomotic leakage at the site where the barbed suture was applied. Results Between July 2012 and March 2015, 242 patients were enrolled. Of 362 anastomoses, the enterotomy hole at 256 sites was closed using the barbed suture. These 256 sites consisted of 95 gastroduodenostomies, 25 gastrogastrostomies, 13 gastrojejunostomies, 90 jejunojejunostomies, 17 esophagojejunostomies and 16 primary closures of the stomach following local gastric resection. There were no anastomosis-related complications, conversion to usual sutures, mechanical closure of the entry hole and reoperation due to adhesive obstructions or mortality over a median follow-up period of 17.8 months. Conclusions The use of the unidirectional barbed absorbable suture for gastrointestinal closure is safe and effective in laparoscopic gastrectomy. PMID:26819279

  14. [The prececal digestibility of corn, sunflower, cottonseed, linseed and soybean extract meal in swine with ileocecal anastomoses].

    PubMed

    Hennig, U; Wünsche, J; Souffrant, W B; Peters, G; Kreienbring, F

    1993-01-01

    Five pigs were each surgically prepared with end-to-side (E.t.S.) and end-to-end (E.t.E.) ileorectal anastomoses (IRA). The ileo-caecal valve was preserved in both modifications. The animals were fed diets with maize or solvent extracted oil seed meals from sunflower, cottonseed, linseed or soybean and maize in combination with one of these oil seed meals. The aim of the experiment was to estimate the influence of both IRA-techniques on the precaecal nutrient digestibility and amino acid (AA) absorption. The crude carbohydrate digestibility in two of the five single protein diets and in three of the four blends were significantly higher in the E.t.S.--than in the E.t.E.--IRA group. There were no significant differences between the two IRA-modifications in crude protein (CP) and crude fat digestibility. No differences were observed in AA absorption for the single components maize, sunflower- and cottonseed meal. The absorption values of isoleucine, leucine and valine from linseed meal were significantly more than 5%-units higher in the E.t.S.-group than in E.t.E.-animals. There were similar results in soybean meal for four essential AA but with differences below 5%-units. Accordingly the two IRA-modifications did not influence the AA absorption to a practically important extent.

  15. Effects of metoclopramide on the expression of metalloproteinases and interleukins in left colonic anastomoses. An experimental study.

    PubMed

    Marques e Silva, Silvana; Jerônimo, Márcio Sousa; Silva-Pereira, Ildinete da; Tavares, Aldo Henrique; Bocca, Anamélia Lorenzetti; Sousa, João Batista de

    2015-11-01

    To evaluate the effects of metoclopramide on metalloproteinases (MMP) and interleukins (IL) gene expression in colonic anastomoses in rats. Eighty rats were divided into two groups for euthanasia on the 3rd or 7th postoperative day (POD), then into two subgroups for sepsis induction or not, and then into subgroups to receive either metoclopramide or saline solution. Left colonic anastomosis were performed and then analyzed. On the 3rd POD, metoclopramide was associated with increased expression of MMP-1a, MMP-13, and TNF-α. On the 7th POD, the transcripts of all MMPs, TNF-α, IL-1β, IFN-γ, and IL-10 of the treated animals became negatively modulated. In the presence of sepsis, metoclopramide did not change MMPs and decreased IL-6, IL-1β, IFN-γ and IL-10 gene expression on the 3rd POD. On the 7th POD, increased expression of all MMPs, IFN-γ and IL-10 and negative modulated TNF-α and IL-6 gene expression. Administration of metoclopramide increased metalloproteinases and interleukins gene expression on the 3rd postoperative day and negatively modulated them on the 7th POD. In the presence of abdominal sepsis, metoclopramide did not change MMPs and decreased ILs gene expression on the 3rd POD. On the 7th POD, the drug increased expression of all MMPs.

  16. Anastomosing hemangioma of the kidney: a case report of a rare subtype of hemangioma mimicking angiosarcoma and review of the literature

    PubMed Central

    Zhao, Ming; Li, Changshui; Zheng, Jiangjiang; Sun, Ke

    2013-01-01

    Anastomosing hemangioma is a recently described, unusual variant of capillary hemangioma which seems to be unique for the genitourinary system, with a particular proclivity for the kidney. Histologically, it is characterized by a unique sinusoidal architecture reminiscent of splenic parenchyma that can lead to concern for angiosarcoma. We herein report a further case of anastomosing hemangioma originating in the right kidney of a 48-year-old Chinese man. The patient had a past medical history significant for hepatocellular carcinoma; this tumor was incidentally identified as an asymptomatic right renal mass during the periodical surveillance of the hepatic cancer. The resected tumor measured 2.5cm in maximum diameter and microscopically demonstrated an overall lobulated growth pattern with alternating cellular areas composed of anastomosing sinusoidal capillary-sized vessels lined by hobnail endothelial cells, and edematous, hyaline paucicellular areas. Cytologically the tumor cells were generally bland and exhibited positivity for CD31, CD34 immunohistochemically. The patient had been in a good status without evidence of tumor recurrence 12 months after the surgery. This rare variant renal hemangioma is in need of more recognition and should not be over-diagnosed as a malignance, particularly angiosarcoma. PMID:23573324

  17. Acute hemorrhage in monochorionic twins with ruptured velamentous vessels: anemic twin resuscitated by its co-twin through placental vascular anastomoses?

    PubMed

    Gillissen, A; Sueters, M; van Lith, J M; Walther, F J; Lopriore, E

    2013-01-01

    Monochorionic (MC) twin pregnancies are at increased risk of several complications including acute or chronic twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). Both TTTS and TAPS result from inter-twin fetofetal transfusion through the placental vascular anastomoses. In addition, MC twin pregnancies are at increased risk of having a velamentous cord insertion, which has been linked with poor perinatal outcome due to risk of rupture of the velamentous vessels. In sporadic cases, these vascular connections may have a positive effect instead of a deleterious effect. We present a case of acute fetal distress in a MC twin pregnancy caused by acute hemorrhage following rupture of velamentous vessels. An emergency cesarean section delivery was performed at 29+2 weeks' gestation. One infant was severely anemic at birth and required immediate treatment with volume expansion and blood transfusion. Acute fetal blood loss through the ruptured vessels led to an acute fetofetal transfusion from the co-twin through the placental vascular anastomoses. Delayed intervention could have resulted in severe hypovolemic shock and acute anemia in both fetuses. Instead, in the current case, placental vascular anastomoses had a transient protective role and allowed transfusion of blood from one co-twin into the circulation of the anemic twin.

  18. Relative contribution of wall shear stress and injury in experimental intimal thickening at PTFE end-to-side arterial anastomoses.

    PubMed

    Loth, Francis; Jones, Steven A; Zarins, Christopher K; Giddens, Don P; Nassar, Raja F; Glagov, Seymour; Bassiouny, Hisham S

    2002-02-01

    Intimal hyperplastic thickening (IHT) is a frequent cause of prosthetic bypass graft failure. Induction and progression of IHT is thought to involve a number of mechanisms related to variation in the flow field, injury and the prosthetic nature of the conduit. This study was designed to examine the relative contribution of wall shear stress and injury to the induction of IHT at defined regions of experimental end-to-side prosthetic anastomoses. The distribution of IHT was determined at the distal end-to-side anastomosis of seven canine Iliofemoral PTFE grafts after 12 weeks of implantation. An upscaled transparent model was constructed using the in vivo anastomotic geometry, and wall shear stress was determined at 24 axial locations from laser Doppler anemometry measurements of the near wall velocity under conditions of pulsatile flow similar to that present in vivo. The distribution of IHT at the end-to-side PTFE graft was determined using computer assisted morphometry. IHT involving the native artery ranged from 0.0+/-0.1 mm to 0.05+/-0.03 mm. A greater amount of IHT was found on the graft hood (PTFE) and ranged from 0.09+/-0.06 to 0.24+/-0.06 mm. Nonlinear multivariable logistic analysis was used to model IHT as a function of the reciprocal of wall shear stress, distance from the suture line, and vascular conduit type (i.e. PTFE versus host artery). Vascular conduit type and distance from the suture line independently contributed to IHT. An inverse correlation between wall shear stress and IHT was found only for those regions located on the juxta-anastomotic PTFE graft. The data are consistent with a model of intimal thickening in which the intimal hyperplastic pannus migrating from the suture line was enhanced by reduced levels of wall shear stress at the PTFE graft/host artery interface. Such hemodynamic modulation of injury induced IHT was absent at the neighboring artery wall.

  19. 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.

  20. [Insertion of autografts after acute damage of the common carotid artery. Experimental microvascular anastomoses after balloon dilatation].

    PubMed

    Friedrich, R E; Plambeck, K; Bartel-Friedrich, S; Hellner, D; Schmelzle, R

    1997-02-01

    The objective of our investigation was to study the patency rates of anastomoses in arteries, damaged by a balloon dilatation, in a training model of microvascular surgery. In general anaesthesia, a balloon dilatation was repeated 5 times in 31 left common carotid arteries of female Wistar rats (body weight: 250 to 350 g). A common carotid artery autograft of 4 mm was harvested 1 minute after reflow, turned 180 degrees, and reinserted into the artery. The reflow of the vessels was investigated by micro-Doppler ultrasound equipment. Autografts without balloon dilatation or any other intended damage were performed in further 26 common carotid arteries. In addition, in further 14 common carotid arteries the balloon dilatation was the sole damage. The vessels were harvested and investigated postoperatively after perfusion with 3% glutaraldehyde at 1 day, 7 days, and 1 month. The balloon dilatation in no instance caused an occlusion of the vessel as judged by the micro-Doppler ultrasound. One vessel was found to be occluded after reflow was allowed following insertion of the autograft in the group without balloon dilatation. However, this vessel proved to be patent after explantation (patency rate: 100%). In the group with balloon dilatation preceding the autograft insertion, by micro-Doppler ultrasound, 16 vessels were occluded and 14 were patent. At different times of follow-up, in this group the summarized patency rates were 50%. The patency differences in both groups with autografts proved to be significant, both after micro-Doppler imaging and by histological evaluation (p < 0.001). For clinical use the balloon dilatation is recommended to remove a thrombus or to dilate a spastic vessel segment in anastomized vessels threatening the success of microvascular flaps. In this training model of microvascular surgery we demonstrated the thrombogenic effect of balloon dilatation.

  1. The use of stents for duct-to-duct anastomoses of biliary reconstruction in orthotopic liver transplantation.

    PubMed

    Kusano, Toshiomi; Randall, Henry B; Roberts, John P; Ascher, Nancy L

    2005-01-01

    Biliary anastomotic complications remain a major cause of morbidity in liver transplant recipients. The objective of this retrospective study is to reassess the use of anastomotic stents for biliary reconstruction while focusing on an end-to-end choledochocholedochostomy (EECC) in orthotopic liver transplantation (OLT). EECC for the biliary reconstruction in OLT was performed in 115 patients. Sixty-three had their bile duct reconstructed over a T-tube stent (S group) while the remaining 52 patients underwent the same procedure without the stent (non-S group). The two groups were compared in terms of biliary complications and the conversion rate to a hepaticojejunostomy (HJS). Twenty-three biliary complications were observed in the OLT patients. In the S group, the incidence of a biliary leak was 12.7%, 8 of 63 patients in which 5 patients showed a bile leak when T tubes were removed. The rate of biliary stricture in the S group was 25.4%, or 16 patients. This stricture rate was not significantly different from the 13.5% rate observed in the non-S group (p=0.086). In the non-S group, 7 patients showed a biliary stricture. Four of 7 patients also developed a bile leak identified to be an anastomotic leak, which consequently resulted in HJS. A total of 6 patients, 5.2% of all OLT patients, underwent a subsequent revision of their primary anastomoses. The incidence of conversion from EECC to HJS in the non-S group, 57.1% was significantly higher than that in the S group, 12.5% (p=0.046). EECC (i.e. with or without a T-tube stent) is both a safe and effective technique for biliary reconstruction in OLT. However, the conversion rate from EECC to HJS in the non-S group was significantly higher than that in the S group. An indwelling T-tube stent is therefore considered to be useful for both achieving the lowest possible rate of severe anastomotic stricture and to prevent any subsequent intervention.

  2. Investigation of the role of 5-HT1B and 5-HT1D receptors in the sumatriptan-induced constriction of porcine carotid arteriovenous anastomoses

    PubMed Central

    Vries, Peter De; Willems, Edwin W; Heiligers, Jan P C; Villalón, Carlos M; Saxena, Pramod R

    1999-01-01

    It has previously been shown that the antimigraine drug sumatriptan constricts porcine carotid arteriovenous anastomoses via 5-HT1-like receptors, identical to 5-HT1B/1D receptors. The recent availability of silent antagonists selective for the 5-HT1B (SB224289) and 5-HT1D (BRL15572) receptor led us to further analyse the nature of receptors involved.In pentobarbitone-anaesthetized, bilaterally vagosympathectomized pigs, sumatriptan (30, 100 and 300 μg kg−1, i.v.) dose-dependently decreased carotid arteriovenous anastomotic conductance by up to 70±5%.The dose-related decreases in carotid arteriovenous anastomotic conductance by sumatriptan (30, 100 and 300 μg kg−1, i.v.) remained unchanged in animals treated (i.v.) with 1 mg kg−1 of BRL15572 (maximum decrease: 72±3%), but were significantly attenuated by 1 mg kg−1 (maximum decrease: 30±11%) and abolished by 3 mg kg−1 (maximum decrease: 3±7%) of SB224289. The highest dose of SB224289 did not attenuate the hypertension, tachycardia or increases in carotid blood flow induced by bolus injections of noradrenaline (0.1–3 μg kg−1, i.v.).The results indicate that sumatriptan constricts porcine carotid arteriovenous anastomoses primarily via 5-HT1B, but not via 5-HT1D receptors. PMID:10385240

  3. The Use of a Compression Device as an Alternative to Hand-Sewn and Stapled Colorectal Anastomoses: Is Three a Crowd?

    PubMed Central

    Buchberg, Brian S.; Masoomi, Hossein; Bergman, Herlinda; Mills, Steven D.

    2010-01-01

    Background The NiTi CAR™ 27 is a newer device that uses compression to create an anastomosis. An analysis of this device in the creation of colorectal anastomoses in humans has yet to be reported in the USA. Methods A non-randomized, prospective pilot study of the NiTi CAR™ 27 device in patients undergoing a left-sided colectomy between March 2008 and August 2009 was performed. Results Twenty-three patients (9 men and 14 women) underwent a left-sided colectomy and compression anastomosis with the CAR™ 27 device. Minor morbidities, 3 of 23 (13%) patients, included one small postoperative abscess requiring antibiotics alone and two postoperative anastomotic strictures requiring balloon dilation. Major morbidities, 1 of 23 (4%) patients, included a partial anastomotic dehiscence/leak requiring surgical dismantling of the anastomosis and diversion. Conclusion The CAR™ 27 device shows promise as a safe and effective alternative for the creation of colorectal anastomoses. However, studies in a larger patient population are warranted to demonstrate equivalence of this device. PMID:21063913

  4. In vitro evaluation of physiological spiral anastomoses for the arterial switch operation in simple transposition of the great arteries: a first step towards a surgical alternative?

    PubMed

    Sievers, Hans-Hinrich; Scharfschwerdt, Michael; Putman, Léon M

    2015-08-01

    The currently most frequently used technique for the arterial switch operation (ASO) in simple transposition of the great arteries (TGA) includes the transposition of the pulmonary artery anterior to the ascending aorta. This arterial arrangement is less anatomical, and although the initial results are excellent, some long-term data are indicating a certain risk of morbidity, encouraging the search for more physiological techniques. As a first step, we studied the feasibility of anatomical spiral anastomoses of the great vessels in vitro. A TGA model was constructed to simulate the different spatial positions of the great arteries followed by ASO with physiological spiral connections of the great arteries. It was possible to perform a physiological spiral connection of the great arteries without tension or torsion when the roots of the great vessels were arranged anterior-posterior and with up to 35° rotation of the aortic root to the right around the pulmonary root. With further rotation of the aorta, patch plasties were required for pulmonary artery elongation. The maximal width of the patch was 5 mm. In this TGA model, it was possible to perform tension- and torsion-free arterial anastomoses for ASO without artificial material, when the aortic root was positioned from 0° up to 35° to the right of the pulmonary root. Evaluation of coronary transfer is the next step. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. 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. Copyright © 2013 Wiley Periodicals, Inc.

  6. Analysis of Computational Fluid Dynamics and Particle Image Velocimetry Models of Distal-End Side-to-Side and End-to-Side Anastomoses for Coronary Artery Bypass Grafting in a Pulsatile Flow.

    PubMed

    Shintani, Yoshiko; Iino, Kenji; Yamamoto, Yoshitaka; Kato, Hiroki; Takemura, Hirofumi; Kiwata, Takahiro

    2017-08-19

    Intimal hyperplasia (IH) is a major cause of graft failure. Hemodynamic factors such as stagnation and disturbed blood flow are involved in IH formation. The aim of this study is to perform a comparative analysis of distal-end side-to-side (deSTS) and end-to-side (ETS) anastomoses using computational fluid dynamics (CFD) after validating the results via particle image velocimetry (PIV).Methods and Results:We investigated the characteristics of our target flow fields using CFD under steady and pulsatile flows. CFD via PIV under steady flow in a 10-times-actual-size model was validated. The CFD analysis revealed a recirculation zone in the heel region in the deSTS and ETS anastomoses and at the distal end of the graft, and just distal to the toe of the host artery in the deSTS anastomoses. The recirculation zone sizes changed with the phase shift. We found regions of low wall shear stress and high oscillating shear index in the same areas. The PIV and CFD results were similar. It was demonstrated that the hemodynamic characteristics of CFD and PIV is the difference between the deSTS and ETS anastomoses; that is, the deSTS flow peripheral to the distal end of the graft, at the distal end and just distal to the toe of the host artery is involved in the IH formation.

  7. Non-invasive evaluation of internal thoracic artery anastomosed to the left anterior descending artery with 320-detector row computed tomography and adenosine thallium-201 myocardial perfusion scintigraphy.

    PubMed

    Takagi, Yasushi; Akita, Kiyotoshi; Kondo, Hiroshi; Ishida, Michiko; Kaneko, Kan; Sato, Masato; Ando, Motomi

    2012-01-01

    We evaluated the relationship between internal thoracic artery (ITA) stenosis anastomosed to the left anterior descending artery (LAD) and the degree of LAD stenosis using 320-detector row computed tomography (320-ADCT) and adenosine thallium-201 myocardial perfusion scintigraphy (Tl-201-MPS). We included 101 patients who underwent coronary artery bypass grafting (CABG) using ITA grafts; 320-ADCT and adenosine Tl-201-MPS were performed 2-3 months after CABG. Clinical parameters, degree of LAD stenosis, and regional myocardial ischemia of the LAD territory were compared between patients without ITA stenosis (Group A) and with ITA stenosis (Group B). Thirty patients (30%) had ≤75% LAD stenosis, and 9 patients (30%) showed significant ITA stenosis. Regional ischemia was noted in 23 patients (23%). There were no differences in clinical parameters between the 2 groups. Twenty-two patients (24%) in Group A and 8 patients (89%) in Group B had ≤75% LAD stenosis (P <0.002). No Group B patients had regional myocardial ischemia of the LAD territory. We concluded that ≤75% LAD stenosis significantly influences ITA stenosis, without associated regional myocardial ischemia of the LAD territory. Non-invasive 320-ADCT and adenosine Tl-201-MPS for ITA evaluation may be useful for long-term follow-up of patients after CABG.

  8. [Effect of exogenous factors on prececal nutrient and amino acid reabsorption, ascertained in swine with ileorectal anastomoses. 1. Effect of the degree of grinding up of grain].

    PubMed

    Wünsche, J; Herrmann, U; Meinl, M; Hennig, U; Kreienbring, F; Zwierz, P

    1987-09-01

    Pigs fitted with ileo-rectal anastomoses (IRA) and in parallel experiments intact (INT) pigs were used to estimate the influence of the different grinding fineness of barley and wheat (coarse, medium, fine) on the apparent and true precaecal and total digestibility resp. absorption of various N free and N containing nutrients, among them crude protein and the indispensable and dispensable amino acids. Coarse grinding (25 ... 50% of the particles greater than 2 mm) resulted in significantly lower digestibility values than medium and fine grinding--with more striking differences in barley than in wheat. Precaecally most nutrients and amino acids are distinctly less digestible than at the end of the total tract. The precaecal lysine absorption determined with IRA pigs is remarkably low. The results are discussed. In order to attain a good utilization of the protein contained in cereals grains should be ground in hammermills with maximal sieve meshes of 3 mm. It is proposed to tabulate crude protein and amino acids in future on the basis of a standardized true precaecal digestibility resp. absorption.

  9. Effets Josephson generalises entre antiferroaimants et entre supraconducteurs antiferromagnetiques

    NASA Astrophysics Data System (ADS)

    Chasse, Dominique

    L'effet Josephson est generalement presente comme le resultat de l'effet tunnel coherent de paires de Cooper a travers une jonction tunnel entre deux supraconducteurs, mais il est possible de l'expliquer dans un contexte plus general. Par exemple, Esposito & al. ont recemment demontre que l'effet Josephson DC peut etre decrit a l'aide du boson pseudo-Goldstone de deux systemes couples brisant chacun la symetrie abelienne U(1). Puisque cette description se generalise de facon naturelle a des brisures de symetries continues non-abeliennes, l'equivalent de l'effet Josephson devrait donc exister pour des types d'ordre a longue portee differents de la supraconductivite. Le cas de deux ferroaimants itinerants (brisure de symetrie 0(3)) couples a travers une jonction tunnel a deja ete traite dans la litterature Afin de mettre en evidence la generalite du phenomene et dans le but de faire des predictions a partir d'un modele realiste, nous etudions le cas d'une jonction tunnel entre deux antiferroaimants itinerants. En adoptant une approche Similaire a celle d'Ambegaokar & Baratoff pour une jonction Josephson, nous trouvons un courant d'aimantation alternee a travers la jonction qui est proportionnel a sG x sD ou fG et sD sont les vecteurs de Neel de part et d'autre de la jonction. La fonction sinus caracteristique du courant Josephson standard est donc remplacee.ici par un produit vectoriel. Nous montrons que, d'un point de vue microscopique, ce phenomene resulte de l'effet tunnel coherent de paires particule-trou de spin 1 et de vecteur d'onde net egal au vecteur d'onde antiferromagnetique Q. Nous trouvons egalement la dependance en temperature de l'analogue du courant critique. En presence d'un champ magnetique externe, nous obtenons l'analogue de l'effet Josephson AC et la description complete que nous en donnons s'applique aussi au cas d'une jonction tunnel entre ferroaimants (dans ce dernier cas, les traitements anterieurs de cet effet AC s'averent incomplets). Nous

  10. Livebirth and utero-placental insufficiency in Papio hamadryas baboons with uterus angiosome perfused by bilateral utero-ovarian microsurgical anastomoses alone.

    PubMed

    Beran, B; Arnolds, K; Shockley, M; Rivas, K; Medina, M; Escobar, P F; Tzakis, A; Falcone, T; Sprague, M L; Zimberg, S

    2017-09-01

    Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy. In an attempt to avoid the time-consuming dissection of the uterine vein, our group has previously shown maintenance of baboon uterine menstrual function after ligation of the uterine vein and after ligation of both the uterine artery and uterine vein. In a 19-month timespan, three baboons underwent laparotomy to surgically alter uterine perfusion, and pregnancy outcomes were monitored after spontaneous mating in a breeding colony. Three nulligravid female Papio hamadryas baboons in a breeding colony underwent laparotomy to ligate uterine arteries and veins along with colpotomy and cervico-vaginal anastomosis. During the same surgery, the utero-ovarian arteries and veins were microsurgically transected and re-anastomosed to themselves. Intraoperative organ perfusion was confirmed with laser angiography. After a recovery period, monitoring of menstrual cycling via menstrual blood flow and sex-skin cycling occurred, as well as uterine viability via sonography and cervical biopsy. Each baboon was released to the breeding colony for spontaneous mating and pregnancies dated by menstrual calendar and compared with early ultrasound. Delivery outcomes were monitored in each including neonate weight and placental pathology. In the event of a stillbirth, the animal was returned to the breeding colony for repeat mating attempts. After achieving a livebirth, the maternal baboon was removed from the study. Each baboon in the trial underwent successful surgery with all uteri demonstrating viability and return of menstrual function within 10 weeks of surgery. Pregnancies occurred

  11. Characterization of 5-HT receptors mediating constriction of porcine carotid arteriovenous anastomoses; involvement of 5-HT1B/1D and novel receptors

    PubMed Central

    De Vries, Peter; Villalón, Carlos M; Heiligers, Jan P C; Saxena, Pramod R

    1998-01-01

    It was previously shown that porcine cranial arteriovenous anastomoses (AVAs) constrict to 5-hydroxytryptamine (5-HT), ergotamine, dihydroergotamine, as well as sumatriptan and that sumatriptan acts exclusively via 5-HT1B/1D receptors. The present study was devoted to establish the contribution of 5-HT1B/1D receptors in the constriction of AVAs elicited by 5-HT (in presence of 0.5 mg kg−1 ketanserin), ergotamine and dihydroergotamine in anaesthetized pigs.Intracarotid infusion of 5-HT (2 μg kg−1 min−1) and intravenous doses of ergotamine (2.5–20 μg kg−1) and dihydroergotamine (3–100 μg kg−1) reduced AVA and increased nutrient blood flows and vascular conductances. The vasodilator response to 5-HT, observed mainly in the skin and ear, was much more prominent than that of the ergot alkaloids.Treatment with the 5-HT1B/1D receptor antagonist GR127935 (0.5 mg kg−1, i.v.) significantly attenuated both ergot-induced AVA constriction and arteriolar dilatation, whereas GR127935 only slightly affected the carotid vascular effects of 5-HT.The results suggest that 5-HT constricts carotid AVAs primarily via receptors, which seem to differ from those (5-HT1B/1D) stimulated by sumatriptan. The ergot alkaloids produce AVA constriction for a substantial part via 5-HT1B/1D receptors, but also stimulate unidentified receptors. Both these non-5-HT1B/1D receptors may be targets for the development of novel antimigraine drugs.The moderate vasodilator response to the ergot derivatives seems to be mediated, at least in part, by 5-HT1B/1D receptors, whereas the arteriolar dilatation caused by 5-HT may be mediated by other, possibly 5-HT7 receptors. PMID:9605562

  12. One-stage dual latissimus dorsi muscle flap transfer with a pair of vascular anastomoses and double nerve suturing for long-standing facial paralysis.

    PubMed

    Okazaki, Mutsumi; Mutsumi, Okazaki; Kentaro, Tanaka; Noriko, Uemura; Satoshi, Usami; Tsutomu, Homma; Alisa, Okubo; Mayuko, Hamanaga; Hiroki, Mori

    2015-06-01

    Various types of neurovascular free-muscle transfers have been reported as surgical treatments for long-standing facial paralysis. Among one-stage methods, two approaches, that is, latissimus dorsi transfer with nerve suturing to the contralateral facial nerve and gracilis transfer with nerve suturing to the ipsilateral masseteric nerve, have recently become popular. The former method has the advantage of making spontaneous smiling possible, but the contraction strength of the transferred muscle varies, whereas the latter approach has the advantage of guaranteeing voluntary contraction of the transferred muscle, but makes spontaneous smiling difficult. Recently, dual innervation methods have also been reported, but uncertainty remains about the utility of such approaches. To overcome these drawbacks, we devised a hybrid method combining the two previously established techniques. Two latissimus dorsi muscle flaps containing the thoracodorsal vessels from one side are transferred with a pair of vascular anastomoses. The true trunk of the thoracodorsal nerve, which innervates one of the muscle flaps, is sutured to the contralateral facial nerve, while the short branch of the thoracodorsal nerve, which innervates the other muscle flap, is sutured to the ipsilateral masseteric nerve. From November 2011 to October 2013, we used this method in four patients with long-standing facial paralysis. Smiling was assessed in the three patients who were followed up for more than 1 year, and satisfactory results were obtained (Harii score: 4-5). In one patient, the movement mediated via the contralateral facial nerve was a little weak, but this was compensated for by the muscles controlled by the ipsilateral masseteric nerve. Our novel one-stage method, which involves a combination of two previously established methods, guarantees early voluntary smiling, and spontaneous smiling becomes possible later. In addition, it is free from the uncertainty associated with double innervation

  13. Effects of a 6-phytase on the apparent ileal digestibility of minerals and amino acids in ileorectal anastomosed pigs fed on a corn-soybean meal-barley diet.

    PubMed

    Guggenbuhl, P; Waché, Y; Simoes Nunes, C; Fru, F

    2012-12-01

    Phosphorus of plant-based feedstuffs for monogastric animals is mainly in the form of phytic P, which has a very low bioavailability. The nondigested phytic P may contribute to P pollution. Furthermore, phytic acid may reduce digestibility of other minerals and protein. This study evaluated effects of the microbial 6-phytase RONOZYME HiPhos on apparent ileal digestibility of P, phytic acid, Ca, CP, energy, and AA in six 60-d-old ileorectal anastomosed pigs. In a duplicated 3 × 3 Latin square design, pigs had free access to alternatively a corn (Zea mays)-soybean (Glycine max) meal-barley (Hordeum vulgare)-based diet or this diet supplemented with RONOZYME HiPhos at either 500 units/kg (RH500) or 1000 units/kg (RH1000). Pigs fed diets supplemented with RH500 or RH1000 increased (P < 0.05) digestibility of P, Ca, and Lys. Pigs fed diet RH1000 increased (P < 0.05) digestibility of CP, total AA, indispensable AA, Glu + Gln, His, Gly, Ala, Tyr, Leu, Phe, and Met. Similar to growth trials with increased total tract digestibility of P and Ca, phytase increased apparent ileal digestibility of these indispensable minerals and phytate. The phytase increased digestibility of CP and indispensable AA indicating a better availability of plant-based proteins.

  14. A global phylogeny of the fern genus Tectaria (Tectariaceae: Polypodiales) based on plastid and nuclear markers identifies major evolutionary lineages and suggests repeated evolution of free venation from anastomosing venation.

    PubMed

    Zhang, Liang; Zhou, Xin-Mao; Chen, De-Kui; Schuettpelz, Eric; Knapp, Ralf; Lu, Ngan Thi; Luong, Thien Tam; Dang, Minh Tri; Duan, Yi-Fan; He, Hai; Gao, Xin-Fen; Zhang, Li-Bing

    2017-09-01

    Tectaria (Tectariaceae) is one of the most confusing fern genera in terms of its circumscription and phylogeny. Since its original description, a number of genera had been moved into or related with this genus, while others had been segregated from it. Tectaria is also among the largest fern genera, comprising 150-210 mostly tropical species. Previous molecular studies have been far from comprehensive (sampling no more than 76 accessions from 52 species), limited in geographic scope (mainly restricted to Asia), and based exclusively on plastid markers. In the present study, DNA sequences of eight plastid and one nuclear marker of 360 accessions representing ca. 130 species of Tectaria, ca. 36 species of six non-Tectaria genera in Tectariaceae, 12 species of Davalliaceae, Oleandraceae, and Polypodiaceae, and 13 species of Lomariopsidaceae were used to infer a phylogeny with maximum likelihood, Bayesian inference, and maximum parsimony approaches. Our major results include: (1) the most recently proposed circumscription of Tectaria is strongly supported as monophyletic; (2) the genera Lenda, Microbrochis, Phlebiogonium, and Sagenia, sampled here for the first time, are resolved as part of Tectaria; (3) four superclades representing early splits in Tectaria are identified, with the Old World species being sister to the New World species; (4) 12 well-supported major clades in Tectaria are revealed, differing from one another in molecular, morphological, and geographical features; (5) evolution of 13 morphological characters is inferred in a phylogenetic context and morphological synapomorphies of various clades are identified; and in particular (6) free venation in Tectaria is inferred to be repeatedly derived from anastomosing venation, an evolutionary phenomenon not documented previously in vascular plants in a phylogenetic context based on both plastid and nuclear evidence. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Work function analysis of vegetarian entrée production.

    PubMed

    Maloney, S; Zolber, K; Burke, K; Connell, B; Shavlik, G

    1986-02-01

    Data on labor time for food production can be used as an effective management tool. It is essential for foodservice managers to know how labor time is being used (1). A continuous time study was conducted to determine total labor time for the production of eight vegetarian entrées in a hospital foodservice system. Two work areas were observed: the ingredient assembly area and the cooks' production area. Times were recorded by work function to identify how labor time was distributed. Results showed (a) observed frequency for each work function, (b) time expended in seconds per portion for each work function, (c) percentage distribution of labor time by work function, (d) total time for each employee involved in entrée production, and (e) percentage of total time in which each employee was involved in the production of each entrée. Total labor time varied by type of entrée, ranging from 39.97 to 19.33 seconds per portion. Entrées with the highest labor time required the largest amount of hand labor. A one-way analysis of variance indicated significant differences in mean labor time among the eight vegetarian entrées for direct labor time (p = .0009), and total labor time (p = .0018). No significant differences were found among entrées for indirect labor or delay time.

  16. 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)

  17. 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)

  18. The Fast-Casual Conundrum: Fast-Casual Restaurant Entrées Are Higher in Calories than Fast Food.

    PubMed

    Schoffman, Danielle E; Davidson, Charis R; Hales, Sarah B; Crimarco, Anthony E; Dahl, Alicia A; Turner-McGrievy, Gabrielle M

    2016-10-01

    Frequently eating fast food has been associated with consuming a diet high in calories, and there is a public perception that fast-casual restaurants (eg, Chipotle) are healthier than traditional fast food (eg, McDonald's). However, research has not examined whether fast-food entrées and fast-casual entrées differ in calorie content. The purpose of this study was to determine whether the caloric content of entrées at fast-food restaurants differed from that found at fast-casual restaurants. This study was a cross-sectional analysis of secondary data. Calorie information from 2014 for lunch and dinner entrées for fast-food and fast-casual restaurants was downloaded from the MenuStat database. Mean calories per entrée between fast-food restaurants and fast-casual restaurants and the proportion of restaurant entrées that fell into different calorie ranges were assessed. A t test was conducted to test the hypothesis that there was no difference between the average calories per entrée at fast-food and fast-casual restaurants. To examine the difference in distribution of entrées in different calorie ranges between fast-food and fast-casual restaurants, χ(2) tests were used. There were 34 fast-food and 28 fast-casual restaurants included in the analysis (n=3,193 entrées). Fast-casual entrées had significantly more calories per entrée (760±301 kcal) than fast-food entrées (561±268; P<0.0001). A greater proportion of fast-casual entrées compared with fast-food entrées exceeded the median of 640 kcal per entrée (P<0.0001). Although fast-casual entrées contained more calories than fast-food entrées in the study sample, future studies should compare actual purchasing patterns from these restaurants to determine whether the energy content or nutrient density of full meals (ie, entrées with sides and drinks) differs between fast-casual restaurants and fast-food restaurants. Calorie-conscious consumers should consider the calorie content of entrée items

  19. 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

  20. Modelo empirico integral de una plantacion de Eucalyptus grandis en Concordia, Entre Rios

    Treesearch

    Jorge Frangi; Carolina Perez; Juan Goya; Natalia Teson; Marcelo Barrera; Marcelo Arturi

    2016-01-01

    The Argentinian Mesopotamia is the core of fast-growing tree species plantations of the country. Eucalyptus grandis plantations constitute 90 % of the forested area with Eucalyptus spp. in NE Entre Rios. Based on previous studies on structural and functional features, a comprehensive model is here proposed on emergence of new properties linked to matter and ecosystem...

  1. 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…

  2. 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…

  3. Kindergarteners' entrée intake increases when served a larger entrée portion in school lunch: a quasi-experiment.

    PubMed

    Ramsay, Samantha; Safaii, Seanne; Croschere, Tom; Branen, Laurel J; Wiest, Michelle

    2013-04-01

    The influence of portion size on children's intake and self-regulation of food has gained attention; however, few studies have examined portion sizes in school lunch. This study investigated kindergarteners' intake when they were given different entrée portion sizes from the lunch menu. Plate waste was used as a proxy to measure intake. A standardized lunch of chicken nuggets, rice, green beans, applesauce, and milk was served every Tuesday for 5 consecutive weeks at a Kinder Center. All menu items and the self-selection of 2, 3, or 4 nuggets were served the first week as a pilot. In the second and fourth weeks, trained servers preportioned kindergarteners' plates with 4 nuggets. In the third and fifth weeks, kindergarteners verbally self-selected 2, 3, or 4 chicken nuggets. A Mann-Whitney test was used to determine a significant difference in intake between the 2 days kindergarteners were allowed to select the portion size and the 2 days they were preportioned. A significant difference (p < .009) in intake was found between the self-selection of entrée portion size and the preportioned entrée regardless of sex or whether kindergarteners attended the am or pm session. No significant difference was found in milk, fruit, vegetable, or rice intake between choice and nonchoice lunches. In this study, kindergarteners ate more chicken nuggets when they were offered a larger portion size. Further investigation is needed on the impact of letting kindergarteners self-select portion sizes, and the potential negative outcomes of larger portion sizes on children's caloric consumption in elementary schools. © 2013, American School Health Association.

  4. 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

  5. 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.

  6. ACTITUDES HACIA LA COMUNICACIÓN SEXUAL ENTRE PADRES/MADRES Y ADOLESCENTES EN PUERTO RICO*

    PubMed Central

    Fernández, Ana Michelle; McFarlane, Melvin Negrón; González, Ricardo; Díaz, Leslie; Betancourt-Díaz, Elba; Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Villarruel, Antonia

    2017-01-01

    RESUMEN La comunicación sobre sexualidad entre padres/madres y adolescentes enfrenta dificultades particulares producto de factores socioculturales. Este estudio tuvo como objetivo documentar las actitudes de padres/madres y adolescentes hacia la comunicación sobre temas de sexualidad. Los resultados emanan de la medición inicial del Proyecto Cuídalos. Los datos de este estudio forman parte de un estudio amplio que evaluó un módulo interactivo basado en la web para mejorar comunicación sobre temas de salud entre padres/madres y adolescentes entre 13–17 años. En este artículo, reportamos datos basales que contestaron los/as participantes sobre comodidad al hablar sobre temas de salud sexual. La muestra, de los datos aquí expuestos, estuvo compuesta por 458 diadas de madres/padres y sus hijos/as adolescentes (n=916). Se realizó análisis de frecuencias y medidas de tendencia central con los datos obtenidos inicialmente. La edad promedio de los adolescentes fue de 15 años, de los que un 15% se encontraban activos sexualmente. Los/as adolescentes tienen mejor disposición que los/as padres/madres para hablar sobre sexualidad. Sin embargo, los/as padres/madres entienden que comparten suficiente información sobre temas relacionados a la sexualidad. Los/as padres/madres y adolescentes reportaron algún grado de dificultad e incomodidad al hablar sobre métodos específicos de prevención. Los resultados destacan la necesidad de incorporar a los/as padres/madres en intervenciones con adolescentes sobre temas de salud sexual. En Puerto Rico es necesario desarrollar programas dirigidos a minimizar las conductas sexuales de alto riesgo en jóvenes. PMID:28736599

  7. Transfert radiatif entre une petite particule et un diélectrique: application au chauffage local

    NASA Astrophysics Data System (ADS)

    Mulet, J.-P.; Joulain, K.; Carminati, R.; Greffet, J. J.

    2002-06-01

    nous montrons dans cette étude que le transfert radiatif entre une particule de taille nanométrique et un diélectrique petit être très important lorsque les distances mises en jeu sont petites devant la longueur d'onde caractéristique du rayonnement thermique. Ce transfert peut devenir dominant lorsque les matériaux utilisés sont polaires. Nous discuterons de la possibilité d'appliquer ces résultats au chauffage local dans les nano-structures.

  8. [Presence of botulinum-producing clostridia in the soils of Entre Ríos].

    PubMed

    Lúquez, C; Fernández, R A; Bianco, M I; de Jong, L I T; Saldaño, V; Ciccarelli, A S

    2003-01-01

    Botulism, well known for centuries, continues to preoccupy the Public Health authorities, food and agricultural industries. In its oldest form it results from ingestion of food containing botulinum toxin. To correctly evaluate the incidence of botulism it is fundamental to know the distribution of botulinum toxin-producing clostridia (Clostridium botulinum, C. baratii, C. butyricum and C. argentinense) in nature, specially in the soil, its main reservoir. In our country, this study has been carried out in a partial way. With the aim to contribute to such knowledge, 240 soil samples from Entre Ríos province were examined for C. botulinum and 35 (14.6%) samples resulted positive.

  9. 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

  10. Miroirs pour l'UV lointain (VUV) entre 80 et 130 nm

    NASA Astrophysics Data System (ADS)

    Bridou, F.; Cuniot-Ponsard, M.; Desvignes, J.-M.

    2006-12-01

    Dans le domaine spectral entre 80 et 130 nm situé dans le VUV (“Vacuum Ultra-Violet”), les matériaux ne sont ni transparents, ni vraiment réfléchissants. Il est difficile de réaliser des systèmes optiques et, en conséquence, de déterminer les constantes optiques des matériaux. Les écarts entre la réflectivité calculée à partir des indices référencés dans les tables et la réflectivité expérimentale nous ont conduits à penser que certains de ces indices n'étaient pas exacts. Nous avons développé une méthode expérimentale de détermination des constantes optiques à partir des mesures de réflectivité au voisinage de l'incidence normale, en fonction de la longueur d'onde. A partir des valeurs ainsi déterminées, des composants tels que miroirs ou polariseurs peuvent être conçus et réalisés.

  11. [Phlebotominae: vectors of leishmaniasis in the provinces of Santa Fe and Entre Ríos, Argentina].

    PubMed

    Salomón, Oscar D; Mocarbel, Nicolás J; Pedroni, Elena; Colombo, Javier; Sandillú, Mónica

    2006-01-01

    The transmission of tegumentary leishmaniasis (TL) has increased in 9 provinces of Argentina since 1985. Santa Fe and Entre Ríos did not record in this period autochtonous probed cases: however, an epidemic outbreak took place in 2003 in Bella Vista, Corrientes, located in an area with ecological continuity and contiguous to both provinces. In order to evaluate the potential risk of transmission of LT, Phlebotominae were captured at locations close to and southern from Bella Vista during February 2004. The traps located on the shores of Parana river in Santa Fe (El Rabón, Villa Ocampo, Cayastá), and Entre Ríos (La Paz. La Celina-Villa Urquiza) captured 860 individuals of Lutzomyia neivai (99.5%) and Lu. migonei (0.5 %), both species with vectorial capacity for Leishmania (V.) braziliensis. In Tartagal, Santa Fe, the captures were consistent with the residual "chaco" landscape, 7 individuals of Lu. nerivai, Lu. migonei and Lu. cortelezzii. The risk of LT epidemic transmission in these provinces is highlighted, mainly due to the progressive southern tropicalization of the paranaense gallery forest. Clinical and entomological surveillance is recommended.

  12. 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

  13. No Financial Disincentive for Choosing More Healthful Entrées on Children’s Menus in Full-Service Restaurants

    PubMed Central

    West, Delia

    2013-01-01

    Children are eating restaurant foods more than ever before, and price is among the top considerations for food choices. We categorized and enumerated entrées on children’s menus from 75 full-service restaurant chains to compare prices of more healthful and less healthful entrées to test the assumption that more healthful food is more expensive. The mean (standard deviation) price of more healthful entrées ($5.38 [$2.01]) was not significantly different from the price of less healthful entrées ($5.27 [$2.04]). In contrast to research demonstrating that more healthful foods tend to be more expensive in grocery stores, more healthful entrées on children’s menus in restaurants were not more expensive than less healthful entrées. PMID:23742942

  14. 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

  15. [Sud Entre Sambre et Meuse intersectoral platform: a local health promotion application in Belgium].

    PubMed

    Bantuelle, Martine; Mouyart, Philippe

    2016-12-19

    The various constituents of the “Sud Entre Sambre et Meuse intersectoral platform” have now been clearly defined. The health promotion legislation and the establishment of decentralized support are the cornerstones of this programme. The choice of a global conceptual model, integrating the health promotion approach into its territorial and intersectoral dimensions, as well as a detailed knowledge of the territory of action constitute the framework of this programme.This structure has allowed the development of health promotion strategies: modification of professionals’ and politicians’ behaviour, emergence of new services for the population, increasing implication of politicians, professionals, inhabitants, and implementation of actions designed to improve the environment (mobility, housing).In line with the definition of health promotion, this local dynamic is a permanently evolving process according to fluctuations of partnerships, modifications of the local context and the effects of the actions undertaken. However, its objective always remains improvement of the quality of life of all citizens and the development of their capacity to be actors in this improvement..

  16. 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.

  17. Analyse des interactions energetiques entre un arena et son systeme de refrigeration

    NASA Astrophysics Data System (ADS)

    Seghouani, Lotfi

    La presente these s'inscrit dans le cadre d'un projet strategique sur les arenas finance par le CRSNG (Conseil de Recherche en Sciences Naturelles et en Genie du Canada) qui a pour but principal le developpement d'un outil numerique capable d'estimer et d'optimiser la consommation d'energie dans les arenas et curlings. Notre travail s'inscrit comme une suite a un travail deja realise par DAOUD et coll. (2006, 2007) qui a developpe un modele 3D (AIM) en regime transitoire de l'arena Camilien Houde a Montreal et qui calcule les flux de chaleur a travers l'enveloppe du batiment ainsi que les distributions de temperatures et d'humidite durant une annee meteorologique typique. En particulier, il calcule les flux de chaleur a travers la couche de glace dus a la convection, la radiation et la condensation. Dans un premier temps nous avons developpe un modele de la structure sous la glace (BIM) qui tient compte de sa geometrie 3D, des differentes couches, de l'effet transitoire, des gains de chaleur du sol en dessous et autour de l'arena etudie ainsi que de la temperature d'entree de la saumure dans la dalle de beton. Par la suite le BIM a ete couple le AIM. Dans la deuxieme etape, nous avons developpe un modele du systeme de refrigeration (REFSYS) en regime quasi-permanent pour l'arena etudie sur la base d'une combinaison de relations thermodynamiques, de correlations de transfert de chaleur et de relations elaborees a partir de donnees disponibles dans le catalogue du manufacturier. Enfin le couplage final entre l'AIM +BIM et le REFSYS a ete effectue sous l'interface du logiciel TRNSYS. Plusieurs etudes parametriques on ete entreprises pour evaluer les effets du climat, de la temperature de la saumure, de l'epaisseur de la glace, etc. sur la consommation energetique de l'arena. Aussi, quelques strategies pour diminuer cette consommation ont ete etudiees. Le considerable potentiel de recuperation de chaleur au niveau des condenseurs qui peut reduire l'energie requise par

  18. [Value of percutaneous catheter cholangiography in postoperative biliodigestive and bilio-biliary anastomoses].

    PubMed

    Barkhausen, J; Bidlingmaier, J; Müller, R D; Langer, R

    1996-09-01

    To examine the relative importance of percutaneous catheter cholangiography in postoperative diagnostics after biliary reconstruction. 55 patients (33 males, 22 females) were subjected to 101 catheter cholangiographies. 30-50 ml of a water-soluble, iodic contrast medium were administered via an infusion system. Initial examinations were performed between the 3rd and 7th day following operation, while follow-up examinations were executed between the 8th and 145th day after surgery. The position of the catheter, the function of the anastomosis, the filling of the biliary ducts and the discharge of the contrast medium were assessed. 45 examinations were inconspicuous. Drainage obstruction of the contrast medium was observed in 24 cases. Filling defects were observed in 8 examinations. A dislocation of the catheter was encountered in 5 cholangiographies while 19 examinations displayed a bile leak. Percutaneous catheter cholangiographies can be used to detect postoperative complications following biliary reconstruction in an easy, reliable, and cost-effective manner that also does not put too much strain on the patient. Indications for the implementation of catheter cholangiographies are the occurrence of abdominal complaints, the clinical appearance of a peritonitis, or an increase of the serum bilirubin value. Routine examinations are recommended in conditions following liver transplantations. In addition to this, a cholangiography should be carried out prior to the removal of the catheter.

  19. Multiple tracheal resections and anastomoses in a blue and gold macaw (Ara ararauna).

    PubMed

    Jankowski, Gwen; Nevarez, Javier G; Beaufrere, Hugues; Baumgartner, Wes; Reed, Scott; Tully, Thomas N; Hedlund, Cheryl; Hennig, Geoff; Huck, Jennifer

    2010-12-01

    A 1.5-year-old, male blue and gold macaw (Ara ararauna) was anesthetized for a health examination and blood collection. The following day it was returned for episodes of coughing. The bird was presented again 13 days after the initial presentation with severe dyspnea. A tracheal stenosis was diagnosed by endoscopy and treated by surgical resection of 5 tracheal rings and tracheal anastomosis. The bird was discharged but returned 2 days later with a recurrent stenosis. Bougienage and balloon dilation of the stenotic area were performed separately; each resulted in less than 48 hours' improvement in clinical signs after treatment. A second tracheal resection and anastomosis was performed, during which an additional 10 tracheal rings were removed. This second anastomosis was significantly more difficult to complete given the marked variation in diameter of the proximal and distal tracheal segments. The macaw recovered without complication and has had no recurrence of respiratory abnormalities 2 years after the second surgery. This report describes the longest total tracheal segment to be resected, followed by tracheal anastomosis, in a psittacine bird. The positive outcome in this case suggests that, when surgical therapy is elected, an aggressive approach is necessary to prevent recurrence of tracheal stenosis. In addition, macaws can recover well even after significant lengths of the trachea are resected.

  20. Intraoperative crystalloid overload leads to substantial inflammatory infiltration of intestinal anastomoses-a histomorphological analysis.

    PubMed

    Kulemann, Birte; Timme, Sylvia; Seifert, Gabriel; Holzner, Philipp A; Glatz, Torben; Sick, Olivia; Chikhladze, Sophia; Bronsert, Peter; Hoeppner, Jens; Werner, Martin; Hopt, Ulrich T; Marjanovic, Goran

    2013-09-01

    It has been shown that crystalloid fluid-overload promotes anastomotic instability. As physiologic anastomotic healing requires the sequential infiltration of different cells, we hypothesized this to be altered by liberal fluid regimes and performed a histomorphological analysis. 36 Wistar rats were randomized into 4 groups (n=8-10 rats/group) and treated with either liberal (+) or restrictive (-) perioperative crystalline (Jonosteril = Cry) or colloidal fluid (Voluven = Col). Anastomotic samples were obtained on postoperative day 4, routinely stained and histophathologically reviewed. Anastomotic healing was assessed using a semiquantitative score, assessing inflammatory cells, anastomotic repair and collagenase activity. Overall, the crystalloid overload group (Cry (+)) showed the worst healing score (P < 0.01). A substantial increase of lymphocytes and macrophages was found in this group compared to the other three (P < 0.01). Both groups that received colloidal fluid (Col (+) and Col (-)) as well as the group that received restricted crystalloid fluid resuscitation (Cry (-)) had better intestinal healing. Collagenase activity was significantly higher in the Cry (+) group. Intraoperative infusion of high-volume crystalloid fluid leads to a pathological anastomotic inflammatory response with a marked infiltration of leukocytes and macrophages resulting in accelerated collagenolysis. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Nettleship collaterals: circumpapillary cilioretinal anastomoses after occlusion of the central retinal artery.

    PubMed

    Ragge, N K; Hoyt, W F

    1992-03-01

    In extremely rare cases, after occlusion of the central retinal artery, a complete ring of peripapillary anastomotic channels develops. One such case is described and a proposed term given to these channels--'Nettleship collaterals'--after the man who first described them. These collaterals are dilated pathways within the terminal capillary networks of the posterior ciliary arteries and the branches of the central retinal artery. Formation of the channels is believed to be promoted by prelaminar obstruction of the central retinal artery.

  2. Defunctioning loop ileostomy for pelvic anastomoses: predictors of morbidity and nonclosure.

    PubMed

    Chun, Linda J; Haigh, Philip I; Tam, Michael S; Abbas, Maher A

    2012-02-01

    The aim of this study was to determine the morbidity of a defunctioning loop ileostomy and the subsequent closure rate, and to identify the predictors of complications and nonclosure of stoma. This study is a retrospective review of a single-institution experience. All patients who underwent a planned temporary defunctioning loop ileostomy performed synchronously with a pelvic anastomosis during a 6-year period were included. The primary outcome measures were the ileostomy complication rate for the entire spectrum of care, readmission and reoperation rates to treat ileostomy complications, and subsequent closure rate. Patient and treatment factors were evaluated for their independent effect on complications and closure rate with the use of multivariable logistic regression. One hundred twenty-three patients were identified (median age, 51 years). Of these patients, 64.2% developed ≥1 minor or major ileostomy complications (13.8% during index hospitalization, 52.8% as outpatient, and 23.4% after closure). Readmitted for dehydration following ileostomy formation were 11.4% of patients. The ileostomy was closed in 76.4% of patients with 8.6% requiring a midline laparotomy. The overall ileostomy-related reoperation rate was 10.4% (2.4% during index hospitalization, 1.6% at readmission, and 6.4% following ileostomy closure). Obesity (BMI ≥30 kg/m) was associated with a higher overall ileostomy complication rate (OR 8.56, 95% CI 1.64-44.74) and outpatient complication rate (OR 7.69, 95% CI 2.48-23.81). Age >65 years (OR 53.34, 95% CI 4.21-676.14) and hypertension (OR 8.36, 95% CI 1.09-64.43) increased the risks of high ileostomy output and dehydration. Obesity (OR 4.61, 95% CI 1.14-18.54) and smoking (4.47, 95% CI 1.43-13.98) decreased the likelihood of ileostomy closure. This study was limited by its retrospective nature. The morbidity of a defunctioning loop ileostomy remains significant. Obesity is an independent predictor of ileostomy complications. Older age and hypertension increase the risks of high-output stoma and dehydration. Almost one quarter of patients never have the ileostomy closed. Obesity and smoking are associated with less likelihood of a subsequent ileostomy closure.

  3. Dynamic behavior of suture-anastomosed arteries and implications to vascular surgery operations.

    PubMed

    Roussis, Panayiotis C; Giannakopoulos, Antonios E; Charalambous, Haralambia P; Demetriou, Demetra C; Georghiou, Georgios P

    2015-01-06

    Routine vascular surgery operations involve stitching of disconnected human arteries with themselves or with artificial grafts (arterial anastomosis). This study aims to extend current knowledge and provide better-substantiated understanding of the mechanics of end-to-end anastomosis through the development of an analytical model governing the dynamic behavior of the anastomotic region of two initially separated arteries. The formulation accounts for the arterial axial-circumferential deformation coupling and suture-artery interaction. The proposed model captures the effects of the most important parameters, including the geometric and mechanical properties of artery and sutures, number of sutures, loading characteristics, longitudinal residual stresses, and suture pre-tensioning. Closed-form expressions are derived for the system response in terms of arterial radial displacement, anastomotic gap, suture tensile force, and embedding stress due to suture-artery contact interaction. Explicit objective functionalities are established to prevent failure at the anastomotic interface. The mathematical formulation reveals useful interrelations among the problem parameters, thus making the proposed model a valuable tool for the optimal selection of materials and improved functionality of the sutures. By virtue of their generality and directness of application, the findings of this study can ultimately form the basis for the development of vascular anastomosis guidelines pertaining to the prevention of post-surgery implications.

  4. Early and late outcome of skeletonised bilateral internal mammary arteries anastomosed to the left coronary system

    PubMed Central

    Bonacchi, M; Battaglia, F; Prifti, E; Leacche, M; Nathan, N S; Sani, G; Popoff, G

    2005-01-01

    Objectives: To investigate in a retrospective study the technical aspects of using the in situ bilateral internal mammary arteries (IMAs), with the right IMA (RIMA) used for revascularisation of the circumflex system, and to evaluate early and late outcome. Materials and methods: Between January 1997 and July 2003, 552 consecutive patients underwent grafting of the circumflex artery system with an in situ skeletonised RIMA routed through the transverse sinus (eventually retrocaval). Mean (SD) age was 63.8 (11) years. 331 (60%) patients underwent total arterial myocardial revascularisation. Mean follow up was 26 (9) months. Results: The success rate of skeletonised RIMA grafting to the circumflex branch was 100%. There were 19 (3.4%) in-hospital deaths. Perioperative myocardial infarction occurred in 12 (2.2%) patients. In 155 patients undergoing postoperative angiography, two had an occluded RIMA and a string-like phenomenon was seen in three RIMA and one left IMA (LIMA). Three RIMA and three LIMA had stenotic lesions. The patency rates of RIMA and LIMA were 94% and 97.4%, respectively. Strong predictors of non-functional IMA grafts were a recipient coronary artery diameter of < 1.5 mm (p  =  0.022), < 60% stenosis of the recipient coronary artery (p  =  0.015), diffuse stenotic lesions of the recipient coronary artery (p  =  0.018), and a small IMA calibre (p  =  0.0001). Cumulative actuarial survival at three years was 96.4% and event-free cumulative survival was 93.8%. Conclusions: Use of the bilateral IMAs offers the possibility of constructing various configurations, making total arterial myocardial revascularisation possible with a minimum number of arterial conduits. Use of the skeletonised RIMA through the transverse sinus and eventually retrocavally can reach most branches of the circumflex system and is associated with an excellent patency rate. Patients who received bilateral IMA grafts for left coronary system revascularisation had improved early and late outcomes and decreased risk of death, reoperation, and angioplasty. PMID:15657231

  5. Arterio-Venous Anastomoses and Thermoregulation (Arterio-Veneuze Anastomosen en Thermoregulatie)

    DTIC Science & Technology

    1991-08-22

    1962) found CIVD in a study on various parts of the human body in the skin of the head, the neck, the olecranon and the patella, the outside of the...reported by Grant and Bland (1931). However, there is no mention of AVA in the skin of the buttocks, olecranon and patella. It seems interesting to

  6. Nettleship collaterals: circumpapillary cilioretinal anastomoses after occlusion of the central retinal artery.

    PubMed Central

    Ragge, N K; Hoyt, W F

    1992-01-01

    In extremely rare cases, after occlusion of the central retinal artery, a complete ring of peripapillary anastomotic channels develops. One such case is described and a proposed term given to these channels--'Nettleship collaterals'--after the man who first described them. These collaterals are dilated pathways within the terminal capillary networks of the posterior ciliary arteries and the branches of the central retinal artery. Formation of the channels is believed to be promoted by prelaminar obstruction of the central retinal artery. Images PMID:1540571

  7. Numerical Assessment of Novel Helical/Spiral Grafts with Improved Hemodynamics for Distal Graft Anastomoses

    PubMed Central

    Kabinejadian, Foad; McElroy, Michael; Ruiz-Soler, Andres; Leo, Hwa Liang; Slevin, Mark A.; Badimon, Lina

    2016-01-01

    In the present work, numerical simulations were conducted for a typical end-to-side distal graft anastomosis to assess the effects of inducing secondary flow, which is believed to remove unfavourable flow environment. Simulations were carried out for four models, generated based on two main features of 'out-of-plane helicity' and 'spiral ridge' in the grafts as well as their combination. Following a qualitative comparison against in vitro data, various mean flow and hemodynamic parameters were compared and the results showed that helicity is significantly more effective in inducing swirling flow in comparison to a spiral ridge, while their combination could be even more effective. In addition, the induced swirling flow was generally found to be increasing the wall shear stress and reducing the flow stagnation and particle residence time within the anastomotic region and the host artery, which may be beneficial to the graft longevity and patency rates. Finally, a parametric study on the spiral ridge geometrical features was conducted, which showed that the ridge height and the number of spiral ridges have significant effects on inducing swirling flow, and revealed the potential of improving the efficiency of such designs. PMID:27861485

  8. Effect of ulcerative colitis in the bursting strength of colonic anastomoses in rats.

    PubMed

    Remes-Troche, Jose Maria; Takahashi, Takeshi; Velasco, Liliana; Garcia-Osogobio, Sandra; Uscanga, Luis; Gamboa-Domínguez, Armando; Santillan-Doherty, Patricio

    2003-01-01

    Inflammatory bowel disease may have a deleterious effect on bowel healing, but its role is difficult to demonstrate in clinical practice because of the association of multiple factors. An experiment was conducted in rats. They were divided into two groups: group I, a model of acetic acid induced colitis, and group II, the control group. Both groups underwent a rectal resection and primary anastomosis. On postoperative day 7, the bursting strength of the anastomosis was evaluated. There were 44 rats in group I and 38 in group II. In 91% of group I rats there were histopathological changes compatible with inflammatory bowel disease (IBD). Mean bursting pressure was significantly reduced in rats with acetic-acid induced IBD (142.18 +/- 18.22 mm Hg in group I, and 208.85 +/- 14.8 mm Hg in group II; p < .05). These results suggest the deleterious effect of IBD on bowel healing.

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

    NASA Astrophysics Data System (ADS)

    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.

  10. [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.

  11. Single-Layer versus Double-Layer Laparoscopic Intracorporeally Sutured Gastrointestinal Anastomoses in the Canine Model

    PubMed Central

    Tavakoli, Azine; Khalaj, Ali Reza; Gharagozlou, Mohammad Javad; Veshkini, Abbas

    2010-01-01

    Objective: The objective of this study was to compare the gross and histopathologic changes following 1- versus 2-layer hand-sewn suture techniques in laparoscopic gastrointestinal anastomosis in dogs. Methods: This was an experimental prospective study of 16 healthy mixed breed male and female dogs. Animals were randomly divided into 2 groups. Two-layer side-to-side hand-sewn laparoscopic gastrojejunostomies were performed in group A, so that simple interrupted sutures were placed in the outer layer and simple continuous suture was used in the inner layer. The 1-layer simple continuous anastomosis between the stomach and jejunum was done in group B precisely. Specimen were collected from the sites of anastomosis, and H&E statining was performed for light microscopic studies. Results: All animals survived the surgery. There was no gross inflammation, ischemia, apparent granulation tissue, abscess or fistula formation, leakage or stricture formation, and all sites of anastomosis were patent. Several adhesion formations were found in the abdomen with the higher incidence in the control group. Mean scores of leukocyte infiltration and granulation tissue formation at the sites of anastomosis were statistically insignificant between groups (P>0.05). Conclusions: Gross and histopathologic findings revealed that hand-sewn laparoscopic gastrointestinal anastomosis with the 1-layer suture technique is comparable to the 2-layer suture technique. PMID:21605513

  12. [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.

  13. Blood and Urinary Changes in Patients with Ileostomies and Ileorectal Anastomoses

    PubMed Central

    Singer, A. M.; Bennett, R. C.; Carter, N. G.; Hughes, E. S. R.

    1973-01-01

    Biochemical investigations done on the blood and urine of currently healthy, uncomplicated patients previously treated by either proctocolectomy and ileostomy or colectomy and ileorectal anastomosis for ulcerative colitis were compared with estimations on matched controls. The most striking finding was the reduced urine volume, and to a lesser extent its sodium content, in patients with ileostomies. The urinary pH indicated persistent acidity in postoperative patients but this was also a remarkably constant feature in control subjects. These findings are in agreement with other studies related to the occurrence of urinary calculi after colectomy and ileostomy, and are consistent with the contention that there is a lower incidence of calculi after ileorectal anastomosis. PMID:4720764

  14. Solution blow spun polymer: A novel preclinical surgical sealant for bowel anastomoses.

    PubMed

    Kern, Nora G; Behrens, Adam M; Srinivasan, Priya; Rossi, Christopher T; Daristotle, John L; Kofinas, Peter; Sandler, Anthony D

    2017-08-01

    Solution blow spinning is a technique for depositing polymer fibers with promising potential use as a surgical sealant. This study assessed the feasibility and efficacy of solution blow spun polymer (BSP) for sealing bowel perforations in a mouse model of partial cecal transection. We then evaluated its use for reinforcing a surgical anastomosis in a preclinical piglet model. Three commercially available surgical sealants (fibrin glue, polyethylene glycol (PEG) hydrogel, and cyanoacrylate) were compared to BSP in the ability to seal partially transected cecum in mice. For anastomosis feasibility testing in a piglet model, piglets were subjected to small bowel transection with sutured anastomosis reinforced with BSP application. Outcome measures included anastomotic burst pressure, anastomotic leak rate, 14-day survival, and complication rate. For the mouse model, the survival rates for the sealants were 30% for fibrin glue, 20% for PEG hydrogel, 78% for cyanoacrylate, and 67% for BSP. Three of 9 mice died after BSP administration because of perforation leak, failure to thrive with partial obstruction at the perforation site, and unknown causes. All other mice died of perforation leak. The mean burst pressure at 24h was significantly higher for BSP (81mm Hg) when compared to fibrin glue (6mm Hg, p=0.047) or PEG hydrogel (10mm Hg, p=0.047), and comparable to cyanoacrylate (64mm Hg, p=0.91). For piglets, 4 of 4 animals survived at 14days. Mean burst pressures at time of surgery were 37±5mm Hg for BSP and 11±9mm Hg for suture-only controls (p=0.09). Solution blow spinning may be an effective technique as an adjunct for sealing of gastrointestinal anastomosis. Further preclinical testing is warranted to better understand BSP properties and alternative surgical applications. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. 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.

  16. Non-Newtonian effects of blood flow on hemodynamics in distal vascular graft anastomoses.

    PubMed

    Chen, Jie; Lu, Xi-Yun; Wang, Wen

    2006-01-01

    Non-Newtonian fluid flow in a stenosed coronary bypass is investigated numerically using the Carreau-Yasuda model for the shear thinning behavior of the blood. End-to-side coronary bypass anastomosis is considered in a simplified model geometry where the host coronary artery has a 75% severity stenosis. Different locations of the bypass graft to the stenosis and different flow rates in the graft and in the host artery are studied. Particular attention is given to the non-Newtonian effect of the blood on the primary and secondary flow patterns in the host coronary artery and the wall shear stress (WSS) distribution there. Interaction between the jet flow from the stenosed artery and the flow from the graft is simulated by solving the three-dimensional Navier-Stokes equation coupled with the non-Newtonian constitutive model. Results for the non-Newtonian flow, the Newtonian flow and the rescaled Newtonian flow are presented. Significant differences in axial velocity profiles, secondary flow streamlines and WSS between the non-Newtonian and Newtonian fluid flows are revealed. However, reasonable agreement between the non-Newtonian and the rescaled Newtonian flows is found. Results from this study support the view that the residual flow in a partially occluded coronary artery interacts with flow in the bypass graft and may have significant hemodynamic effects in the host vessel downstream of the graft. Non-Newtonian property of the blood alters the flow pattern and WSS distribution and is an important factor to be considered in simulating hemodynamic effects of blood flow in arterial bypass grafts.

  17. Seroprevalence of Salmonella and Mycoplasma infection in backyard chickens in the state of Entre Rios in Argentina.

    PubMed

    Xavier, J; Pascal, D; Crespo, E; Schell, H L; Trinidad, J A; Bueno, D J

    2011-04-01

    The present work was conducted to study the seroprevalence of Salmonella, Mycoplasma gallisepticum (MG), and Mycoplasma synoviae (MS) infection in backyard chickens located in Entre Ríos, Argentina, over 3 periods of time. A total of 2,441 sera samples were collected from backyard chickens belonging to 256 family farms in 16 counties in the state of Entre Ríos from January to May 2003 (first period), December 2004 to April 2005 (second period), and October 2006 to May 2007 (third period). The prevalence of family farms testing seropositive for Salmonella averaged 23.9, 15.9, and 28.6% during the first, second, and third period, respectively. The highest prevalence of Salmonella-seropositive farms recorded (66.7%) was on farms from Concordia county, and the lowest prevalence (0%) was on farms from La Paz county. In contrast, the prevalence of family farms seropositive for MG averaged 32.8, 55.1, and 76.2% during the first, second, and third periods, respectively. The highest prevalence of MG-seropositive farms (100%) was found in the counties of Victoria and Tala, and the lowest prevalence (8.7%) was found on farms on Colón county. The prevalence of family farms seropositive for MS averaged 68.6 and 100% during the first and second periods, respectively. The highest prevalence of MS-seropositive farms (100%) was on farms in 85% of the counties tested, and the lowest prevalence (21.7%) was on farms from Colón county. Salmonella, MG, and MS infection are present at high levels in backyard chicken farms, and this presents a high risk to commercial poultry production in Entre Ríos, the state with the highest chicken population and density in Argentina.

  18. 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.

  19. Cook/chill foodservice systems. Predicting cooling time of a ground beef entrée chilled in bulk.

    PubMed

    Rollin, J L; Matthews, M E; Lung, D B

    1979-10-01

    Mathematical formulas which incorporate thermal properties of the food, geometry of the food mass, and process conditions during cooling were used to predict the time required for a cooked ground beef product chilled in bulk to cool to 45 degrees F. (7 degrees C.). Formulas predicted cooling time within 36 min. (11 per cent) of the actual cooling time. For widespread application, additional information on thermal properties of entrée products of the type served in foodservice operations needs to be obtained.

  20. Etude de la transition tribologique entre le fretting et le meso-fretting pour des materiaux de contact electrique

    NASA Astrophysics Data System (ADS)

    Gagnon, Daniel

    Dans les installations electriques, les contacts sont toujours soumis a des contraintes alternees ou a des micro-deplacements. Il en resulte une corrosion par fretting, phenomene defini comme un type de deterioration de la surface qui se produit lorsque deux materiaux en contact sont soumis a des mouvements microscopiques d'oscillations de tres faible amplitude (0 a 100 mum). Ceci a pour effet de provoquer une degradation de la resistance de contact et une interruption du passage du courant. Ce phenomene a des repercussions considerables sur le plan pratique puisque les micro-deplacements de pieces en contact peuvent etre causes par la dilatation thermique differentielle des metaux, par des vibrations mecaniques, par la relaxation des contraintes ou par l'echauffement des contacts lorsqu'on interrompt et retablit le courant. Nous avons donc dans le cadre de cette these etudie plusieurs aspects du fretting (0--100 mum) et du meso-fretting (100 a 1000 mum) pour differents materiaux de contact electrique. Des travaux experimentaux ont ete realises a partir de deux montages reproduisant divers aspects de la degradation par le fretting. Un premier montage de fretting de type bille-plaque a ete entierement developpe a l'ETS et un second montage, de type fil-plaque a ete utilise en collaboration avec Hydro Quebec IREQ a Varennes. Plusieurs techniques de mesures et d'analyse relevant tant du domaine de la mecanique du contact que de la metallurgie ont ete utilisees pour traiter les resultats. L'influence du courant sur le taux d'usure et la force de friction a ete examinee pour divers materiaux de contacts. Des essais de fatigue thermique et electrique ont ete realises sur divers materiaux et lubrifiants de contact. Il a ete demontre que pour le domaine entre 100 mum et 1000 mum, le taux d'usure n'est pas le meme de 0 a 100 mum et au dela de 1000 mum. La plupart des materiaux evalues montrent un stade de comportement intermediaire dont le debut se situe entre 100 mum et

  1. Observation de l'interaction entre atome et surface en cellule de vapeur submicrométrique

    NASA Astrophysics Data System (ADS)

    Dutier, G.; Saltiel, S.; Bloch, D.; Ducloy, M.; Papoyan, A.; Sarkisyan, D.

    2002-06-01

    Sur une cellule de vapeur d'épaisseur submicrométrique ( 300 nm), les spectres d'absorption linéaire se révèlent très peu sensibles à l'effet Doppler (les effets transitoires favorisent fortement les atomes lents), et font apparaître les effets de l'interaction van der Waals à longue portée entre atome-surface. L'étude, entreprise d'abord sur la raie de résonance D1 de Cs, est poursuivie sur une transition à deux photons vers le niveau Cs 6(D{3/2}) résonnant avec la surface de YAG de la fenêtre. Elle ouvre diverses perspectives, notamment la détection d'états liés par un puits de potentiel induit par la surface.

  2. 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 (

  3. 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

  4. 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

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

    USDA-ARS?s Scientific Manuscript database

    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...

  6. 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…

  7. 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…

  8. A Late Pleistocene Guloninae (Carnivora, Mustelidae) from South America (Argentina, Entre Ríos province), biogeographic implications

    NASA Astrophysics Data System (ADS)

    Schiaffini, Mauro I.; Prevosti, Francisco J.; Ferrero, Brenda S.; Noriega, Jorge I.

    2017-10-01

    The record of Guloninae presents mainly a Holarctic distribution, with only Eira barbara occurring in South America (SA). This lineage immigrated from Central America at least in the Pleistocene. The fossil record of Guloninae for SA is limited to a few known specimens of Eira from Late Pleistocene of Brazil. We report a new specimen of E. barbara (an upper carnassial) from Late Pleistocene of Entre Ríos, Argentina. We also discuss the taxonomic assignation of this new fossil and its paleoenvironmental relevance using Species Distribution Modeling (SDM). The new material comes from Ensenada Creek, Salto Ander Egg Formation, from the Late Pleistocene between 120 and 60 ky BP. The locality is farther south than its recent distribution, and SDM shows low suitability values for such area, which also indicates that the species is absent from this area in present time. The P4 is bigger and the protocone has a more anterior position relative to the paracone than that of recent specimens of E. barbara. This new fossil indicates that E. barbara had a wider distribution over the Late Pleistocene and, if our interpretation is correct, it has been present in SA at least since 120-60 ky BP. The presence of E. barbara in such a southern locality, together with other taxa recorded in this site and the associated geological and paleoenvironmental evidences, indicates warmer and more humid conditions, compared with the current conditions, which might have allowed a southern displacement of taxa more related to forested and tropical environments.

  9. 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.

  10. Changes in the energy and sodium content of main entrées in US chain restaurants from 2010 to 2011.

    PubMed

    Wu, Helen W; Sturm, Roland

    2014-02-01

    The food environment shapes individual diets, and as food options change, energy and sodium intake may also shift. Understanding whether and how restaurant menus evolve in response to labeling laws and public health pressures could inform future efforts to improve the food environment. To track changes in the energy and sodium content of US chain restaurant main entrées between spring 2010 (when the Affordable Care Act was passed, which included a federal menu labeling requirement) and spring 2011. Nutrition information was collected from top US chain restaurants' websites, comprising 213 unique brands. Descriptive statistics and regression analysis evaluated change across main entrées overall and compared entrées that were added, removed, and unchanged. Tests of means and proportions were conducted for individual restaurant brands to see how many made significant changes. Separate analyses were conducted for children's menus. Mean energy and sodium did not change significantly overall, although mean sodium was 70 mg lower across all restaurants in added vs removed menu items at the 75th percentile. Changes were specific to restaurant brands or service model: family-style restaurants reduced sodium among higher-sodium entrées at the 75th percentile, but not on average, and entrées still far exceeded recommended limits. Fast-food restaurants decreased mean energy in children's menu entrées by 40 kcal. A few individual restaurant brands made significant changes in energy or sodium, but the vast majority did not, and not all changes were in the healthier direction. Among those brands that did change, there were slightly more brands that reduced energy and sodium compared with those that increased it. Industry marketing and pledges may create a misleading perception that restaurant menus are becoming substantially healthier, but both healthy and unhealthy menu changes can occur simultaneously. Our study found no meaningful changes overall across a 1-year time

  11. Natural occurrence of aflatoxins, deoxynivalenol, fumonisins and zearalenone in maize from Entre Ríos Province, Argentina.

    PubMed

    Broggi, L E; Pacin, A M; Gasparovic, A; Sacchi, C; Rothermel, A; Gallay, A; Resnik, S

    2007-06-01

    In Entre Ríos, Argentina, corn is one of the most important cereal grains produced, being an important income for the regional economy. The aim of this work was to assess aflatoxins, zearalenone, deoxynivalenol (DON) and fumonisins (FB) in corn harvest in 2003 and 2004 in the most contaminated departments found in previous studies in selected sampling places. At the harvest time, when the trucks arrived to store plants, samples of corn were taken from seven different positions of the trucks and from five in the trailer. Composite samples were randomised reduced to 10 kg. The samples were analysed by immunological tests, by thin layer chromatography (TLC), high performance liquid chromatography (HPLC) and/or gas liquid chromatography-electron capture detector (GLC-ECD). In 2003 average contamination was 3.19 u.g/kg for aflatoxins, 118.5 μg/kg for deoxynivalenol, 230.8 μg/kg for zearalenone and 10200 μg/kg of total fumonisins (HPLC and ELISA quantification showed a linear correlation (r(2) =0.9618), but RIDASCREEN®FAST values were 1.7 higher than HPLC values); in 2004 deoxynivalenol and zearalenone were not detected and an average of 2.0 μg/kg for aflatoxins and 4700 μg/kg for total fumonisins was found.This province, with the earliest harvested corn in the country each summer, tends to display different contaminations from the rest of the provinces, probably due to climate characteristics, particularly hotter weather.

  12. Contexts of occurrence of child malnutrition in the district of Villaguay, Entre Ríos, Argentina. A multivariate analysis.

    PubMed

    Bergel Sanchís, María Laura; Cesani, María Florencia; Oyhenart, Evelia Edith

    2017-01-01

    The analysis of nutritional status is anthropologically important to address the complex interaction of biological, social, political, economic and cultural factors. To deepen the knowledge about contexts of occurrence of child malnutrition, we analyzed nutritional status in relation to socio-environmental conditions of residence in children between three and six years from Villaguay, Entre Ríos, Argentina. We performed a cross-sectional study of 1,435 school children of both sexes. Body weight and height were measured and prevalence of low height/age (LH/A), low weight/age (LW/A), low BMI/age (LBMI/A), overweight (Ow) and obesity (Ob) was calculated using World Health Organization reference charts. Socio-environmental information was obtained through a semi-structured survey and processed by Categorical Principal Component Analysis (CatPCA). Anthropometric data showed 1.5% LW/A, 5.2% LH/A; 0.6% LBMI/A, 20.9% Ow and 10.9% Ob. CatPCA allowed us to define four groups (G1-G4) with better (G2), middle (G1) and worst (G4) urban socio-environmental conditions and one with rural characteristics (G3). G4 presented the highest LH/A prevalence and G2 the highest Ow and Ob prevalence (P<0.05). It is concluded that since the distribution of malnutrition was not even it may dependent on the context in which children grow up. Thus, the higher the socio-economic level, the higher the incidence of overweight and obesity. Conversely, at the other end of the social scale, undernutrition and increasing weight excess remained major health problems.

  13. Contexts of occurrence of child malnutrition in the district of Villaguay, Entre Ríos, Argentina. A multivariate analysis

    PubMed Central

    2017-01-01

    The analysis of nutritional status is anthropologically important to address the complex interaction of biological, social, political, economic and cultural factors. To deepen the knowledge about contexts of occurrence of child malnutrition, we analyzed nutritional status in relation to socio-environmental conditions of residence in children between three and six years from Villaguay, Entre Ríos, Argentina. We performed a cross-sectional study of 1,435 school children of both sexes. Body weight and height were measured and prevalence of low height/age (LH/A), low weight/age (LW/A), low BMI/age (LBMI/A), overweight (Ow) and obesity (Ob) was calculated using World Health Organization reference charts. Socio-environmental information was obtained through a semi-structured survey and processed by Categorical Principal Component Analysis (CatPCA). Anthropometric data showed 1.5% LW/A, 5.2% LH/A; 0.6% LBMI/A, 20.9% Ow and 10.9% Ob. CatPCA allowed us to define four groups (G1-G4) with better (G2), middle (G1) and worst (G4) urban socio-environmental conditions and one with rural characteristics (G3). G4 presented the highest LH/A prevalence and G2 the highest Ow and Ob prevalence (P<0.05). It is concluded that since the distribution of malnutrition was not even it may dependent on the context in which children grow up. Thus, the higher the socio-economic level, the higher the incidence of overweight and obesity. Conversely, at the other end of the social scale, undernutrition and increasing weight excess remained major health problems. PMID:28441444

  14. [Non-insulin treated diabetes: relationship between disease management and quality of care. The Entred study, 2001].

    PubMed

    Fagot-Campagna, Anne; Romon, Isabelle; Poutignat, Nathalie; Bloch, Juliette

    2007-12-31

    We studied the relationship between 100% medical fee coverage for chronic disease and quality of care in people with type 2 diabetes treated with oral hypoglycaemic agents (OHA) only, in France. For the Entred study, 10,000 adults who received reimbursements for a delivery of OHA or insulin were randomly sampled from the database of the major national medical insurance system in 2001. For these 10,000 people, we extracted all medical consumption from the 2001 database and mailed a medical questionnaire; another questionnaire was mailed to their medical provider. We restricted the analysis to people with type 2 diabetes, treated with OHA only, with no annual visit to an endocrinologist (n = 1167), and to a sub-group with no complication reported by their medical provider (n = 525). 71% of people benefited from a waiver of co-payment due to a chronic disease (100% medical fee coverage for a list of 30 diseases including diabetes). People with 100% coverage were more likely to be women, older, with a longer duration of the disease, more often on several OHA and a drug for cardiovascular disease, and had a higher level of HbA1c. In multivariate analyses, 100% fee coverage was linked with a higher frequency of three HbA1c measurements (OR = 2,5 [1,6-4,0]), one electrocardiogram (1,9 [1,2-3,1]) and one podiatric visit (2,2 [1,1-4,3]) in 2001 in people without complications. No association was found with one measurement of albuminuria, creatininemia, lipids, and ophtalmological, dental or dietitian visit. In 2001, a significant relationship was found between 100% medical fee coverage on a better quality of care for people with diabetes on OHA at an early stage of the disease. Several explanations are further discussed.

  15. 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.

  16. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. 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.

  18. 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

  19. A model of stress-induced geometrical remodeling of vessel segments adjacent to stents and artery/graft anastomoses.

    PubMed

    Rachev, A; Manoach, E; Berry, J; Moore, J E

    2000-10-07

    The mismatch between the elastic properties and initial geometry of a host artery and an implanted stent or graft cause significant stress concentration at the zones close to junctions. This may contribute to the often observed intimal hyperplasia, resulting in late lumen loss and eventual restenosis. This study proposes a mathematical model for stress-induced thickening of the arterial wall at the zones close to an implanted stent or graft. The host artery was considered initially as a cylindrical shell with constant thickness that was clamped to the stent or graft, which was assumed to be non-deformable in the circumferential direction. It was assumed that the abnormal circumferential and axial stresses due to the bending of the arterial wall cause wall thickening that tends to restore the stress state close to that existing far from the junction. The linear equations of a cylindrical shell with variable thickness were coupled to an evolution equation for the wall thickness. These equations were solved numerically and a parametric study was performed using finite difference method and explicit time step. The results show that the remodeling process is self-limiting and leads to local thickening that gradually decreases with distance from the edge of the stent/graft. Model predictions were tested against morphological findings existing in the literature. Recommendations on stent designs that reduce stress concentrations are discussed. Copyright 2000 Academic Press.

  20. Minimisation of the wall shear stress gradients in bypass grafts anastomoses using meshless CFD and genetic algorithms optimisation.

    PubMed

    El Zahab, Zaher; Divo, Eduardo; Kassab, Alain

    2010-02-01

    The wall shear stress (WSS) spatial and temporal gradients are two hemodynamics parameters correlated with endothelial damage. Those two gradients become well pronounced in a bypass graft anastomosis geometry where the blood flow patterns are quite disturbed. The WSS gradient minimisation on the host artery floor can be achieved by optimising the anastomosis shape and hence may lead to an improved long-term post-surgical performance of the graft. The anastomosis shape optimisation can be executed via an integrated computational tool comprised of a meshless computational fluid dynamics (CFD) solver and a genetic algorithm (GA) shape optimiser. The meshless CFD solver serves to evaluate the WSS gradients and the GA optimiser serves to search for the end-to-side distal anastomosis (ETSDA) optimal shape that best minimises those gradients. We utilise a meshless CFD method to resolve hemodynamics and a GA for the purpose of optimisation. We consider three different anastomotic models: the conventional ETSDA, the Miller Cuff ETSDA and the hood ETSDA. The results reported herein demonstrate that the graft calibre should always be maximised whether a conventional or Miller Cuff ETSDA model is utilised. Also, it was noted that the Miller Cuff height should be minimised. The choice of an optimal anastomotic angle should be optimised to achieve a compromise between the concurrent minimisations of both the spatial WSS gradient and the temporal WSS gradient.

  1. Safety and Efficacy of Occlusion of Large Extra-Prostatic Anastomoses During Prostatic Artery Embolization for Symptomatic BPH.

    PubMed

    Amouyal, Gregory; Chague, Pierre; Pellerin, Olivier; Pereira, Helena; Del Giudice, Costantino; Dean, Carole; Thiounn, Nicolas; Sapoval, Marc

    2016-09-01

    During PAE, preembolization angiography of the prostatic artery can show large extra-prostatic shunts, at high risk, if embolized, of rectal or penile necrosis. We report our experience with 11 consecutive patients who underwent protective embolization of large extra-prostatic shunts before successful PAE. We treated 11 consecutive male patients (mean age 67 years), part of a series of 55 consecutive male patients referred for PAE to treat LUTS due to BPH, between December 2013 and January 2015. The procedure involved the exclusion of an extra-prostatic shunt originating from the PA, prior to complete bilateral PAE. We compared the safety and efficacy of the 11 shunt exclusions followed by embolization of the PA to the other 44 basic PAE. Clinical success was defined as a decrease of 25 % or eight points of IPSS, QoL <3 or a one-point decrease, and a Qmax improvement of 25 % or 2.5 mL/s. We had a 100 % rate of occlusion of the anastomosis. Bilateral embolization of the PA was performed in all patients with no additional time of procedure (p = 0.18), but a significant increase of dose area product (p = 0.03). Distal (PErFecTED) embolization was possible in 64 %. There was no worsening of erectile dysfunction, no rectal or penile necrosis, no immediate or late other clinical complications. Clinical success was 91 % (mean follow-up: 3.5 months), compared to 78 % for the entire PAE group. PAE using the protection technique in case of large extra-prostatic shunts is as safe and effective as basic procedures and does not induce any additional time of procedure.

  2. Does calcium score in great pelvic vessels predict colorectal anastomotic leakage? A prospective study of one hundred anastomoses.

    PubMed

    Norooz, M T; Moradi, H; Safdarian, M; Jahangiri, F; Amoli, H A

    2016-01-01

    Anastomotic leakage is one of the most severe surgical complications following surgery. This prospective study was designed to investigate an association between the calcification in the descending aorta and its major branches using a calcium-scoring software and colorectal anastomotic leakage. From January 2012 to March 2013, one hundred patients underwent surgeries involving colorectal anastomosis procedures. Calcium score in descending aorta and great pelvic vessels was measured using the Syngo-CT 2006G-W software. A questionnaire was completed containing demographic and underlying risk factors suspicious to be associated with anastomotic leakage, in addition to surgical characteristics data. 55 males and 45 females entered the study with the mean age of 63.70±7.17 years. The average duration time of surgery was 149.30±20.24 minutes. The type of surgery was elective for 90 patients and emergency for 10 others. The mean calcium score was higher in greater arteries as in abdominal aorta and common iliac arteries in comparison to the other pelvic vessels. Comparing two groups of patients with and without anastomotic leakage, the calcium score was higher in descending aorta and all great pelvic vessels of patients with colorectal anastomotic leakage (P<0.001). One patient (1%) died due to postoperative anastomotic leakage two weeks after the surgery. Atherosclerotic calcification in the descending aorta and its major branches can be considered as a risk factor in the development of colorectal anastomotic leakage. (Acta gastroenterol. belg., 2016, 79, 415-420).

  3. 3D Anastomosed Microvascular Network Model with Living Capillary Networks and Endothelial Cell-Lined Microfluidic Channels.

    PubMed

    Wang, Xiaolin; Phan, Duc T T; George, Steven C; Hughes, Christopher C W; Lee, Abraham P

    2017-01-01

    This protocol describes detailed practical procedures for generating 3D intact and perfusable microvascular network that connects to microfluidic channels without appreciable leakage. This advanced 3D microvascular network model incorporates different stages of vascular development including vasculogenesis, endothelial cell (EC) lining, sprouting angiogenesis, and anastomosis in sequential order. The capillary network is first induced via vasculogenesis in a middle tissue chamber and then EC linings along the microfluidic channel on either side serve as artery and vein. The anastomosis is then induced by sprouting angiogenesis to facilitate tight interconnection between the artery/vein and the capillary network. This versatile device design and its robust construction methodology establish a physiological microcirculation transport model of interconnected perfused vessels from artery to vascularized tissue to vein.

  4. A simple arteriotomy method for microsurgical end-to-side anastomoses: technical aspects of use in training and laboratory applications.

    PubMed

    Dash, H; Kononov, A; Maloney, J; Browne, E

    1993-09-01

    An experiment was carried out to show the patency rates of microsurgical carotid artery bypasses with femoral artery grafts, using a single-cut arteriotomy in rats. A bypass was done on 127 Sprague-Dawley rats. Of these, 125 were patent after 20 min, and all of these were patent after the animals were sacrificed at 3 days, for a 98 percent patency rate. The method of performing the arteriotomies, as well as the bypass itself, is described. The benefits of using the end-to-side anastomosis are explained. The authors conclude that the single-cut arteriotomy is convenient and easy to perform. The end-to-side anastomosis is a worthwhile technique and should encourage the proficiency of every student of microsurgery.

  5. The Amount of Time to Eat Lunch is Associated with Children’s Selection and Consumption of School Meal Entrée, Fruits, Vegetable, and Milk

    PubMed Central

    Cohen, Juliana F.W.; Jahn, Jaquelyn L.; Richardson, Scott; Cluggish, Sarah A.; Parker, Ellen; Rimm, Eric B.

    2015-01-01

    Background There are currently no national standards for school lunch period lengths and little is known about the association between the amount of time students have to eat and school food selection and consumption. Objectives To examine plate waste measurements from students in the control arm from the MEALS study (2011-2012 school year) for the association of the amount of time to eat with school meal selection and consumption. Design Prospective study using up to six repeated measures among students over the school year. Participants/Setting 1001 students in grades 3-8 attending 6 participating elementary/middle schools in an urban, low-income school district where lunch period lengths varied from 20-30 minutes. Main Outcome Measures School food selection and consumption were collected using plate waste methodology. Statistical Analyses Performed Logistic regression and mixed-model ANOVA was used to examine food selection and consumption. Results Compared with meal component selection when students had at least 25 minutes to eat, students were significantly less likely to select a fruit (44% vs. 57%; p=0.0001) compared with when students had fewer than 20 minutes to eat. There were no significant differences in entrée, milk, or vegetable selection. Among those who selected a meal component, students with fewer than 20 minutes to eat consumed 13% less of their entrée (p<0.0001), 10% less of their milk (p<0.0001), and 12% less of their vegetable (p=0.0002) compared to when students had at least 25 minutes to eat. Conclusions Over the school year, a substantial number of students had insufficient time to eat, which was associated with significantly decreased entrée, milk, and vegetable consumption compared with students who had more time to eat. School policies that encourage lunches with at least 25 minutes of seated time may reduce food waste and improve dietary intake. PMID:26372337

  6. Comunidades de aves y lepidopteros diurnos y las relaciones entre ellas en bosque nuboso y cafetal de Finca Santa Maura, Jinotega

    Treesearch

    M. Torrez; W. Arendt; J. M. Maes

    2013-01-01

    Para evaluar la diversidad de aves y mariposas ninfálidas visitamos la Estación Biológica Juan Roberto Zarruk en Jinotega, donde colectamos datos en todos los hábitats presentes en la finca. Obtuvimos 123 especies de aves y 29 especies de ninfálidos. El hábitat con mayor riqueza para aves fue el cafetal y para ninfálidos el tacotal. Entre las especies más comunes...

  7. 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

  8. 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

  9. 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.

  10. Amount of Time to Eat Lunch Is Associated with Children's Selection and Consumption of School Meal Entrée, Fruits, Vegetables, and Milk.

    PubMed

    Cohen, Juliana F W; Jahn, Jaquelyn L; Richardson, Scott; Cluggish, Sarah A; Parker, Ellen; Rimm, Eric B

    2016-01-01

    There are currently no national standards for school lunch period length and little is known about the association between the amount of time students have to eat and school food selection and consumption. Our aim was to examine plate-waste measurements from students in the control arm of the Modifying Eating and Lifestyles at School study (2011 to 2012 school year) to determine the association between amount of time to eat and school meal selection and consumption. We used a prospective study design using up to six repeated measures among students during the school year. One thousand and one students in grades 3 to 8 attending six participating elementary and middle schools in an urban, low-income school district where lunch period lengths varied from 20 to 30 minutes were included. School food selection and consumption were collected using plate-waste methodology. Logistic regression and mixed-model analysis of variance was used to examine food selection and consumption. Compared with meal-component selection when students had at least 25 minutes to eat, students were significantly less likely to select a fruit (44% vs 57%; P<0.0001) when they had <20 minutes to eat. There were no significant differences in entrée, milk, or vegetable selections. Among those who selected a meal component, students with <20 minutes to eat consumed 13% less of their entrée (P<0.0001), 10% less of their milk (P<0.0001), and 12% less of their vegetable (P<0.0001) compared with students who had at least 25 minutes to eat. During the school year, a substantial number of students had insufficient time to eat, which was associated with significantly decreased entrée, milk, and vegetable consumption compared with students who had more time to eat. School policies that encourage lunches with at least 25 minutes of seated time might reduce food waste and improve dietary intake. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. 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.

  12. Magnetotellurics applied to the study of the Guaraní aquifer in Entre Ríos Province, N-E Argentina

    NASA Astrophysics Data System (ADS)

    Favetto, Alicia; Curcio, Ana; Pomposiello, Cristina

    2011-07-01

    The South American Guaraní Aquifer System covers the entire Parana basin and part of the Chaco-Parana basin. This system is one of the most important groundwater reservoirs; it is shared by four neighboring countries covering an area larger than one million square kilometers. The geological units closely related to the Guaraní Aquifer are the Piramboia and Botucatu Formations that consist of Triassic-Jurassic aeolian, fluvial and lacustrine sandstones, and the Serra Geral basalts with clastic intercalations. Serra Geral, an effusive Cretaceous complex, covers the sandstones and provides a high degree of confinement to the system. This paper presents the interpretation of magnetotelluric (MT) data collected during 2007-2008 in Entre Ríos Province, Argentina. These data, recorded in three profiles, mainly provide the depth to the crystalline basement, determinant for the presence of aquifer-related sediments. Models showed that the discrimination of the basalts strongly depends on local electrical characteristics. Model information is quite consistent with the information from oil and thermal wells located close to the profiles.

  13. 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.

  14. 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. © 2015 Society for Public Health Education.

  15. Relación Entre el Tamaño Condilar y la Asimetría Facial Transversal en Individuos con Hiperplasia Condilar

    PubMed Central

    Olate, Sergio; Cantín, Mario; Alister, Juan Pablo; Uribe, Francisca; Navarro, Pablo; Olate, Gabriela; de Moraes, Márcio

    2016-01-01

    La asimetría facial es una patología de compromiso funcional y estético que puede estar generado por hiperplasia condilar; el objetivo de esta investigación es determinar la influencia del tamaño condilar en la asimetría facial. Doce sujetos fueron estudiados mediante el análisis de tomografía computadorizada cone beam; todos los pacientes presentaron cintigrama óseo que determino la presencia de hiperplasia condilar activa; el análisis se realizo en un software del sistema de captura modelo Pax Zenith, marca Vatech (Korea 2011), utilizando 90 kV y 120 mA; se obtuvo mediciones de la distancia antero-posterior, superior-inferior y medio-lateral de la cabeza del cóndilo, relacionándose con la posición del cóndilo con la línea mediana facial y la posición de puntos faciales entre incisivos centrales superior e inferior así como con el mentón. Los resultados mostraron un promedio de desvío de mentón de 6,5 mm considerando un cóndilo hiperplásico con un tamaño de 2,7 mm mas que los cóndilos normales. El desvío de incisivo central inferior determinó que por cada 1 mm de desvío dentario existe 2,2 mm de desvío de mentón. El cóndilo hiperplásico fue de mayor tamaño y se posiciono casi 2 mm mas hacia lateral que los cóndilos no hiperplásicos. Es posible concluir que el cóndilo hiperplásico presenta clara influencia en la asimetría facial transversa y es posible estimar una relación de tamaño condilar con grado de asimetría facial. PMID:28066127

  16. 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

  17. 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

  18. Le rôle médiateur du fonctionnement familial dans la relation entre l’adversité familiale et l’adaptation sociale des enfants d’âge préscolaire1

    PubMed Central

    Felli, M. C.; Parent, S.; Zelazo, P. D.; Tremblay, R. E.; Séguin, J. R.

    2017-01-01

    Résumé À la petite enfance, l’adaptation sociale de l’enfant dépend en partie des risques auxquels il est exposé dans son environnement. Toutefois, les mécanismes par lesquels les facteurs de risque opèrent leurs influences sur l’adaptation sociale de l’enfant sont peu documentés. Ainsi, cette étude examine dans un premier temps l’effet principal de l’adversité familiale, un cumul de facteurs de risque, sur les problèmes de comportement intériorisés et extériorisés, ainsi que sur la sécurité d’attachement des enfants d’âge préscolaire. Dans un deuxième temps, elle évalue le rôle médiateur du fonctionnement familial dans le lien entre l’adversité familiale et les problèmes de comportement de même qu’entre l’adversité familiale et la sécurité d’attachement des enfants d’âge préscolaire. Les 572 participants à l’étude (n=572) sont âgés entre cinq et 42 mois lors des mesures de l’adversité familiale et de 42 mois lors de la mesure des problèmes de comportement et du fonctionnement familial. Quatre-vingt d’entre eux (n=80) ont fait l’objet d’une mesure de sécurité d’attachement à 48 mois. Les résultats indiquent, d’abord, un effet principal de l’adversité familiale sur les problèmes de comportement intériorisés et extériorisés. Un effet médiateur significatif du fonctionnement familial est ensuite rapporté dans le lien entre l’adversité familiale et les problèmes de comportement intériorisés et extériorisés. Aucun effet significatif n’est observé pour la sécurité d’attachement des enfants de 48 mois. PMID:28567062

  19. Etude des phenomenes chimiques au contact entre le bloc cathodique et la barre collectrice d'une cellule d'electrolyse d'aluminium

    NASA Astrophysics Data System (ADS)

    Lebeuf, Martin

    La production d'aluminium est une industrie importante au Québec. Les propriétés de ce métal le vouent à de multiples usages présents et futurs dans le cadre d'une économie moderne durable. Toutefois, le procédé Hall-Héroult est très énergivore et des progrès demeurent donc nécessaires pour en diminuer les coûts financiers et environnementaux. Parmi les améliorations envisageables de la cellule d'électrolyse se trouve le contact entre la cathode et la barre collectrice, qui doit offrir une faible résistivité au passage du courant électrique. En cours d'opération de la cellule, ce contact a tendance à se dégrader, générant des pertes énergétiques significatives. Les causes de cette dégradation, pouvant provenir de phénomènes chimiques, thermiques, mécaniques et/ou électriques, demeurent mal comprises. Le but du présent projet était donc d'étudier les phénomènes chimiques se produisant au contact bloc-barre de la cellule d'électrolyse Hall-Héroult. En premier lieu, un aspect crucial à considérer est la pénétration du bain électrolytique dans la cathode, car des composés de bain atteignent éventuellement la barre collectrice et peuvent y réagir. A cet effet, une méthode novatrice a été développée afin d'étudier les cathodes et la pénétration du bain dans celles-ci à l'aide de la microtomographie à rayons X. Cette méthode rapide et efficace s'est avérée fort utile dans le projet et a un potentiel important pour l'étude future des cathodes et des phénomènes qui s'y produisent. Ensuite, une cellule d'électrolyse rectangulaire à petite échelle a été développée. Plusieurs phénomènes observés 'en industrie sur des autopsies de cellules post-opération et rapportés dans la littérature ont été reproduis avec succès à l'aide de cette cellule expérimentale. Puis, des tests sans électrolyse, ciblant l'effet du bain électrolytique sur l'acier, ont aussi été conçus et complétés afin de s

  20. 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

  1. 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

  2. Use of circular stapling gun with peranal insertion of anorectal purse-string suture for construction of very low colorectal or colo-anal anastomoses.

    PubMed

    Goligher, J C

    1979-07-01

    A technique is described for construction of the colorectal or colo-anal anastomosis in low rectal resection by using an automatic circular stapling device and inserting the anorectal purse-string suture peranally from below. This method was employed in 4 patients resulting in complete healing in 3 cases and a moderate leak in 1, which, however, eventually healed satisfactorily.

  3. 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.

  4. 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

  5. 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

  6. Competition entre supraconductivite et magnetisme au voisinage de la transition de Mott dans le conducteur organique quasi-bidimensionnel k-(BEDT-TTF)2copper[N(CN)2]bromine

    NASA Astrophysics Data System (ADS)

    Fournier, David

    Les conducteurs organiques quasi-bidimensionnels kappa-ET2X presentent d'importantes similitudes avec les SCHT telles qu'une phase isolant de Mott, un regime de pseudogap et un etat supraconducteur. L'etude de leurs proprietes apparait donc complementaire. Parmi les interrogations persistantes concernant la physique de ces systemes, l'origine du (ou des) processus exotique d'appariement, responsable de la supraconductivite est le sujet suscitant l'interet le plus marque dans la communaute. L'hypothese d'un mecanisme lie a la proximite d'un etat antiferromagnetique est privilegiee. Une etape importante dans la resolution de cette problematique est l'identification de la symetrie du parametre d'ordre. D'apres de nombreux travaux sur les systemes fortement correles, la sonde ultrasonore, de par sa sensibilite aux excitations de quasiparticule a basse temperature, est consideree comme particulierement adaptee a l'etude de cette propriete. Cependant, son emploi necessite l'utilisation d'un compose metallique a basse temperature et completement supraconducteur. Le compose metallique organique kappa-ET 2Cu[N(CN)2]Br presente toutes les caracteristiques necessaires a l'etude de cette propriete. En effet, il est situe loin de la transition du premier ordre de Mott et est completement supraconducteur. De facon surprenante, ce systeme semble se coupler fortement avec le reseau ce qui augmente significativement la sensibilite de cette sonde aux proprietes du gaz electronique. Cependant, des difficultes techniques importantes, liees a la nature intrinseque de ce materiau, doivent etre surmontees pour proceder a des mesures suivant differentes polarisations. La presente etude a profondement modifie notre comprehension de ce systeme. En effet, ces mesures ont permis de constater que le kappa-ET2Cu[N(CN)2]Br est un compose qui est situe en bordure de la zone de coexistence entre la supraconductivite et le magnetisme, ce qui constitue un resultat totalement inattendu. De plus, la

  7. Etude théorique de l'interaction de van der Waals entre une sonde métallique et une surface diélectrique : application à la microscopie par mesure de forces atomiques

    NASA Astrophysics Data System (ADS)

    Maghezzi, S.; Girard, C.; van Labeke, D.

    1991-02-01

    The van der Waals interaction force between a metallic tip and a non planar dielectric is derived from a non local formalism. A general formulation is given for a spherical tip of nanometric size and for surfaces of arbitrary shape (monocrystal adsorbed on planar surfaces). The dispersion part of the attractive force is obtained from a non local theory expressed in terms of generalized electric susceptibilities of the two partners. Implications for atomic force microscopy in attractive mode are also discussed. La force d'interaction de van der Waals entre une pointe métallique et une surface diélectrique est calculée à partir d'une théorie non-locale. Plus précisément, on considère comme point de départ que l'interaction sonde-surface est due au couplage entre les fluctuations des densités de charges des solides en présence. De plus, dans cette approche la force de van der Waals est calculée dans le cadre de la théorie de la réponse linéaire en utilisant pour chacun des milieux la fonction réponse non-locale correspondante. En particulier la sonde, de nature métallique, est caractérisée par un jeu de susceptibilités du champ décrites par un formalisme auto-cohérent. On effectue enfin une étude numérique de la force sur des surfaces présentant des corrugations de dimensions nanométriques.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. Étude physico-chimique des réactions entre oxydes d'azote Application à l'analyse de ces gaz en sortie de systèmes de combustion

    NASA Astrophysics Data System (ADS)

    Leblanc, E.; Jokela, K.; Perier-Camby, L.; Thomas, G.

    1999-05-01

    éaction pour des paramètres expérimentaux représentatifs des atmosphères générées par les systèmes de combustion (teneur en NOx : 1000 ppm, présence d'oxygène, température comprise entre 25 circC et 1000 circC). Les constantes cinétiques ont ainsi été déterminées pour des températures inférieures à 300 circC. L'influence catalytique de la paroi du réacteur a été mise en évidence au delà de cette température. Les valeurs concernant les équilibres thermodynamiques entre les NOx ont également pu être validées expérimentalement.

  14. L’annonce d’une déficience motrice cérébrale : Une relation de confiance à construire entre les parents, le personnel paramédical et les médecins

    PubMed Central

    Pelchat, Diane; Lefebvre, Hélène; Bouchard, Jean-Marie

    2001-01-01

    RÉSUMÉ : L’annonce d’une déficience motrice cérébrale et des incapacités qui en découlent est une situation difficile à vivre pour les parents et les dispensateurs de soins (personnel paramédical et médecins). Un examen de la documentation médicale démontre que depuis vingt ans, le nombre de parents insatisfaits n’a pas changé. L’étude de type qualitatif et exploratoire, effectuée à la demande de milieux de réadaptation, vise à décrire le processus d’annonce d’un diagnostic de déficience motrice cérébrale (DMC) à partir de l’expérience des différents acteurs en cause et à déterminer les facteurs qui facilitent ou compliquent la relation de confiance. Les résultats indiquent que les parents et les dispensateurs de soins vivent dans deux mondes de perception différents au moment de l’annonce, lesquels se rejoignent difficilement. Les parents sont envahis par le drame qu’ils vivent, tandis que les médecins sont concentrés sur le contenu à transmettre aux parents. Cette annonce provoque une importante incertitude qui bloque la communication entre les partenaires, mais elle pourrait devenir un stimulant à de nouvelles stratégies d’adaptation. PMID:20084263

  15. 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

  16. Pollution Atmosphérique et Santé: Corrélation ou Causalité? Le Cas de la Relation entre l'Exposition aux Particules et la Mortalité Cardio-pulmonaire.

    PubMed

    Dab, William; Ségala, Claire; Dor, Frédéric; Festy, Bernard; Lameloise, Philippe; Moullec, Yvon Le; Tertre, Alain Le; Médina, Sylvia; Quénel, Philippe; Wallaert, Benoît; Zmirou, Et Denis

    2001-02-01

    De nombreuses études épidémiologiques ont observé dans des contextes différents une faible relation à court terme entre les particules et la mortalité cardio-pulmonaire, même quand les normes de qualité de l'air n'étaient pas dépassées. La causalité de cette relation est un enjeu de santé publique en raison de l'importance de la population exposée. Notre objectif est de faire l'inventaire critique des arguments utilisés dans 15 revues de la littérature publiées. Nous expliquons l'importance de distinguer la validité de la causalité et analysons de façon systématique les différents critères de jugement dans le contexte des études écologiques temporelles. Notre conclusion est que la relation observée est valide et que la plupart des critères de causalité sont respectés. Diminuer le niveau d'exposition des populations aux particules est souhaitable. En Europe, en agissant à la source, notamment sur les émissions Diesel, on diminuera aussi d'autres polluants qui peuvent jouer un rôle sanitaire. Aux États-Unis, la situation est plus complexe car les particules sont surtout secondaires. Il est également indispensable de poursuivre les recherches pour mieux connaître les déterminants des expositions globales des individus et mieux comprendre le rôle toxique des différents facteurs physico-chimiques des particules.

  17. 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.

  18. Analyse quantitative des foraminifères benthiques actuels de la marge atiantique marocaine entre Cap Draˆa et Cap Juby: reponses fauniques aux changements de l'environnement

    NASA Astrophysics Data System (ADS)

    Rezqi, H.; Oujidi, M.; Boutakiout, M.; Labraimi, M.

    2000-02-01

    La population des foraminifères benthiques actuels de la marge atlantique marocaine, entre Cap Draˆa et Cap Juby, aétéétudiée dans 58 prélèvements parmi 430 répartis suivant un système de radiales perpendiculaireàla ligne de rivage. Quarante-sept espèces parmi 104 appartenantà58 genres et 28 familles ontétéreconnues. Les abondances absolues de chacune des espèces ontétécomparées dans les différents prélèvements ainsi que les indices biocénotiques (richesse spécifique, abondance, indice de pélagisme, nombre d'espèces benthiques enroulées, nombre d'espèces benthiques costulées) et les paramètres abiotiques (nature de substrat et profondeur). L'analyse factorielle des correspond ances, complétée par la classification hiérarchique et la projection des paramètres biotiques et abiotiques en tant que colonnes supplémentaires ont révéléclue la profondeur est le facteur principal de la distribution des espèces et des prélèvements. En effet, elle oppose les associations d'espèces infralittorales enroulées lisses aux associations d'espècesépibathyales rectilignes ornées, les espèces circalittorales occupent une position intermédiaire. Le facteur secondare correspondàla nature du substrat, oppose les associations d'espèces vasicoles aux associations d'espèces sabulicoles aussi bien celles de l'environnement infralittoral que celles de l'épibathyal.

  19. 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

  20. Le rôle du soutien parental dans la relation entre la victimisation homophobe, l’homophobie intériorisée et la détresse psychologique chez les jeunes de minorités sexuelles (JMS) : une approche de médiation modérée

    PubMed Central

    Bergeron, Félix-Antoine; Blais, Martin; Hébert, Martine

    2016-01-01

    Résumé Cet article explore le rôle modérateur du soutien parental dans les relations entre la victimisation homophobe, l’homophobie intériorisée et la détresse psychologique chez des jeunes de minorités sexuelles (JMS), que l’on dit aussi lesbiennes, gais, bisexuels ou en questionnement. Il vise à 1) documenter la prévalence des différentes formes de victimisation homophobe vécue par les JMS, et ce, selon le genre et l’âge et 2) à explorer l’effet modérateur du soutien parental dans la relation entre la victimisation homophobe, l’homophobie intériorisée et la détresse psychologique. Un échantillon de 228 JMS âgés de 14 à 22 ans, non exclusivement hétérosexuels, recrutés en milieu communautaire dans le cadre de l’enquête sur le Parcours Amoureux des Jeunes (PAJ) du Québec a été analysé. L’impact de la victimisation homophobe, du soutien parental, de l’homophobie intériorisée sur la détresse psychologique est exploré par un modèle de régression linéaire avec effets de médiation modérée. Le rôle modérateur du soutien parental est confirmé dans la relation entre la victimisation homophobe et la détresse psychologique. Ces variables peuvent constituer des leviers pour prévenir les effets négatifs des préjudices homophobes sur la santé mentale des JMS. PMID:26966851

  1. "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…

  2. Optics Microwave Interactions (Interactions entre optique et micro-ondes)

    DTIC Science & Technology

    2003-04-01

    semiconductor laser with optical power of only a few mW is used as a source. Monolithically integrated EA modulator with sampled grating DBR laser...bandwidth and monolithic integration with other components such as laser diodes. In Fig. 4 an EAM is sketched which has been designed for a wavelength of...operating at S-band is rendered in Table II, where the best performance is achieved. For DFB laser monolithically integrated with EA modulator. The

  3. 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.

  4. Plano Entrópico de galaxias tempranas

    NASA Astrophysics Data System (ADS)

    Volpe, M. G.; Alonso, M. V.; García Lambas, D.

    Early-type galaxies are systems in quasi-equilibrium and we can assume that their specific entropy is constant. This property is reflected in the ob- served correlations among photometric parameters describing the galaxy profiles. We discuss preliminary results of computing the specific entropy in several clusters and groups of galaxies. The galaxy sample is a subsam- ple of the spectro-photometric ENEAR survey (da Costa et al. 2000) of early-type galaxies in the local Universe. The Entropic Plane would allow us to understand the Fundamental Plane of early-type galaxies in dynamical terms and the processes involved in such relationships. FULL TEXT IN SPANISH

  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 semi-structured…

  6. Evaluacion entre colegas profesores (Peer Review of Teachers). ERIC Digest.

    ERIC Educational Resources Information Center

    Hertling, Elizabeth

    This digest in Spanish examines peer review, focusing on how these types of reviews can improve teacher competence. Peer review is often linked to peer assistance, which helps new and veteran teachers improve their knowledge and skills. In peer-review programs, consulting teachers conduct formal evaluations and recommend whether the participating…

  7. 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

  8. 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

  9. [Giardia duodenalis and chronic malnutrition in children under five from a rural area of Guinea-Bissau].

    PubMed

    Centeno-Lima, Sónia; Rosado-Marques, Vítor; Ferreira, Filipa; Rodrigues, Ruben; Indeque, Benjamim; Camará, Idrissa; De Sousa, Bruno; Aguiar, Pedro; Nunes, Baltazar; Ferrinho, Paulo

    2013-01-01

    Introdução: A desnutrição e as infecções por parasitas intestinais como Giardia duodenalis coexistem nas mesmas regiões geográficas, atingindo maiores prevalências em países em desenvolvimento. O ciclo da desnutrição e infecção implica que ambas as condições se podem agravar mutuamente e comprometer o crescimento e desenvolvimento das crianças, com especial relevância para as menores de cinco anos. O objectivo do presente estudo foi investigar a associação entre a desnutrição crónica e a infecção por G. duodenalis em crianças de uma comunidade rural da Guiné-Bissau.Material e Métodos: Realizou-se um estudo de caso-controlo que incluiu 109 crianças com idades entre os 0 e os 59 meses de uma comunidade rural da Guiné-Bissau. A avaliação antropométrica das crianças em estudo permitiu identificar 31 casos de desnutrição crónica (z-score estatura para a idade < -2) e 78 controlos (z-score estatura para a idade ≥ -2). Foi realizado exame microscópico de fezes para a detecção e identificação de G. duodenalis e de outros parasitas.Resultados: Foi detectada infecção por G. duodenalis em 29,0% (9/31) dos casos e 35,9% (28/78) dos controlos. Não foi encontrada associação entre a infecção por G. duodenalis e a desnutrição crónica nas crianças em estudo.Discussão e Conclusão: Os resultados obtidos mantêm em aberto o interesse em desenhar estudos que explorem esta associação em diferentes regiões e contextos epidemiológicos, apontando para a reflexão sobre a importância dos critérios de definição de desnutrição e concomitantemente da análise subsequente.

  10. EFFECT OF SIZE OF INTESTINAL DIVERSIONS IN OBESE PATIENTS WITH METABOLIC SYNDROME SUBMITTED TO GASTRIC BYPASS.

    PubMed

    Ramos, Rafael Jacques; Mottin, Cláudio Corá; Alves, Letícia Biscaino; Benzano, Daniela; Padoin, Alexandre Vontobel

    /m2) diabéticos com síndrome metabólica submetidos ao bypass gástrico em Y-de-Roux. Foram divididos em três grupos conforme a dimensão das alças intestinais: grupo 1, alça biliopancreática de 50 cm e alça alimentar de 100 cm; grupo 2, alça biliopancreática de 50 cm e alça alimentar de 150 cm e grupo 3, alça biliopancreática de 100 cm e alça alimentar de 150 cm. Foram avaliados os parâmetros que compõem a síndrome metabólica. Incluíram-se 63 pacientes, com média de idade de 44.7±9.4 anos. Todos eram diabéticos, 62 (98.4%) hipertensos e 51 (82.2%) dislipidêmicos. Os três grupos eram homogêneos em relação às variáveis estudadas. Em 24 meses houve remissão da hipertensão arterial sistêmica em 65% do grupo 1, 62.5% no grupo 2 e 68.4% no grupo 3. A remissão do diabete melito tipo 2 ocorreu em 85% dos pacientes do grupo 1, 83% no grupo 2, e 84% no grupo 3. Não houve diferença estatística na porcentagem de perda do excesso de peso entre os grupos e as medidas da cintura abdominal reduziram de forma homogênea em todos os grupos. A dimensão das alças também não influenciou na melhora da dislipidemia. A variação da dimensão das alças intestinais não influenciou na melhora da síndrome metabólica neste grupo de pacientes.

  11. [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.

  12. Sutureless cholecystojejunostomy in pigs using an absorbable intraluminal stent and fibrin glue.

    PubMed

    Detweiler, M B; Verbo, A; Marino, I R; Kobos, J W; Granone, P; Magistrelli, P; Picciocchi, A

    1996-01-01

    The absence of foreign bodies in sutureless anastomoses provides faster healing. The first sutureless cholecystojejunostomies were reported by Murphy in 1892. The common bile duct was tied and 11 cholecystojejunostomies plus 12 jejunojejunostomies were performed in 12 Landrace pigs employing sliding absorbable intraluminal nontoxic stents (SAINTs) and fibrin glue. One cholecystojejunostomy was not performed owing to a gallbladder morphologic anomaly. Three animals died of problems unrelated to the SAINT-glue anastomoses. Of the 18 anastomoses in the 9 remaining animals, all were patent at the verification times of 14, 30, 120, and 480 days. Morphologically,there was greater edema and reduced height of the glandular epithelium in the 30-day CJs when compared to the jejunojejunal anastomoses. Results indicate that the sutureless SAINT-fibrin glue procedure is quite versatile and may be utilized for cholecystoenteric anastomoses.

  13. SIMPLIFIED LAPAROSCOPIC GASTRIC BYPASS WITH GASTROJEJUNAL LINEAR MECHANICAL ANASTOMOSIS: TECHNICAL ASPECTS.

    PubMed

    Palermo, Mariano; Serra, Edgardo

    ástrica. O bypass gastrointestinal serve como o elemento malabsortivo. Descrever uma abordagem de bypass gástrico simplificado para pacientes obesos mórbidos, mostrando os resultados, e também destacando a importância desta técnica para reduzir a curva de aprendizagem. O paciente é posicionado em posição de pernas abertas e cuidadosamente amarrado à mesa da sala de operação com o cirurgião entre as pernas. Cinco trocárteres são inseridos após pneumoperitônio no umbigo. Dissecção do ângulo esofagogástrico e curvatura menor é obrigatória antes da realização da bolsa gástrica. Esta bolsa é feita com dois grampeadores de carga azuis. Usando um grampeador carga linear azul inserido apenas a meio caminho para dentro do orifício na bolsa é executada a anastomose gastrojejunal a fim de criar anastomose de cerca de 2 cm de comprimento. Jejunojejunostomia laretolateral é feita com um grampeador carga linear branca. A última etapa do bypass gástrico consiste no corte do jejuno entre as duas anastomoses com um grampeador carga linear branco. Teste de azul é realizado de modo a detectar vazamentos. De janeiro de 2012 a dezembro de 2015, foram realizadas 415 RYGB simplificadas. Gênero: 67% homens e 33% mulheres. A média do IMC foi de 44,7 e a de idade 42 anos. A média de tempo operatório foi de 79 min. 39% desta amostra tinha diabete melito tipo 2. Quanto às complicações foram observadas uma fístula, uma estenose gastrojejunal e uma obstrução devido à bezoar. A técnica descrita é uma abordagem simplificada, na qual todas as anastomoses são realizadas na parte superior do abdome, permitindo aos cirurgiões serem mais sistematizados e evitando cometerem erros na confecção da anastomose em Y-de-Roux. Este bypass gástrico simplificado é técnica segura e reprodutível.

  14. 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.

  15. L'Harmonisation des langues maliennes: entre l'Integration nationale et régionale

    NASA Astrophysics Data System (ADS)

    Ouane, Adama

    1991-03-01

    The standardization of Malian languages, which began in the period after independence, has been an educational reform guided more by linguists than by any institutional framework laid down by the political authorities of the country. This situation has permitted the technical application of a scientific strategy, but it has not led to widespread and general acceptance of the formulas which have been worked out. The consequent opposition between technical and political considerations, which have admittedly not always been in conflict, has been complicated by a set of additional factors which have made it difficult to reconcile internal (national) harmonization, dictated by local tendencies and balances between languages, and the need to respect the (regional) ecolinguistics of the country, whose linguistic and sociocultural divisions frequently extend well into other countries of the sub-region. This conflict is illustrated by the example of Malian languages with a wide regional distribution — Bamanan (Bambara) and Fulfulde (Fulani) — and by that of languages with a narrower distribution such as Bomu and Syenara-Mamara. The standardization of orthography and the creation of terminology in the MAPE (Mandingo-Peul) Project are the manifestation of a general acceptance of regionalism, while the choice of central, standard languages has often been made without regard for regional factors.

  16. 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.

  17. 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.

  18. Entre Nous: A Tutorial Approach to the Teaching of Business French.

    ERIC Educational Resources Information Center

    Chaisson, Arthur P.

    Suffolk University (Massachusetts) has developed a degree program in international marketing in French and Spanish that links curricula in the economics department and the department of humanities and modern languages. Language tutorials are mandatory for students in the international economics major. The tutorials are taught by native French- and…

  19. 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,…

  20. 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.

  1. 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.…

  2. 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)

  3. Virtual Interfaces: Research and Application (Les Interfaces Virtuelles entre Recherche et Applications).

    DTIC Science & Technology

    1994-05-01

    donndes et de la d6tection des mouvements humains, alli6s aux mod6les informatis6s des milieux naturels et artificiels, ont conduit A la mise el pltace...d’interfaces dites virtuelles. Les interfaces virtuelles offrent plus de souplesse et de naturel et elles sont donc envisag6es pour les domaines tels...contr6leurs a6ricns. principes d𔄀tude du langage naturel . Basd sur l’utilisation concomnitante d’une interface 11 GENERALITES vocale (synth~se et

  4. Legume Lectins Inhibit Human Parainfluenza Virus Type 2 Infection by Interfering with the Entr

    PubMed Central

    Uematsu, Jun; Koyama, Aoi; Takano, Sayaka; Ura, Yukari; Tanemura, Miho; Kihira, Sahoko; Yamamoto, Hidetaka; Kawano, Mitsuo; Tsurudome, Masato; O’Brien, Myles; Komada, Hiroshi

    2012-01-01

    Three lectins with different sugar binding specificities were investigated for anti-viral activity against human parainfluenza virus type 2 (hPIV-2). The lectins, concanavalin A (Con A), lens culinaris agglutinin (LCA) and peanut agglutinin (PNA), inhibited cell fusion and hemadsorption induced by hPIV-2. Virus nucleoprotein (NP) gene synthesis was largely inhibited, but fusion (F) and hemagglutinin-neuraminidase (HN) gene syntheses were not. An indirect immunofluorescence study showed that Con A inhibited virus NP, F and HN protein syntheses, but LCA did not completely inhibit them, and that PNA inhibited only NP protein synthesis. Using a recombinant green fluorescence protein-expressing hPIV-2, without matrix protein (rghPIV-2ΔM), it was found that virus entry into the cells was not completely prevented. The lectins considerably reduced the number of viruses released compared with that of virus infected cells. The lectins bound to cell surface within 10 min, and many aggregates were observed at 30 min. Con A and LCA slightly disrupted actin microfilaments and microtubules, but PNA had almost no effect on them. These results indicated that the inhibitory effects of the lectins were caused mainly by the considerable prevention of virus adsorption to the cells by the lectin binding to their receptors. PMID:22852043

  5. 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.…

  6. 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…

  7. La mécanique des fluides à la Sorbonne entre les deux guerres

    NASA Astrophysics Data System (ADS)

    Fontanon, Claudine

    2017-08-01

    World War I opened the way to a restructuring of research in the field of aviation sciences in France as abroad. Technical advances were made possible under the impulse of a new science: aerodynamics, notably owing to Gustave Eiffel's works. Nevertheless, the experimental approach that most marked this foundational period was replaced, after the Great War, with a much more theoretical approach of aerodynamic phenomena. And it is under the name ;fluid mechanics; that both theoretical and experimental approaches were gathered together to constitute, with classical hydrodynamics, the basis of teaching and university research at the Faculty of Sciences in Paris. The patronage era that had anchored aeronautical teaching and research to the Faculty of Sciences in Paris was succeeded by an era when the government authorities directly intervened to institutionalize fluid mechanics and orientate it toward applications to aviation. In this article, we will analyse the steps and modalities of the emergence of this science, with the aim to determine how much the scientific policy deployed between the two wars by the public authorities influenced the evolution and the progress of aeronautical techniques, and met the expectations of its promoters.

  8. 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…

  9. 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…

  10. Targeting children's dietary behaviors in a family intervention: 'Entre familia: reflejos de salud'.

    PubMed

    Horton, Lucy A; Parada, Humberto; Slymen, Donald J; Arredondo, Elva; Ibarra, Leticia; Ayala, Guadalupe X

    2013-01-01

    This intervention sought to promote healthy eating with the ultimate goal of reducing childhood obesity risk. Three hundred and sixty-one Latino families living on the US-Mexico border with at least one child between 7-13 years of age were eligible to participate. Families randomly assigned to the four-month intervention received 14 contacts with a promotora (community health worker), consisting of 11 home visits and three telephone calls; the control condition was a delayed treatment intervention. Children reported on their dietary intake at baseline, immediately post-intervention and at the six month follow-up visit. The intervention reduced weekly consumption of fast food (p<0.05). A dose-response relationship was observed such that for every seven hours of promotora contact, monthly variety of fruits (p<0.01) and vegetables (p<0.01) increased by one. No other intervention effects were observed. Family-based interventions can improve children's eating habits, with the amount of contact with the promotora being key to success.

  11. 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…

  12. Comparación entre los sitios de LLAMA y APEX

    NASA Astrophysics Data System (ADS)

    Bareilles, F. A.; Morras, R.; Hauscarriaga, F. P.; Guarrera, L.; Arnal, E. M.; Lepine, J. R. D.

    A comparison among the meteorological condition prevailing at the location of APEX (Atacama Pathfinder Experiment) telescope and the site selected to deploy LLAMA (Long Latin American Millimeter Array) is carried out. The later is dubbed Alto Chorrillo, and is located 4800 m above sea level and around 16 km eastward from the town of San Antonio de los Cobres (province of Salta). This work is part of a long term monitoring campaign aim at selecting sites for millimeter and submillimeter radioastronomy that is being carried out by the Instituto Argentino de Radioastronomía (IAR) since 2002. FULL TEXT IN SPANISH

  13. [Esophageal perforation in children: a review of one pediatric surgery institution's experience (16 years)].

    PubMed

    Vieira, Elizabete; Cabral, Maria João; Gonçalves, Mroslava

    2013-01-01

    Introdução: O estudo teve por objetivo avaliar a experiência do nosso Serviço no tratamento das perfurações esofágicas. Material e Métodos: Análise retrospetiva de nove casos ocorridos entre 1 de Janeiro de 1996 e 31 de Dezembro de 2011. Destes casos, sete ocorreram após ingestão acidental de corpos estranhos e em dois tratou-se de lesões iatrogénicas após dilatação esofágica: por estenose péptica num caso e no outro por estenose da anastomose esofágica término-terminal de uma criança operada por atrésia do esófago. Resultados: Em 78% dos casos a abordagem inicial foi médica, com encerramento comprovado da perfuração em média ao fim de 20 dias; 22% dos doentes (dois casos) foram submetidos a cirurgia sem sucesso, acabando um deles por curar sem sequelas com pausa alimentar e terapêutica médica; no outro caso verificou-se necessidade de realizar posteriormente uma esofagocoloplastia. Na nossa série não se registou mortalidade. Discussão: A perfuração esofágica é uma das lesões mais graves do trato alimentar, continuando a ser devastadora, e, de difícil diagnóstico e tratamento. O reconhecimento desta complicação é fundamental para o seu tratamento com sucesso. Conclusões: O atraso do diagnóstico está associado a uma mortalidade que pode oscilar entre os 20 e 40%.

  14. Color-dye injection of monochorionic placentas and correlation with pregnancy complications.

    PubMed

    Lanna, Mariano Matteo; Consonni, Dario; Faiola, Stefano; Schena, Vito; Ratti, Martina; Ferrazzi, Enrico; Rustico, Maria Angela

    2015-10-01

    Vascular anastomoses in monochorionic (MC) twin placenta can be easily identified with color-dye injection. The aim of this study is to analyze the relationship between different type of anastomoses and twin pregnancy complications. From January 2011 to October 2014, MC placentas were analyzed with color-dye injection and five group of pregnancies were identified: those that were not complicated (NC), those complicated with selective intrauterine growth restriction (sIUGR), twin-twin transfusion syndrome (TTTS), or twin anemia-polycitemia sequence (TAPS) and those with amniotic fluid discordance (AFD) between twins. Cases of TTTS treated with endoscopic laser coagulation of placenta anastomoses or cases with in utero death of one twin were excluded. A total of 118 MC placentas were observed, 58 (49%) NC, 35 (30%) sIUGR, 10 (8%) TTTS, 13 (11%) AFD and 2 (2%) TAPS. The median number of anastomoses was 7 (range 1-15), 8 (2-18), 4 (2-11), 7 (2-13) and 1 (1-1), respectively. At least one artero-venous anastomoses was found in the placenta observed, while the prevalence of artero-arterial anastomoses was 95% for NC, 91% for sIUGR, 60% for TTTS, and 77% for AFD; no TAPS placenta had this type of anastomoses. The diameter of arteroarterial anastomoses was greater in the AFD group (3.3 mm), compared to the NC, sIUGR and TTTS groups (2.3, 2.5 and 1.4 respectively, p 0.04). In this large serie of MC placenta analyzed with color-dye injection, a specific distribution of anastomoses emerged for twins with amniotic fluid discordance, which points to a need for intensive surveillance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. The sutureless excimer laser assisted non-occlusive anastomosis (SELANA); a feasibility study in a pressurized cadaver model.

    PubMed

    van Doormaal, Tristan P C; van der Zwan, Albert; Aboud, Emad; Berkelbach van der Sprenkel, Jan Willem; Tulleken, Cornelius A F; Krisht, Ali F; Regli, Luca

    2010-09-01

    To compare intracranial feasibility of the conventional Excimer laser assisted non-occlusive anastomosis (ELANA) with the new experimental sutureless ELANA (SELANA). Four pressurized human cadaver heads were bilaterally trepanated, using a combined pterional/pretemporal/transcavernous approach. In each head, seven ELANA anastomoses and seven contralateral SELANA anastomoses were constructed on (1) the proximal PCA/basilar artery (P1 segment/basilar artery; BA), (2) the distal posterior cerebral artery (PCA, P2 segment), (3) the supraclinoidal internal carotid artery (ICA), (4) the ICA bifurcation, (5) the proximal anterior cerebral artery (ACA, A1 segment), (6) the proximal middle cerebral artery (MCA, M1 segment), and (7) the distal MCA (M2 segment). In total, 26 of 28 ELANA anastomoses (93%) and 22 of 28 SELANA anastomoses (79%) could be completed. Two ELANA anastomoses on the BA could not be finished because of limited space. Six SELANA anastomoses could not be attached because the applicator did not facilitate an angulated anastomosis spot. Of the remaining anastomoses, more ELANA (eight) than SELANA (two) anastomoses could not be realized without manipulation of surrounding structures. The SELANA anastomoses were completed significantly faster than the ELANA, mean difference ranging from 11 min on the M2 to 107 min on the P1/BA. This comparative study shows potential advantages of the SELANA anastomosis over the ELANA anastomosis because during application, it causes less manipulation of surrounding structures while it is faster and easier. Further preclinical research should be performed in order to improve SELANA feasibility on angulated anastomosis spots and to assess long-term SELANA patency and endothelialization.

  16. Mirizzi syndrome grades III and IV: surgical treatment.

    PubMed

    Reverdito, Ronald; Moricz, André DE; Campos, Tércio DE; Pacheco, Adhemar Monteiro; Silva, Rodrigo Altenfelder

    2016-01-01

    : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity. avaliar a epidemiologia e os resultados do tratamento cirúrgico de doentes portadores de graus III e IV, mais avançados, da Síndrome de Mirizzi (SM) de acordo com a classificação de Csendes. estudo retrospectivo, de corte transversal através da revisão de prontuários de 13 pacientes portadores de graus III e IV da SM operados de dezembro de 2001 a setembro de 2013, entre 3691 colecistectomias realizadas neste período. a incidência da SM foi 0,6% (23 casos) e os graus III e IV perfizeram 0,35% deste número. Houve um predomínio de tipo IV (12 casos). O diagnóstico pré-operatório foi possível em 53,8% dos casos. A conduta preferencial foi derivação biliodigestiva (10 casos) e foi optado por drenagem

  17. Clinical-epidemiological profile of acute appendicitis: retrospective analysis of 638 cases.

    PubMed

    Lima, Amanda Pereira; Vieira, Felipe José; Oliveira, Gabriela Procópio DE Moraes; Ramos, Plínio Dos Santos; Avelino, Marielle Elisa; Prado, Felipe Garcia; Salomão, Gilson; Silva, Francisco Campos; Rodrigues, João Vicente Linhares

    2016-01-01

    to describe the clinical and epidemiological profile of acute appendicitis (AA) of the patients treated at a referral center in the Juiz de Fora macro-region, Minas Gerais State, Brazil. we conducted a retrospective, observational study in the Dr. Mozart Geraldo TeixeiraEmergency Hospital. We selected 638 patients diagnosed with AA, and analyzed the variables gender, age, evolutionary phase, length of hospital stay, pathological diagnosis, use of antibiotics, use of drains, complications and mortality. AA was more prevalent in young adults (19-44 years) and males (65.20%). The mean hospital stay was seven days and phase II was the most prevalent. We found the histopathological diagnosis of primary tumor of the appendix in six patients (0.94%), adenocarcinoma being the most common histologic type (66.7%). Regarding the use of antibiotics, 196 patients underwent antibiotic prophylaxis and 306 received antibiotic therapy. Eighty-one patients used some kind of drain, for an average of 4.8 days. Seventeen patients died (2.67%), predominantly males (70.59%), with mean age of 38.47 years. AA has a higher prevalence in males and young adults. The length of stay is directly associated with the evolutionary phase. The most common complication is infection of the surgical site. Mortality in our service is still high when compared with developed centers. avaliar a epidemiologia e os resultados do tratamento cirúrgico de doentes portadores de graus III e IV, mais avançados, da Síndrome de Mirizzi (SM) de acordo com a classificação de Csendes. estudo retrospectivo, de corte transversal através da revisão de prontuários de 13 pacientes portadores de graus III e IV da SM operados de dezembro de 2001 a setembro de 2013, entre 3691 colecistectomias realizadas neste período. a incidência da SM foi 0,6% (23 casos) e os graus III e IV perfizeram 0,35% deste número. Houve um predomínio de tipo IV (12 casos). O diagnóstico pré-operatório foi possível em 53,8% dos casos. A

  18. [Auto-suture stapler EEA in surgery of the colon and rectum [author's transl)].

    PubMed

    Thiede, A; Troidl, H; Poser, H; Jostarndt, L; Hamelmann, H

    1980-01-01

    The increasing use of auto-suture staplers for gastrointestinal anastomoses makes it necessary to test the value of this new method of suturing. In a "pilot study" the practicability, the tightness and permeability of the anastomosis and complications were tested and analysed in a total of 30 colon and rectal anastomoses using the EEA-suture gun. The results of 14 colon resections and 16 low anterior resections justify the further use of the EEA auto-suture apparatus and raise the question of a prospective controlled random study in which manual and mechanical machine sutured anastomoses are compared.

  19. Use of absorbable sutures in canine carotid arteries.

    PubMed

    Rey, A R; Carrillo-Farga, J; Velasco, C O; Valencia, M O

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on until the 12th group, which was observed for 12 months. At the end of each observation period, reoperation was undertaken to evaluate the vascular anastomoses by means of angiography and microscopy. The polypropylene anastomoses showed a marked deformity, with tissue retraction and a foreign body reaction. In contrast, the polydioxanone anastomoses exhibited satisfactory healing, without deformity, and were well tolerated histologically. We believe that polydioxanone may be a useful, alternative vascular suture material.

  20. Atresia of the superior vena cava causing cyanosis and increasing head circumference in an infant.

    PubMed

    Lytrivi, Irene D; Avramidis, Dimosthenis; Sfyridis, Panagiotis; Kirvassilis, George; Sarris, George; Papagiannis, John

    2010-01-01

    We report a case of congenital atresia of the superior vena cava (SVC) with stenotic anastomoses between systemic and pulmonary veins, resulting in cyanosis and symptoms consistent with SVC syndrome in an infant.

  1. 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.

  2. INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY.

    PubMed

    Vidal, Eduardo Arevalo; Rendon, Francisco Abarca; Zambrano, Trino Andrade; García, Yudoco Andrade; Viteri, Mario Ferrin; Campos, Josemberg Marins; Ramos, Manoela Galvão; Ramos, Almino Cardoso

    da má-rotação intestinal durante operações bariátricas sequenciais. Retrospectivamente foram analisados os prontuários médicos de 20.000 casos de operações bariátricas de janeiro 2002 a janeiro de 2016, procurando por ocorrência de má-rotação intestinal, sua interferência na técnica operatória aplicada e a evolução imediata no pós-operatório. Foram encontrados cinco casos (0.025%) de má-rotação intestinal em homens com idades de 37, 39, 45, 49 e 52 anos e IMC de 35, 42, 49, 47 e 52 kg/m2. O paciente com IMC de 35 kg/m2 também sofria de diabete melito tipo 2. Todos os procedimentos foram realizados através de laparoscopia, sem conversões. Em um paciente não foi possível mover o jejuno para o abdome superior a fim de realizar gastrojejunostomia; foi, então, realizada gastrectomia vertical. Em outro paciente, não foi possível reconhecer totalmente a anatomia devido às aderências intestinais e foi decidido realizar bypass gástrico com anastomose única. Nenhum vazamento ou sangramento foi identificado. Não houve nenhuma complicação pós-operatória. Todos os pacientes foram liberados 72 h após o procedimento e nenhuma complicação foi notificada nos primeiros 30 dias. A cirurgia bariátrica laparoscópica pode ser realizada com sucesso em pacientes com má-rotação. Mudanças talvez sejam necessárias com relação à anomalia. Os cirurgiões devem verificar toda a condição anatômica abdominal antes de iniciar a secção gástrica.

  3. Differences in capillary architecture, hemodynamics, and angiogenic factors in rat slow and fast plantarflexor muscles.

    PubMed

    Fujino, Hidemi; Kondo, Hiroyo; Murakami, Shinichiro; Nagatomo, Fumiko; Fujita, Naoto; Takeda, Isao; Ishihara, Akihiko; Roy, Roland R

    2012-02-01

    The capillary architecture in skeletal muscles is unique in that it has anastomoses that interconnect individual capillaries. We used new techniques to measure velocity of red blood cells (V(RBC) ) in both capillaries and anastomoses in situ. The volume of capillaries/anastomoses was determined, and the levels of several angiogenic regulators were compared between the soleus and the superficial gastrocnemius (LG(sup) ). The V(RBC) in both capillaries and anastomoses was slower in soleus than in LG(sup) . The numbers of capillaries and anastomoses were higher, diameter of capillaries smaller, and tortuosity greater in soleus than in LG(sup) . Consequently, the capillary/anastomoses volume was larger in soleus than in LG(sup) . Furthermore, several angiogenic regulators (HIF-1α, VEGF, Flt-1, KDR, angiopoietin-1 and -2, and Tie-2) were higher in soleus than in LG(sup) . The differences in microvascular architecture, V(RBC) , and levels of angiogenic regulators between soleus and LG(sup) reflect the greater oxygen demands of the highly active soleus muscle. Copyright © 2011 Wiley Periodicals, Inc.

  4. 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.

  5. Long term results of the use of compression anastomosis clips (CAC) in gastrointestinal surgery – the first report.

    PubMed

    Kuśnierz, Katarzyna; Lampe, Paweł

    2015-06-01

    The aim of the study was to present the first long-term results on the clinical use of compression anastomosis clips (CAC) in upper and lower gastrointestinal tract anastomoses. The study included 50 patients who underwent anastomosis of the upper (n = 32) or lower GI tract (n = 18) with the use of CAC. In the period of 6-7 months after the surgery, patients underwent endoscopic examination and computed tomography evaluation of the anastomosis. Each anastomosis was evaluated macro and microscopically. The width of anastomoses was evaluated using a 4-point-scale for grading stenosis. Of the 50 patients who underwent anastomosis with compression anastomosis clip, 28 (56%) patients reported to the follow-up examination within 190-209 days of the execution of the anastomosis. Among the 22 patients who did not report to the study, 18 (36%) patients died within 91-154 days from the execution of the anastomosis (mean 122 days), 4 (8%) patients were impossible to contact after discharge from hospital. Two mild stenoses (I0) were diagnosed; 1 of them was found in the gastroenterostomy and 1 in Braun enteroenterostomy. Microscopic changes were diagnosed in 4 anastomoses (3 gastroenterostomies, 1 Braun enteroenterostomy). Anastomoses were well-formed and wide, scars in the line of anastomoses were thin. During the period of 6 months after the anastomoses performed using CAC have been formed, they were evaluated as unobstructed and functioning properly; therefore, they can be safely performed within the upper and lower gastrointestinal tract.

  6. 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

  7. Correspondances entre la variabilite des conduites maternelles et la diversification des comportements de la progeniture chez la souris.

    PubMed

    Chevalet, P; Le Pape, G

    1989-12-01

    Maternal behaviour may be used as a tool for hereditary transmission of behavioural characters in mammals. The maternal behaviour of mice from three different origins which reared foster pups of the same inbred strain was observed. Multivariate analysis revealed differences in maternal style related either to genotype effects or to grandmaternal influences. The behavioural development of the pups was studied at days 10, 14 and 17 for neuromotor coordination and spontaneous activity, at day 21, 40 and 75 for locomotor activity and food hoarding in a semi natural environment and at day 120 of age for water escape learning performance. Body weights were noted at the same ages. Results showed both maternal effects (differences between pups reared by an inbred or hybrid mother) and great-grandmaternal effects (differences between pups reared by two reciprocal F2's). An analysis of correspondences between mother and pup behaviour permitted the description of a large panel of correlations suggesting causal relations between maternal activities and pups characteristics. These maternal activities may be considered primarily as agents of hereditary transmission. Copyright © 1989. Published by Elsevier B.V.

  8. Metonymie dans la presse ecrite: entre discours et langue (Metonymies in the Press: Between Discourse and Language).

    ERIC Educational Resources Information Center

    Lecolle, Michelle

    2001-01-01

    This paper describes certain metonymies that are often employed in the daily French press. In such metonymies, a human being or a set of individuals are referred to by means of the name of an institutional location (i.e., a capital city, a ministry in a western country, the name of a country). These metonymic patterns do not seem to be used by…

  9. 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.…

  10. 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).

  11. 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.

  12. 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 interest of in-resonance gold nanorods for this type of process. (Abstract shortened by UMI.)

  13. Relation entre la composition des smectites d'alteration sous-marine et leur cortege de terres rares

    NASA Astrophysics Data System (ADS)

    Desprairies, Alain; Bonnot-Courtois, Chantal

    1980-06-01

    In basalts and volcanogenic sediments from the Indian Ocean, the successive stages of submarine alteration of volcanic rocks and glasses give rise to the incorporation or the relative increase of iron in smectite lattices. During the first stage, the Mg-smectites are the most abundant; they are occasionally associated with Al-smectites. Afterwards, they are gradually replaced by iron-rich smectites. The REE distribution follows the same trend as the mineralogical changes. During the first stage of alteration, REE distribution in clay minerals is the same as in the fresh glasses but, when the iron-rich smectites increase, the Ce has a specific behaviour. The Ce shows a positive anomaly in iron-rich smectites formed early in palagonitized glasses, and a negative one in authigenic smectites formed later from solutions in equilibrium with seawater.

  14. 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…

  15. Dissolved organic carbon in water fluxes of Eucalyptus grandis plantations in northeastern Entre Ríos Province, Argentina

    Treesearch

    Natalia Tesón; Víctor H Conzonno; Marcelo F Arturi; Jorge L Frangi

    2014-01-01

    Water fluxes in tree plantations and other ecosystems carry dissolved organic carbon (DOC) provided by atmospheric inputs, autotrophic and heterotrophic metabolisms and from the lysis of dead material. These compounds may be colorless or provide a yellow-to-brown color to water and may also absorb visible light due to the presence of chromophores in the chemical...

  16. 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.…

  17. Estudio de la interacción entre Tit·n y la magnetósfera de Saturno

    NASA Astrophysics Data System (ADS)

    Villarreal D'Angelo, C. S.; Caranti, G. M.

    In this work we present a study of the interaction between Titan and the plasma in Saturn magnetosphere from the data obtained with the magne- tometer on board Cassini during one flyby to the saturnian moon in 2009. The analisys of the data was divided in two parts, one corresponding to the entire trajectory and the other corresponding to a few hours around closest approach. Also, an MHD code was utilized to reproduce the observation. FULL TEXT IN SPANISH

  18. Investigation des correlations existant entre la perception de qualite audio et les reactions physiologiques d'un auditeur

    NASA Astrophysics Data System (ADS)

    Baudot, Matthias

    Les tests d'ecoute subjectifs permettent d'evaluer la fiabilite de reproduction des systemes de codage audio (codecs). Le projet presente ici vise a evaluer la possibilite d'utiliser les reactions physiologiques (activite electrodermale, cardiaque, musculaire et cerebrale) a la place d'une note donnee par l'auditeur, afin de caracteriser la performance d'un codec. Ceci permettrait d'avoir une methode d'evaluation plus proche de la perception reelle de qualite audio du sujet. Des tests d'ecoute mettant en oeuvre des degradations audio bien connues en concours avec la mesure des reactions physiologiques ont ete realises pour 4 auditeurs. L'analyse des resultats montre que certaines caracteristiques physiologiques permettent d'avoir une information fiable sur la qualite audio percue, et ce de maniere repetable pour pres de 70% des signaux audio testes chez un sujet, et pres de 60% des sequences audio testees chez tous les sujets. Ceci permet de postuler sur la faisabilite d'une telle methode d'evaluation subjective des codecs audio. Mots-cles : test d'ecoute subjectif, evaluation des codecs audio, mesures physiologiques, qualite audio percue, conductance electrodermale, photoplethysmographie, electromyogramme, electroencephalogramme

  19. 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

  20. 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.

  1. Outbreak of Paratyphoid Fever Among Naval Personnel in Peru (Brote de Fiebre Paratifoidea Entre Personal de la Marina Del Peru.)

    DTIC Science & Technology

    1992-01-01

    histo- bre o ambos foe S. 1wrathypllr B. ria clfnica (presunta y confirmada) Se traz6 una curva de la epidemnia basada en [a fecha Instrunmn de encuesta ...apatentemnente sanos queacccdieron acon fiebre. Dadas las m~dtiples pi-esentacio- participat en la encuesta . En el cuestionano nes dinicas dejla...Ofotin Da Cnkimia d V = nuimero de voluntarios que partic- nwal and itteraipwtic ettiaunj c 411 badere peron en la encuesta deexcretoree sn. 9h95 79 F

  2. 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

  3. A comparison of para-anastomotic compliance profiles after vascular anastomosis: nonpenetrating clips versus standard sutures.

    PubMed

    Baguneid, M S; Goldner, S; Fulford, P E; Hamilton, G; Walker, M G; Seifalian, A M

    2001-04-01

    Anastomotic compliance is an important predictive factor for long-term patency of small diameter vascular reconstruction. In this experimental study we compare the compliance of continuous and interrupted sutured vascular anastomoses with those using nonpenetrating clips. Both common carotid arteries in nine goats (average weight, 57 +/- 5.7 kg) were transected, and end-to-end anastomoses were constructed with nonpenetrating clips or polypropylene sutures. The latter were applied with both interrupted and continuous techniques. Intraluminal pressure was measured with a Millar Mikro-tip transducer, and vessel wall motion was determined with duplex ultrasound equipped with an echo-locked wall-tracking system. Diametrical compliance was determined. Environmental scanning electron microscopy was performed on explanted anastomoses. There was a reduction in anastomotic compliance and associated proximal and distal para-anastomotic hypercompliant zones with the use of all techniques. However, compliance loss was significantly less in those anastomoses with clips and interrupted sutures when compared with continuous suture (P <.001). Furthermore, the total compliance mismatch across anastomoses with continuous sutures was significantly greater than those with clips or interrupted sutures (P <.05). The mean time for constructing clipped anastomoses was 5.7 +/- 1.4 minutes, which was significantly less than either continuous (P <.0001) or interrupted sutures (P <.0001). Furthermore, environmental scanning electron microscopy demonstrated minimal intimal damage with good intimal apposition in the clip group. Anastomoses performed with nonpenetrating clips resulted in improved para-anastomotic compliance profiles and reduced intimal damage when compared with those with polypropylene sutures. These benefits may enhance long-term graft patency by reducing the risk of anastomotic intimal hyperplasia.

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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.

  5. 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

  6. 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

  7. Triple sequential grafts using the internal mammary artery. An angiographic and short-term follow-up study.

    PubMed

    van Sterkenburg, S M; Ernst, S M; Brutel de la Rivière, A; Defauw, J A; Hamerlynck, R P; Knaepen, P J; van Swieten, H A; Vermeulen, F E

    1992-07-01

    Between December 1984 and December 1988, coronary artery bypass operations, involving the use of 119 sequential internal mammary artery grafts with three or more anastomoses per conduit, were performed in 116 patients. Patients included 14 women and 102 men, with a mean age of 60 years. They received a total of 629 anastomoses; 373 anastomoses were used in multiple sequential arterial bypass grafts; 116 sequential left and three right internal mammary artery jump grafts were performed. There were 27 patients with bilateral internal mammary artery grafts, but only 17 had completely arterial revascularizations. Perioperative infarction occurred in 3.4% of the patients; 1.7% of infarctions were related to sequential internal mammary artery grafts. There were no hospital deaths. Control angiography was performed within a month of the operation in 72 patients (with 371 anastomoses, of which 229 were in sequential arterial bypass grafts). The overall patency rate was 94.6%, and for the internal mammary artery sequential graft with three or more anastomoses it was 96.1%. The mean follow-up period was 13 months; 110 patients were in New York Heart Association class I; there was one non-cardiac-related death, and three patients (2.6%) had a late myocardial infarction. One was related to the area revascularized by the sequential internal mammary artery graft. Multiple sequential internal mammary artery bypass grafts in coronary artery disease are feasible, with a high short-term patency and a low perioperative morbidity and mortality.

  8. Colo-colonic anastomosis in a continuous-flow left ventricular assist device patient.

    PubMed

    Knaus, William J; Olson, Craig H

    2015-03-12

    Noncardiac operations are being increasingly performed on patients with left ventricular assist devices (LVADs). However, little is known on the impact of continuous-flow LVADs on the vascular supply of the colon for anastomoses. In this case, a 67-year-old male supported on an LVAD underwent four successful noncardiac operations including two intestinal anastomoses; left colon and small bowel anastomosis. To the best of our knowledge, no existing literature has reported successful colonic anastomosis on a continuous-flow LVAD. This case illustrates the plausibility of performing colonic anastomoses with appropriately selected patients supported on an LVAD. A 67-year-old male with congestive heart failure underwent LVAD placement for decompensated heart failure while awaiting orthotopic transplantation. During his recovery, he developed a stage IV sacral decubitus ulcer which required a sigmoid loop colostomy placement and a rotational flap. Subsequent stoma closure with partial sigmoid colectomy and stapled anastomosis was performed, and healed without evidence of anastomotic leak. This case illustrates the potential for colonic anastomoses for patients on continuous-flow LVAD support. Although oxygenation is known to be an important aspect of healing, this patient's outcome suggests that intestinal anastomoses can be performed on the induced pulseless environment of an LVAD. Further studies will be needed to further elucidate the success of longer segment resections and appropriate surgical candidates.

  9. Fluorescein sodium fluorescence microscope-integrated lymphangiography for lymphatic supermicrosurgery.

    PubMed

    Ayestaray, Benoit; Bekara, Farid

    2015-07-01

    Microscope-integrated lymphangiography is a useful method in the field of lymphatic supermicrosurgery. Fluorescence based on indocyanine green (ICG) is the most commonly used. Fluorescein sodium is a fluorescent tracer used for retinal and neurosurgical angiography but not yet for lymphatic supermicrosurgery. In this report, we present a case in which the fluorescein sodium fluorescence microscope-integrated lymphangiography was used for assessment of lymphatic drainage pathway and patency in a patient treated for secondary lymphedema by lymphaticovenular anastomoses. Fluorescein sodium fluorescence microscope-integrated lymphangiography was evaluated in a 67-year-old female presented for a Campisi clinical stage IV lymphedema of the upper limb. Transcutaneous guidance and vascular fluorescence were assessed. A comparison with ICG fluorescence was made intraoperatively. Two lymphaticovenular anastomoses were performed and their patency were checked by lymphangiography. Transcutaneous signal was found higher with fluorescein sodium fluorescence. Intraluminal visualization was possible with fluorescein sodium coloration during lymphaticovenular anastomoses. No adverse reaction occurred. The circumferential differential reduction rate of affected limb was 8.1% 3 months after lymphaticovenular anastomoses. The use of fluorescence microscope-integrated lymphangiography with fluorescein sodium may be superior to ICG fluorescence in assistance of lymphaticovenular anastomoses.

  10. Lower uterine blood supply: extrauterine anastomotic system and its application in surgical devascularization techniques.

    PubMed

    Palacios Jaraquemada, José Miguel; García Mónaco, Ricardo; Barbosa, Nicolás E; Ferle, Luciana; Iriarte, Hernán; Conesa, Horacio Alejandro

    2007-01-01

    To establish the arterial components that determine lower uterine blood supply, varieties and anastomoses that result in complications during selective devascularization procedures. Thirty-nine female cadaveric pelvises with latex repletion in pelvic arteries were used. All the material was studied through direct dissection, and dissection enlarged with a 90-diopter magnifying glass, establishing origin, course, and anastomoses of the genital arteries. Axial calibers of the uterine and the main vaginal arteries were compared. An anatomical and a historical compilation of the uterine artery was made, with special reference to anastomotic areas in the lower sector. Three main pedicles were determined in the lower uterine blood supply: a cephalic one constituted by the uterine artery, a medial one made up by the cervical artery, and a distal one formed by the vaginal arteries. Different types of anastomoses were distinguished among the upper, middle, and lower pedicles. All types of anastomoses displayed similar features and were interconnected along the isthmic-vaginal borders, or as an intramural anastomotic network. In many cases, a transmedial interuterine anastomosis of axial caliber equivalent to the uterine artery itself could be observed. The bibliography consulted provided neither detailed descriptions of the cervical-segmental arterial system nor of the vaginal system or its anastomoses. In two cases, images were found in books that show this anastomotic system without further explanation. A not very well known anastomotic system was described between uterine and vaginal arteries. This system explains some reported failures, complications, and hemodynamic changes after uterine devascularization procedures.

  11. Robotic surgery of locally advanced gastric cancer: a single-surgeon experience of 41 cases.

    PubMed

    Vasilescu, C; Procopiuc, L

    2012-01-01

    The mainstay of curative gastric cancer treatment is open gastric resection with regional lymph node dissection. Minimally invasive surgery is yet to become an established technique with a well defined role. Robotic surgery has by-passed some of the limitations of conventional laparoscopy and has proven both safe and feasible. We present our initial experience with robotic surgery based on 41 gastric cancer patients. We especially wish to underline the advantages of the robotic system when performing the digestive tract anastomoses. We present the techniques of end-to-side eso-jejunoanastomoses (using a circular stapler or manual suture) and side-to-side eso-jejunoanastomoses. In our hands, the results with circular stapled anastomoses were good and we advocate against manual suturing when performing anastomoses in robotic surgery. Moreover, we recommend performing totally intracorporeal anastomoses which have a better post-operative outcome, especially in obese patients. We present three methods of realising the total intracorporeal eso-jejuno-anastomosis with a circular stapler: manual purse-string suture, using the OrVil and the double stapling technique. The eso-jejunoanastomosis is one of the most difficult steps in performing the total gastrectomy, but these techniques allow the surgeon to choose the best option for each case. We consider that surgeons who undertake total gastrectomies must have a special training in performing these anastomoses.

  12. [A serious complication in colorectal surgery: anastomotic leakage. Our experience].

    PubMed

    Petitti, T; Lippolis, G; Ferrozzi, L

    2005-10-01

    Anastomotic leakage is a severe complication in colorectal surgery with a lot of generic and specific risk factors. There are still controversies about the possibility to prevent it or to limit its severity with the use of faecal diversions. We report our experience on 189 patients operated in five years on colon-rectum, in election and emergency, with manual or mechanical anastomoses in the last 20 cm from the anal verge. We have had 21 anastomotic leakages (11%), symptomatic in 10 cases (5.5%), and 5 deaths (2.6%), 3 directly correlated to the leakage. In the patients (n 98) with loop-ileostomy there wasn't anastomotic leakages reduction, but only of clinical impact. We prefer loop-ileostomy in cases of extraperitoneal anastomoses, always in emergency and in anastomoses at risk.

  13. [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.

  14. [Choice of surgical correction of varicocele based on the characteristics of venous hemodynamics].

    PubMed

    Loran, O B; Sokol'shchik, M M; Gagarina, S V; Stoĭko, Iu M; Golitsyn, A V

    2006-01-01

    A complex ultrasound investigation of the left renal, testicular veins, those of the pampiniform plexus and intraoperative analysis of varicose venous truncks specify hemodynamic aspects of varicocele genesis, identify a group of patients with suspected regional venous renal hypertension and help to decide on surgical policy. Hemodynamic disorders leading to varicocele can be corrected with consideration of regional venous renal hypertension by surgical interventions with creation of testiculo-inferio-epigastric, testiculo-inferio-epigastric superficial and testiculosafic anastomoses and their combinations. Valid are microsurgical corrections of types I and II according to Coolsaet disorders of venous hemodynamics in varicocele using non-varicose testicular veins. In the presence of type III and/or signs of venous renal hypertension, combinations of venous anastomoses are practiced. The results of duplex angioscanning of the region of anastomoses and analysis of male fertility evidence for positive early and late outcomes of microsurgical treatment of varicocele.

  15. Navigation lymphatic supermicrosurgery for the treatment of cancer-related peripheral lymphedema.

    PubMed

    Yamamoto, Takumi; Yamamoto, Nana; Numahata, Takao; Yokoyama, Ai; Tashiro, Kensuke; Yoshimatsu, Hidehiko; Narushima, Mitsunaga; Koshima, Isao

    2014-02-01

    Lymphatic supermicrosurgery is becoming the treatment of choice for refractory lymphedema. Detection and anastomosis of functional lymphatic vessels are important for lymphatic supermicrosurgery. Navigation lymphatic supermicrosurgery was performed using an operating microscope equipped with an integrated near-infrared illumination system (OPMI Pentero Infrared 800; Carl Zeiss, Oberkochen, Germany). Eight patients with extremity lymphedema who underwent navigation lymphatic supermicrosurgery were evaluated. A total of 21 lymphaticovenular anastomoses were performed on 8 limbs through 14 skin incisions. Lymphatic vessels were enhanced by intraoperative microscopic indocyanine green (ICG) lymphography in 12 of the 14 skin incisions, which resulted in early dissection of lymphatic vessels. All anastomoses showed good anastomosis patency after completion of anastomoses. Postoperative extremity lymphedema index decreased in all limbs. Navigation lymphatic supermicrosurgery, in which lymphatic vessels are visualized with intraoperative microscopic ICG lymphography, allows a lymphatic supermicrosurgeon to find and dissect lymphatic vessels earlier and facilitates successful performance of lymphaticovenular anastomosis.

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

    PubMed

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

    2015-07-01

    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.

  17. 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.

  18. [Localization of efferent sympathetic neurons and afferent neurons in dorsal root ganglia innervating the heart].

    PubMed

    Fateev, M M; Zaikina, M G

    1989-01-01

    The retrograde transport of horseradish peroxidase (HRP) has been used to study the localization and the number of neurons innervating the heart in the right stellate ganglion and accessory cervical ganglion, spinal cord and dorsal root ganglia of the cat. HRP was applied to the central cuts of anastomose of the stellate ganglion with the vagal nerve, of the vagosympathetic trunk caudal to anastomose and of the inferior cardiac nerve. HRP-labelled neurons were detected in the stellate ganglion in the regions which give off nerves, whereas in the accessory cervical ganglion labelled neurons were distributed throughout the whole ganglion. HRP-stained cells were found in the anastomose. In the spinal cord labelled neurons were detected in the lateral horn of T1-T5 segments. In the dorsal root ganglion the greatest number of neurons was observed in T2-T4 segments.

  19. 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

  20. Effect of modified proximal anastomosis of the free right internal thoracic artery: piggyback and foldback techniques

    PubMed Central

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Tokoro, Masayoshi; Yanagisawa, Junji; Murotani, Kenta

    2016-01-01

    OBJECTIVES Few studies have reported the free right internal thoracic artery (RITA) being used in an aorto-coronary fashion. This study aimed to evaluate the free RITA with modified proximal anastomosis in an aorto-coronary fashion. METHODS Between January 2000 and December 2012, 282 patients underwent coronary artery bypass grafting with bilateral internal thoracic arteries for complete revascularization of the left coronary system at our institution. The left internal thoracic artery (LITA) was anastomosed to the left anterior descending artery (LAD) and the RITA was anastomosed to the left circumflex branches (LCX). The RITA was used as a free graft in 213 patients (free group) and as an in situ graft in 69 patients (in situ group). Proximal anastomosis of the free RITA onto the ascending aorta was performed in two different ways. We compared early and late results and graft patency of the free RITA with those of the in situ RITA retrospectively. RESULTS The numbers of anastomoses per patient and anastomoses of the RITA were larger in the free group than in the in situ group (P < 0.01). There was no significant difference in postoperative survival between the groups (free group: 93.3% vs in situ group: 90.0%, P = 0.82). The 5-year patency of the free RITA was higher than that of the in situ RITA (97.0 vs 80.3%, P = 0.01). The 5-year patency of the free RITA was comparable with that of the in situ LITA anastomosed to the LAD (97.0 vs 92.9%, P = 0.28). CONCLUSIONS The free RITA anastomosed to the LCX might have better late patency than the in situ RITA. The free RITA with modified proximal anastomosis in an aorto-coronary fashion enables complete revascularization of the left coronary system with the in situ LITA to the LAD. PMID:26657002

  1. Conidial anastomosis fusion between Colletotrichum species.

    PubMed

    Roca, Maria Gabriela; Davide, Lisete C; Davide, Livia M C; Mendes-Costa, Maria C; Schwan, Rosane F; Wheals, Alan E

    2004-11-01

    Colletotrichum lindemuthianum is a pathogen of the common bean plant (Phaseolus vulgaris) causing anthracnose. Large numbers of isolates can rapidly arise with different genetic and chromosomal compositions but their origin is unknown since sexual fruit bodies have only been found in the laboratory. We have recently described the occurrence of special kinds of hyphae that create anastomoses directly between conidia. In this work we show that conidial anastomoses can occur between two different Colletotrichum species. The implications of this observation on the generation of genetic diversity in these species are discussed.

  2. Anatomy of the medial femoral circumflex artery with respect to the vascularity of the femoral head.

    PubMed

    Zlotorowicz, M; Szczodry, M; Czubak, J; Ciszek, B

    2011-11-01

    We performed a series of 16 anatomical dissections on Caucasian cadaver material to determine the surgical anatomy of the medial femoral circumflex artery (MFCA) and its anastomoses. These confirmed that the femoral head receives its blood supply primarily from the MFCA via a group of posterior superior nutrient arteries and the posterior inferior nutrient artery. In terms of anastomoses that may also contribute to the blood supply, the anastomosis with the inferior gluteal artery, via the piriformis branch, is the most important. These dissections provide a base of knowledge for further radiological studies on the vascularity of the normal femoral head and its vascularity after dislocation of the hip.

  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. [A new technique of intrahepatic cholangiodigestive shunt in the right lobe of the liver].

    PubMed

    Machado, M C; da Cunha, J E; Bacchella, T; Penteado, S; Pinotti, H W

    1992-01-01

    Intra-hepatic cholangiojejunostomy in the left liver lobe is a well standardized procedure. For the right lobe however this procedure may be tedious, difficult and followed by early and late complications. A new technique is described based on two principles: minimal sacrifice of hepatic parenchyma and establishment of latero-lateral cholangio-intestinal anastomoses. Five patients were submitted to this procedure and one of them is alive without jaundice three years after the operation. It's concluded that this technique can be indicated in cases of biliary obstruction in which the anastomoses of the left duct cannot be performed because of local changes and in cases with cholangitis.

  5. ANALYSIS OF BIOMECHANICAL PARAMETERS IN COLONIC ANASTOMOSIS.

    PubMed

    Iwanaga, Tiago Cavalcanti; Aguiar, José Lamartine de Andrade; Martins-Filho, Euclides Dias; Kreimer, Flávio; Silva-Filho, Fernando Luiz; Albuquerque, Amanda Vasconcelos de

    2016-01-01

    , ainda não foi testado para este fim. Analisar os parâmetros biomecânicos em suturas colônicas de ratos submetidos à colectomia esquerda após aplicação de fita ou gel do polissacarídeo do melaço da cana-de-açúcar no sítio cirúrgico. Quarenta e cinco ratos (Rattus norvegicus albinus da linhagem Wistar) foram sorteados em três grupos de 15 submetidos a: irrigação das suturas entéricas com soro fisiológico a 0,9%; aplicação de fita de polissacarídeo do melaço da cana-de-açúcar; e aplicação do gel do mesmo melaço. Os ratos foram submetidos à colectomia esquerda com anastomose primária, e tratados segundo os respectivos grupos. Cinco ratos de cada grupo foram avaliados em diferentes tempos após o procedimento: 30º, 90º e 180º dias de pós-operatório. Foram avaliadas as variáveis de força máxima de ruptura, módulo de elasticidade e deformação específica da força máxima. As variáveis biomecânicas entre os tempos de coleta da pesquisa e os grupos de tratamento foram analisados estatisticamente. As características biomecânicas de força máxima de ruptura e o módulo de elasticidade do corpo de prova permaneceram idênticas, independente do tratamento com soro, fita ou gel de polissacarídeo, e do tempo de tratamento. No entanto, foi evidenciada maior deformação específica da força máxima da parede intestinal, aos 180 dias nos ratos tratados com gel de polissacarídeo de cana-de-açúcar. (p=0,09). Em relação ao controle, foi detectada maior elasticidade da parede intestinal nos ratos tratados com gel de polissacarídeo de cana-de-açúcar, sem alteração de outras características biomecânicas, independente do tipo ou tempo de tratamento.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  7. 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…

  8. 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.

  9. Optimisation de l'émission du continuum femtoseconde de lumière blanche entre 600 nm et 800 nm

    NASA Astrophysics Data System (ADS)

    Ramstein, S.; Mottin, S.

    2005-06-01

    Un dispositif de spectroscopie avec résolution du temps de vol des photons en milieu diffus a été développé. Celui-ci repose sur l'utilisation d'un continuum de lumière blanche généré par focalisation d'un laser amplifié (830 nm, 1 kHz, 0.5 W, 170 fs) dans de l'eau déminéralisée. Afin d'optimiser spectralement et en puissance la source blanche sur la fenêtre spectrale 600 800 nm, une étude de la mise en forme spatio-temporelle avant autofocalisation de l'impulsion laser par le milieu a été menée. Cette mise en forme est effectuée de manière spatiale en changeant la focale de la lentille de focalisation et de manière temporelle en changeant le taux de compression de l'impulsion. L'étude montre que le cône de lumière émise possède plus de puissance dans la fenêtre spectrale d'intérêt pour des focales longues. Sur la fenêtre 600-800 nm, le rendement énergétique intégré varie de 5%, avec une focalef=6cm, à 15%, avec une focale f = 30 cm. La mise en forme temporelle montre des effets similaires avec les mêmes ordres de grandeur.

  10. 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…

  11. 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…

  12. L'accident du Toulourenc : une limite tectonique entre la plate-forme provençale et le Bassin vocontien à l'Aptien?Albien (SE France)

    NASA Astrophysics Data System (ADS)

    Montenat, Christian; Janin, Marie-Christine; Barrier, Pascal

    2004-11-01

    The WNW-ESE trending Toulourenc Fault Zone (TFZ) is the western segment of the major Ventoux-Lure Fault Zone, which separates the Provençal platform from the Baronnies Vocontian Basin. The TFZ was subject to polyphased Mid-Cretaceous movements, during the Early Aptian and Middle-Late Albian times. The latter faulting episode generated conglomerates and olistoliths resulting from dismantled faultscarps cutting Barremian-Bedoulian limestones. The deformation is related to compressional wrench faulting (NE-SW sinistral faults; dextral component for the TFZ). It induced the uplift of the northwestern corner of the platform, as indicated by a mid-Cretaceous hiatus (Early Aptian pro parte to Early Albian) narrowly delimited in space. The opening of submeridian grabens within the platform favoured the northward transit of channelised coarse-grained Albian sands originating from a southern area. To cite this article: C. Montenat et al., C. R. Geoscience 336 (2004).

  13. 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

  14. Étude de la transition entre le gaz atomique et le gaz moléculaire dans deux cirrus de la boucle céleste nord

    NASA Astrophysics Data System (ADS)

    Barriault, Léo

    2010-11-01

    The infrared (IR) cirrus clouds observed at high Galactic latitude are excellent candidates to study the transition between the atomic gas and the molecular gas. In this thesis, two potential sites of H2 formation have been discovered in the North Celestial Loop (l = 135°, b = 40°) through examining the far-IR-Hl ratio and looking for an excess over that expected from an atomic medium. I call these sites the Spider and Ursa Major fields. The comparison between the IR excess map and the 12CO (J - 1 - 0) data from the Five College Radio Astronomical Observatory (resolution = 45 arcsec) shows that the IR excess peaks do not coincide with the 12CO peaks. The absence of coincidence is explained by (i) a density too small to allow CO excitation, (ii) insufficient CO self-shielding or (iii) variations of the dust properties. The comparison between 12CO data and Hi data from the Dominion Radio Astrophysical Observatory (resolution = 1 arcmin) is in agreement with the models! that predict CO formation where large velocity shears and turbulence dissipation are observed. OH observations of 108 locations over the two diffuse clouds from the Green Bank Telescope (resolution = 7 arcmin) are analyzed. OH is a precursor molecule to CO and its formation requires H2. The coincidence between the OH emission peak and the IR excess peak indicates that OH could be a better tracer of H2 than CO in these low-density regions. 12CO (7 = 1-0) and 13CO (J = 1 -0) observations from the Institut de Radioastronomie Millimétrique and 12CO ( J = 2 - 1) observations from the James Clerk Maxwell Telescope (resolution = 20 arcsec) are analyzed on a small number of fields in both regions. Using a large velocity gradient model, we found smaller densities at the location of the IR excess peak while self-shielding should be efficient given the computed column densities.

  15. Entre dois mundos: vida quotidiana de criancas portuguesas na america [Between Two Worlds: The Daily Life of Portuguese Children in America].

    ERIC Educational Resources Information Center

    de Meneses, Fernando

    This Portuguese reader with accompanying teacher's guide describes the culture shock that Portuguese children and their families face when they immigrate to North America. The reader is divided into 75 short stories about the families that come from the rural areas of Portugal where there has been little industrialization. The purpose of the…

  16. 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.

  17. Champ dynamique dans une cellule d'échangeur à vortex : 1. Régime d'entrée laminaire

    NASA Astrophysics Data System (ADS)

    Petitot, Stéphane; Lyazid, Abdel; Devienne, René

    Numerical simulation and LDV measurements are performed for laminar inlet flow condition in a vortex exchange chamber with isothermal conditions. Newtonian and non-Newtonian fluids were used. Experimental measurements are compared to results of numerical computations with good agreement. Both show the existence of a secondary flow generated by hydrodynamical instabilities due to streamline curvature. The main vortex flow appears then to be restricted by this secondary flow.

  18. L'Alternance entre les auxiliaires "avoir" et "etre" en francais parle a Montreal (Alternation between the Auxiliaries "Avoir" and "Etre" in Spoken French in Montreal)

    ERIC Educational Resources Information Center

    Sankoff, Gillian; Thibault, Pierrette

    1977-01-01

    A study of the spoken French of 120 residents of Montreal. The researchers were interested in the linguistic and social factors influencing the use of "avoir" and "etre." Results show that this usage corresponds to a tendancy to regularize conjugations. (Text is in French.) (AMH)

  19. NGC 5044-N50: Una etapa evolutiva intermedia entre galaxias compactas azules (BCD) y enanas elípticas (dE)

    NASA Astrophysics Data System (ADS)

    Cellone, S. A.; Buzzoni, A.

    The possible connection between dwarf elliptical (dE), dwarf irregular (dI), and blue compact dwarf (BCD) galaxies, is a subject of sustained interest, with deep consequences on our underestanding of star formation and evolution of galaxies. We present here observational results (ESO - CASLEO) on the dwarf galaxy N50 in the NGC 5044 Group, which appears to be at an intermediate stage BCD-dE, after its last star-formation burst. We focused on this galaxy because of its strong departure from the relation between luminosity and surface brightness profile curvature, despite its integrated color [(B-V)0=0.76], normal for a dE. However, new observations under sub-arcsec seeing conditions (ESO 3.6 m Tel.) showed several knots surrounding the nucleus whose colors (g-r, g-i, Gunn system) indicate, through evolutionary population synthesis models, ages around ~5 × 109 years with slightly sub-solar metallicities. The spectroscopic data support this scenario; hence, while the main component of N50 is an old (~ 15 × 109 yr) population, there is evidence of recent star formation activity within ~400 pc of the nucleus. The incidence of these structures on the anomalous profile of N50 is discussed, as well as the particular evolutive stage of this galaxy within the dE-BCD relation.

  20. Special Course on Shock-Wave/Boundary-Layer Interactions in Supersonic and Hypersonic Flows (Interactions entre Ondes de Choc et Couches Limites dans les Ecoulements Supersoniques et Hpersoniques).

    DTIC Science & Technology

    1993-08-01

    Dolling, C. C. 0 2 Horstman, D. D. Knight, and A. A. Zheltovodov. The work of current and former graduate students F. S. Alvi, S. Garg, T. J... Research Office Report M.S.E. Thesis , Aerospace Engineering and ARO-14026, 1977. Engineering Mechanics Dept., University of 64. Knight, D. D., private...author, his collpagues, and his graduate students , mining flowlield physics, and relatively little and was supported by AFOSR (monitored by Dr

  1. 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.

  2. 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.

  3. Entre le mythe et l'histoire: L'oscillation du romanesque (Between Myth and History: The Oscillation of the Romanticism).

    ERIC Educational Resources Information Center

    Tremblay, Victor Laurent

    1989-01-01

    A discussion of Romantic literature examines the links between literature and history and a mythic mechanism, a recurrent polarization between two opposite trends (myth and history) at the level of discourse, symbols, and representation. Mytho-romantic and neo-romantic are distinguished and examined. (Author/MSE)

  4. 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. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. Associação entre lipid accumulation product (LAP) e hirsutismo na síndrome do ovário policístico.

    PubMed

    de Oliveira, Flávia Ribeiro; Rezende, Mariana Bicalho; Faria, Nícolas Figueiredo; Dias, Tomás Ribeiro Gonçalves; de Oliveira, Walter Carlos Santos; Rocha, Ana Luiza Lunardi; Cândido, Ana Lúcia

    2016-02-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder in women between menarche and menopause. Clinical hyperandrogenism is the most important diagnostic criterion of the syndrome, which manifests as hirsutism in 70% of cases. Hirsute carriers of PCOS have high cardiovascular risk. Lipid accumulation product (LAP) is an index for the evaluation of lipid accumulation in adults and the prediction of cardiovascular risk. The aim of this study was to evaluate the association between LAP and hirsutism in women with PCOS. This was a cross-sectional observational study of a secondary database, which included 263 patients who had visited the Hyperandrogenism Outpatient Clinic from November 2009 to July 2014. The exclusion criteria were patients without Ferriman-Gallwey index (FGI) and/or LAP data. We used the Rotterdam criteria for the diagnosis of PCOS. All patients underwent medical assessment followed by measurement and recording of anthropometric data and the laboratory tests for measurement of the following: thyroid-stimulating hormone, follicle-stimulating hormone, prolactin, total testosterone, sex hormone binding globulin, 17-α-hydroxyprogesterone (follicular phase), glycohemoglobin A1c, and basal insulin. In addition, the subjects underwent lipid profiling and oral glucose tolerance tests. Other laboratory measurements were determined according to clinical criteria. LAP and the homeostatic model assessment index (HOMA-IR) were calculated using the data obtained. We divided patients into two groups: the PCOS group with normal LAP (< 34.5) and the PCOS group with altered LAP (> 34.5) to compare the occurrence of hirsutism. For statistical analysis, we used SPSS Statistics for Windows® and Microsoft Excel programs, with descriptive (frequencies, percentages, means, and standard deviations) and comparative analyses (Student's t-test and Chi-square test). We considered relations significant when the p-value was ≤ 0.05. LAP was high in most patients (n = 177; 67.3%) and the FGI indicated that 58.5% of the patients (n = 154) had hirsutism. The analysis by LAP quartiles showed a positive correlation (p = 0.04) among patients with a high FGI and an upper quartile LAP (> 79.5) when compared with those with LAP < 29.0 (lower quartile). This study demonstrated an association between high LAP and hirsutism. The FGI could represent a simple and low-cost tool to infer an increased cardiovascular risk in women with PCOS. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  6. 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…

  7. Étude de l'interdiffusion entre l'argent et le palladium dans des couches minces par spectrométrie auger

    NASA Astrophysics Data System (ADS)

    Guglielmacci, J. M.; Gillet, M.

    1981-04-01

    We investigate the interdiffusion in epitaxial thin films of Ag(111)-Pd(111) heated at 500°C during 15 min. The interdiffusion coefficient D is determined by two methods: (1) the concentration profile is established using the Auger technique associated with sputtering; (2) we follow the surface concentration during the diffusion process. This last technique avoids problems associated with ion sputtering. The two techniques give interdiffusion coefficients D in good agreement with a mean value of 7 × 10 -17 cm 2 s -1.

  8. 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…

  9. 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.

  10. Entre dois mundos: vida quotidiana de criancas portuguesas na america [Between Two Worlds: The Daily Life of Portuguese Children in America].

    ERIC Educational Resources Information Center

    de Meneses, Fernando

    This Portuguese reader with accompanying teacher's guide describes the culture shock that Portuguese children and their families face when they immigrate to North America. The reader is divided into 75 short stories about the families that come from the rural areas of Portugal where there has been little industrialization. The purpose of the…

  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 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)

  13. Entre didactique et pedagogie: Epistemologie de l'espace/temps strategique (Between Instruction and Pedagogie: The Epistemology of Strategic Time/Space).

    ERIC Educational Resources Information Center

    Tochon, Francois, V.

    1991-01-01

    Analyzes the components of teaching, envisioning a strategic moment when instruction and pedagogy merge. Examines the way in which transformations of knowledge could be represented according to recent trends in artificial intelligence. (DMM)

  14. 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.

  15. 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…

  16. L'Harmonisation des langues Maliennes: Entre l'intregration nationale et regionale (The Harmonization of the Malian Languages: Between National and Regional Integration).

    ERIC Educational Resources Information Center

    Ouane, Adama

    1991-01-01

    Assesses efforts to standardize the Malian languages, including the standardization of orthography and the creation of terminology in the Mandingo-Peul Project. Points to conflicts between technical and political considerations, and between local tendencies and balances among languages and the need to respect the ecolinguistics of the country.…

  17. 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,…

  18. 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.

  19. Origine physique du contraste entre activité électrique au dessus des terres et des océans

    NASA Astrophysics Data System (ADS)

    Williams, Earle; Stanfill, Sharon

    2002-12-01

    New tests and older ideas are explored to understand the origin of the pronounced contrast in lightning between land and sea. The behavior of islands as miniature continents with variable area supports the traditional thermal hypothesis over the aerosol hypothesis for lightning control. The substantial land-ocean contrast in updraft strength is supported globally by TRMM (Tropical Rainfall Measuring Mission) radar comparisons of mixed phase radar reflectivity. The land-ocean updraft contrast is grossly inconsistent with the land-ocean contrast in CAPE (Convective Available Potential Energy), from the standpoint of parcel theory. This inconsistency is resolved by the scaling of buoyant parcel size with cloud base height, as suggested by earlier investigators. Strongly electrified continental convection is then favored by a larger surface Bowen ratio, and by larger, more strongly buoyant boundary layer parcels which more efficiently transform CAPE to kinetic energy of the updraft in the moist stage of conditional instability. To cite this article: E. Williams, S. Stanfill, C. R. Physique 3 (2002) 1277-1292.

  20. Les relations universite-entreprise entre l'etat et le besoin (University-Business Relationships between the State and the Need).

    ERIC Educational Resources Information Center

    Leclerc, Michel

    1991-01-01

    A discussion of the role of government in supporting the relationship between business and higher education focuses on academic research and the economic and industrial value placed on it. The actual support provided by the private sector, roles of the three players, and major issues in the debate are examined. (MSE)

  1. 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)

  2. Joseph Kampé de Fériet et la mécanique des fluides en France durant l'entre-deux-guerres

    NASA Astrophysics Data System (ADS)

    Demuro, Antonietta

    2017-08-01

    Up until the twentieth century, fluid mechanics was characterised by a strong division between theory and practice. The formulas of mathematicians and physicists were difficult to apply experimentally and their relevance was neither well accepted nor well understood by engineers. In France, where priority was given to the theoretical aspects of this subject, the creation of several centres of fluid mechanics in the 1930s (Lille, Marseille, Paris and Toulouse) represented an attempt at a rapprochement between fluid mechanics, experimental aerodynamics, and hydrodynamics. The aim was to re-establish France's international profile, which had been lost after 1918. In Lille, the leadership of the ;Institut de mécanique des fluides; (IMFL) was entrusted to Jospeh Kampé de Fériet, who was able to address questions of both theoretical and experimental nature in the context of his work at the IMFL and at the ;Commission de la turbulence atmosphérique;. On the one hand, Kampé de Fériet used a probabilistic approach to give greater mathematical rigour to the statistical theory of turbulence due to Taylor-von Kármán. On the other hand, he played an active part in his group's experimental research on atmospheric turbulence. This paper aims to show in what way Kampé de Fériet's approach to fluid mechanics enabled him to contribute to the international development of the statistical theory of turbulence during the interwar period.

  3. 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…

  4. 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…

  5. La Littérature De Jeunesse Entre Normes Pédagogiques Et Littéraires : Le Cas Des Pays Francophones D'afrique

    NASA Astrophysics Data System (ADS)

    Attikpoé, Kodjo

    2007-01-01

    YOUTH LITERATURE IN THE CONTEXT OF PEDAGOGIC AND LITERARY NORMS: THE FRENCH-SPEAKING COUNTRIES OF AFRICA - There are two approaches to children's and youth literature, one didactic, the other aesthetic. This gives rise to the following question: taking into account the fact that children's literature aspires to be a literary form in its own right, should more weight be attibuted to its aesthetic value when evaluating it? This paper examines this question - which has in the past been the subject of highly controversial discussions in the German-speaking regions - by focusing on youth literature in the French-speaking coutries of Africa. The pedagogic dimension cannot be ignored when considering this literary context because it is so much a part of the post-colonial dynamic. Youth literature in the French-speaking countries of Africa echoes current realities. Examples are used to demonstrate how literature can deal with vital questions without neglecting the literary aspect.

  6. EXPERIENCIAS RELACIONADAS A UNA INTERVENCIÓN PARA REDUCIR EL ESTIGMA RELACIONADO AL VIH/SIDA ENTRE ESTUDIANTES DE MEDICINA EN PUERTO RICO

    PubMed Central

    Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Marzán-Rodríguez, Melissa; Neilands, Torsten B.

    2016-01-01

    Existe estigma relacionado al VIH. A las personas con VIH/SIDA-PCVS se les viola sus derechos y obstaculiza su bienestar mental/físico. Profesionales de la salud-PS son fuente de apoyo primordial, sin embargo estos/as le estigmatizan. Es útil adiestrar a PS en relación al estigma social. Implantamos la intervención para reducir el estigma relacionado al VIH/SIDA con 507 estudiantes de medicina. Resultó ser una intervención efectiva, hubo reducción en los niveles de estigma a partir de nuestra intervención y diferencias significativas con el grupo control (p≤.05). Generar espacios de adiestramiento para atender el estigma relacionado al VIH/SIDA es pertinente para la psicología comunitaria porque colaboramos en la reducción de actitudes estigmatizantes que afectan adversamente la prevención de nuevas infecciones, la adherencia al tratamiento antirretroviral y la calidad de vida. PMID:27829690

  7. 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.

  8. 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.

  9. 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…

  10. 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,…

  11. Les kystes hydatiques du foie rompus dans les voies biliaires: à propos de 120 cas

    PubMed Central

    Moujahid, Mountassir; Tajdine, Mohamed Tarik

    2011-01-01

    Etude rétrospective rapportant une série de kystes hydatiques rompus dans les voies biliaires colligés dans le service de chirurgie de l'hôpital militaire Avicenne à Marrakech. Entre 1990 à 2008, sur 536 kystes hydatiques du foie opérés dans le service, 120 étaient compliqués de rupture dans les voies biliaires soit 22,38%. Il y avait 82hommes et 38 femmes. L’âge moyen était de 35 ans avec des extrêmes allant de 10 à 60 ans. La clinique était dominée par la crise d'angiocholite ou une douleur du flanc droit. L'ictère était isolé dans huit cas. La fistule biliokystique était latente dans plus de 50% des cas. Le traitement a consisté en une résection du dôme saillant dans103cas (85,84%), une périkystectomie chez 11 malades (9,16%) et une lobectomie gauche dans six cas (5%). Le traitement de la fistule bilio kystique a consisté en une suture chez 36malades et un drainage bipolaire dans 25 cas, La déconnexion kysto-biliaire ou cholédocotomie trans hépatico kystique selon Perdomo était pratiquée dans 49cas et une anastomose bilio-digestive cholédoco-duodénale dans 10 cas. La durée moyenne d'hospitalisation était de 20jours. Nous déplorons deux décès par choc septique et un troisième par encéphalopathie secondaire à une cirrhose biliaire. La morbidité était représentée par huit abcès sous phrénique, douze fistules biliaires prolongées et deux occlusions intestinales. Les kystes hydatiques rompus dans les voies biliaires représentent la complication la plus grave de cette pathologie bénigne. Le traitement repose sur des méthodes radicales qui sont d'une efficacité reconnue, mais de réalisation dangereuse et les méthodes conservatrices, en particulier la déconnexion kysto-biliaire qui est une méthode simple et qui donne de bons résultats à court et à long terme. PMID:22384289

  12. 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

  13. The circumflex branch of the left coronary artery in the human infant.

    PubMed Central

    Reig, J; Loncán, M P; Martin, S; Doménech, J M

    1987-01-01

    Coronary arterial vascularisation in the human infant in the first five weeks of life, was studied by radiological and injection-corrosion techniques. The main differences lay in the characteristics of the circumflex artery and its distribution over the myocardial wall. These differences were age-related. Coronary arterial anastomoses were detected in 61% of the hearts. PMID:3503054

  14. 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.

  15. Acardiac twin: an unusual case report.

    PubMed

    Kariappa, T M; Chidananda, H T; Mamatha, R

    2007-10-01

    Acardiac twinning is a rare anomaly .75% of cases occurring in monzygotic triplet pregnancies and the rest in monozygotic twins. We report an antenatally undiagnosed case of acardius amorphous. The condition results from abnormal placental vascular anastomoses termed as twin reversed arterial perfusion (TRAP) theory. Early sonographic prenatal diagnosis improves the survival of the normal twin called the pump twin.

  16. Microsurgery in liver research: end-to-side portocaval microanastomoses in dogfish.

    PubMed

    Leclère, F M; Germain, M A; Lewbart, G A; Unglaub, F; Mordon, S; Louis, D

    2011-10-01

    The use of an operating microscope in animal liver surgery has made it possible to obtain new experimental models. The goal of this prospective animal study is to present our experience with dogfish portocaval microanastomoses. Nineteen portocaval microanastomoses were performed in dogfish. The end-to-side anastomoses were accomplished using continuous 11-0 sutures. The diameter of the vessels and time required for the anastomoses were measured. A patency test and its outcome were also prospectively evaluated at the time of anastomoses and then 3 and 6 months after. The mean vessel diameter was 2.5 ± 0.2mm. The mean anastomosis time was 14 ± 1.5 min. The anastomoses patency rate was 100% at the time of surgery. A postoperative control performed after 3 and 6 months showed a partial stenosis in three animals. The dogfish appears to be a reliable experimental model in liver research. Moreover, this technique could be used for microsurgical training. Copyright © 2011. Published by Elsevier Masson SAS.

  17. [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.

  18. 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...

  19. Effects of albumin/glutaraldehyde glue on healing of colonic anastomosis in rats

    PubMed Central

    Despoudi, Kalliopi; Mantzoros, Ioannis; Ioannidis, Orestis; Cheva, Aggeliki; Antoniou, Nikolaos; Konstantaras, Dimitrios; Symeonidis, Savvas; Pramateftakis, Manousos George; Kotidis, Efstathios; Angelopoulos, Stamatis; Tsalis, Konstantinos

    2017-01-01

    AIM To evaluate the effect of local surgical adhesive glue (albumin/glutaraldehyde-Bioglue) on the healing of colonic anastomoses in rats. METHODS Forty Albino-Wistar male rats were randomly divided into two groups, with two subgroups of ten animals each. In the control group, an end-to-end colonic anastomosis was performed after segmental resection. In the Bioglue group, the anastomosis was protected with extraluminar application of adhesive glue containing albumin and glutaraldehyde. Half of the rats were sacrificed on the fourth and the rest on the eighth postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Other parameters of healing, such as hydroxyproline and collagenase concentrations, were evaluated. The experimental data were summarized and computed from the results of a one-way ANOVA. Fisher’s exact test was applied to compare percentages. RESULTS Bursting pressures, adhesion formation, inflammatory cell infiltration, and collagen deposition were significantly higher on the fourth postoperative day in the albumin/glutaraldehyde group than in the control group. Furthermore, albumin/glutaraldehyde significantly increased adhesion formation, inflammatory cell infiltration, neoangiogenesis, and collagen deposition on the eighth postoperative day. There was no difference in fibroblast activity or hydroxyproline and collagenase concentrations. CONCLUSION Albumin/glutaraldehyde, when applied on colonic anastomoses, promotes their healing in rats. Therefore, the application of protective local agents in colonic anastomoses leads to better outcomes. PMID:28883693

  20. A Different Method of Hepaticojejunostomy for Proximal Biliary Injuries

    PubMed Central

    Schaefer, Glennon

    1996-01-01

    The management of proximal biliary injuries presents a surgical challenge. Anastomoses can be difficult to perform and can have poor results. We describe a method of hepaticojejunostomy done from within the Roux-en-Y loop, which can be utilized in this situation. PMID:9184866

  1. Bronchopulmonary arterial anastomosis at the precapillary level in human lung. Visualization using CT angiography compared with microangiography of autopsied lung.

    PubMed

    Hasegawa, I; Kobayashi, K; Kohda, E; Hiramatsu, K

    1999-11-01

    To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses. CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min.

  2. Are intersecting staple lines a hazard in intestinal anastomosis?

    PubMed

    Zilling, T; Walther, B S

    1992-09-01

    To determine the safety of intersecting staple lines, 22 pigs were operated upon with a functional end-to-end enteroanastomosis 40 cm distal to the ligament of Treitz using linear stapling devices. The procedure was repeated on the colon, where a colocolostomy was created. The blood flow at intersecting staple lines and single-row staple lines for each anastomosis was studied with the reference organ method 24 hours after the first operation. The purpose was to evaluate whether there is a reduction in blood flow at the site of intersecting staple lines, causing an increased risk for anastomotic leakage. The reduction in mean blood flow in crossing compared with noncrossing staple lines was 6 percent (-5-17 percent) for small bowel anastomoses and 7 percent (-6-19 percent) for colonic anastomoses. An equivalence test showed that, if a reduction in blood flow exists between crossing and noncrossing staple lines, it is most likely less than 30 percent (P less than 0.001) for both small bowel and colonic anastomoses. This experimental study demonstrates that intersecting staple lines in small bowel and colonic anastomoses do not reduce anastomotic blood flow to a dangerous level.

  3. 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.

  4. 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.

  5. [Practical and theoretical aspects of cost-benefit relations in viscerosynthesis].

    PubMed

    Fuchs, K H; Heimbucher, J; Geiger, D; Thiede, A

    1997-01-01

    The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expensive suture devices, such as stapling instruments, can be used in a cost saving aspect, if they help to increase anastomotic safety, time saving and expansion of surgical indication. Manual sutures thus represent the cheapest anastomotic technique as continuous sutures would cost between DM 10.- to 20.- and single stitch sutures between DM 60.- and 100.-. A surgical school should prevalently aim at training manual anastomoses, while special anastomotic techniques should only complete the skill for selected indications. The overall staff expenditure for extended operations amounts around DM 600.- per hour respectively DM 10.- per minute. Time for surgery might be shortened by auxiliary tools as much as to perform an additional operation. However, a circular stapler anastomosis that costs between DM 650.- to 850.- is twice as expensive as manual sutures notwithstanding the double time needed. In the past years, the necessity for a rational use of different anastomotic techniques has shown to be mandatory since, increasingly, financial aspects of health economy require cost benefit calculations in visceral surgery.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  7. 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.

  8. Use of Absorbable Sutures in Canine Carotid Arteries

    PubMed Central

    Rey, Alejandro R.; Carrillo-Farga, Joaquin; Velasco, Carlos O.; Valencia, Martin O.V.

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on until the 12th group, which was observed for 12 months. At the end of each observation period, reoperation was undertaken to evaluate the vascular anastomoses by means of angiography and microscopy. The polypropylene anastomoses showed a marked deformity, with tissue retraction and a foreign body reaction. In contrast, the polydioxanone anastomoses exhibited satisfactory healing, without deformity, and were well tolerated histologically. We believe that polydioxanone may be a useful, alternative vascular suture material. (Texas Heart Institute Journal 1990;17:99-102) Images PMID:15227391

  9. A Quantitative Assessment of the Structure and Functions of a Mature Bottomland Hardwood Community: The Iatt Creek Ecosystem Site

    Treesearch

    Calvin E. Meier; John A. Stanturf; Emile S. Gardiner; Paul B. Hamel; Melvin L. Warren

    1999-01-01

    We report our efforts, initiated in 1995, to quantify ecological processes and functions in a relatively undisturbed, mature hardwood forest. The 320-ha site is located in central Louisiana on the upper reaches of Iatt Creek, an anastomosing minor stream bottom. The forest is a mature sweetgum (Liquidambar styraciflua L.)-cherrybark oak (

  10. 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

  11. 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

  12. Solomon Technique Versus Selective Coagulation for Twin-Twin Transfusion Syndrome.

    PubMed

    Slaghekke, Femke; Oepkes, Dick

    2016-06-01

    Monochorionic twin pregnancies can be complicated by twin-to-twin transfusion syndrome (TTTS). The best treatment option for TTTS is fetoscopic laser coagulation of the vascular anastomoses between donor and recipient. After laser therapy, up to 33% residual anastomoses were seen. These residual anastomoses can cause twin anemia polycythemia sequence (TAPS) and recurrent TTTS. In order to reduce the number of residual anastomoses and their complications, a new technique, the Solomon technique, where the whole vascular equator will be coagulated, was introduced. The Solomon technique showed a reduction of recurrent TTS compared to the selective technique. The incidence of recurrent TTTS after the Solomon technique ranged from 0% to 3.9% compared to 5.3-8.5% after the selective technique. The incidence of TAPS after the Solomon technique ranged from 0% to 2.9% compared to 4.2-15.6% after the selective technique. The Solomon technique may improve dual survival rates ranging from 64% to 85% compared to 46-76% for the selective technique. There was no difference reported in procedure-related complications such as intrauterine infection and preterm premature rupture of membranes. The Solomon technique significantly reduced the incidence of TAPS and recurrent TTTS and may improve survival and neonatal outcome, without identifiable adverse outcome or complications; therefore, the Solomon technique is recommended for the treatment of TTTS.

  13. A comparison of absorbable suture and argon laser welding for lateral repair of arteries.

    PubMed

    Lawrence, P F; Li, K; Merrell, S W; Goodman, G R

    1991-08-01

    Conventional vascular anastomoses between autogenous vessels are performed with nonabsorbable sutures. Recently, use of absorbable sutures and laser-assisted vascular anastomoses has been advocated because of their improved healing characteristics. This study compared arterial repairs with the argon laser, absorbable suture, and nonabsorbable suture for technical characteristics including additional suture and overall success rates, burst strength, and cost. Absorbable and nonabsorbable suture closures were comparable with respect to technique, but laser-assisted vascular anastomosis was technically more demanding and required almost twice as much time for completion. The argon laser successfully closed only 58.6% of the arteriotomies, and 90% of the closures required additional sutures for complete hemostasis. All sutured arteriotomies were successfully completed by use of either absorbable or nonabsorbable suture. Burst strength was similar for all groups, but was uniformly greater than 300 mm Hg for sutured repairs, whereas two of five laser-assisted closures burst below 300 mm Hg. Finally, costs for purchasing ($35,000) and operating ($300/hr.) an argon laser make laser-assisted vascular anastomosis much more expensive than sutured repair. These data suggest argon laser-assisted vascular anastomoses are more technically demanding, less successful, and more expensive than conventional sutured anastomoses when evaluated in large caliber arteries in a canine model. Absorbable suture, however, is comparable to conventional nonabsorbable sutured arterial repairs in expense, handling characteristics, and success rates with the added advantage of eliminating permanent foreign body in the arterial wall when it is absorbed.

  14. High-Pressure Fibrin Sealant Foam: An Effective Hemostatic Agent for Treating Severe Parenchymal Hemorrhage

    DTIC Science & Technology

    2008-01-01

    least 7 days and carefully checked for any preexisting disease before undergoing surgical procedures. The daily food was withdrawn from the surgical...2003;237:871; discussion 876. 31. Jakob H, Campbell CD, Qiu ZK , et al. Use of fibrin sealant for reinforcing arterial anastomoses. J Vasc Surg 1984;1:171

  15. 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.

  16. Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery.

    PubMed

    Langer, Stefan; Schildhauer, Thomas A; Dudda, Marcel; Sauber, Jeannine; Spindler, Nick

    2015-01-01

    Einleitung: Fibrinkleber ist ein immer häufiger in der klinischen Routine eingesetztes Tool zur Stabilisierung von Mikroanastomosen und Nervenreparatur.Dieser Artikel fasst die technischen Eigenschaften und Vorteile im Gebrauch sowie die variable Anwendungsmöglichkeit von Fibrinkleber im mikrochirurgischen Kontext zusammen und illustriert dies an einem extremitätenrekonstruierenden Fallbeispiel.Patienten und Methoden: 131 Patienten, an welchen sowohl elektiv als auch in einer Notfallsituation eine mikrochirurgische Intervention durchgeführt wurde, hauptsächlich in der Extremitäten erhaltenden Chirurgie, wurden retrospektiv untersucht; ebenso die Patienten, welche eine freie Lappenplastik erhalten hatten.Ergebnisse: Die Verwendung von Fibrinkleber in der Mikrochirurgie erlaubt ein exaktes Positionieren der Anastomose von Gefäßen und Nerven. Ein Verdrehen oder Kinking des Pedickels konnte in keinem Fall festgestellt werden. Die Überlebensrate der Lappen betrug >94%. In 99% der Fälle konnte der Fibrinkleber belassen werden. In dem seltenen Fall der Revision konnte der Fibrinkleber leicht entfernt werden ohne Schaden an der Anastomose zu hinterlassen. Zusammenfassung: Fibrinkleber ist nicht geeignet Anastomoseninsuffizienzen oder leckende Anastomosen zu behandeln, allerdings schützt er die Anastomose vor schadendem Druck ausgelöst durch Gewebe oder Flüssigkeit. Er bewahrt den Gefäßstiel vor Verdrehung und hilft dem Operateur beim Wiederauffinden der Anastomose im Fall einer Revision.

  17. 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.

  18. 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...

  19. 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.

  20. [Postoperative imaging of synthetic coronary artery bypass graft patency by means of CT angiography].

    PubMed

    Froelich, J J; Alfke, H; Hoppe, M; Vogt, S; Vannucchi, A; Moosdorf, R; Klose, K J

    1998-08-01

    CT angiography was performed in 12 patients with insufficient autologous graft situations to evaluate postoperative patency and situation of the proximal, distal and coronary artery anastomoses of synthetic Perma-Flow coronary artery bypass grafts. Bypass grafts were evaluated postoperatively with spiral CT of the mediastinum. At a flow rate of 3 ml/s, 120 ml of contrast material were applied over a cubital vein. Slice thickness was 3 mm, maximum pitch factor 2 and image reconstruction was performed at 2 mm increment. Shaded surface displays were analysed together with axial scans for bypass evaluation. 8 out of 12 synthetic bypasses proved to be patent. One bypass was completely occluded and in three patients the distal portions of the grafts were occluded. Coronary angiography performed in one case confirmed complete bypass occlusion. Due to the occlusions, 8 distal and 12 proximal anastomoses were visible. Only 8 out of 19 side-to-side coronary artery anastomoses could be sufficiently well imaged with this technique. CT angiography is suitable for postoperative screening of synthetic coronary bypasses to determine the patency and anastomotic situations. Coronary artery anastomoses however are not sufficiently imaged and coronary angiography continues to be required.

  1. [The defecation balloon proctogram in the study of idiopathic incontinence].

    PubMed

    Ciarelli, A; Ciarelli, F; Mascia, D; Tentarelli, M

    1991-01-01

    The authors report their findings in the study of idiopathic rectal incontinence using a defecatory balloon proctogram. The study provides a detailed anatomico-functional analysis of the sphincteric tract and, together with manometric and electromyographic studies, is useful in assessing the need for reconstructive surgery and for monitoring the results of ileoanal and coloanal anastomoses, sphincteric plastic surgery and posterior anal plastic surgery.

  2. Gastrointestinal sutureless anastomosis using fibrin glue: reinforcement of the sliding absorbable intraluminal nontoxic stent and development of a stent placement device.

    PubMed

    Detweiler, M B; Verbo, A; Kobos, J W; Durastante, V; Pignoli, V

    1996-01-01

    Sutureless anastomosis of the gastrointestinal tract using fibrin glue and sliding absorbable intraluminal nontoxic stents (SAINTs) has two shortcomings, stent shaft breakage and the lack of a transanal insertion device (TID) for low anterior resection. Reinforcement of the sucrose base SAINT (R-SAINT) is described. Sutureless anastomosis is attempted using a stapleless mechanical stapler (SS) and used as preprototype to screen histologically and mechanically for TID anastomoses in the small intestine. Finally, a prototype absorbable head SAINT placement device (SAINT-PD) intended for TID, similar to the SS, is utilized on the small intestine. Fifty-seven Landrace pigs weighing 25-35 kg were used to perform 58 anastomoses, including the small intestine (15 manual, 19 SAINT, 11 SS, 5 R-SAINT, 6 SAINT-PD) and large intestine (2 R-SAINT). All anastomoses performed with the R-SAINT succeeded on the first attempt even if the shaft cracked. The SS technique proved impractical, but the histological screen results from 7 to 60 days did approximate those of corresponding SAINT anastomoses. The SAINT-PD demonstrated operational improvement over the SS, but the histological results were similar to both the SS and SAINT. The advantages of the R-SAINT and SAINT-PD are that they leave no foreign bodies or pressure clamping devices at the anastomostic site. Larger studies may show the R-SAINT and the SAINT-PD to be practical, new surgical tools in sutureless fibrin glue anastomosis.

  3. COMPRES: a prospective postmarketing evaluation of the compression anastomosis ring CAR 27(™) /ColonRing(™).

    PubMed

    D'Hoore, A; Albert, M R; Cohen, S M; Herbst, F; Matter, I; Van Der Speeten, K; Dominguez, J; Rutten, H; Muldoon, J P; Bardakcioglu, O; Senagore, A J; Ruppert, R; Mills, S; Stamos, M J; Påhlman, L; Choman, E; Wexner, S D

    2015-06-01

    Preclinical studies have suggested that nitinol-based compression anastomosis might be a viable solution to anastomotic leak following low anterior resection. A prospective multicentre open label study was therefore designed to evaluate the performance of the ColonRing(™) in (low) colorectal anastomosis. The primary outcome measure was anastomotic leakage. Patients were recruited at 13 different colorectal surgical units in Europe, the United States and Israel. Institutional review board approval was obtained. Between 21 March 2010 and 3 August 2011, 266 patients completed the study protocol. The overall anastomotic leakage rate was 5.3% for all anastomoses, including a rate of 3.1% for low anastomoses. Septic anastomotic complications occurred in 8.3% of all anastomoses and 8.2% of low anastomoses. Nitinol compression anastomosis is safe, effective and easy to use and may offer an advantage for low colorectal anastomosis. A prospective randomized trial comparing ColonRing(™) with conventional stapling is needed. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  4. Feto-fetal transfusion syndrome

    PubMed Central

    Galea, P; Scott, J M; Goel, K M

    1982-01-01

    Out of 42 pairs of liveborn monochorial twins there were 32 pairs with vascular anastomoses. Of these, 11 pairs had feto-fetal transfusion syndrome. There were another 8 pairs of stillborn twin fetuses with vascular communications and in these chronic feto-fetal transfusion syndrome might have resulted in intrauterine death. PMID:6890328

  5. Transfer of training in robotic-assisted microvascular surgery.

    PubMed

    Karamanoukian, Raffy L; Bui, Trung; McConnell, Michael P; Evans, Gregory R D; Karamanoukian, Hratch L

    2006-12-01

    Transfer of training refers to the ability to transfer acquired skills from one discipline to another. This study aims to determine whether experience in traditional freehand microsurgery facilitates mastery of robotic microsurgery. Microsurgical anastomoses of coronary arteries harvested from explanted pig models were used to demonstrate whether prior experience with microsurgery is required in learning robot-assisted microsuturing. Eighty microsurgical anastomoses were performed. Three fully trained vascular surgeons (n = 3) (Group A) and 5 midlevel surgical residents (n = 5) (Group B) performed the anastomoses. Each subject performed 5 freehand and 5 robotic-assisted (Zeus robotic system) anastomoses. Anastomosis time and integrity of anastomoses were recorded, including errors of management (EOM) (breaking suture, breaking knots, breaking or damaging needles). For fully trained surgeons, all anastomoses in the robotic-assisted group were mechanically intact. There was significantly increased anastomosis time with the robot (Robot: 14 minutes, versus freehand: 7.2 minutes, P < 0.01). The robotic-assisted anastomoses were associated with a higher EOM (Robot: 1.2, versus freehand: 0.3, P < 0.01). Surgical trainees had longer anastomosis times with robotic assistance (Robot: 14.8 minutes, versus freehand, 12.7 minutes; P < 0.01) and increased EOM (Robot: 1.6, versus freehand: 1.0; P < 0.05).Overall, surgical trainees and fully trained vascular surgeons had longer anastomotic times with robotic assistance [Robot: 14.0 versus 14.8 minutes; P = not significant (NS)], and EOM (Robot: 1.6, versus freehand: 1.2; P = NS) were not significantly different. The technical feasibility of performing a safe and efficient robotic-assisted microsurgical anastomosis in explanted vessels was repeatedly tested and demonstrated in this study within reasonable time required for the anastomosis. Compared with conventional microanastomosis, both fully trained surgeons and residents

  6. Vascular anatomy of the small intestine-a comparative anatomic study on humans and pigs.

    PubMed

    von Trotha, Klaus-Thilo; Butz, Nick; Grommes, Jochen; Binnebösel, Marcel; Charalambakis, Natascha; Mühlenbruch, Georg; Schumpelick, Volker; Klinge, Uwe; Neumann, Ulf P; Prescher, Andreas; Krones, Carsten J

    2015-05-01

    Porcine models are well established for studying intestinal anastomotic healing. In this study, we aimed to clarify the anatomic differences between human and porcine small intestines. Additionally, we investigated the influences of longitudinal and circular sutures on human small intestine perfusion. Intestines were obtained from human cadavers (n = 8; small intestine, n = 51) and from pigs (n = 10; small intestine, n = 60). Vascularization was visualized with mennige gelatin perfusion and high-resolution mammography. Endothelial cell density was analyzed with immunohistochemistry and factor VIII antibodies. We also investigated the influence of suture techniques (circular anastomoses, n = 19; longitudinal sutures, n = 15) on vascular perfusion. Only human samples showed branching of mesenteric vessels. Compared to the pig, human vessels showed closer connections at the entrance to the bowel wall (p = 0.045) and higher numbers of intramural anastomoses (p < 0.001). Porcine main vessels formed in multifilament-like vessel bundles and displayed few intramural vessel anastomoses. Circular anastomoses induced a circular perfusion defect at the bowel wall; longitudinal anastomoses induced significantly smaller perfusion defects (p < 0.001). Both species showed higher vascular density in the jejunum than in the ileum (p < 0.001). Human samples showed similar vascular density within the jejunum (p = 0.583) and higher density in the ileum (p < 0.001) compared to pig samples. The results showed significant differences between human and porcine intestines. The porcine model remains the standard for studies on anastomotic healing because it is currently the only viable model for studying anastomosis and wound healing. Nevertheless, scientific interpretations must consider the anatomic differences between humans and porcine intestines.

  7. Long-term functional changes after low anterior resection for rectal cancer compared between a colonic J-pouch and a straight anastomosis.

    PubMed

    Hida, Jin-ichi; Yoshifuji, Takehito; Matsuzaki, Tomohiko; Hattori, Takashi; Ueda, Kazuki; Ishimaru, Eizaburou; Tokoro, Tadao; Yasutomi, Masayuki; Shiozaki, Hitoshi; Okuno, Kiyotaka

    2007-03-01

    We prospectively compared changes in function between colonic J-pouch and straight anastomoses from 1 to 5 years after low anterior resection for rectal cancer. At 1, 3, and 5 years after surgery, functional outcome was compared between 48 patients with J-pouch reconstruction (J group) and 51 with straight anastomosis (S group), using a 17-item questionnaire (overall best, 0; overall worst, 26). Reservoir function was evaluated manovolumetrically. At 5 years, patients with ultralow anastomoses (< or =4 cm from anal verge) had fewer bowel movements during day or night, and less urgency and soiling in the J than S group. At that time, patients with low anastomoses (5 to 8 cm above the verge), had fewer bowel movements at night and less urgency in the J than S group. Manovolumetric results were better in the J than S group for both anastomotic levels. Functional scores improved significantly over time for both anastomotic levels, especially in the S group. Mean scores with ultralow anastomoses were J-group, 5.6 at 1 year vs. 5.3 at 3 years (P = 0.0304) vs. 3.7 at 5 years (P < 0.0001); and S group, 10.2 at 1 year vs. 9.6 at 3 years (P = 0.0063) vs. 7.3 at 5 years (P < 0.0001). Mean scores with low anastomoses were J group, 3.4 at 1 year vs. 3.1 at 3 years (P = 0.0052) vs. 2.1 at 5 years (P = 0.0003); and S group, 5.2 at 1 year vs. 3.8 at 3 years (P < 0.0001) vs. 2.7 at 5 years (P < 0.0001). Manovolumetric results improved overtime in both groups. Functional outcome improved in the J and especially the S group over 5 years. However, function was better in the J than S group at all time points.

  8. 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.

  9. Effect of modified proximal anastomosis of the free right internal thoracic artery: piggyback and foldback techniques.

    PubMed

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Tokoro, Masayoshi; Yanagisawa, Junji; Murotani, Kenta

    2016-03-01

    Few studies have reported the free right internal thoracic artery (RITA) being used in an aorto-coronary fashion. This study aimed to evaluate the free RITA with modified proximal anastomosis in an aorto-coronary fashion. Between January 2000 and December 2012, 282 patients underwent coronary artery bypass grafting with bilateral internal thoracic arteries for complete revascularization of the left coronary system at our institution. The left internal thoracic artery (LITA) was anastomosed to the left anterior descending artery (LAD) and the RITA was anastomosed to the left circumflex branches (LCX). The RITA was used as a free graft in 213 patients (free group) and as an in situ graft in 69 patients (in situ group). Proximal anastomosis of the free RITA onto the ascending aorta was performed in two different ways. We compared early and late results and graft patency of the free RITA with those of the in situ RITA retrospectively. The numbers of anastomoses per patient and anastomoses of the RITA were larger in the free group than in the in situ group (P < 0.01). There was no significant difference in postoperative survival between the groups (free group: 93.3% vs in situ group: 90.0%, P = 0.82). The 5-year patency of the free RITA was higher than that of the in situ RITA (97.0 vs 80.3%, P = 0.01). The 5-year patency of the free RITA was comparable with that of the in situ LITA anastomosed to the LAD (97.0 vs 92.9%, P = 0.28). The free RITA anastomosed to the LCX might have better late patency than the in situ RITA. The free RITA with modified proximal anastomosis in an aorto-coronary fashion enables complete revascularization of the left coronary system with the in situ LITA to the LAD. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. Computational fluid dynamic evaluation of the side-to-side anastomosis for arteriovenous fistula.

    PubMed

    Hull, Jeffrey E; Balakin, Boris V; Kellerman, Brad M; Wrolstad, David K

    2013-07-01

    The goal of this research was to compare side-to-side (STS) and end-to-side (ETS) anastomoses in a computer model of the arteriovenous fistula with computational fluid dynamic analysis. A matrix of 17 computer arteriovenous fistula models (SolidWorks, Dassault Systèmes, France) of artery-vein pairs (3-mm-diameter artery + 3-mm-diameter vein and 4-mm-diameter artery +6-mm-diameter vein elliptical anastomoses) in STS, 45° ETS, and 90° ETS configurations with cross-sectional areas (CSAs) of 3.5 to 18.8 mm(2) were evaluated with computational fluid dynamic software (STAR-CCM+; CD-adapco, Melville, NY) in simulations at defined flow rates from 600 to 1200 mL/min and mean arterial pressures of 50 to 140 mm Hg. Models and configurations were evaluated for pressure drop across the anastomosis, arterial inflow, venous outflow, arterial outflow, velocity vector, and wall shear stress (WSS) profile. Pressure drop across the anastomosis was inversely proportional to anastomotic CSA and to venous outflow and was proportional to arterial inflow. Pressure drop was greater in 3 + 3 models than in 4 + 6 STS models; 90° ETS configurations had the lowest pressure drops and were nearly identical, whereas 45° ETS configurations had the highest pressure drops. Venous outflow in the 4 + 6 model in STS configurations, evaluated at 100 mm Hg arterial inflow pressure, was 390, 592, 610, and 886 mL/min in anastomotic CSAs of 3.5, 5.3, 7.1, and 18.8 mm(2), respectively, and was similar in 90° ETS (609 and 908 mL/min) and lower in 45° ETS (534 and 562 mL/min) configurations at CSAs of 5.3 and 18.8 mm(2). The mean increase in venous outflow was 69 mL/min (range, -59 to 134) between 3 + 3 and 4 + 6 models at 100 mm Hg arterial inflow. The most uniform WSS profile occurs in STS anastomoses followed by 45° ETS and then 90° ETS anastomoses. The STS and 90° ETS anastomoses have high venous outflow and a tendency toward reversed arterial outflow. The 45° ETS anastomosis has reduced venous

  11. Atrial arrhythmias and pacing after orthotopic heart transplantation: bicaval versus standard atrial anastomosis.

    PubMed

    Grant, S C; Khan, M A; Faragher, E B; Yonan, N; Brooks, N H

    1995-08-01

    Right and left atrial configuration is more normal when the donor left atrium is anastomosed to a recipient left atrial cuff with direct anastomoses of the donor and recipient vena cavas on the right side. The right atrium and sinus node may be less disturbed by the technique of bicaval anastomosis than by the standard procedure. To compare the incidence of atrial arrhythmias and pacing after bicaval and standard anastomoses. 75 patients had heart transplants between January 1991 and December 1993. The notes were reviewed. Nine patients who died within the first 30 days were excluded from further analysis (seven patients with standard anastomoses, one with bicaval anastomosis, and one with a hybrid technique). 66 patients survived for more than 30 days. Thirty five patients had standard anastomoses and 31 bicaval anastomoses. Atrial tachyarrhythmias (atrial fibrillation, atrial flutter, atrial tachycardia, or supraventricular tachycardia) occurred on four days in three patients in the bicaval group compared with 27 days in 13 patients in the standard group (P = 0.009). The relative risk of atrial tachyarrhythmias with standard anastomosis was 5.52 (P = 0.015) compared with that of bicaval anastomosis. Atrial tachyarrhythmias requiring treatment occurred less often in the bicaval group (four episodes in three patients in the bicaval group and eight episodes in four patients in the standard group), and fewer patients with a bicaval anastomosis required temporary pacing (pacing on 20 days in 10 patients in the bicaval group, but pacing on 49 days in 16 patients in the standard group) and late permanent pacing (no patients in the bicaval group and three patients in the standard group), although these differences were not statistically significant. Patients in the bicaval group were discharged from hospital sooner than those in the standard group (mean 24.1 v 29.1 days, P = 0.024). The technique of bicaval anastomosis, in addition to theoretical advantages from

  12. [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.

  13. [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.

  14. 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.

  15. 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.

  16. [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.

  17. 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.

  18. Gross and microscopical blood supply of the trachea.

    PubMed

    Salassa, J R; Pearson, B W; Payne, W S

    1977-08-01

    Twenty-one human tracheal specimens were perfused and dissected, 10 with conventional techniques and 11 with clearing and microdissection techniques. The lateral pedicles of the trachea and esophagus induct vessels from the inferior thyroid, subclavian, supreme intercostal, internal thoracic, innominate, and superior and middle bronchial arteries. These vessels are interconnected along the lateral surface of the trachea by an important longitudinal vascular anstomosis. From the 2 lateral longitudinal anastomoses the lateral and anterior tracheal walls receive their blood supply through transverse segmental vessels that run in the soft tissues between the cartilages. These transverse vessels interconnect the longitudinal anastomoses across the midline and feed the submucosal capillary network that arborizes richly beneath the endotracheal mucosa. The tracheal cartilages receive nourishment from the capillary bed applied to their internal surface. The esophageal arteries and their subdivisions that supply the posterior membranous wall of the trachea contribute almost nothing to the circulation of the cartilaginous walls.

  19. A new approach to preexisting vertical midline abdominal scars with crossover DIEP flap breast reconstruction.

    PubMed

    Hsieh, Frank; Somia, Naveen; Lam, Thomas C

    2010-01-01

    Breast reconstruction using a free transverse rectus abdominis myocutaneous flap or a deep inferior epigastric perforator (DIEP) flap is a challenge in patients with a vertical midline abdominal scar due to the poor perfusion of the lower abdominal skin ellipse across the midline. In such patients, only one half of the abdominal skin ellipse can be used with certainty, and this limits the amount of tissue available for reconstructing the breast. Two cases of breast reconstruction in patients with a lower midline abdominal scar are presented using the DIEP flap, in which the poor perfusion across the midline scar was overcome by a technique of crossover anastomoses between the two deep inferior epigastric pedicles. Reliable perfusion of the entire lower abdominal skin ellipse was achieved. This crossover anastomoses technique overcomes the poor perfusion imposed by the vertical midline abdominal scar and enables DIEP flap breast reconstruction to be offered to women with midline abdominal scars. Copyright 2009 Wiley-Liss, Inc. Microsurgery, 2010.

  20. 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

  1. Anatomy of the Ophthalmic Artery: Embryological Consideration.

    PubMed

    Toma, Naoki

    2016-10-15

    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.

  2. Progressive cerebral occlusive disease after radiation therapy.

    PubMed

    Bitzer, M; Topka, H

    1995-01-01

    A case of progressive irradiation-induced cerebral vasculopathy with abnormal netlike vessels and transdural anastomoses (moyamoya syndrome) is presented. Radiological findings in an additional 40 cases reported in the literature are analyzed, and their clinical relevance is discussed. A 19-year-old woman presented with recurrent ischemic brain lesions after radiation therapy for treatment of a craniopharyngioma during childhood. Cerebral angiography 6 and 12 years after completion of radiation therapy revealed progressive cerebral arterial occlusive disease involving the internal carotid artery on either side of the circle of Willis, with abnormal netlike vessels and transdural anastomoses (moyamoya syndrome). Extensive similarities between irradiation-induced cerebral vasculopathy and primary moyamoya syndrome (Nishimoto's disease) support the notion that both disorders share common pathophysiological mechanisms. The occurrence of moyamoya-like vascular changes may not depend on specific trigger mechanisms but may rather represent a nonspecific response of the developing vascular system to a number of various noxious events.

  3. Calcification of Cryopreserved Arterial Graft Causing Delayed Obstruction of Portal Vein Flow After Liver Transplant.

    PubMed

    Cimsit, Bayindir; Yankol, Yucel; Mecit, Nesimi; Kanmaz, Turan; Acarli, Koray; Kalayoglu, Munci

    2015-10-01

    In patients with biliary atresia, portal vein problems may cause challenges for liver transplant. Interposition grafts have been used for vascular anastomoses in transplant recipients with varied success. A cryopreserved iliac artery graft was used for the reconstruction of the portal vein in a 29-month-old infant with biliary atresia. At 17 months after transplant, she developed upper gastrointestinal bleeding that was caused by portal vein occlusion because of vascular calcifications in the graft. Upper gastrointestinal endoscopy showed esophageal varices with fresh bleeding, and the varices were band ligated. At 3 months after the bleeding episode, the patient was asymptomatic and biochemical tests were normal. In summary, liver transplant with cryopreserved iliac artery graft may be complicated by calcifications and portal vein occlusion, and caution is advised in using this graft material for portal vein anastomoses.

  4. 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.

  5. Fetal Intra-Peritoneal Transfusion for the Management of Very Early Spontaneous Twin Anemia-Polycythemia Sequence in an Obese Patient With a Whole Anterior Placenta.

    PubMed

    Guenot, Cécile; Robyr, Romaine; Jastrow, Nicole; Vial, Yvan; Raio, Luigi; Baud, David

    2016-04-01

    Twin anemia-polycythemia sequence (TAPS) is a rare condition in monochorionic twin pregnancies. Small intertwin placental vascular communications allow transfusion, which results in a hemoglobin difference in the twins in the absence of oligohydramnios or polyhydramnios. We report here a case of TAPS diagnosed at 17 weeks' gestation in an obese patient (BMI 42) with a whole anterior placenta. The only possible treatment at this stage of pregnancy was intra-uterine transfusion (IUT), which was repeated weekly until photocoagulation of placental anastomoses was feasible. Fetoscopic laser surgery is the only curative treatment, but is challenging in TAPS because of the absence of polyhydramnios and the presence of minuscule anastomoses. An anterior placenta and high BMI can make the procedure even more challenging. This case report demonstrates that very early and rapidly progressing TAPS with technically complicated conditions (elevated BMI and anterior placenta) can be successfully managed with IUT until laser procedure is achievable.

  6. Genetic control of anastomosis in Podospora anserina.

    PubMed

    Tong, Laetitia Chan Ho; Silar, Philippe; Lalucque, Hervé

    2014-09-01

    We developed a new microscopy procedure to study anastomoses in the model ascomycete Podospora anserina and compared it with the previous method involving the formation of balanced heterokaryons. Both methods showed a good correlation. Heterokaryon formation was less quantifiable, but enabled to observe very rare events. Microscopic analysis evidenced that anastomoses were greatly influence by growth conditions and were severely impaired in the IDC mutants of the PaMpk1, PaMpk2, IDC1 and PaNox1 pathways. Yet some mutants readily formed heterokaryons, albeit with a delay when compared to the wild type. We also identified IDC(821), a new mutant presenting a phenotype similar to the other IDC mutants, including lack of anastomosis. Complete genome sequencing revealed that IDC(821) was affected in the orthologue of the Neurospora crassa So gene known to control anastomosis in several other ascomycetes.

  7. Comparison of laser-assisted fibrinogen bonding to sutured closure of umbilical vein graft

    NASA Astrophysics Data System (ADS)

    Oz, Mehmet C.; Souza, John E.; Williams, Matthew R.; Dardik, Herbert; Bass, Lawrence S.; Treat, Michael R.; Nowygrod, Roman

    1993-07-01

    Despite success with autologous tissue welding, laser welding of synthetic vascular prostheses has not been possible. The graft material appears inert and fails to allow the collagen breakdown and electrostatic bonding which results in tissue welding. In order to develop a laser welding system for graft material, we repaired gluataldehyde-tanned human umbilical cord vein graft incisions using laser-assisted fibrinogen bonding (LAFB) technology. Modified umbilical vein graft was incised transversely (1.2 cm). Incisions were repaired using sutures, laser energy alone, or LAFB. In vivo evaluation of umbilical graft bonding with canine arteries demonstrates that LAFB can reliably reinforce sutured anastomoses. The described system for bonding graft material with laser exposed fibrinogen may allow creation or reinforcement of vascular anastomoses in procedures where use of autologous tissue is not feasible.

  8. [A case of total cavopulmonary connection by utilization of coronary sinus as a hepatic venous return].

    PubMed

    Koide, M; Sakai, A; Iwata, Y; Sanae, T; Kunii, Y; Moriki, N; Ayusawa, Y; Seguchi, M

    2000-10-01

    A 2-year-old boy with polysplenia, double outlet right ventricle after pulmonary banding and unilateral bidirectional shunt was operated on. A modified total cavopulmonary connection was done by utilization of coronary sinus as a retrograde route for the hepatic venous return. Left SVC was transected and its distal end was anastomosed to the left pulmonary artery after PA angioplasty. An equine pericardial patch was placed over the ostia of the hepatic vein and coronary sinus. Two ostia of the coronary veins were excluded from the created route. The proximal end of the left SVC was anastomosed to the inferior side of the left pulmonary artery. Postoperative course was uneventful. The postoperative angiogram showed smooth hepatic venous return through the coronary sinus and no pressure gradient was recorded between hepatic vein and pulmonary artery.

  9. The "Rolled-Up Sleeve" Technique for Microvascular Venous Anastomosis in Head and Neck Reconstruction: Animal Study and Clinical Series.

    PubMed

    Scaglioni, Mario F; Kuo, Yur-Ren; Chen, Yen-Chou

    2016-03-01

    Venous anastomosis is challenging especially when encountering the thin recipient vein wall in the head and neck region. The authors developed the "rolled-up sleeve" technique to solve this scenario. An animal study was performed to access the safety and reliability of the "rolled-up sleeve" technique. This technique was performed in 53 consecutive patients during head and neck reconstruction. In the animal study, all anastomoses were patent. Histological analysis revealed neo-endothelialization over the anastomotic site. This technique was applied to 59 recipient veins: branch of internal jugular vein (27), external jugular vein (17), superficial temporal vein (9), retromandibular vein (4), facial vein (2), and internal mammary vein (2). No venous thrombosis occurred in these clinical series. The "rolled-up sleeve" technique is a useful procedure that can be performed safely to deal with thin vascular walls for venous anastomoses in head and neck reconstructions.

  10. Arterial vascularization of the pineal gland in the fetus of Zavot-bred cattle.

    PubMed

    Aslan, K; Ozcan, S; Aksoy, G; Kurtul, I; Dursun, N

    2003-04-01

    This study aimed at revealing arterial vascularization of the pineal gland of the Zavot-bred foetus. Twenty foetuses, regardless of their sex, at the age of 2-7 months were used. Coloured-latex was injected by way of both the right and left common carotid arteries. Then, dissection was performed and vessels nourishing the pineal gland were documented. The pineal gland is vascularized by a number of 2-5 central rami. A small vessel arising from each of the central rami in two foetuses (10%) was shown anastomosing with a branch of the cranial cerebral artery, which advances in cranio-caudal direction in the callosal groove. Hence, anastomoses were observed between several sub-branches of each caudal cerebral and cranial cerebellar arteries.

  11. Sutureless anastomosis of the small intestine and the colon in pigs using an absorbable intraluminal stent and fibrin glue.

    PubMed

    Detweiler, M B; Durastante, V; Verbo, A; Muttillo, I; Piantelli, M; Kobos, J W; Antinori, A; Granone, P; Magistrelli, P; Picciocchi, A

    1995-01-01

    A new sutureless anastomosis technique employing a sliding absorbable intraluminal nontoxic stent (SAINT) and fibrin glue with limited (minutes) stump margin pressure is described. Fifty-one (27 small intestine, 24 colon) SAINT anastomoses were performed in 31 Landrace pigs (25-35 kg). Controls consisted of 48 (26 small intestine, 22 colon) continuous single-layer submucosal anastomoses in 26 pigs. SAINTs, which dissolve in about 30-60 min, were formed from heated sucrose and water poured into handcrafted aluminum molds. Follow-up from 7 to 540 days showed no stenosis or anastomotic imperfections in the latter part of the experiment after the SAINT production and surgical techniques were improved. The SAINT group had fewer site adhesions, faster healing, less foreign body reaction, and fewer lymphocytes than the control group. Initial results indicate that the SAINT-fibrin glue procedure may be an effective sutureless anastomotic method from the duodenum to the sigmoid colon.

  12. Introduction of a potent single-donor fibrin glue for vascular anastomosis: An animal study

    PubMed Central

    Ardakani, Mehdi Rasti; Hormozi, Abdoljalil Kalantar; Ardakani, Jalal Rasti; Davarpanahjazi, Amir Hossein; Moghadam, Ali Shayesteh

    2012-01-01

    Background: Vascular anastomosis is considered as a difficult surgical procedure. Although different alternative methods have been tried to tackle these difficulties, none were found to be successful. Commercial fibrin glue has recently been used for vascular anastomosis. However, it did not gain popularity due to some limitations such as low tensile strength, rapid removal by the immune system, and risk of transmission of blood-borne viral infections. In this article, we presented a novel method for producing single-donor human fibrin glue and determined its success rate for vascular anastomosis in an animal model. Materials ans Methods: In this study, 3 mL of single-donor fibrin sealant was prepared from 150 mL of whole blood containing 50-70 mg/mL of fibrinogen. The study was performed on 10 dogs and 5 cats. After transection of the carotid artery, both ends were anastomosed by means of 3-4 sutures (Prolene 8-0). The suture line was then sealed with one layer of the new fibrin sealant. After 3-8 weeks, the site of anastomosis was evaluated angiographically and morphologically for healing and possible complications such as thrombosis or aneurysm. Results: In evaluations 3 weeks after the surgery, all arterial anastomoses were patent in dogs, but some degree of subintimal hyperplasia was noted. After 8 weeks, all anastomoses were patent and the degree of subintimal hyperplasia was decreased. In cats on the other hand, after 4 weeks, all anastomoses were patent and subintimal hyperplasia was absent. Conclusions: Single-donor fibrin glue was a quite reliable and practical alternative to minimize suturing and therefore operative time in our animal model. This sealant can easily be obtained from the patient's whole blood. Its application in humans would require further studies. PMID:23626612

  13. Supermicrosurgery and hyaluronic acid: experimental feasability study of a new method.

    PubMed

    Qassemyar, Q; Gianfermi, M

    2015-02-01

    As a technique of anastomosis for vessels of less than 0.8mm in diameter, supermicrosurgery has aroused renewed interest on account of its potential clinical applications. The technical difficulty of surgery at such a small scale necessitates exploration of new methods likely to render the anastomoses accessible and reliable. The aim of this article is to present the results of an experimental study on the feasibility of anastomoses (arterial diameter ≤0.5mm), assisted by the injection of hyaluronic acid (HA). Ten end-to-end arterial anastomoses of the inferior epigastric artery (diameter ≤0.5mm) were performed in 5 rats. An injection of HA had previously been carried out in the vessel lumen and the sutures were made with 12-0 nylon. Immediate and 3-day permeability were controlled and anastomosis times were measured. Average diameter of the arteries was 0.42 mm (range 0.29-0.48 mm). Mean anastomosis duration was 19.5 min (range 15-23 min). The average number of stitches was 6. Immediate patency was 100% with a success rate of 80% at 3 days. The properties of HA seem to effectively facilitate anastomoses of arteries with a diameter ≤0.5mm. HA provides comfort and promotes safety in performance of exceedingly small-scale surgery. While the results appear promising, but further studies are needed in order to determine the potential toxicity of this method on tissues. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. The Superior-Edge-of-the-Knee Incision Method in Lymphaticovenular Anastomosis for Lower Extremity Lymphedema.

    PubMed

    Seki, Yukio; Yamamoto, Takumi; Yoshimatsu, Hidehiko; Hayashi, Akitatsu; Kurazono, Arito; Mori, Masanori; Kato, Yoichi; Koshima, Isao

    2015-11-01

    Lymphatic vessel diameter and lymph flow are important for accurate anastomosis and effective lymph-to-venous flow in lymphaticovenular anastomosis. The authors developed a reliable method, the superioredge-of-the-knee incision method, for detecting and making the best use of high-flow lymphatic vessels in the distal medial thigh between the deep and superficial fascia, where movement of the knee, combined with compression between these fascial layers, theoretically results in upward propulsion of lymphatic fluid. Intraoperative detection of large lymphatic vessels and of venous reflux and postoperative lymphedematous volume reduction were compared between 15 patients in whom lymphaticovenular anastomoses with the superior-edge-of-the-knee incision method were undergone and 15 in whom conventional lymphaticovenular anastomoses were undergone. Lymphaticovenular anastomosis at the thigh yielded 30 anastomoses in the superior-edge-of-the-knee incision group and 32 anastomoses in the non-superior-edge-of-the-knee incision group. Large lymphatic vessels were more frequently found in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (60.0 percent versus 18.8 percent; p = 0.002). Venous reflux occurred less frequently in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (10.0 percent versus 65.6 percent; p < 0.001). Reduction of the lower extremity lymphedema index was significantly greater in the superior-edge-of-the-knee incision group than in the non-superior-edge-of-the-knee incision group (24.427 ± 12.400 versus 0.032 ± 20.535; p < 0.001). The superior-edge-of-the-knee incision method facilitates detection and use of large, high-flow lymphatic vessels in the distal medial thigh, both of which are important for optimum therapeutic effects in patients with lower extremity lymphedema. Therapeutic, III.

  15. Effect of Palm Cooling with Negative Pressure on Heat Balance During Exercise in a Hot, Dry Environment

    DTIC Science & Technology

    2006-11-15

    reducing heat exchange. Blood flow to the palm and sole are controlled by arteriovenous anastomoses, small blood vessels with thick muscular walls...Body fat was measured in each subject using Lange skinfold calipers and the gender-specific, sum of three skinfold equations of Jackson and Pollack...balanced order (see table below). One HST test was performed without cooling. Another test was performed with the left hand placed in the RTX cooling

  16. N-Butyl Cyanoacrylate Proved Beneficial to Avoid a Nontarget Embolization of the Ophthalmic Artery in Endovascular Management of Epistaxis

    PubMed Central

    Shuster, A.; Gunnarsson, T.; Klurfan, P.; Larrazabal, R.

    2011-01-01

    Summary Epistaxis is a common disorder affecting equally both genders. Posterior origin of epistaxis in some instances requires endovascular treatment. Anastomoses between external carotid artery and internal carotid or ophthalmic arteries heighten the risk of stroke or blindness, if particles of polyvinyl alcohol are used for embolization. We report a case of 90-year-old man for whom successful embolization with N-Butyl Cyanoacrylate glue was performed as an alternative treatment for recurrent epistaxis. PMID:21561554

  17. Extreme fenestration of the right vertebral artery: magnetic resonance angiographic demonstration.

    PubMed

    Uchino, A; Sawada, A; Takase, Y; Kudo, S

    2002-12-01

    The authors describe an extreme fenestration of the right vertebral artery. This anomaly was found incidentally in a female patient undergoing MR imaging and MR angiography evaluation for severe dizziness and headache. Magnetic resonance angiography showed that the right posterior inferior cerebellar artery originated possibly extracranially and anastomosed with the terminal portion of the right vertebral artery, indicating the presence of an extremely large fenestration. This, to our knowledge, is the first report of MR angiographic demonstration of this variation.

  18. 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

  19. Vascular anatomy: the head, neck, and skull base.

    PubMed

    Johnson, Michele H; Thorisson, Hjalti M; Diluna, Michael L

    2009-07-01

    Knowledge of the anatomy of the vasculature of the head and neck from the thorax to the skull base is critical to the approach to diagnosis and treatment of cerebrovascular disease. Awareness of the anatomic variations that may be encountered, common and uncommon, is necessary to avoid diagnostic pitfalls and to avert therapeutic disasters. Careful anatomic analysis and understanding of collateral pathways and dangerous anastomoses facilitates cross-sectional and angiographic diagnosis and the development of surgical and endovascular treatment strategies.

  20. Prediction of Susceptibility to Acute Mountain Sickness Using Hypoxia-Induced Intrapulmonary Arteriovenous Shunt and Intracardiac Shunt Fractions

    DTIC Science & Technology

    2013-10-01

    intracardiac shunting (through patent foramen ovale (PFO)) are responsible for the greater degree of arterial hypoxemia in AMS susceptible subjects compared...arteriovenous anastomoses, patent foramen ovale and nuclear medicine shunt fraction quantification Post-doctoral fellow JJ Duke is working to complete...significant differences. Non-Task Specific Accomplishments: Collaboration with Dr. Robert Roach, role of patent foramen ovale in symptoms of acute mountain

  1. Flowmetry evolution in microvascular surgery: A systematic review.

    PubMed

    Pafitanis, Georgios; Raveendran, Maria; Myers, Simon; Ghanem, Ali M

    2017-09-01

    This review aims to provide a summary of the flowmeter devices used in microvascular surgery and assesses their contribution to improving the clinical outcomes of free tissue transfer. Flowmeters are widely accepted as the standard method of intraoperative assessment of the patency of coronary vascular anastomoses, providing thresholds that predict outcome. There is limited evidence regarding the use of flow measurements in plastic surgery microvascular anastomoses; however, flowmetry appears to have some role in postoperative free flap monitoring and prevention of complications. Surgeons rely on subjective clinical robust findings (patency test) as proof of immediate flow. The current literature lacks evidence regarding an objective predictor tool used to evaluate adequate flow changes before and after microvascular anastomosis. An electronic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement by using the MEDLINE, EMBASE, and Cochrane databases. A combination of algorithms including "flowmeter," "Doppler ultrasound," "transit volume flow," and "laser Doppler flowmeter" meshed with "microsurgery" was used to search for experimental and clinical studies that assess microvascular anastomoses by using a flowmeter device. A total of 718 peer-reviewed publications and 14 full-text articles described the use of microvascular flowmeters to determine anastomotic patency or free flap viability. Flowmeters are currently used to provide the qualitative assessment of microvascular anastomoses. It seems reasonable to expect flowmetry to provide quantitative values that can be used intraoperatively to predict both outcomes and the necessity for an on-table anastomosis revision; this may allow surgeons to better understand the other factors that predict failure by exclusion. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. Persistent proatlantal artery associated with carotid artery stenosis treatment by percutaneous transluminal balloon angioplasty.

    PubMed

    Bour, P; Bracard, S; Frisch, N; Frisch, R; Fiévé, G

    1991-01-01

    A 58-year-old man had an asymptomatic tight stenosis of the internal carotid artery associated with a persistent proatlantal artery. This as well as other compositional arterial anomalies of the basilar artery were discovered on arteriograms. The stenosis was successfully treated by percutaneous transluminal balloon angioplasty. Therapeutic choices are discussed in this setting because of the risk of carotid clamping in the presence of persistent carotid-basilar anastomoses.

  3. Postoperative peridural analgesia increases the strength of colonic contractions without impairing anastomotic healing in rats.

    PubMed

    Jansen, Marc; Lynen Jansen, Petra; Junge, Karsten; Anurov, Michael; Titkova, Svetlana; Ottinger, Alexander; Schumpelick, Volker

    2003-01-01

    Peridural analgesia (PDA) is a common treatment in postoperative management after abdominal surgery to shorten postoperative ileus and to permit early postoperative nutrition. There are conflicting opinions on the effect of early peristalsis on healing of colonic anastomoses. A short segment of the distal colon was resected in 32 Wistar rats. Two strain gauge transducers were placed on the serosa proximal to the anastomosis to measure the strength and periodicity of bowel contractions. A peridural catheter was placed between lumbar vertebra 7 and the sacral crest. The animals received 4, 16, 20, and 24 h after operation an injection of either 0.03 ml ropivacaine 0.75%/kg body weight or the same amount of sodium chloride (controls). After 3 and 10 days the colonic anastomoses were resected to measure the bursting pressure. The anastomoses were prepared for histopathological examination and determination of relative collagen content. Postoperative PDA led to an increasing amplitude of phasic and tonic contractions while the frequency of contractions was not significantly affected. None of the groups presented with any anastomotic complications. The bursting pressure after 3 and 10 days was similar in the two groups. The relative amount of collagen I in the anastomotic area was significantly higher after treatment with peridural ropivacaine. Postoperative PDA with ropivacaine increases the strength of colonic contractions. The increase in phasic contractions suggests a better propulsive bowel function. The significantly higher amount of collagen I in the anastomosis of animals in the PDA group supports the idea that healing of colonic anastomoses is improved rather than diminished by PDA.

  4. 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.

  5. Endoluminal negative-pressure therapy for preventing rectal anastomotic leaks: a pilot study in a pig model.

    PubMed

    Shada, Amber L; Rosenberger, Laura H; Mentrikoski, Mark J; Silva, Michael A; Feldman, Sanford H; Kleiner, Daniel E

    2014-04-01

    Anastomotic leak after rectal resection carries substantial morbidity and mortality. A diverting ileostomy is beneficial for high-risk anastomoses, but its creation and reversal carry a surgical risk in addition to that of resection itself. We sought an alternative method for managing complications of rectal anastomosis. We developed an endoluminal negative-pressure technology with a diverting proximal sump, and hypothesized that it would close anastomotic disruptions in pigs. We performed rectal resections on pigs, with primary anastomoses and the creation of an anastomotic defect. In animals in the treatment group we inserted an endoluminal negative-pressure device and kept it at a low level of continuous suction for 5 d. No device was inserted in a control group of animals. After the 5-d period of treatment we evaluated the anastomoses in both the treatment and control groups of animals for leakage, using contrast enemas. Specimens of anastomosed rectum were evaluated histologically for mucosal integrity and for the location and density of inflammatory responses. Fourteen pigs were assigned to either the treatment (n=10) or control (n=4) group. Of the pigs in the treatment group, 90% had complete closure of their rectal defect, as compared with 25% of the animals in the control group (χ(2) test, p=0.04). The animals in the treatment group had only minimal mucosal and serosal inflammation, whereas those in the control group had extensive mucosal damage with associated serositis. Endoluminal negative-pressure therapy was well-tolerated and led to successful closure of 90% of the anastomic rectal defects in the treatment group of animals in the present study. Additional evaluation of this therapy is warranted.

  6. Residues from Live Fire Detonations of 155-mm Howitzer Rounds

    DTIC Science & Technology

    2005-07-01

    tests were conducted on an ice- and snow-covered range, which allowed us to sample the residues on an explosives- free surface and to visually...manufacturing impurity in RDX. We selected 155-mm rounds for testing because they are one of the top five most commonly used rounds in the U.S. arsenal...Delta River is a large anastomosing river with a cobble and gravel flood plain characterized, in winter, by intermixed ice and cobble bars. Although

  7. Fate of coronary collateral circulation after aorto-coronary saphenous vein bypass grafts.

    PubMed Central

    Di Luzio, V; Roy, P R; Sowton, E; Dow, J

    1975-01-01

    The pre- and postoperative patterns of coronary artery collateral circulation have been studied in 34 patients who had saphenous vein bypass grafting. When the graft remained patent homocoronary collaterals could not be visualized after operation, but new intercoronary anastomoses frequently developed to other diseased arteries. When the graft and the bypassed artery were both obstructed there was a high incidence (5 out of 11) of myocardial infarction despite good preoperative collaterals. Images PMID:1079134

  8. [An improved single-layer suture in the surgery of small and large intestines].

    PubMed

    Kapustin, B B; Sysoev, S V

    2010-01-01

    The methods and results of using single-layer interrupted intestinal suture in operations on the small and large intestines are presented. Using the suture decreases the number of complications associated with this technique, improves the direct results of operations and reduces postoperative lethality both in urgent and planned surgery. The proposed intestinal suture is thought to be justified in connecting similar and dissimilar parts of the intestinal tube in the variants of longitudinal, transversal, terminal, lateral and termino-lateral interintestinal anastomoses.

  9. Use of circumferential stapler in reconstruction following resections for carcinoma of the cardia.

    PubMed

    Molina, J E; Lawton, B R; Avance, D

    1981-04-01

    The use of the End-to-End Anastomosis (EEA) circumferential stapler for reconstruction following resection of the esophagus and stomach for carcinoma of the cardia is reported here in 9 consecutive patients with fifteen anastomoses performed with this unit. The technical aspects of the EEA stapler are emphasized. Two frequent problems associated with this type of operation namely, stenosis or leak at the suture line, are completely avoided by the use of this stapler unit. Its use is recommended.

  10. 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.

  11. Recurrent hemangioendothelioma in a pediatric patient: report and review of the literature.

    PubMed

    Kim, Michael E; Fallon, Sara C; Lopez, Monica E; Hicks, M John; Brandt, Mary L

    2013-06-01

    The most common adrenal tumor in the pediatric population is a benign hemangioma. Adrenal hemangioendotheliomas are extremely rare variants of the hemangioma which are characterized by the presence of multiple anastomosing vascular spaces lined by endothelial cells, and have indeterminant biologic behavior. We report a unique case in a pediatric patient with Beckwith-Wiedemann syndrome which was complicated by a recurrence of the lesion. Copyright © 2013. Published by Elsevier Inc.

  12. Minimally invasive entero-enteral dual-path bypass using self-assembling magnets.

    PubMed

    Ryou, Marvin; Aihara, Hiroyuki; Thompson, Christopher C

    2016-10-01

    A minimally invasive method of entero-enteral bypass may be desirable for treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets which create large-caliber anastomoses (incisionless anastomosis system or IAS). The aim of this study was to assess (a) procedural characteristics of IAS deployment and (b) long-term integrity and patency of the resulting jejuno-ileal dual-path bypass. Endoscopic jejuno-ileal bypass creation using IAS magnets was performed in 8 Yorkshire pigs survived 3 months. The jejunal magnet was endoscopically deployed. However, the ileal magnet required surgical delivery given restraints of porcine anatomy. A 5-mm enterotomy was created through which the ileal magnet was inserted using a modified laparoscopic delivery tool. Magnets were manually coupled. Pigs underwent serial endoscopies for anastomosis assessment. Three-month necropsies were performed, followed by pressure testing of anastomoses and histological analysis. Jejuno-ileal bypass creation using self-assembling IAS magnets was successful in all 8 pigs (100 %). Patent, leak-free bypasses formed in all animals by day 10. All IAS magnets were expelled by day 12. Anastomoses were widely patent at 3 months, with mean maximal diameter of 30 mm. At necropsy, adhesions were minimal. Pressure testing confirmed superior integrity of anastomotic tissue. Histology showed full epithelialization across the anastomosis with no evidence of submucosal fibrosis or inflammation. Entero-enteral bypass using self-assembling IAS magnets is safe and technically feasible in the porcine model. IAS magnets can be rapidly delivered endoscopically or through a modified laparoscopic device. Expulsion of fused magnets avoids retention of prosthetic material. Anastomoses are widely patent and fully re-epithelialized. Three-month pressure testing reveals anastomotic tissue to be as robust as native tissue, while necropsy and histology

  13. 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

  14. [Mechanical suture during resection of the rectum through the abdomen (author's transl)].

    PubMed

    Gauthier-Benoît, C; Prat, A

    1979-01-01

    A mechanical suture using the URSS PKZ 28 or SPTU stapler was used in 30 low colo-rectal anastomoses. There were two deaths related to anastomotic complications. It is safe to establish a colostomy when the colon is not well prepared. Fistulae are frequent after palliative operations: this is a poor indication. Local recurrences are no more frequent with stapling than with manual suture.

  15. Standard versus bicaval techniques for orthotopic heart transplantation: an analysis of the United Network for Organ Sharing database.

    PubMed

    Davies, Ryan R; Russo, Mark J; Morgan, Jeffrey A; Sorabella, Robert A; Naka, Yoshifumi; Chen, Jonathan M

    2010-09-01

    Most studies of anastomotic technique have been underpowered to detect subtle differences in survival. We analyzed the United Network for Organ Sharing database for trends in use and outcomes after either bicaval or traditional (biatrial) anastomoses for heart implantation. Review of United Network for Organ Sharing data identified 20,999 recipients of heart transplants from 1997 to 2007. Patients were stratified based on the technique of atrial anastomosis: standard biatrial (atrial group, n = 11,919, 59.3%), bicaval (caval group, n = 7661, 38.1%), or total orthotopic (total group, n = 519, 2.6%). The use of the bicaval anastomosis is increasing, but many transplantations continue to use a biatrial anastomosis (1997, 0.2% vs 97.6%; 2007, 62.0% vs 34.7%; P < .0001). Atrial group patients required permanent pacemaker implantation more often (odds ratio, 2.6; 95% confidence interval, 2.2-3.1). Caval group patients had a significant advantage in 30-day mortality (odds ratio, 0.83; 95% confidence interval, 0.75-0.93), and Cox regression analysis confirmed the decreased long-term survival in the atrial group (hazard ratio, 1.11; 95% confidence interval, 1.04-1.19). Heart transplantations performed with bicaval anastomoses require postoperative permanent pacemaker implantation at lower frequency and have a small but significant survival advantage compared with biatrial anastomoses. We recommend that except where technical considerations require a biatrial technique, bicaval anastomoses should be performed for heart transplantation. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  16. Topographic and hydraulic controls over alluviation on a bedrock template

    NASA Astrophysics Data System (ADS)

    Milan, David; Heritage, George; Entwistle, Neil; Tooth, Stephen

    2017-04-01

    Bedrock-alluvial anastomosed channels found in dryland rivers are characterised by an over-wide channel cut into the host rock containing a network of interconnecting bedrock sub-channels separated by bedrock influenced interfluve areas. Whilst the channels remain largely free of sediment the interfluves display varying levels of alluviation ranging from bare rock, sand sheets and silt drapes through to consolidated bedrock core bars, islands and lateral deposits. Examination of the sedimentary units associated with the bedrock anastomosed reaches of the Sabie river in the Kruger National Park, South Africa reveal a repeating sequence of coarse sand / fine gravel grading through to silt representing successive flood related depositional units. Unit development in relation to the bedrock template was investigated using pre-flood aerial imagery of bedrock core bar locations and post flood LiDAR data of bedrock anastomosed sites stripped during the 2000 and 2012 extreme flood events. This revealed a propensity for bar development associated with bedrock hollows disconnected from the principal high-energy sub-channels. 2-D morpho-dynamic modelling was used to further investigate spatial patterns of deposition over the bedrock template. Although topographic lows displayed mid-range velocities during peak flow events, these are likely to be preferential routing areas, with sediments stalling in low energy areas on the falling limb of floods. It is also likely that vegetation development plays a fundamental role in the development of alluviated zones, through increasing strength of alluvial units and capturing new sediments. With these results in mind we present a conceptual model for the development of bedrock-core bars, the fundamental unit in bedrock-alluvial anastomosed channels.

  17. Safety and efficacy of the NiTi Shape Memory Compression Anastomosis Ring (CAR/ColonRing) for end-to-end compression anastomosis in anterior resection or low anterior resection.

    PubMed

    Kang, Jeonghyun; Park, Min Geun; Hur, Hyuk; Min, Byung Soh; Lee, Kang Young; Kim, Nam Kyu

    2013-04-01

    Compression anastomoses may represent an improvement over traditional hand-sewn or stapled techniques. This prospective exploratory study aimed to assess the efficacy and complication rates in patients undergoing anterior resection (AR) or low anterior resection (LAR) anastomosed with a novel end-to-end compression anastomosis ring, the ColonRing. In all, 20 patients (13 male) undergoing AR or LAR were enrolled to be anastomosed using the NiTi Shape Memory End-to-End Compression Anastomosis Ring (NiTi Medical Technologies Ltd, Netanya, Israel). Demographic, intraoperative, and postoperative data were collected. Patients underwent AR (11/20) or LAR using laparoscopy (75%), robotic (10%) surgery, or an open laparotomy (15%) approach, with a median anastomotic level of 14.5 cm (range, 4-25 cm). Defunctioning loop ileostomies were formed in 6 patients for low anastomoses. Surgeons rated the ColonRing device as either easy or very easy to use. One patient developed an anastomotic leakage in the early postoperative period; there were no late postoperative complications. Mean time to passage of first flatus and commencement of oral fluids was 2.5 days and 3.2 days, respectively. Average hospital stay was 12.6 days (range, 8-23 days). Finally, the device was expelled on average 15.3 days postoperatively without difficulty. This is the first study reporting results in a significant number of LAR patients and the first reported experience from South Korea; it shows that the compression technique is surgically feasible, easy to use, and without significant complication rates. A large randomized controlled trial is warranted to investigate the benefits of the ColonRing over traditional stapling techniques.

  18. Anastomotic disruption after large bowel resection

    PubMed Central

    NasirKhan, Mohammad U; Abir, Farshad; Longo, Walter; Kozol, Robert

    2006-01-01

    Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial. Despite proper caution and excellent surgical technique, some anastomotic leaks are inevitable. The rapid identification of anastomotic leaks and the timely treatment in these cases are paramount. PMID:16688793

  19. The radius surgical system - a new device for complex minimally invasive procedures in urology?

    PubMed

    Frede, Thomas; Hammady, Ahmed; Klein, Jan; Teber, Dogu; Inaki, Noriyuki; Waseda, Masahiro; Buess, Gerhard; Rassweiler, Jens

    2007-04-01

    Complex laparoscopic procedures in urology are technically demanding with an extended learning curve. Robotic systems add significant cost to laparoscopic procedures. We therefore evaluated the use of the Radius Surgical System (RSS), a mechanical manipulator, for complex laparoscopic cases in urology. The RSS (Tuebingen Scientific) consists of two hand-guided surgical manipulators and provides a deflectable and rotatable tip allowing six degrees of freedom. We evaluated the system by using a series of standardized models in the pelvitrainer. We analyzed the effectiveness of the system and the learning curve. We then evaluated the system in the clinical setting during laparoscopic radical prostatectomy. Surgeons with experience on the RSS were compared to surgeons without previous experience on the system. We identified a learning curve in those participants without experience on the system only when performing complete anastomoses in the pelvitrainer. However, this learning curve included less than 10 anastomoses. The first clinical experiences during laparoscopic extraperitoneal radical prostatectomy (n=10) are promising. All anastomoses were patent on routine (X-ray) examination 8 days after surgery. The RSS system is easy to use and we identified a very short learning curve. We now optimize the system for use in urology. This device may facilitate complex laparoscopic procedures without the use of costly robotic systems and should be further evaluated in the experimental and clinical setting.

  20. Different characteristics of circular staplers make the difference in anastomotic tensile strength.

    PubMed

    Giaccaglia, V; Antonelli, M S; Franceschilli, L; Salvi, P F; Gaspari, A L; Sileri, P

    2016-01-01

    Anastomotic leak after gastrointestinal surgery is a severe complication associated with relevant short and long-term sequelae. Most of the anastomoses are currently performed with a surgical stapler that is required to have appropriate characteristics in order to guarantee good performances. The aim of our study was to evaluate, ex vivo, pressure resistance and tensile strength of anastomosis performed with different circular staplers available in the market. We studied 7 circular staplers of 3 different companies, 3 of them used for gastrointestinal anastomosis and 4 staplers for hemorrhoidal prolapse excision. A total of 350 anastomoses, 50 for each of the 7 staplers, were performed using healthy pig fresh intestine, then injected saline solution and recorded the leaking pressure. There were no statistically significant differences between the mean pressure necessary to induce an anastomotic leak in the various instruments (p>0.05). For studying tensile strength, we performed a total of 350 anastomoses with 7 different circular staplers on a special strong paper (Tyvek), and then recorded the maximal tensile force that could open the anastomosis. There were statistically significant differences between one brand stapler vs other 2 companies staplers about the strength necessary to open the staple line (p<0.05). In conclusion, we demonstrated that different circular staplers of three companies available in the market give comparable anastomotic pressure resistance but different tensile strengths. This is probably due to different technical characteristics.

  1. The Retrograde Ulnar Dorsal Flap: Surgical Technique and Experience as Island Flap in Coverage of Hand Defects.

    PubMed

    Vergara-Amador, Enrique

    2015-09-01

    Flaps from the forearm are often used to reconstruct soft-tissue defects in the hand. The retrograde ulnar dorsal flap has the advantage that it does not sacrifice a major vascular axis. The anatomic bases of this flap are the proximal and distal branch of the ulnar dorsal artery. The distal branch is partially accompanied with the dorsal branch of the ulnar nerve, and arrives under the abductor digiti quinti muscle making anastomoses with the deep branch of the ulnar artery. The proximal branch reaching the proximal third of the forearm, and anastomose with perforating branches of the ulnar artery. I used this island flap in 12 patients with coverage defects on the hand. The biggest flap was 13×6 cm. Only 1 flap had partial necrosis which did not lead to problems. The retrograde ulnar dorsal flap is a flap designed with reverse flow from the distal branch of the ulnar dorsal artery, and which does not sacrifice the ulnar artery. The donor defect on the forearm ulnar side had a greater esthetic acceptance. Knowing other distal anastomoses, described by other authors later, dorsal at the base of the fourth interdigital space grant greater security to the retrograde ulnar dorsal flap. It is worth highlighting the importance of preserving the adipofascial tissue around the pedicle. Experience with this flap permits us to state that it is a safe and reproducible flap to cover any defect on the dorsal of the hand as well as the first web space.

  2. Anorectal autotransplantation in a canine model: the first successful report in the short term with the non-laparotomy approach

    PubMed Central

    Araki, Jun; Nishizawa, Yuji; Nakamura, Tatsuo; Sato, Tomoyuki; Naito, Munekazu; Hatayama, Naoyuki; Hirai, Shuichi; Tashiro, Kensuke; Koshima, Isao

    2014-01-01

    Colostomy is conventional treatment for anal dysfunction. Recently, a few trials of anorectal transplantation in animals have been published as a potential alternative to colostomies; however, further development of this technique is required. In this study, we utilized a canine model of anorectal transplantation, evaluated the patency of our microsurgical anastomoses, and assessed the perfusion of the transplanted anus. We designed a canine anorectal transplantation model, wherein anorectal autotransplantation was performed in four healthy beagle dogs by anastomoses of the lower rectum, the bilateral pudendal arteries (PAs) and veins (PVs), and pudendal nerves (PNs). Postoperative graft perfusion was measured by indocyanine green (ICG) angiography and histological examination. The length of the anorectal graft including perianal skin, anal sphincter muscle, bilateral PAs, PVs, and PNs was 4.9 ± 0.3 cm. All diameters of the PAs, PVs, and PNs were large enough to be microscopically anastomosed. Both ICG angiography and histological examination demonstrated good graft perfusion, except for one case that lead to venous congestion. These results show that anastomosis of the bilateral PAs, PVs, and PNs is required for anorectal transplantation. This is the first successful report of canine anorectal autotransplantation. PMID:25204282

  3. Clinical and placental characteristics in four new cases of twin anemia-polycythemia sequence.

    PubMed

    Weingertner, A S; Kohler, A; Kohler, M; Bouffet, N; Hunsinger, M C; Mager, C; Hornecker, F; Neumann, M; Schmerber, E; Tanghe, M; Viville, B; Favre, R

    2010-04-01

    We report and analyze four new cases of spontaneous twin anemia-polycythemia sequence (TAPS) and discuss antenatal management by fetoscopic laser coagulation for this uncommon form of chronic intertwin transfusion. The clinical course and placental characteristics of four pairs of monochorionic-diamniotic (MCDA) twins with spontaneous TAPS, of which one was treated with fetoscopic laser surgery, are described. For the three cases that did not undergo intrauterine intervention, serial Doppler measurement revealed a gradual increase in the middle cerebral artery peak systolic velocity (MCA-PSV) in the donor and a concomitant decrease in the recipient. These twins were born at between 32 and 34 weeks' gestation by Cesarean section. At birth, the donor twins were severely anemic and the recipient twins were polycythemic. Placental injection studies revealed a few small arteriovenous (AV) and venoarterial anastomoses. In the fourth case, because of the high suspicion of TAPS on MCA-PSV data at 24 weeks' gestation, fetoscopic laser coagulation of three small AV anastomoses was successfully performed. No hematological abnormalities were detected at birth. TAPS is a newly described form of chronic twin-to-twin transfusion associated with chronic anemia in the donor and polycythemia in the recipient, without twin oligo-polyhydramnios sequence (TOPS). The monitoring of MCDA pregnancies should include measurement of MCA-PSV in both fetuses even in the absence of intertwin discordance in amniotic fluid volume. Early detection of TAPS could indicate fetoscopic laser coagulation of AV anastomoses. Copyright 2009 ISUOG. Published by John Wiley & Sons, Ltd.

  4. Use of cryopreserved rat arteries for microsurgical training.

    PubMed

    Lausada, Natalia R; Escudero, E; Lamonega, R; Dreizzen, E; Raimondi, J C

    2005-01-01

    Silastic tubes are used as training material for performing microvascular anastomoses. However, silastic texture differs from that of actual blood vessels. In the present work, we evaluate the use of preserved rat arterial segments for training in microvascular anastomoses. One-centimeter-long rat arterial segments were obtained from femoral, carotid, and abdominal arteries, preserved in cold saline solution, and frozen. Trainees performed microvascular anastomoses using the aforementioned material and answered questions about texture, consistency, and wall resistance to the needle, comparing preserved arterial wall and silastic tubes. They were also asked whether the arterial pedicles had a consistency and texture similar to normal vessels, and if they were a more reliable method for practicing microsurgery techniques than synthetic materials. They preferred frozen arterial pedicles over silastic tubes. We conclude that arterial cadaveric segments are a suitable biologic material for microsurgical training. Since they can be obtained from other experiments, this is an effective way to reduce the number of animals bred and sacrificed for teaching purposes. Copyright 2005 Wiley-Liss, Inc.

  5. Venous outflow reconstruction using an expanded polytetrafluoroethylene vascular graft in living-donor liver transplant: a single-center experience.

    PubMed

    Lai, Chia-Yu; Han, Shao-Min; Chen, Yi-Ju; Huang, Shou-Sen; Wu, Cheng-Chung; Cheng, Shao-Bin

    2014-06-01

    Limited studies have focused on the feasibility and technical requirements of using expanded polytetrafluoroethylene vessel grafts for venous outflow reconstruction in a living-donor liver transplant using right liver grafts without the middle hepatic vein. Between August 2007 and December 2012, thirty-two patients who had received an expanded polytetrafluoroethylene vascular graft for outflow reconstruction during a living-donor liver transplant using a right liver graft without the middle hepatic vein were retrospectively reviewed. Preoperative and operative data, complications, and mortality were compared among patients who received the expanded polytetrafluoroethylene grafts with individual anastomoses (n = 18) or confluent anastomoses (n =14). For patients who had received an individual and a confluent anastomosis, graft reconstruction time was 25.8 and 14.9 minutes (P = .000). No cases of graft occlusion occurred during first 72 hours after surgery. Although 5 patients (15.6%) died within 90 days, none of the deaths were associated with the vascular grafts. Operative mortality was not statistically different between patients who had received an individual anastomosis (3/18, 16.7%) and those who had received a confluent anastomosis (2/14, 14.3%) (P = 1.000). Individual and confluent anastomoses using an expanded polytetrafluoroethylene vascular graft is a feasible approach to venous outflow reconstruction in a living-donor liver transplant using right liver grafts without the middle hepatic vein.

  6. Granular cell ameloblastoma: case report of a particular ameloblastoma histologically resembling oncocytoma.

    PubMed

    Matsushita, Yuki; Fujita, Shuichi; Kawasaki, Goro; Hirota, Yoshinosuke; Rokutanda, Satoshi; Yamashita, Kentaro; Yanamoto, Souichi; Ikeda, Tohru; Umeda, Masahiro

    2015-01-01

    Granular cell ameloblastoma is classified as a histological subtype of solid/multicystic ameloblastoma. Usual granular cell ameloblastoma is histologically characterized by granular changes of stellate-like cells located in the inner portion of the epithelial follicles. Here we report a case of another type of granular cell ameloblastoma, showing predominant anastomosing double-stranded trabeculae of granular cells. This type of granular cell ameloblastoma is extremely rare, and the World Health Organization classification does not contain the entity. We tentatively termed it 'anastomosing granular cell ameloblastoma' in this report. The present case suggests the importance of differential diagnosis because the histology of 'anastomosing granular cell ameloblastoma' resembles that of salivary gland oncocytoma rather than that of usual granular cell ameloblastoma. The trabeculae observed in our case continued to the peripheral cells of a small amount of epithelial sheets of plexiform ameloblastoma, and the tumor cells were positive for CK19, which is regarded as an immunohistochemical marker of odontogenic epithelium. Similar to usual granular cell ameloblastoma, the tumor cells had CD68-positive granules. For precise diagnosis of this condition, immunohistochemistry using CK19 and CD68, as well as detailed histological observation, are recommended. © 2014 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

  7. 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.

  8. In vitro measurements of velocity and wall shear stress in a novel sequential anastomotic graft design model under pulsatile flow conditions.

    PubMed

    Kabinejadian, Foad; Ghista, Dhanjoo N; Su, Boyang; Nezhadian, Mercedeh Kaabi; Chua, Leok Poh; Yeo, Joon Hock; Leo, Hwa Liang

    2014-10-01

    This study documents the superior hemodynamics of a novel coupled sequential anastomoses (SQA) graft design in comparison with the routine conventional end-to-side (ETS) anastomoses in coronary artery bypass grafts (CABG). The flow fields inside three polydimethylsiloxane (PDMS) models of coronary artery bypass grafts, including the coupled SQA graft design, a conventional ETS anastomosis, and a parallel side-to-side (STS) anastomosis, are investigated under pulsatile flow conditions using particle image velocimetry (PIV). The velocity field and distributions of wall shear stress (WSS) in the models are studied and compared with each other. The measurement results and WSS distributions, computed from the near wall velocity gradients reveal that the novel coupled SQA design provides: (i) a uniform and smooth flow at its ETS anastomosis, without any stagnation point on the artery bed and vortex formation in the heel region of the ETS anastomosis within the coronary artery; (ii) more favorable WSS distribution; and (iii) a spare route for the blood flow to the coronary artery, to avoid re-operation in case of re-stenosis in either of the anastomoses. This in vitro investigation complements the previous computational studies of blood flow in this coupled SQA design, and is another necessary step taken toward the clinical application of this novel design. At this point and prior to the clinical adoption of this novel design, in vivo animal trials are warranted, in order to investigate the biological effects and overall performance of this anastomotic configuration in vivo.

  9. 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.

  10. Sutureless open vascular anastomosis connector: An experimental study.

    PubMed

    Kapischke, Matthias; Gerhard, Dietmar; Pries, Alexandra

    2017-02-01

    The objective of this study was to assess the safety of a new developed sutureless vascular adapter system in a porcine model. In five pigs, 4-cm-long polyester prosthesis (6 mm diameter) were implanted and anastomosed with the newly developed adapter proximally and suture anastomosis distally. The integration of the adapter was investigated in comparison to the suture anastomosis. These investigations were performed by light microscopy and scanning electron microscopy. Median operative time for performing the adapter anastomosis was significantly shorter compared to suture anastomosis (66 s vs. 246 s, p < 0.05). Median estimated blood loss during adapter anastomosis implementation was 22.5 mL (range 19.0-25.0 mL) compared to 48.2 mL (range 45.4-63.5 mL, p < 0.05). In five hand-sewn anastomoses, overall eight additional stitches were necessary whereas all adapter anastomoses showed primary leak tightness. This in vivo study shows the technical feasibility of the newly developed adapter.

  11. 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).

  12. 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.

  13. Twin anemia-polycythemia sequence in a case of monoamniotic twins.

    PubMed

    Diehl, W; Glosemeyer, P; Tavares De Sousa, M; Hollwitz, B; Ortmeyer, G; Hecher, K

    2013-07-01

    Twin anemia-polycythemia sequence (TAPS) complicates up to 6% of monochorionic diamniotic twin pregnancies, typically in the late second or third trimester. The presence of only a few and very small arteriovenous vascular anastomoses characterizes the underlying angioarchitecture at the chorionic plate in cases of TAPS. In monoamniotic twins, large vascular anastomoses can usually be seen at the placental vascular equator, and therefore one would not expect the development of TAPS in monoamniotic twins. We report a case of TAPS in a monoamniotic pregnancy at 26 + 5 weeks' gestation which responded favorably to fetoscopic laser coagulation of the small placental anastomoses, resolving severe anemia in one twin and polycythemia in the other. The pregnancy continued until 32 + 5 weeks, when worsening cord entanglement with increased resistance and the development of postsystolic notches in the umbilical artery of one twin prompted delivery by Cesarean section. There was only a moderate difference in neonatal hemoglobin concentrations, with the former polycythemic twin needing a single partial volume exchange transfusion. The postnatal course of the neonates was uneventful, according to their gestational age at birth. To our knowledge this is the first case report describing successful laser therapy for TAPS in monoamniotic twins.

  14. 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.

  15. 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.

  16. 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).

  17. Coronary artery bypass grafting with an expanded polytetrafluoroethylene graft.

    PubMed

    Weyand, M; Kerber, S; Schmid, C; Rolf, N; Scheld, H H

    1999-05-01

    We report our experience with the Perma-Flow aortocoronary-right heart graft in 15 patients in whom autologous conduits were not available. Fifteen patients received 39 coronary anastomoses--10 to left anterior descending coronary artery branches, 15 to circumflex coronary artery branches, and 14 to branches of the right coronary artery. Early angiography was done in 11 patients. One patient died on postoperative day 17 of multiorgan failure. The graft was patent at postmortem examination. Of 30 coronary anastomoses at risk, 24 were patent. Three connections to the left anterior descending system were occluded in patients with an additional internal mammary artery graft to the same coronary system, and three connections to the circumflex system were occluded in patients with a history of major posterior infarction. Three of five distal anastomoses to the right atrial appendage were occluded, whereas all six connections to the superior vena cava were patent. None of the patients had shown recurrent angina at a mean follow-up of 10.9 months (range, 2-39 months). The synthetic Perma-Flow coronary graft appears to be a safe alternative in patients in whom arterial or venous conduits are not available. Competitive flow may lead to anastomotic occlusions. The appropriate site for the distal arteriovenous fistula seems to be the superior vena cava.

  18. Off-Pump Minimally Invasive Coronary Artery Bypass Grafting With a Heart Positioner: Direct Retraction for a Better Exposure.

    PubMed

    Kikuchi, Keita; Une, Dai; Suzuki, Koutaro; Endo, Yoshiki; Matsuyama, Takayoshi; Osaka, Shin-Ichi; Kurata, Atsushi

    2015-01-01

    Lateral and inferior territories are difficult to expose during off-pump minimally invasive coronary artery bypass grafting (MICS CABG). The use of cardiopulmonary bypass is required at times. We initiated a direct retraction method by using a cardiac positioner for a better exposure, in order to complete off-pump, multivessel MICS CABG safely. We recently initiated multivessel MICS CABG, performed via a 6- to 9-cm left thoracotomy. For distal anastomoses, the lateral pericardial edge was pulled to the chest wall to optimize exposure of the lateral and inferior area. Next, a single- or multisuction cardiac positioner was put on the sides of the target vessel through the small thoracotomy and pulled directly toward the incision. Finally, a distal anastomosis was made with an epicardial stabilizer via the thoracotomy, as in standard off-pump CABG. There was no mortality or conversion to sternotomy. A total of 10 cases were targeted for off-pump multivessel MICS CABG with this approach. Nine were completed, while 1 still required pump assist. The average number of distal anastomoses was 2.8 ± 0.8. Two were successful off-pump quadruple bypass grafting with sequential anastomoses. All patients were discharged and remain well to this day. Most multivessel MICS CABG was feasible without pump assist even at the initiation period. This approach is easy and helpful in providing good exposure of target vessels without requirement of additional incisions.

  19. Robotic tubal anastomosis: surgical technique and cost effectiveness.

    PubMed

    Dharia Patel, Sejal P; Steinkampf, Michael P; Whitten, Scott J; Malizia, Beth A

    2008-10-01

    To evaluate the feasibility of robotic microsurgical tubal anastomosis and compare the results and cost effectiveness with the same procedure performed by laparotomy. Prospective cohort study. University hospital. Patients with a history of bilateral tubal ligation who desired reversal for future fertility. Tubal anastomoses through either a robotic approach or through a laparotomy. Operative times, hospitalization, complications, postoperative patency, clinical outcomes, and the cost per live birth. The mean operative time for robotic anastomoses was statistically significantly greater than open anastomoses (ROBOT 201 minutes; OPEN 155.3 minutes), although hospitalization times were statistically significantly shorter (ROBOT 4 hours; OPEN 34.7 hours). The return to instrumental activities of daily living was accelerated in the patients who had undergone a robotic anastomosis (ROBOT 11.1 days; OPEN 28.1 days). Although this was a small series, the pregnancy rates were comparable between groups (ROBOT 62.5%; OPEN 50%), yet the rate of abnormal pregnancy was higher in the robotic group (ectopic: ROBOT 4, OPEN 1; spontaneous pregnancy loss: ROBOT 2, OPEN 1). The cost per delivery was similar between the groups (ROBOT $92,488.00, OPEN $92,205.90). Robotically assisted laparoscopic microsurgical tubal anastomosis is feasible and cost effective with results that are comparable with the traditional open approach.

  20. Quilt venoplasty using recipient saphenous vein graft for reconstruction of multiple short hepatic veins in right liver grafts.

    PubMed

    Hwang, Shin; Lee, Sung-Gyu; Park, Kwang-Min; Kim, Ki-Hun; Ahn, Chul-Soo; Moon, Deok-Bog; Ha, Tae-Yong

    2005-01-01

    Major short hepatic veins (SHV) are indicated for vascular reconstruction to prevent excessive hepatic venous congestion of right liver grafts. As separate anastomoses of multiple small SHVs are vulnerable to stenosis or regeneration-related torsion, a conjoined large opening of SHVs may be better than multiple separate anastomoses. We devised an innovative method to reconstruct SHVs through a patchwork quilt using autologous greater saphenous vein (GSV). We applied this method to 3 different configurations of multiple SHVs. For double SHVs in alignment, 2 GSV fragments were stitched longitudinally to wrap 2 SHVs, forming the cuff shape of an ovoid bowl. For double SHVs not in alignment, a central patch of GSV was placed between 2 SHVs to offset the alignment gap, and the outer fence of a long GSV fragment was anastomosed to make a common cuff. For complex anatomy of quadruple SHVs, the central patch was designed to contact with 4 SHVs altogether and the outer fence was similarly created. Although this method was applied to only 4 right liver grafts, there was no disturbance of SHV drainage during 4 months of follow-up. In conclusion, we think that this quilt venoplasty technique using autologous GSV may be applicable for reconstruction of multiple or variant SHVs.

  1. 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.

  2. 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. Copyright © 2013 Wiley Periodicals, Inc.

  3. 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…

  4. 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.

  5. 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…

  6. 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.

  7. Etude de la Recharge de l’Accumulateur Plomb-Acide Red Camel Entre +20 C et -30 C (A Study of the Rechargeability of the Red Camel Lead-Acid Battery between +20 C and -30 C).

    DTIC Science & Technology

    1983-10-01

    Pour un voltage limite imposg de 14.3 V et une dur~e de charge de 7 heures, les rendements en courant (Rc) et en gnergie fi1ectrique (Re), calcul~s en...pour le d~marrage des v~hicules A moteur . Cependant en dega de -20*C, on assiste A une diminution importante des performances en dicharge rapide...rficup~ration de la capaciti dana le calcul des rendements en courant et en finergie filectrique. CONDUITE DES ESSAIS Lors de toul lea easais, le courant

  8. 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.

  9. Correlación entre síntomas gastrointestinales funcionales y la histopatología de la mucosa gástrica, incluyendo la infección por Helicobacter pylori, en Lima, Perú.

    PubMed

    McDonald, Katharine; Shopinski, Samuel; Wilkinson, Ariana; Meza, Claudia; Cok, Jaime; Bussalleu, Alejandro; Valdivieso, Manuel

    2015-01-01

    This study aims to investigate the relationship between functional gastrointestinal disorders and histopathology characteristics, including H. pylori infection, of gastric mucosa, at Cayetano Heredia National Hospital, Lima-Peru, in 2013. 112 patients were interviewed prospectively between June and July 2013 in the gastroenterology service. Dyspepsia, irritable bowel syndrome, and postprandial distress syndrome were characterized using the Rome III Survey. Pathology results were determined by gastric biopsies obtained by endoscopy. Of the patients interviewed, biopsy results were obtained for 101. 22.8% had atrophy, 24.8% had intestinal metaplasia, 57.4% presented with H pylori. Using chi-square analysis, no statistically significant relationship could be identified between clinical presentation and biopsy results.

  10. Une correlation entre les rendements radiochimiques en hydrogène et les énergies de liaisons calculées pour des familles d'alkènes, d'amines et d'alcools liquides

    NASA Astrophysics Data System (ADS)

    Graffeuil, Marcel; Girouy, Christiane; Grob, Robert; Casanovas, Joseph; Labarre, Jean-Fracçois; Mathieu, Jacques

    A quantum calculation of bond energies for some alkenes, amines and alcohols in the ground state allows the hydrogen yield obtained on irradiation of such molecules to be interpreted. This yield increases normally with the length of saturated chain for alkanes, alkenes and amines, in contrast with alcohols. The behaviour of alcohols could not be interpreted, even when hydrogen bonds, which characterize these alcohols in the liquid state, were included in quantum calculations.

  11. 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…

  12. Evaluating a peer intervention strategy for the promotion of sexual health-related knowledge and skills in 10- to 14-year-old girls. Findings from the "Entre amigas" project in Nicaragua.

    PubMed

    Peña, R; Quintanilla, M; Navarro, K; Martínez, J; Castillo, V; Pérez, W; Källestäl, C

    2008-01-01

    Report effects on knowledge of sexual health and gender from an intervention using peer methodology in Nicaragua. A prepost nonequivalent control group design. Ciudad Sandino, Managua, Nicaragua. A total of 599 girls were surveyed, 60% nonintervened and 40% intervened. Peer methodology consisted of (1) meetings in which girls talked and worked with other girls, (2) mothers taking an active role in the peer groups, and/or (3) girls watching the soap opera "Sexto Sentido." Indices measuring changes in sexual knowledge and gender vision. Girls participating in the peer groups were twice as likely to have satisfactory sexual health-related self-esteem as those who did not participate. Eleven percent of the girls achieved satisfactory self-esteem as a result of the (peer groups x mothers) interaction and 15% due to the (peer groups x mothers x "Sexto Sentido") interaction. Girls participating in the peer groups were three times as likely to have satisfactory gender visions; if exposed to all three components, they were almost four times as likely to develop satisfactory gender visions. Peer methodology, participation of a female family member, and an educational soap opera seem beneficial in promoting sexual health-related knowledge and gender vision in young girls.

  13. Histoire d’un itinéraire épidémiologique entre le Burkina Faso et la Côte d’Ivoire : le cas des foyers de maladie du sommeil de Koudougou

    PubMed Central

    Kiendrébéogo, D.; Kambiré, R.; Jamonneau, V.; Lingué, K.; Solano, P.; Courtin, F.

    2012-01-01

    Dans la première moitié du XXème siècle, alors que la Haute-Volta (actuel Burkina Faso) subissait une terrible épidémie de maladie du sommeil, l’administration coloniale française a orchestré des déplacements massifs de populations de la Haute-Volta vers la Côte d’Ivoire, pour exploiter le territoire. Cela a conduit à la mise en place de villages de colonisation Mossi en zone forestière ivoirienne, comme ceux de Koudougou, issus de l’une des régions les plus peuplées de Haute-Volta, mais aussi l’une des plus touchées par la maladie du sommeil. Depuis 2000, au Burkina Faso, c’est dans le district sanitaire de Koudougou que sont dépistés passivement le plus grand nombre de trypanosomés en provenance de Côte d’Ivoire. Qui sont-ils ? Où habitent-ils au Burkina Faso ? D’où viennent-ils de Côte d’Ivoire ? Après avoir retracé l’histoire épidémiologique des villages de Koudougou au Burkina Faso et en Côte d’Ivoire, nous avons recherché les trypanosomés dépistés passivement depuis 2000 dans le district sanitaire de Koudougou au Burkina Faso. Au total, dix trypanosomés ont été enquêtés. Le processus de propagation de la maladie du sommeil dans l’espace ivoiro-burkinabé a été mis en évidence et des zones à risque de la maladie identifiées dans ce même espace. PMID:23193525

  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.

  15. Comparación del funcionamiento entre PMT y SiPM para la detección de Cherenkov atmosférico en el Complejo Astronómico El Leoncito

    NASA Astrophysics Data System (ADS)

    Yelós, L. D.; Suarez, F.; García, B.

    2017-10-01

    Most recent discoveries in gamma ray astronomy with energies around 50 GeV to 30 TeV, were achieved with ground Cherenkov Telescopes, traditionally composed of a parabolic mirror and a single or an array of photo multiplier tubes (PMTs) in their focus. The same detectors (or similar) are used in most astrophysics experiments. Recently, a new detector, the silicon photo-multiplier (SiPM), is progressively replacing the PMTs due to their technical advantages. However some limitations in their functioning make them more complex to use than PMTs and forces their characterization for each project. This work describes the characterization of SiPM from SensL (model MicroFC-SMA-30035) and a PMT from Hamamatsu (model R1463), both detectors are possible options to be used in an array of three Cherenkov telescopes at CASLEO. Additionally, we include the results of the operation of both detectors under controlled laboratory conditions that simulate expected conditions at field. Laboratory test were run in a darkbox with a data acquisition system, a personalized data analyze system with ROOT libraries, temperature control and monitoring, polarization control, a controlled light source, and humidity monitoring.

  16. Suivis temporels comparés de la structure thermique d'eaux côtières libanaises (Batroun) et françaises (Marseille) entre juin 1999 et octobre 2002

    NASA Astrophysics Data System (ADS)

    Abboud-Abi Saab, Marie; Romano, Jean-Claude; Bensoussan, Nathaniel; Fakhri, Milad

    2004-11-01

    Vertical temperature profiles were recorded from June 1999 to October 2002 (at least once a month) at two Mediterranean sites, in the eastern basin (Batroun, Lebanon; 0-100 m) and in the northwestern basin (Marseilles, France; 0-55 m). At the two sites, the thermal seasonal evolution and the thermocline time dynamics are quite identical. But in the Lebanese waters, at comparable water depths, temperatures are currently 4 to 5 °C higher than in the French waters, the thermocline is longer (more than 6 months), permanent and deeper (40-50 m) than in Marseilles (20-30 m). The latter frequently disappears in summer due to northwest winds inducing cold waters. This is principally due to differences in prevailing wind regimes at each site. Such evaluation, coupled with long-term observations of temporal evolution of coastal water at the regional level of the Mediterranean basins, will shed light on temperature regime fluctuations and their consequences in the context of global warming of the Mediterranean. To cite this article: M. Abboud-Abi Saab et al., C. R. Geoscience 336 (2004).

  17. 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)

  18. 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…

  19. 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…

  20. 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…