Internal Carotid Artery Agenesis with an Intercavernous Anastomosis: A Rare Case.

PubMed

Erdogan, Mucahid; Senadim, Songul; Ince Yasinoglu, K Nur; Selcuk, H Hakan; Atakli, H Dilek

2017-10-01

Agenesis of the internal carotid artery (ICA) is a rare vascular anomaly that was first observed postmortem. Various anastomoses supply the distal vessels at the site of agenesis. Of these anastomoses, an intercavernous anastomosis is very rare. This paper presents a patient with ischemic stroke in whom we discovered left ICA agenesis and an ipsilateral intercavernous anastomosis. A 58-year-old man with a history of myocardial infarction and diabetes mellitus presented with sudden-onset difficulty in speaking, numbness on the left side of the face, and weakness of the left arm and leg. Neurological examination revealed dysarthria, left facial paralysis, left hemiparesis, and bilateral absence of the plantar reflexes. Diffusion-weighted magnetic resonance imaging showed a right middle cerebral artery (MCA) infarction. On cranial and cervical magnetic resonance angiography, the left ICA could not be seen distal to the bifurcation; the left MCA was supplied through an intercavernous anastomosis between the right ICA and the left ICA. Cranial computed tomography (CT) revealed the absence of the left carotid canal. Digital subtraction angiography led to a diagnosis of left ICA agenesis with an intercavernous anastomosis. The patient was discharged on acetylsalicylic acid and warfarin. ICA agenesis with an intercavernous anastomosis is a rare vascular anomaly that should be differentiated from secondary causes of ICA stenosis and occlusions by showing agenesis of the carotid canal on cranial CT. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

International magnetic pulse compression workshop: (Proceedings)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirbie, H.C.; Newton, M.A.; Siemens, P.D.

1991-04-01

A few individuals have tried to broaden the understanding of specific and salient pulsed-power topics. One such attempt is this documentation of a workshop on magnetic switching as it applies primarily to pulse compression (power transformation), affording a truly international perspective by its participants under the initiative and leadership of Hugh Kirbie and Mark Newton of the Lawrence Livermore National Laboratory (LLNL) and supported by other interested organizations. During the course of the Workshop at Granlibakken, a great deal of information was amassed and a keen insight into both the problems and opportunities as to the use of this switchingmore » approach was developed. The segmented workshop format proved ideal for identifying key aspects affecting optimum performance in a variety of applications. Individual groups of experts addressed network and system modeling, magnetic materials, power conditioning, core cooling and dielectrics, and finally circuits and application. At the end, they came together to consolidate their input and formulate the workshop's conclusions, identifying roadblocks or suggesting research projects, particularly as they apply to magnetic switching's trump card--its high-average-power-handling capability (at least on a burst-mode basis). The workshop was especially productive both in the quality and quantity of information transfer in an environment conducive to a free and open exchange of ideas. We will not delve into the organization proper of this meeting, rather we wish to commend to the interested reader this volume, which provides the definitive and most up-to-date compilation on the subject of magnetic pulse compression from underlying principles to current state of the art as well as the prognosis for the future of magnetic pulse compression as a consensus of the workshop's organizers and participants.« less

Compression-sensitive magnetic resonance elastography

NASA Astrophysics Data System (ADS)

Hirsch, Sebastian; Beyer, Frauke; Guo, Jing; Papazoglou, Sebastian; Tzschaetzsch, Heiko; Braun, Juergen; Sack, Ingolf

2013-08-01

Magnetic resonance elastography (MRE) quantifies the shear modulus of biological tissue to detect disease. Complementary to the shear elastic properties of tissue, the compression modulus may be a clinically useful biomarker because it is sensitive to tissue pressure and poromechanical interactions. In this work, we analyze the capability of MRE to measure volumetric strain and the dynamic bulk modulus (P-wave modulus) at a harmonic drive frequency commonly used in shear-wave-based MRE. Gel phantoms with various densities were created by introducing CO2-filled cavities to establish a compressible effective medium. The dependence of the effective medium's bulk modulus on phantom density was investigated via static compression tests, which confirmed theoretical predictions. The P-wave modulus of three compressible phantoms was calculated from volumetric strain measured by 3D wave-field MRE at 50 Hz drive frequency. The results demonstrate the MRE-derived volumetric strain and P-wave modulus to be sensitive to the compression properties of effective media. Since the reconstruction of the P-wave modulus requires third-order derivatives, noise remains critical, and P-wave moduli are systematically underestimated. Focusing on relative changes in the effective bulk modulus of tissue, compression-sensitive MRE may be useful for the noninvasive detection of diseases involving pathological pressure alterations such as hepatic hypertension or hydrocephalus.

Laser-driven magnetic-flux compression in high-energy-density plasmas.

PubMed

Gotchev, O V; Chang, P Y; Knauer, J P; Meyerhofer, D D; Polomarov, O; Frenje, J; Li, C K; Manuel, M J-E; Petrasso, R D; Rygg, J R; Séguin, F H; Betti, R

2009-11-20

The demonstration of magnetic field compression to many tens of megagauss in cylindrical implosions of inertial confinement fusion targets is reported for the first time. The OMEGA laser [T. R. Boehly, Opt. Commun. 133, 495 (1997)10.1016/S0030-4018(96)00325-2] was used to implode cylindrical CH targets filled with deuterium gas and seeded with a strong external field (>50 kG) from a specially developed magnetic pulse generator. This seed field was trapped (frozen) in the shock-heated gas fill and compressed by the imploding shell at a high implosion velocity, minimizing the effect of resistive flux diffusion. The magnetic fields in the compressed core were probed via proton deflectrometry using the fusion products from an imploding D3He target. Line-averaged magnetic fields between 30 and 40 MG were observed.

Use of the shape memory effect of a titanium nickelide spring in a suturing device for the formation of compression esophageal anastomoses.

PubMed

Robak, A N

2008-11-01

A new method for the formation of a compression esophagointestinal anastomosis is proposed. The compression force in the new device for creation of compression circular anastomoses is created by means of a titanium nickelide spring with a "shape memory" effect. Experimental study showed good prospects of the new device and the advantages of the anastomosis compression suture formed by means of this device in comparison with manual ligature suturing.

Computational modeling of joint U.S.-Russian experiments relevant to magnetic compression/magnetized target fusion (MAGO/MTF)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheehey, P.T.; Faehl, R.J.; Kirkpatrick, R.C.

1997-12-31

Magnetized Target Fusion (MTF) experiments, in which a preheated and magnetized target plasma is hydrodynamically compressed to fusion conditions, present some challenging computational modeling problems. Recently, joint experiments relevant to MTF (Russian acronym MAGO, for Magnitnoye Obzhatiye, or magnetic compression) have been performed by Los Alamos National Laboratory and the All-Russian Scientific Research Institute of Experimental Physics (VNIIEF). Modeling of target plasmas must accurately predict plasma densities, temperatures, fields, and lifetime; dense plasma interactions with wall materials must be characterized. Modeling of magnetically driven imploding solid liners, for compression of target plasmas, must address issues such as Rayleigh-Taylor instability growthmore » in the presence of material strength, and glide plane-liner interactions. Proposed experiments involving liner-on-plasma compressions to fusion conditions will require integrated target plasma and liner calculations. Detailed comparison of the modeling results with experiment will be presented.« less

Practicality of magnetic compression for plasma density control

DOE PAGES

Gueroult, Renaud; Fisch, Nathaniel J.

2016-03-16

Here, plasma densification through magnetic compression has been suggested for time-resolved control of the wave properties in plasma-based accelerators [P. F. Schmit and N. J. Fisch, Phys. Rev. Lett. 109, 255003 (2012)]. Using particle in cell simulations with real mass ratio, the practicality of large magnetic compression on timescales shorter than the ion gyro-period is investigated. For compression times shorter than the transit time of a compressional Alfven wave across the plasma slab, results show the formation of two counter-propagating shock waves, leading to a highly non-uniform plasma density profile. Furthermore, the plasma slab displays large hydromagnetic like oscillations aftermore » the driving field has reached steady state. Peak compression is obtained when the two shocks collide in the mid-plane. At this instant, very large plasma heating is observed, and the plasmaβ is estimated to be about 1. Although these results point out a densification mechanism quite different and more complex than initially envisioned, these features still might be advantageous in particle accelerators.« less

Predicting burst pressure of radiofrequency-induced colorectal anastomosis by bio-impedance measurement.

PubMed

Zhao, Lingxi; Zhou, Yu; Song, Chengli; Wang, Zhigang; Cuschieri, Alfred

2017-03-01

The present study investigates the relationship between bio-impedance and burst pressure of colorectal anastomosis created by radiofrequency (RF)-induced tissue fusion. Colorectal anastomosis were created with ex vivo porcine colorectal segments, during which 5 levels of compression pressure were applied by a custom-made bipolar prototype, with 5 replicate experiments at each compression pressure. Instant anastomotic tensile strength was assessed by burst pressure. Bio-impedance of fused tissue was measured by Impedance Analyzer across frequency that 100 Hz to 3 MHz. Statistical analysis shows only a weak correlation between bio-impedance modulus and burst pressures at frequency of 445 kHz ([Formula: see text]  =  -0.426, P  =  0.099  >  0.05). In contrast, results demonstrated a highly significant negative correlation between reactance modulus and burst pressures ([Formula: see text]  =  -0.812, P  =  0.000  <  0.05). The decrease in mean reactance modulus with increasing burst pressures was highly significant (P  =  0.019  <  0.05). The observed strong negative correlation between reactance modulus and burst pressures at frequency of 445 kHz indicates that reactance is likely to be a good index for tensile strength of RF-induced colorectal anastomosis, and should be considered for inclusion in a feedback loops in devices design.

A design approach for systems based on magnetic pulse compression.

PubMed

Kumar, D Durga Praveen; Mitra, S; Senthil, K; Sharma, D K; Rajan, Rehim N; Sharma, Archana; Nagesh, K V; Chakravarthy, D P

2008-04-01

A design approach giving the optimum number of stages in a magnetic pulse compression circuit and gain per stage is given. The limitation on the maximum gain per stage is discussed. The total system volume minimization is done by considering the energy storage capacitor volume and magnetic core volume at each stage. At the end of this paper, the design of a magnetic pulse compression based linear induction accelerator of 200 kV, 5 kA, and 100 ns with a repetition rate of 100 Hz is discussed with its experimental results.

Experimental Design of a Magnetic Flux Compression Experiment

NASA Astrophysics Data System (ADS)

Fuelling, Stephan; Awe, Thomas J.; Bauer, Bruno S.; Goodrich, Tasha; Lindemuth, Irvin R.; Makhin, Volodymyr; Siemon, Richard E.; Atchison, Walter L.; Reinovsky, Robert E.; Salazar, Mike A.; Scudder, David W.; Turchi, Peter J.; Degnan, James H.; Ruden, Edward L.

2007-06-01

Generation of ultrahigh magnetic fields is an interesting topic of high-energy-density physics, and an essential aspect of Magnetized Target Fusion (MTF). To examine plasma formation from conductors impinged upon by ultrahigh magnetic fields, in a geometry similar to that of the MAGO experiments, an experiment is under design to compress magnetic flux in a toroidal cavity, using the Shiva Star or Atlas generator. An initial toroidal bias magnetic field is provided by a current on a central conductor. The central current is generated by diverting a fraction of the liner current using an innovative inductive current divider, thus avoiding the need for an auxiliary power supply. A 50-mm-radius cylindrical aluminum liner implodes along glide planes with velocity of about 5 km/s. Inward liner motion causes electrical closure of the toroidal chamber, after which flux in the chamber is conserved and compressed, yielding magnetic fields of 2-3 MG. Plasma is generated on the liner and central rod surfaces by Ohmic heating. Diagnostics include B-dot probes, Faraday rotation, radiography, filtered photodiodes, and VUV spectroscopy. Optical access to the chamber is provided through small holes in the walls.

Magnetic Flux Compression Concept for Aerospace Propulsion and Power

NASA Technical Reports Server (NTRS)

Litchford, Ron J.; Robertson, Tony; Hawk, Clark W.; Turner, Matt; Koelfgen, Syri

2000-01-01

The objective of this research is to investigate system level performance and design issues associated with magnetic flux compression devices for aerospace power generation and propulsion. The proposed concept incorporates the principles of magnetic flux compression for direct conversion of nuclear/chemical detonation energy into electrical power. Specifically a magnetic field is compressed between an expanding detonation driven diamagnetic plasma and a stator structure formed from a high temperature superconductor (HTSC). The expanding plasma cloud is entirely confined by the compressed magnetic field at the expense of internal kinetic energy. Electrical power is inductively extracted, and the detonation products are collimated and expelled through a magnetic nozzle. The long-term development of this highly integrated generator/propulsion system opens up revolutionary NASA Mission scenarios for future interplanetary and interstellar spacecraft. The unique features of this concept with respect to future space travel opportunities are as follows: ability to implement high energy density chemical detonations or ICF microfusion bursts as the impulsive diamagnetic plasma source; high power density system characteristics constrain the size, weight, and cost of the vehicle architecture; provides inductive storage pulse power with a very short pulse rise time; multimegajoule energy bursts/terawatt power bursts; compact pulse power driver for low-impedance dense plasma devices; utilization of low cost HTSC material and casting technology to increase magnetic flux conservation and inductive energy storage; improvement in chemical/nuclear-to-electric energy conversion efficiency and the ability to generate significant levels of thrust with very high specific impulse; potential for developing a small, lightweight, low cost, self-excited integrated propulsion and power system suitable for space stations, planetary bases, and interplanetary and interstellar space travel

Thermally generated magnetic fields in laser-driven compressions and explosions

NASA Technical Reports Server (NTRS)

Tidman, D. A.

1975-01-01

The evolution of thermally generated magnetic fields in a plasma undergoing a nearly spherically symmetric adiabatic compression or expansion is calculated. The analysis is applied to obtain approximate results for the development of magnetic fields in laser-driven compression and explosion of a pellet of nuclear fuel. Localized sources, such as those occurring at composition boundaries in structured pellets or at shock fronts, give stronger fields than those deriving from smoothly distributed asymmetries. Although these fields may approach 10 million G in the late stages of compression, this is not expected to present difficulties for the compression process. Assuming ignition of a nuclear explosion occurs, the sources become much stronger, and values of approximately 10 billion G are obtained at tamper boundaries assuming a 20% departure from spherical symmetry during the explosion.

Compression of magnetized target in the magneto-inertial fusion

NASA Astrophysics Data System (ADS)

Kuzenov, V. V.

2017-12-01

This paper presents a mathematical model, numerical method and results of the computer analysis of the compression process and the energy transfer in the target plasma, used in magneto-inertial fusion. The computer simulation of the compression process of magnetized cylindrical target by high-power laser pulse is presented.

Three-dimensional density and compressible magnetic structure in solar wind turbulence

NASA Astrophysics Data System (ADS)

Roberts, Owen W.; Narita, Yasuhito; Escoubet, C.-Philippe

2018-03-01

The three-dimensional structure of both compressible and incompressible components of turbulence is investigated at proton characteristic scales in the solar wind. Measurements of the three-dimensional structure are typically difficult, since the majority of measurements are performed by a single spacecraft. However, the Cluster mission consisting of four spacecraft in a tetrahedral formation allows for a fully three-dimensional investigation of turbulence. Incompressible turbulence is investigated by using the three vector components of the magnetic field. Meanwhile compressible turbulence is investigated by considering the magnitude of the magnetic field as a proxy for the compressible fluctuations and electron density data deduced from spacecraft potential. Application of the multi-point signal resonator technique to intervals of fast and slow wind shows that both compressible and incompressible turbulence are anisotropic with respect to the mean magnetic field direction P⟂ ≫ P∥ and are sensitive to the value of the plasma beta (β; ratio of thermal to magnetic pressure) and the wind type. Moreover, the incompressible fluctuations of the fast and slow solar wind are revealed to be different with enhancements along the background magnetic field direction present in the fast wind intervals. The differences in the fast and slow wind and the implications for the presence of different wave modes in the plasma are discussed.

A simple accurate chest-compression depth gauge using magnetic coils during cardiopulmonary resuscitation

NASA Astrophysics Data System (ADS)

Kandori, Akihiko; Sano, Yuko; Zhang, Yuhua; Tsuji, Toshio

2015-12-01

This paper describes a new method for calculating chest compression depth and a simple chest-compression gauge for validating the accuracy of the method. The chest-compression gauge has two plates incorporating two magnetic coils, a spring, and an accelerometer. The coils are located at both ends of the spring, and the accelerometer is set on the bottom plate. Waveforms obtained using the magnetic coils (hereafter, "magnetic waveforms"), which are proportional to compression-force waveforms and the acceleration waveforms were measured at the same time. The weight factor expressing the relationship between the second derivatives of the magnetic waveforms and the measured acceleration waveforms was calculated. An estimated-compression-displacement (depth) waveform was obtained by multiplying the weight factor and the magnetic waveforms. Displacements of two large springs (with similar spring constants) within a thorax and displacements of a cardiopulmonary resuscitation training manikin were measured using the gauge to validate the accuracy of the calculated waveform. A laser-displacement detection system was used to compare the real displacement waveform and the estimated waveform. Intraclass correlation coefficients (ICCs) between the real displacement using the laser system and the estimated displacement waveforms were calculated. The estimated displacement error of the compression depth was within 2 mm (<1 standard deviation). All ICCs (two springs and a manikin) were above 0.85 (0.99 in the case of one of the springs). The developed simple chest-compression gauge, based on a new calculation method, provides an accurate compression depth (estimation error < 2 mm).

Technical Nuances of Exposing Rat Common Carotid Arteries for Practicing Microsurgical Anastomosis.

PubMed

Tayebi Meybodi, Ali; Aklinski, Joseph; Gandhi, Sirin; Lawton, Michael T; Preul, Mark C

2018-04-17

Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. However, technical nuances of exposing rat CCAs have been understudied. The purpose of this study is to describe nuances of technique for safely and efficiently exposing rat CCAs in preparation for a vascular anastomosis. Bilateral CCAs were exposed and prepared for anastomosis in 10 anesthetized Sprague-Dawley rats through a midline cervical incision. The exposed length of the CCA was measured. Additionally, technical nuances of exposure and surgically relevant anatomic details were recorded. The CCAs were exposed from the sternoclavicular joint to their bifurcation (average length, 19.1 ± 2.8 mm). Tenets important for a safe and efficient exposure of the CCAs included 1) generous subcutaneous dissection to expose the external jugular veins (EJVs), 2) avoiding injury to or compression of the EJVs, 3) superior mobilization of the salivary glands, 4) division of internal jugular veins, 5) opening the carotid sheath at its midlevel and from medial to lateral, and 6) avoiding injury to the vagus nerve or sympathetic trunk. Using the principles introduced in this study, trainees may safely and efficiently expose rat CCAs in preparation for a bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

Magnetic Flux Compression Experiments Using Plasma Armatures

NASA Technical Reports Server (NTRS)

Turner, M. W.; Hawk, C. W.; Litchford, R. J.

2003-01-01

Magnetic flux compression reaction chambers offer considerable promise for controlling the plasma flow associated with various micronuclear/chemical pulse propulsion and power schemes, primarily because they avoid thermalization with wall structures and permit multicycle operation modes. The major physical effects of concern are the diffusion of magnetic flux into the rapidly expanding plasma cloud and the development of Rayleigh-Taylor instabilities at the plasma surface, both of which can severely degrade reactor efficiency and lead to plasma-wall impact. A physical parameter of critical importance to these underlying magnetohydrodynamic (MHD) processes is the magnetic Reynolds number (R(sub m), the value of which depends upon the product of plasma electrical conductivity and velocity. Efficient flux compression requires R(sub m) less than 1, and a thorough understanding of MHD phenomena at high magnetic Reynolds numbers is essential to the reliable design and operation of practical reactors. As a means of improving this understanding, a simplified laboratory experiment has been constructed in which the plasma jet ejected from an ablative pulse plasma gun is used to investigate plasma armature interaction with magnetic fields. As a prelude to intensive study, exploratory experiments were carried out to quantify the magnetic Reynolds number characteristics of the plasma jet source. Jet velocity was deduced from time-of-flight measurements using optical probes, and electrical conductivity was measured using an inductive probing technique. Using air at 27-inHg vacuum, measured velocities approached 4.5 km/s and measured conductivities were in the range of 30 to 40 kS/m.

Note: An approach to 1000 T using the electro-magnetic flux compression.

PubMed

Nakamura, D; Sawabe, H; Takeyama, S

2018-01-01

The maximum magnetic field obtained by the electro-magnetic flux compression technique was investigated with respect to the initial seed magnetic field. It was found that the reduction in the seed magnetic field from 3.8 T to 3.0 T led to a substantial increase in the final peak magnetic field. The optical Faraday rotation method with a minimal size probe evades disturbances from electromagnetic noise and shockwave effects to detect such final peak fields in a reduced space of an inner wall of the imploding liner. The Faraday rotation signal recorded the maximum magnetic field increased significantly to the highest magnetic field of 985 T approaching 1000 T, ever achieved by the electro-magnetic flux compression technique as an indoor experiment.

New anastomosis technique for (laparoscopic) instrumental small-diameter anastomosis.

PubMed

Schöb, O; Schmid, R; Schlumpf, R; Klotz, H P; Spiess, M; Largiadèr, F

1995-04-01

This study presents a new technique for visceral anastomosis. The principle consists of connecting the two parts to be anastomosed around a reabsorbable stent which is transluminally introduced into small-diameter viscus, where it is fixed. Advancing a larger tube along the axis of the machine, the larger, perforated viscus is inverted and pulled over the stent, and finally a rubber band pops off the machine endoluminally in order to fix the intestinal walls in seroserosal contact onto the stent. To evaluate this "micro" anastomosis, a biliary bypass (choledochojejunostomy and roux-en-y-loop) was performed in ten pigs. Nine of ten animals showed biliary bypass with good runoff in contrast radiography and completely reabsorbed stent after a 3-month follow-up. Weight gain, bilirubin, and alkaline phosphatase were normal. This technology demonstrates a safe and quick way to perform instrumental "micro" anastomosis without remnant foreign material.

The Role of Fluid Compression in Particle Energization during Magnetic Reconnection

NASA Astrophysics Data System (ADS)

Li, X.; Guo, F.; Li, H.; Li, S.

2017-12-01

Theories of particle transport and acceleration have shown that fluid compression is the leading mechanism for particle energization. However, the role of compression in particle energization during magnetic reconnection is unclear. We present a cluster of studies to clarify and show the effect of fluid compression in accelerating particles to high energies during magnetic reconnection. Using fully kinetic reconnection simulations, we show that fluid compression is the leading mechanism for high-energy particle energization. We find that the compressional energization is more important in a low-beta plasma or in a reconnection layer with a weak guide field (the magnetic field component perpendicular to the reconnecting magnetic field), which are relevant to solar flares. Our analysis on 3D kinetic simulations shows that the self-generated turbulence scatters particles and enhances the particle diffusion processes in the acceleration regions. Based on these results, we then study large-scale reconnection acceleration by solving the particle transport equation in a large-scale reconnection layer evolved with MHD simulations. Due to the compressional effect, particles are accelerated to high energies and develop power-law energy distributions. This study clarifies the nature of particle acceleration in reconnection layer and is important to understand particle energization during large-scale acceleration such as solar flares.

[Application of compression equipment using the "form memory" effect and super-elasticity of titanium nickelide in surgery for rectal cancer].

PubMed

Vlasov, A A; Vazhenin, A V; Plotnikov, V V; Spirev, V V; Chinarev, Iu B

2010-01-01

The study is concerned with development of equipment for forming circular compression intestinal anastomosis using the "form memory" effect and super-elasticity of titanium nickelide. A sequence of technological operations is suggested, experimental tests and clinical trials carried out and immediate and end-results for anterior resection in rectal cancer are evaluated. Compression equipment for forming colorectal anastomosis proved reliable in long-term operation.

Robust ferromagnetism in the compressed permanent magnet Sm2Co17

NASA Astrophysics Data System (ADS)

Jeffries, J. R.; Veiga, L. S. I.; Fabbris, G.; Haskel, D.; Huang, P.; Butch, N. P.; McCall, S. K.; Holliday, K.; Jenei, Z.; Xiao, Y.; Chow, P.

2014-09-01

The compound Sm2Co17 displays magnetic properties amenable to permanent magnet applications owing to both the 3d electrons of Co and the 4f electrons of Sm. The long-standing description of the magnetic interactions between the Sm and Co ions implies a truly ferromagnetic configuration, but some recent calculations challenge this axiom, suggesting at least a propensity for ferrimagnetic behavior. We have used high-pressure synchrotron x-ray techniques to characterize the magnetic and structural properties of Sm2Co17 to reveal a robust ferromagnetic state. The local Sm moment is at most weakly affected by compression, and the ordered moments show a surprising resilience to volumetric compressions of nearly 20%. Density functional theory calculations echo the magnetic robustness of Sm2Co17.

The Origin of Compressible Magnetic Turbulence in the Very Local Interstellar Medium

NASA Astrophysics Data System (ADS)

Zank, G. P.; Du, S.; Hunana, P.

2017-06-01

Voyager 1 observed compressible magnetic turbulence in the very local interstellar medium (VLISM). We show that inner heliosheath (IHS) fast- and slow-mode waves incident on the heliopause (HP) generate VLISM fast-mode waves only that propagate into the VLISM. We suggest that this is the origin of compressible turbulence in the VLISM. We show that fast- and slow-mode waves transmitted across a tangential discontinuity such as the HP are strongly refracted on crossing the HP and subsequently propagate at highly oblique angles to the VLISM magnetic field. Thus, fast-mode waves in the VLISM contribute primarily to the compressible and not the transverse components of the VLISM fluctuating magnetic field variance < δ {\\hat{B}}2> since < δ {\\hat{B}}{fz}2> \

Magnetic Compression Experiment at General Fusion with Simulation Results

NASA Astrophysics Data System (ADS)

Dunlea, Carl; Khalzov, Ivan; Hirose, Akira; Xiao, Chijin; Fusion Team, General

2017-10-01

The magnetic compression experiment at GF was a repetitive non-destructive test to study plasma physics applicable to Magnetic Target Fusion compression. A spheromak compact torus (CT) is formed with a co-axial gun into a containment region with an hour-glass shaped inner flux conserver, and an insulating outer wall. External coil currents keep the CT off the outer wall (levitation) and then rapidly compress it inwards. The optimal external coil configuration greatly improved both the levitated CT lifetime and the rate of shots with good compressional flux conservation. As confirmed by spectrometer data, the improved levitation field profile reduced plasma impurity levels by suppressing the interaction between plasma and the insulating outer wall during the formation process. We developed an energy and toroidal flux conserving finite element axisymmetric MHD code to study CT formation and compression. The Braginskii MHD equations with anisotropic heat conduction were implemented. To simulate plasma / insulating wall interaction, we couple the vacuum field solution in the insulating region to the full MHD solution in the remainder of the domain. We see good agreement between simulation and experiment results. Partly funded by NSERC and MITACS Accelerate.

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

PubMed

Gatkin, E Ja; Razumovskij, A Ju; Korsunskij, A A; Konovalov, A K; Sergeev, A V; Vinogradov, A Ja; 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.

Cardiovascular anatomy in children with bidirectional Glenn anastomosis, regarding the transcatheter Fontan completion.

PubMed

Sizarov, Aleksander; Raimondi, Francesca; Bonnet, Damien; Boudjemline, Younes

2018-04-01

Transcatheter stent-secured completion of total cavopulmonary connection (TCPC) after surgical preparations during the Glenn anastomosis procedure has been reported, but complications from this approach have precluded its clinical acceptance. To analyse cardiovascular morphology and dimensions in children with bidirectional Glenn anastomosis, regarding the optimal device design for transcatheter Fontan completion without special surgical "preconditionings". We retrospectively analysed 60 thoracic computed tomography and magnetic resonance angiograms performed in patients with a median age of 4.1 years (range: 1.8-17.1 years). Additionally, we simulated TCPC completion using different intra-atrial stent-grafts in a three-dimensional model of the representative anatomy, and performed calculations to determine the optimal stent-graft dimensions, using measured distances. Two types of cardiovascular arrangement were identified: left atrium interposing between the right pulmonary artery (RPA) and inferior vena cava, with the right upper pulmonary vein (RUPV) orifice close to the intercaval axis (65%); and intercaval axis traversing only the right(-sided) atrial cavity, with the RUPV located posterior to the atrial wall (35%). In the total population, the shortest median RPA-to-atrial wall distance was 1.9mm (range: 0.6-13.8mm), while the mean intra-atrial distance along the intercaval axis was 50.1±11.2mm. Regardless of the arrangement, 83% of all patients required a deviation of at least 5.9±2.4mm (range: 1.2-12.7mm) of the stent-graft centre at the RUPV level anteriorly to the intercaval axis to avoid covering or compressing this vein. Fixing the anterior deviation of the curved stent-graft centre at 10mm significantly decreased the range of bend angle per every given RUPV-RPA distance. For both types of cardiovascular arrangement, after conventional bidirectional Glenn anastomosis, the intra-atrial curved stent-graft seemed most suitable for achieving

Saturable inductor and transformer structures for magnetic pulse compression

DOEpatents

Birx, Daniel L.; Reginato, Louis L.

1990-01-01

Saturable inductor and transformer for magnetic compression of an electronic pulse, using a continuous electrical conductor looped several times around a tightly packed core of saturable inductor material.

Seeding magnetic fields for laser-driven flux compression in high-energy-density plasmas.

PubMed

Gotchev, O V; Knauer, J P; Chang, P Y; Jang, N W; Shoup, M J; Meyerhofer, D D; Betti, R

2009-04-01

A compact, self-contained magnetic-seed-field generator (5 to 16 T) is the enabling technology for a novel laser-driven flux-compression scheme in laser-driven targets. A magnetized target is directly irradiated by a kilojoule or megajoule laser to compress the preseeded magnetic field to thousands of teslas. A fast (300 ns), 80 kA current pulse delivered by a portable pulsed-power system is discharged into a low-mass coil that surrounds the laser target. A >15 T target field has been demonstrated using a <100 J capacitor bank, a laser-triggered switch, and a low-impedance (<1 Omega) strip line. The device has been integrated into a series of magnetic-flux-compression experiments on the 60 beam, 30 kJ OMEGA laser [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. The initial application is a novel magneto-inertial fusion approach [O. V. Gotchev et al., J. Fusion Energy 27, 25 (2008)] to inertial confinement fusion (ICF), where the amplified magnetic field can inhibit thermal conduction losses from the hot spot of a compressed target. This can lead to the ignition of massive shells imploded with low velocity-a way of reaching higher gains than is possible with conventional ICF.

Robot-sewn ileoileal anastomosis during robot-assisted cystectomy.

PubMed

Loertzer, P; Siemer, S; Stöckle, M; Ohlmann, C H

2018-07-01

To analyze the feasibility and perioperative results of patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. This is a mono-centric analysis of perioperative data from 48 consecutive patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. Data include the preoperative variables, operative and postoperative course and complication rates related to bowel anastomosis. End points were time spent for anastomosis and intra- and postoperative complication rates. Median operating time was 23.0 (13-60) min for the ileoileal anastomosis. Median overall operating time was 295 (200-780) min, with a median of 282 (200-418) min and 414.0 (225-780) min for the ileum conduit (N = 35) and ileal neobladder (N = 13). Two patients developed paralytic ileus; in another patient acute peritonitis occurred, but was caused by urinary leakage and therefore unrelated to the bowel anastomosis. No anastomotic leakage was noticed. Costs for the robot-sewn anastomosis was 8€ compared to 1250€ for a stapled anastomosis which was performed in previous cases. Limitations are the non-comparative nature of the analysis and the limited number of patients. Robot-sewn ileoileal anastomosis is feasible with low complication rates. Compared to the stapled anastomosis, a robot-sewn ileoileal anastomosis may serve as an alternative and cost-saving approach.

The Role of Compressibility in Energy Release by Magnetic Reconnection

NASA Technical Reports Server (NTRS)

Birn, J.; Borovosky, J. E.; Hesse, M.

2012-01-01

Using resistive compressible magnetohydrodynamics, we investigate the energy release and transfer by magnetic reconnection in finite (closed or periodic) systems. The emphasis is on the magnitude of energy released and transferred to plasma heating in configurations that range from highly compressible to incompressible, based on the magnitude of the background beta (ratio of plasma pressure over magnetic pressure) and of a guide field in two-dimensional reconnection. As expected, the system becomes more incompressible, and the role of compressional heating diminishes, with increasing beta or increasing guide field. Nevertheless, compressional heating may dominate over Joule heating for values of the guide field of 2 or 3 (in relation to the reconnecting magnetic field component) and beta of 5-10. This result stems from the strong localization of the dissipation near the reconnection site, which is modeled based on particle simulation results. Imposing uniform resistivity, corresponding to a Lundquist number of 10(exp 3) to 10(exp 4), leads to significantly larger Ohmic heating. Increasing incompressibility greatly reduces the magnetic flux transfer and the amount of energy released, from approx. 10% of the energy associated with the reconnecting field component, for zero guide field and low beta, to approx. 0.2%-0.4% for large values of the guide field B(sub y0) > 5 or large beta. The results demonstrate the importance of taking into account plasma compressibility and localization of dissipation in investigations of heating by turbulent reconnection, possibly relevant for solar wind or coronal heating.

Magnetic dynamo activity in mechanically driven compressible magnetohydrodynamic turbulence

NASA Technical Reports Server (NTRS)

Shebalin, John V.; Montgomery, David

1989-01-01

Magnetic dynamo activity in a homogeneous, dissipative, polytropic, two-dimensional, turbulent magneto-fluid is simulated numerically. The magneto-fluid is simulated numerically. The magneto-fluid is, in a number of cases, mechanically forced so that energy input balances dissipation, thereby maintaining constant energy. In the presence of a mean magnetic field, a magneto-fluid whose initial turbulent magnetic energy is zero quickly arrives at a state of non-zero turbulent magnetic energy. If the mean magnetic field energy density is small, the turbulent magnetic field can achieve a local energy density more than four hundred times larger; if the mean magnetic field energy density is large, then equipartition between the turbulent magnetic and kinetic energy is achieved. Compared to the presence of a mean magnetic field, compressibility appears to have only a marginal effect in mediating the transfer of turbulent kinetic energy into magnetic energy.

Estimation of the iron loss in deep-sea permanent magnet motors considering seawater compressive stress.

PubMed

Xu, Yongxiang; Wei, Yanyu; Zou, Jibin; Li, Jianjun; Qi, Wenjuan; Li, Yong

2014-01-01

Deep-sea permanent magnet motor equipped with fluid compensated pressure-tolerant system is compressed by the high pressure fluid both outside and inside. The induced stress distribution in stator core is significantly different from that in land type motor. Its effect on the magnetic properties of stator core is important for deep-sea motor designers but seldom reported. In this paper, the stress distribution in stator core, regarding the seawater compressive stress, is calculated by 2D finite element method (FEM). The effect of compressive stress on magnetic properties of electrical steel sheet, that is, permeability, BH curves, and BW curves, is also measured. Then, based on the measured magnetic properties and calculated stress distribution, the stator iron loss is estimated by stress-electromagnetics-coupling FEM. At last the estimation is verified by experiment. Both the calculated and measured results show that stator iron loss increases obviously with the seawater compressive stress.

Estimation of the Iron Loss in Deep-Sea Permanent Magnet Motors considering Seawater Compressive Stress

PubMed Central

Wei, Yanyu; Zou, Jibin; Li, Jianjun; Qi, Wenjuan; Li, Yong

2014-01-01

Deep-sea permanent magnet motor equipped with fluid compensated pressure-tolerant system is compressed by the high pressure fluid both outside and inside. The induced stress distribution in stator core is significantly different from that in land type motor. Its effect on the magnetic properties of stator core is important for deep-sea motor designers but seldom reported. In this paper, the stress distribution in stator core, regarding the seawater compressive stress, is calculated by 2D finite element method (FEM). The effect of compressive stress on magnetic properties of electrical steel sheet, that is, permeability, BH curves, and BW curves, is also measured. Then, based on the measured magnetic properties and calculated stress distribution, the stator iron loss is estimated by stress-electromagnetics-coupling FEM. At last the estimation is verified by experiment. Both the calculated and measured results show that stator iron loss increases obviously with the seawater compressive stress. PMID:25177717

[Resection anastomosis of the small intestine by celioscopy in swine. Comparative experimental study between manual and mechanical anastomosis].

PubMed

Noël, P; Fagot, H; Fabre, J M; Mann, C; Quenet, F; Guillon, F; Baumel, H; Domergue, J

1994-01-01

Laparoscopic intestinal anastomosis is not very reliable and needs to be evaluate in an experimental model in animals before being performed in man. The purpose of this study was to evaluate the feasibility, efficacy and safety of manual anastomosis comparatively to the standard stapling suture. Twenty female pigs weighing 20 +/- 5 kg. were used for this study. A 5 cm ileal segment resection was performed under laparoscopy. The animals were assigned to 2 groups. Group I: 10 animals underwent end-to-end hand-swen anastomosis with Polyglactin 910, dec 1.5. Group II: 10 animals underwent side-to-side anastomosis using the Endo stapler. Operating time and anastomosis time were compared using the Mann-Whitney test for statistical analysis. On the 15th postoperative day, the animals were sacrificed and the anastomoses were evaluated. There was no operating death in the 2 groups. The operative time was significantly longer in group I than in group II (p < 0.01), with 180 +/- 40 min vs 49 +/- 25 min respectively. This difference was due to the anastomosis time of 130 +/- 40 min vs 16 +/- 6 min respectively (p < 0.01). There was 1 postoperative death related to fistula and peritonitis in group I and none in group II. The post-operative follow-ing showed 5 anastomotic leakages (4 in group I and 1 in group II) and 2 relative stenoses in group I. This study shows the simplicity and rapidity of performing stapling intestinal anastomosis under laparoscopy. Hand-sewn anastomosis is technically more difficult to perform under laparoscopy and requires a greater experience.

Pressure and compressibility factor of bidisperse magnetic fluids

NASA Astrophysics Data System (ADS)

Minina, Elena S.; Blaak, Ronald; Kantorovich, Sofia S.

2018-04-01

In this work, we investigate the pressure and compressibility factors of bidisperse magnetic fluids with relatively weak dipolar interactions and different granulometric compositions. In order to study these properties, we employ the method of diagram expansion, taking into account two possible scenarios: (1) dipolar particles repel each other as hard spheres; (2) the polymer shell on the surface of the particles is modelled through a soft-sphere approximation. The theoretical predictions of the pressure and compressibility factors of bidisperse ferrofluids at different granulometric compositions are supported by data obtained by means of molecular dynamics computer simulations, which we also carried out for these systems. Both theory and simulations reveal that the pressure and compressibility factors decrease with growing dipolar correlations in the system, namely with an increasing fraction of large particles. We also demonstrate that even if dipolar interactions are too weak for any self-assembly to take place, the interparticle correlations lead to a qualitative change in the behaviour of the compressibility factors when compared to that of non-dipolar spheres, making the dependence monotonic.

Magnetic compression ostomy for simple tube colostomy in rats--magnacolostomy.

PubMed

Uygun, Ibrahim; Okur, Mehmet H; Arayici, Yilmaz; Keles, Aysenur; Ozturk, Hayrettin; Otcu, Selcuk

2012-01-01

Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. Objectives. Herein, the authors report the creation of a magnetic compression colostomy (magnacolostomy) using a simple technique in rats. Animals were randomized into two groups (n = 8, each): a magnetic colostomy (MC) group and a control surgical tube colostomy (SC) group. In the MC group, the first magnetic ball (3 mm) was rectally introduced into the rat colon. The second magnetic ball (4 mm) was placed subcutaneously into the left quadrant, and the two magnetic balls strongly coupled. On postoperative day 20 for the MC group and postoperative day 10 in the SC group, the rats were sacrificed and the colostomies evaluated macroscopically, histopathologically, and for mechanical burst testing. From the macroscopic evaluation, two rats failed to form the colostomy canal due to colostomy catheter and magnetic ball removal. In the remaining rats, evidence of complications were not observed. Two rats in the MC group displayed mild adhesion and all rats in the SC group displayed moderate adhesion. No significant differences between the burst pressures were observed. However, a significant difference (p < 0.001) between the procedure times of the MC (4.13 +/- 1.00 minutes) and SC groups (14.25 +/- 2.05 minutes) was evident. Magnacolostomy is an easy and effective procedure in the rat model and presents a safe, minimally invasive alternative to current tube colostomy procedures such as antegrade continence enemas, percutaneous endoscopic, and colostomy/cecostomy in humans.

Large-scale vortices in compressible turbulent medium with the magnetic field

NASA Astrophysics Data System (ADS)

Gvaramadze, V. V.; Dimitrov, B. G.

1990-08-01

An averaged equation which describes the large scale vortices and Alfven waves generation in a compressible helical turbulent medium with a constant magnetic field is presented. The presence of the magnetic field leads to anisotropization of the vortex generation. Possible applications of the anisotropic vortex dynamo effect are accretion disks of compact objects.

Magnetic ring anastomosis of suprahepatic vena cava: novel technique for liver transplantation in rat.

PubMed

Shi, Yuan; Zhang, Wei; Deng, Yong-lin; Zhang, Ya-min; Zhang, Quan-sheng; Zhang, Wei-ye; Zheng, Hong; Pan, Cheng; Shen, Zhong-Yang

2015-01-01

To improve the technique of suprahepatic vena cava (SHVC) reconstruction in rat OLT, novel magnetic rings were designed and manufactured to facilitate reconstruction of SHVC and shorten the anhepatic time. One-hundred and twenty adult male Wistar rats were randomly divided into two groups: rings group (n = 30), using magnetic rings for SHVC reconstruction; suture group (n = 30), 7/0 prolene suture was used for SHVC running anastomosis as control. Cuff techniques were used for portal vein and infrahepatic vena cava reconstruction as Kamada and Calne described. The bile duct was reconnected with a stent. The hepatic re-arterialization was omitted. In the rings group, the SHVC reconstruction took 0.91 ± 0.24 (mean ± SD) min; the anhepatic phase and the recipient operation time were 5.63 ± 0.65 min and 36.02 ± 8.02 min, respectively. In suture group, the anastomotic time of SHVC was 10.40 ± 2.11 min; the anhepatic phase and the recipient operation time were 17.76 ± 2.51 and 49.38 ± 12.06 min, respectively, and there was statistically significant difference between the two groups. The ALT levels reached peak at 24 h post-OLT (186.2 ± 32.5 IU/l) and restored to normal level at 96 h gradually. In the rings group, 29 of 30 rats survived at day 7 and 28 of 30 rats survived at day 30. In contrast, only 25 of 30 recipients in suture group remained alive at day 7 and 22 of 30 remained alive at day 30 (P < 0.05). Better anastomotic healing was founded in rings group by pathology and scanning electron microscope. The magnetic rings technique provides a novel, simple method for SHVC reconstruction of OLT in rat. It significantly shortens anhepatic phase, while the success rate of the operation is satisfactory. © 2014 Steunstichting ESOT.

Direct current force sensing device based on compressive spring, permanent magnet, and coil-wound magnetostrictive/piezoelectric laminate.

PubMed

Leung, Chung Ming; Or, Siu Wing; Ho, S L

2013-12-01

A force sensing device capable of sensing dc (or static) compressive forces is developed based on a NAS106N stainless steel compressive spring, a sintered NdFeB permanent magnet, and a coil-wound Tb(0.3)Dy(0.7)Fe(1.92)/Pb(Zr, Ti)O3 magnetostrictive∕piezoelectric laminate. The dc compressive force sensing in the device is evaluated theoretically and experimentally and is found to originate from a unique force-induced, position-dependent, current-driven dc magnetoelectric effect. The sensitivity of the device can be increased by increasing the spring constant of the compressive spring, the size of the permanent magnet, and/or the driving current for the coil-wound laminate. Devices of low-force (20 N) and high-force (200 N) types, showing high output voltages of 262 and 128 mV peak, respectively, are demonstrated at a low driving current of 100 mA peak by using different combinations of compressive spring and permanent magnet.

The role of fluid compression in energy conversion and particle energization during magnetic reconnection

NASA Astrophysics Data System (ADS)

Li, X.; Guo, F.; Li, G.; Li, H.

2016-12-01

Theories of particle transport and acceleration have shown that fluid compression is the leading mechanism for particle acceleration and plasma energization. However, the role of compression in particle acceleration during magnetic reconnection is unclear. We use two approaches to study this issue. First, using fully kinetic simulations, we quantitatively calculate the effect of compression in energy conversion and particle energization during magnetic reconnection for a range of plasma beta and guide field. We show that compression has an important contribution for the energy conversion between the bulk kinetic energy and the internal energy when the guide field is smaller than the reconnecting component. Based on this result, we then study the large-scale reconnection acceleration by solving the Parker's transport equation in a background reconnecting flow provided by MHD simulations. Due to the compression effect, the simulations suggest fast particle acceleration to high energies in the reconnection layer. This study clarifies the nature of particle acceleration in reconnection layer, and may be important to understand particle acceleration and plasma energization during solar flares.

Circumferentially oversewn inverted stapled anastomosis.

PubMed

Karam, Charbel; Lord, Sally; Gett, Rohan; Meagher, Alan P

2018-04-01

Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015). All patients had a widely patent anastomosis constructed by two firings of a linear cutting stapler, as previously described. Additionally, the entire staple line was carefully oversewn with interrupted, inverting 4/0 polydioxanone sutures. Anastomotic leak was defined as a patient requiring re-operation or radiological drainage. One thousand and twelve patients underwent ileo-colic anastomosis and 685 patients underwent closure of ileostomy by surgeon 1, and 165 patients underwent ileo-colic anastomosis by surgeon 2. None of the 1862 patients required re-operation or radiological drainage for a leak (event rate 0%, 95% confidence interval 0-0.2%). However, there were three possible contained leaks treated successfully conservatively. The time taken to perform the actual anastomosis was measured in the last 30 ileo-colic resections. The median time was 42 min. While this method may well be too slow to gain widespread adoption, we hope this report encourages increased research into finding techniques with similar low leak rates. © 2016 Royal Australasian College of Surgeons.

Significance of coupling device for vessel anastomosis in esophageal reconstruction.

PubMed

Watanabe, Y; Horiuchi, A; Yamamoto, Y; Kikkawa, H; Kusunose, H; Sugishita, H; Sato, K; Yoshida, M; Yukumi, S; Kawachi, K

2005-01-01

To prevent an anastomotic failure due to impaired blood supply, several trials have been performed such as preoperative ischemic conditioning by transarterial embolization of the left gastric, right gastric and splenic arteries or microvascular anastomosis. We assess the significance of an automatic anastomotic coupling device for vessel anastomosis, which we have continuously utilized, to simplify the task and shorten the anastomotic time since March 1999. 8 patients who underwent venous anastomosis by an automatic anastomotic coupling device were evaluated for the time of anastomosis, total ischemic time and outcomes. Venous anastomosis was completed within 5 minutes on average. Microscopic arterial anastomosis by hand took 35 minutes on average. For gastric tube reconstruction, venous anastomosis by an automatic coupling device took only 5 minutes. The top of the gastric tube showed congestion before venous anastomosis, but rapidly recovered from it after anastomosis. Postoperative endoscopic observation of the mucosal color of the replaced intestine or gastric tube was started 3 days after surgery and revealed no ischemia or congestion. The postoperative course was uneventful except one case suffering from pneumonia but leakage was not observed in any case. An automatic anastomotic coupling device can perform an easy and reliable vascular anastomosis for patients who undergo esophageal reconstruction. The device may shorten the operating time and consequently the ischemic time of the gastric tube or jejunal or colonic graft, which in turn may lead to a decrease of complications.

Magnetic Flux Compression Concept for Nuclear Pulse Propulsion and Power

NASA Technical Reports Server (NTRS)

Litchford, Ronald J.

2000-01-01

The desire for fast, efficient interplanetary transport requires propulsion systems having short acceleration times and very high specific impulse attributes. Unfortunately, most highly efficient propulsion systems which are within the capabilities of present day technologies are either very heavy or yield very low impulse such that the acceleration time to final velocity is too long to be of lasting interest, One exception, the nuclear thermal thruster, could achieve the desired acceleration but it would require inordinately large mass ratios to reach the range of desired final velocities. An alternative approach, among several competing concepts that are beyond our modern technical capabilities, is a pulsed thermonuclear device utilizing microfusion detonations. In this paper, we examine the feasibility of an innovative magnetic flux compression concept for utilizing microfusion detonations, assuming that such low yield nuclear bursts can be realized in practice. In this concept, a magnetic field is compressed between an expanding detonation driven diamagnetic plasma and a stationary structure formed from a high temperature superconductor (HTSC). In general, we are interested in accomplishing two important functions: (1) collimation of a hot diamagnetic plasma for direct thrust production; and (2) pulse power generation for dense plasma ignition. For the purposes of this research, it is assumed that rnicrofusion detonation technology may become available within a few decades, and that this approach could capitalize on recent advances in inertial confinement fusion ICF) technologies including magnetized target concepts and antimatter initiated nuclear detonations. The charged particle expansion velocity in these detonations can be on the order of 10 (exp 6)- 10 (exp 7) meters per second, and, if effectively collimated by a magnetic nozzle, can yield the Isp and the acceleration levels needed for practical interplanetary spaceflight. The ability to ignite pure

Multispectral tissue characterization for intestinal anastomosis optimization.

PubMed

Cha, Jaepyeong; Shademan, Azad; Le, Hanh N D; Decker, Ryan; Kim, Peter C W; Kang, Jin U; Krieger, Axel

2015-10-01

Intestinal anastomosis is a surgical procedure that restores bowel continuity after surgical resection to treat intestinal malignancy, inflammation, or obstruction. Despite the routine nature of intestinal anastomosis procedures, the rate of complications is high. Standard visual inspection cannot distinguish the tissue subsurface and small changes in spectral characteristics of the tissue, so existing tissue anastomosis techniques that rely on human vision to guide suturing could lead to problems such as bleeding and leakage from suturing sites. We present a proof-of-concept study using a portable multispectral imaging (MSI) platform for tissue characterization and preoperative surgical planning in intestinal anastomosis. The platform is composed of a fiber ring light-guided MSI system coupled with polarizers and image analysis software. The system is tested on ex vivo porcine intestine tissue, and we demonstrate the feasibility of identifying optimal regions for suture placement.

[Pancreaticojejunal anastomosis. Indication, technique and results].

PubMed

Gebhardt, C

2001-01-01

Pancreaticojejunal anastomosis. Indication, technique and results. Pancreaticojejunal anastomoses are performed for the treatment of chronic pancreatitis and after resection of pancreatic carcinomas. In chronic pancreatitis by drainage procedures (Partington-Rochelle and Puestow-Gillesby) one can expect good long term results, if the diameter of the pancreatic duct is at least 1 cm and the length of the anastomosis 6 cm. The duodenumpreserving head resection (Beger or Frey) is a combination of resection and drainage and is significant in the therapy of inflammatory head processes. In the surgical treatment of pancreatic carcinomas pancreaticojejunostomies are applied after head resection (Whipple-, pyloruspreserving modification). The end-to-side mucosa-mucosa anastomosis offers the best results concerning postoperativ complications and mortality rates.

Cerebral magnetic resonance imaging of compressed air divers in diving accidents.

PubMed

Gao, G K; Wu, D; Yang, Y; Yu, T; Xue, J; Wang, X; Jiang, Y P

2009-01-01

To investigate the characteristics of the cerebral magnetic resonance imaging (MRI) of compressed air divers in diving accidents, we conducted an observational case series study. MRI of brain were examined and analysed on seven cases compressed air divers complicated with cerebral arterial gas embolism CAGE. There were some characteristics of cerebral injury: (1) Multiple lesions; (2) larger size; (3) Susceptible to parietal and frontal lobe; (4) Both cortical grey matter and subcortical white matter can be affected; (5) Cerebellum is also the target of air embolism. The MRI of brain is an sensitive method for detecting cerebral lesions in compressed air divers in diving accidents. The MRI should be finished on divers in diving accidents within 5 days.

Splenorenal shunt via magnetic compression technique: a feasibility study in canine and cadaver.

PubMed

Xue, Fei; Li, Jianpeng; Lu, Jianwen; Zhu, Haoyang; Liu, Wenyan; Zhang, Hongke; Yang, Huan; Guo, Hongchang; Lv, Yi

2016-12-01

The concept of magnetic compression technique (MCT) has been accepted by surgeons to solve a variety of surgical problems. In this study, we attempted to explore the feasibility of a splenorenal shunt using MCT in canine and cadaver. The diameters of the splenic vein (SV), the left renal vein (LRV), and the vertical interval between them, were measured in computer tomography (CT) images obtained from 30 patients with portal hypertension and in 20 adult cadavers. The magnetic devices used for the splenorenal shunt were then manufactured based on the anatomic parameters measured above. The observation of the anatomical structure showed there were no special structural tissues or any important organs between SV and LRV. Then the magnetic compression splenorenal shunt procedure was performed in three dogs and five cadavers. Seven days later, the necrotic tissue between the two magnets was shed and the magnets were removed with the anchor wire. The feasibility of splenorenal shunt via MCT was successfully shown in both canine and cadaver, thus providing a theoretical support for future clinical application.

[Recent advances of anastomosis techniques of esophagojejunostomy after laparoscopic totally gastrectomy in gastric tumor].

PubMed

Li, Xi; Ke, Chongwei

2015-05-01

The esophageal jejunum anastomosis of the digestive tract reconstruction techniques in laparoscopic total gastrectomy includes two categories: circular stapler anastomosis techniques and linear stapler anastomosis techniques. Circular stapler anastomosis techniques include manual anastomosis method, purse string instrument method, Hiki improved special anvil anastomosis technique, the transorally inserted anvil(OrVil(TM)) and reverse puncture device technique. Linear stapler anastomosis techniques include side to side anastomosis technique and Overlap side to side anastomosis technique. Esophageal jejunum anastomosis technique has a wide selection of different technologies with different strengths and the corresponding limitations. This article will introduce research progress of laparoscopic total gastrectomy esophagus jejunum anastomosis from both sides of the development of anastomosis technology and the selection of anastomosis technology.

Multispectral tissue characterization for intestinal anastomosis optimization

PubMed Central

Cha, Jaepyeong; Shademan, Azad; Le, Hanh N. D.; Decker, Ryan; Kim, Peter C. W.; Kang, Jin U.; Krieger, Axel

2015-01-01

Abstract. Intestinal anastomosis is a surgical procedure that restores bowel continuity after surgical resection to treat intestinal malignancy, inflammation, or obstruction. Despite the routine nature of intestinal anastomosis procedures, the rate of complications is high. Standard visual inspection cannot distinguish the tissue subsurface and small changes in spectral characteristics of the tissue, so existing tissue anastomosis techniques that rely on human vision to guide suturing could lead to problems such as bleeding and leakage from suturing sites. We present a proof-of-concept study using a portable multispectral imaging (MSI) platform for tissue characterization and preoperative surgical planning in intestinal anastomosis. The platform is composed of a fiber ring light-guided MSI system coupled with polarizers and image analysis software. The system is tested on ex vivo porcine intestine tissue, and we demonstrate the feasibility of identifying optimal regions for suture placement. PMID:26440616

Clampless anastomosis with an intraluminal thermosensitive gel: first application in reconstructive microsurgery and literature review.

PubMed

Giessler, G A; Fischborn, G T; Schmidt, A B

2012-01-01

Microvascular clamps of various designs provide a bloodless field for a safe anastomosis but can cause intimal lesions, occupy space in confined sites and have a risk of backwalling due to vessel flattening. They are often insufficient in their haemostatic effect in plaque-filled atherosclerotic vessels. A new, CE-certified thermosensitive gel (LeGoo™) clinically proven in cardiovascular surgery allows a clampless microanastomosis technique. We operated on a series of five consecutive patients aged 24-71 years with six flaps for lower-extremity reconstruction using a clampless anastomosis technique with LeGoo™. We transplanted one fabricated chimaeric fibula plus gracilis, three gracilis muscle and one anterolateral thigh (ALT) flap. Pre- and postoperative protocols were similar to a 'standard' procedure with micro-clamps. All flaps survived completely except for a small area on fibula skin island, which was unrelated to gel use. The gel-assisted technique has a quick learning curve, according to this case series. The veins should be sutured first to prevent stasis in the flap. The gel provides circular stenting and gentle distension of the vessels for a safe and blood-free anastomotic site. It is completely dissolved after completion of the anastomosis with cold saline irrigation. Repolymerisation in the periphery will not occur, making it safe for microvascular flap surgery. From the experiences from this series and other specialities, the use of the thermosensitive gel LeGoo™ permits a safe clampless microanastomosis technique minimising mechanical vessel manipulation and compression. This makes it an attractive alternative to micro-clamps, especially for atherosclerotic arteries and confined anastomosis sites. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Performance characteristics of an excimer laser (XeCl) with single-stage magnetic pulse compression

NASA Astrophysics Data System (ADS)

Varshnay, N. K.; Singh, A.; Benerji, N. S.

2017-02-01

Performance characteristics of an excimer laser (XeCl) with single-stage magnetic pulse compression suitable for material processing applications are presented here. The laser incorporates in-built compact gas circulation and gas cooling to ensure fresh gas mixture between the electrodes for repetitive operation. A magnetically coupled tangential blower is used for gas circulation inside the laser chamber for repetitive operation. The exciter consists of C-C energy transfer circuit and thyratron is used as a high-voltage main switch with single-stage magnetic pulse compression (MPC) between thyratron and the laser electrodes. Low inductance of the laser head and uniform and intense pre-ionization are the main features of the electric circuit used in the laser. A 250 ns rise time voltage pulse was compressed to 100 ns duration with a single-stage magnetic pulse compressor using Ni-Zn ferrite cores. The laser can generate about 150 mJ at ˜100 Hz rep-rate reliably from a discharge volume of 100 cm 3. 2D spatial laser beam profile generated is presented here. The profile shows that the laser beam is completely filled with flat-top which is suitable for material processing applications. The SEM image of the microhole generated on copper target is presented here.

Proceedings of the International Magnetic Pulse Compression Workshop. Volume 2: Technical summary

NASA Astrophysics Data System (ADS)

Kirbie, H. C.; Newton, M. A.; Siemens, P. D.

1991-04-01

A few individuals have tried to broaden the understanding of specific and salient pulsed-power topics. One such attempt is this documentation of a workshop on magnetic switching as it applies primarily to pulse compression (power transformation), affording a truly international perspective by its participants under the initiative and leadership of Hugh Kirbie and Mark Newton of the Lawrence Livermore National Laboratory (LLNL) and supported by other interested organizations. During the course of the Workshop at Granlibakken, a great deal of information was amassed and a keen insight into both the problems and opportunities as to the use of this switching approach was developed. The segmented workshop format proved ideal for identifying key aspects affecting optimum performance in a variety of applications. Individual groups of experts addressed network and system modeling, magnetic materials, power conditioning, core cooling and dielectrics, and finally circuits and application. At the end, they came together to consolidate their input and formulate the workshop's conclusions, identifying roadblocks or suggesting research projects, particularly as they apply to magnetic switching's trump card--its high average power handling capability (at least on a burst-mode basis). The workshop was especially productive both in the quality and quantity of information transfer in an environment conducive to a free and open exchange of ideas. We will not delve into the organization proper of this meeting, rather we wish to commend to the interested reader this volume, which provides the definitive and most up-to-date compilation on the subject of magnetic pulse compression from underlying principles to current state of the art as well as the prognosis for the future of magnetic pulse compression as a consensus of the workshop's organizers and participants.

Clinical application of layered anastomosis during esophagogastrostomy.

PubMed

Zhu, Zi-Jiang; Zhao, Yong-Fan; Chen, Long-Qi; Hu, Yang; Liu, Lun-Xu; Wang, Yun; Kou, Ying-Li

2008-04-01

The aim of this study was to compare the operative results in regard to reducing anastomotic leakage and stricture formation using a newly designed layered manual esophagogastric anastomosis versus a stapler esophagogastrostomy versus the conventional hand-sewn whole-layer anastomosis after resection for esophageal or gastric cardiac carcinoma. From January 2004 to September 2006, a total of 1024 patients with esophageal or gastric cardia carcinoma underwent a layered esophagogastric anastomosis with the assistance of a three-leaf clipper in a single university medical center. The mucosal layers of the esophagus and stomach were sutured continuously with 4/0 Vicryl plus antibacterial suture (polyglyconate). From May 2002 to December 2003, there were also 170 patients and 69 patients who underwent stapler and conventional whole-layer anastomosis, respectively; they served as control groups. The results were analyzed retrospectively. The operative mortality rate was 0.7% in the layered group compared to 5.9% and 7.2% for the stapler group and the whole-layer group (p < 0.01), The anastomotic leakage rates were 0%, 3.5%, and 5.8% for the layered group, stapler group, and whole-layer group, respectively (p < 0.01). All patients were followed postoperatively. Six patients in the layered group (0.6%) developed mild stricture formation compared to 16 patients in stapled group (9.9%) and 5 patients in the conventional whole-layer group (7.8%) (p < 0.01). The application of layered esophagogastric anastomosis could reduce the incidence of anastomotic leakage and stricture after esophagectomy compared with the stapler and whole-layer manual anastomoses. It is easy to apply and could be used as an alternative for esophagogastric anastomosis after resection for esophageal or cardiac carcinoma.

Superfast assembly and synthesis of gold nanostructures using nanosecond low-temperature compression via magnetic pulsed power

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Binsong; Bian, Kaifu; Lane, J. Matthew D.

Gold nanostructured materials exhibit important size- and shape-dependent properties that enable a wide variety of applications in photocatalysis, nanoelectronics and phototherapy. Here we show the use of superfast dynamic compression to synthesize extended gold nanostructures, such as nanorods, nanowires and nanosheets, with nanosecond coalescence times. Using a pulsed power generator, we ramp compress spherical gold nanoparticle arrays to pressures of tens of GPa, demonstrating pressure-driven assembly beyond the quasi-static regime of the diamond anvil cell. Our dynamic magnetic ramp compression approach produces smooth, shockless (that is, isentropic) one-dimensional loading with low-temperature states suitable for nanostructure synthesis. Transmission electron microscopy clearlymore » establishes that various gold architectures are formed through compressive mesoscale coalescences of spherical gold nanoparticles, which is further confirmed by in-situ synchrotron X-ray studies and large-scale simulation. As a result, this nanofabrication approach applies magnetically driven uniaxial ramp compression to mimic established embossing and imprinting processes, but at ultra-short (nanosecond) timescales.« less

Superfast assembly and synthesis of gold nanostructures using nanosecond low-temperature compression via magnetic pulsed power

DOE PAGES

Li, Binsong; Bian, Kaifu; Lane, J. Matthew D.; ...

2017-03-16

Gold nanostructured materials exhibit important size- and shape-dependent properties that enable a wide variety of applications in photocatalysis, nanoelectronics and phototherapy. Here we show the use of superfast dynamic compression to synthesize extended gold nanostructures, such as nanorods, nanowires and nanosheets, with nanosecond coalescence times. Using a pulsed power generator, we ramp compress spherical gold nanoparticle arrays to pressures of tens of GPa, demonstrating pressure-driven assembly beyond the quasi-static regime of the diamond anvil cell. Our dynamic magnetic ramp compression approach produces smooth, shockless (that is, isentropic) one-dimensional loading with low-temperature states suitable for nanostructure synthesis. Transmission electron microscopy clearlymore » establishes that various gold architectures are formed through compressive mesoscale coalescences of spherical gold nanoparticles, which is further confirmed by in-situ synchrotron X-ray studies and large-scale simulation. As a result, this nanofabrication approach applies magnetically driven uniaxial ramp compression to mimic established embossing and imprinting processes, but at ultra-short (nanosecond) timescales.« less

Superfast assembly and synthesis of gold nanostructures using nanosecond low-temperature compression via magnetic pulsed power

NASA Astrophysics Data System (ADS)

Li, Binsong; Bian, Kaifu; Lane, J. Matthew D.; Salerno, K. Michael; Grest, Gary S.; Ao, Tommy; Hickman, Randy; Wise, Jack; Wang, Zhongwu; Fan, Hongyou

2017-03-01

Gold nanostructured materials exhibit important size- and shape-dependent properties that enable a wide variety of applications in photocatalysis, nanoelectronics and phototherapy. Here we show the use of superfast dynamic compression to synthesize extended gold nanostructures, such as nanorods, nanowires and nanosheets, with nanosecond coalescence times. Using a pulsed power generator, we ramp compress spherical gold nanoparticle arrays to pressures of tens of GPa, demonstrating pressure-driven assembly beyond the quasi-static regime of the diamond anvil cell. Our dynamic magnetic ramp compression approach produces smooth, shockless (that is, isentropic) one-dimensional loading with low-temperature states suitable for nanostructure synthesis. Transmission electron microscopy clearly establishes that various gold architectures are formed through compressive mesoscale coalescences of spherical gold nanoparticles, which is further confirmed by in-situ synchrotron X-ray studies and large-scale simulation. This nanofabrication approach applies magnetically driven uniaxial ramp compression to mimic established embossing and imprinting processes, but at ultra-short (nanosecond) timescales.

Superfast assembly and synthesis of gold nanostructures using nanosecond low-temperature compression via magnetic pulsed power.

PubMed

Li, Binsong; Bian, Kaifu; Lane, J Matthew D; Salerno, K Michael; Grest, Gary S; Ao, Tommy; Hickman, Randy; Wise, Jack; Wang, Zhongwu; Fan, Hongyou

2017-03-16

Gold nanostructured materials exhibit important size- and shape-dependent properties that enable a wide variety of applications in photocatalysis, nanoelectronics and phototherapy. Here we show the use of superfast dynamic compression to synthesize extended gold nanostructures, such as nanorods, nanowires and nanosheets, with nanosecond coalescence times. Using a pulsed power generator, we ramp compress spherical gold nanoparticle arrays to pressures of tens of GPa, demonstrating pressure-driven assembly beyond the quasi-static regime of the diamond anvil cell. Our dynamic magnetic ramp compression approach produces smooth, shockless (that is, isentropic) one-dimensional loading with low-temperature states suitable for nanostructure synthesis. Transmission electron microscopy clearly establishes that various gold architectures are formed through compressive mesoscale coalescences of spherical gold nanoparticles, which is further confirmed by in-situ synchrotron X-ray studies and large-scale simulation. This nanofabrication approach applies magnetically driven uniaxial ramp compression to mimic established embossing and imprinting processes, but at ultra-short (nanosecond) timescales.

Superfast assembly and synthesis of gold nanostructures using nanosecond low-temperature compression via magnetic pulsed power

PubMed Central

Li, Binsong; Bian, Kaifu; Lane, J. Matthew D.; Salerno, K. Michael; Grest, Gary S.; Ao, Tommy; Hickman, Randy; Wise, Jack; Wang, Zhongwu; Fan, Hongyou

2017-01-01

Gold nanostructured materials exhibit important size- and shape-dependent properties that enable a wide variety of applications in photocatalysis, nanoelectronics and phototherapy. Here we show the use of superfast dynamic compression to synthesize extended gold nanostructures, such as nanorods, nanowires and nanosheets, with nanosecond coalescence times. Using a pulsed power generator, we ramp compress spherical gold nanoparticle arrays to pressures of tens of GPa, demonstrating pressure-driven assembly beyond the quasi-static regime of the diamond anvil cell. Our dynamic magnetic ramp compression approach produces smooth, shockless (that is, isentropic) one-dimensional loading with low-temperature states suitable for nanostructure synthesis. Transmission electron microscopy clearly establishes that various gold architectures are formed through compressive mesoscale coalescences of spherical gold nanoparticles, which is further confirmed by in-situ synchrotron X-ray studies and large-scale simulation. This nanofabrication approach applies magnetically driven uniaxial ramp compression to mimic established embossing and imprinting processes, but at ultra-short (nanosecond) timescales. PMID:28300067

Microvascular anastomosis in rodent model evaluated by Fourier domain Doppler optical coherence tomography

NASA Astrophysics Data System (ADS)

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

2014-03-01

Vascular and microvascular anastomosis are critical components of reconstructive microsurgery, vascular surgery and transplant surgery. Imaging modality that provides immediate, real-time in-depth view and 3D structure and flow information of the surgical site can be a great valuable tool for the surgeon to evaluate surgical outcome following both conventional and innovative anastomosis techniques, thus potentially increase the surgical success rate. Microvascular anastomosis for vessels with outer diameter smaller than 1.0 mm is extremely challenging and effective evaluation of the outcome is very difficult if not impossible using computed tomography (CT) angiograms, magnetic resonance (MR) angiograms and ultrasound Doppler. Optical coherence tomography (OCT) is a non-invasive high-resolution (micron level), high-speed, 3D imaging modality that has been adopted widely in biomedical and clinical applications. Phaseresolved Doppler OCT that explores the phase information of OCT signals has been shown to be capable of characterizing dynamic blood flow clinically. In this work, we explore the capability of Fourier domain Doppler OCT as an evaluation tool to detect commonly encountered post-operative complications that will cause surgical failure and to confirm positive result with surgeon's observation. Both suture and cuff based techniques were evaluated on the femoral artery and vein in the rodent model.

Compressing the fluctuation of the magnetic field by dynamic compensation

NASA Astrophysics Data System (ADS)

Wang, Wenli; Dong, Richang; Wei, Rong; Chen, Tingting; Wang, Qian; Wang, Yuzhu

2018-03-01

We present a dynamic compensation method to compress the spatial fluctuation of the static magnetic field (C-field) that provides a quantization axis in the atomic fountain clock. The coil current of the C-field is point-by-point modulated in accordance with the atoms probing the magnetic field along the flight trajectory. A homogeneous field with a 0.2 nT inhomogeneity is produced compared to a 5 nT under the static magnetic field with a constant current during the Ramsey interrogation. The corresponding uncertainty associated with the second-order Zeeman shift that we calculate is improved by one order of magnitude. The technique provides an alternative method to improve the uniformity of the magnetic field, particularly for large-scale equipment that is difficult to construct with an effective magnetic shielding. Our method is simple, robust, and essentially important in frequency evaluations concerning the dominant uncertainty contribution due to the quadratic Zeeman shift.

Microvascular Anastomosis: Proposition of a Learning Curve.

PubMed

Mokhtari, Pooneh; Tayebi Meybodi, Ali; Benet, Arnau; Lawton, Michael T

2018-04-14

Learning to perform a microvascular anastomosis is one of the most difficult tasks in cerebrovascular surgery. Previous studies offer little regarding the optimal protocols to maximize learning efficiency. This failure stems mainly from lack of knowledge about the learning curve of this task. To delineate this learning curve and provide information about its various features including acquisition, improvement, consistency, stability, and recall. Five neurosurgeons with an average surgical experience history of 5 yr and without any experience in bypass surgery performed microscopic anastomosis on progressively smaller-caliber silastic tubes (Biomet, Palm Beach Gardens, Florida) during 24 consecutive sessions. After a 1-, 2-, and 8-wk retention interval, they performed recall test on 0.7-mm silastic tubes. The anastomoses were rated based on anastomosis patency and presence of any leaks. Improvement rate was faster during initial sessions compared to the final practice sessions. Performance decline was observed in the first session of working on a smaller-caliber tube. However, this rapidly improved during the following sessions of practice. Temporary plateaus were seen in certain segments of the curve. The retention interval between the acquisition and recall phase did not cause a regression to the prepractice performance level. Learning the fine motor task of microvascular anastomosis adapts to the basic rules of learning such as the "power law of practice." Our results also support the improvement of performance during consecutive sessions of practice. The objective evidence provided may help in developing optimized learning protocols for microvascular anastomosis.

Quasi-isentropic compression of materials using the magnetic loading technique

NASA Astrophysics Data System (ADS)

Ao, Tommy

2009-06-01

The Isentropic Compression Experiment (ICE) technique has proven to be a valuable complement to the well-established method of shock compression of condensed matter. The magnetic loading technique using pulsed power generators was first developed about a decade ago on the Z Accelerator, and has matured significantly. The recent development of small pulsed power generators have enabled several key issues in ICE, such as panel & sample preparation, uniformity of loading, and edge effects to be studied. Veloce is a medium-voltage, high-current, compact pulsed power generator developed for cost effective isentropic experiments. The machine delivers up to 3 MA of current rapidly (˜ 440-530 ns) into an inductive load where significant magnetic pressures are produced. Examples of recent material strength measurements from quasi-isentropic loading and unloading of materials will be presented. In particular, the influence that the strength of interferometer windows has on wave profile analyses and thus the inferred strength of materials is examined. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the U.S. Department of Energy's National Nuclear Security Administration under Contract No. DE-AC04-94AL85000.

Colonic anastomosis using the valtrac biofragmentable anastomosis ring: a new and useful surgical technique in gynecologic oncology.

PubMed

Hicks, M L; Kim, W; Jenkins, S A

1994-10-01

Patients with a primary malignancy of the female genital tract may present with the majority of their disease confined to the pelvis. Not infrequently, infiltrating contiguous extension of disease may involve the rectosigmoid colon, resulting in symptoms of partial obstruction. This presentation in the patient with an epithelial ovarian malignancy may represent a patient that can be adequately cytoreduced if a segmental resection of the rectosigmoid colon is performed. Following resection, the continuity of the lower GI tract can be restored by anastomosis of the proximal and distal ends of the colon. In our institution three patients explored for large abdominal pelvic masses required segmental resection of the rectosigmoid colon. In each patient the colonic anastomosis was performed using the valtrac biofragmentable anastomosis ring (V-BAR). None of the patients experienced any intraoperative complications, and postoperatively there was no evidence of any anastomotic leaks. The average time of return of GI function was 6 days and there was no prolongation of their hospital stay. Currently, with 3 months of follow-up no patients have reported any symptoms suggestive of anastomotic stricture. Although our experience is limited, we found that this technique can be performed much faster than traditional hand-sewn or staple techniques. We submit that in the presence of uncompromised colon, the V-BAR is a safe and effective new alternative for colonic anastomosis in gynecologic oncological surgery.

Sutureless microvascular anastomosis assisted by an expandable shape-memory alloy stent

PubMed Central

Saegusa, Noriko; Sarukawa, Shunji; Ohta, Kunihiro; Takamatsu, Kensuke; Watanabe, Mitsuhiro; Sugino, Takashi; Nakagawa, Masahiro; Akiyama, Yasuto; Kusuhara, Masatoshi; Kishi, Kazuo; Inoue, Keita

2017-01-01

Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5–10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology. In the present study, we designed a bare metal stent, Microstent, that was constructed by laser machining of a shape-memory alloy, NiTi. An end-to-end microvascular anastomosis was performed in SD rats by placing the Microstent at the anastomotic site and gluing the junction. The operation time for the anastomosis was significantly shortened using Microstent. Thrombus formation, patency rate, and blood vessel strength in the Microstent anastomosis were superior or comparable to hand-sewn anastomosis. The results demonstrated the safety and effectiveness, as well as the operability, of the new method, suggesting its great benefit for surgeons by simplifying the technique for microvascular anastomosis. PMID:28742116

Phase unwinding for dictionary compression with multiple channel transmission in magnetic resonance fingerprinting.

PubMed

Lattanzi, Riccardo; Zhang, Bei; Knoll, Florian; Assländer, Jakob; Cloos, Martijn A

2018-06-01

Magnetic Resonance Fingerprinting reconstructions can become computationally intractable with multiple transmit channels, if the B 1 + phases are included in the dictionary. We describe a general method that allows to omit the transmit phases. We show that this enables straightforward implementation of dictionary compression to further reduce the problem dimensionality. We merged the raw data of each RF source into a single k-space dataset, extracted the transceiver phases from the corresponding reconstructed images and used them to unwind the phase in each time frame. All phase-unwound time frames were combined in a single set before performing SVD-based compression. We conducted synthetic, phantom and in-vivo experiments to demonstrate the feasibility of SVD-based compression in the case of two-channel transmission. Unwinding the phases before SVD-based compression yielded artifact-free parameter maps. For fully sampled acquisitions, parameters were accurate with as few as 6 compressed time frames. SVD-based compression performed well in-vivo with highly under-sampled acquisitions using 16 compressed time frames, which reduced reconstruction time from 750 to 25min. Our method reduces the dimensions of the dictionary atoms and enables to implement any fingerprint compression strategy in the case of multiple transmit channels. Copyright © 2018 Elsevier Inc. All rights reserved.

Numerical Investigation of Magnetically Driven Isentropic Compression of Solid Aluminum Cylinders with a Semi-Analytical Code

NASA Astrophysics Data System (ADS)

Largent, Billy T.

The state of matter at extremely high pressures and densities is of fundamental interest to many branches of research, including planetary science, material science, condensed matter physics, and plasma physics. Matter with pressures, or energy densities, above 1 megabar (100 gigapascal) are defined as High Energy Density (HED) plasmas. They are directly relevant to the interiors of planets such as Earth and Jupiter and to the dense fuels in Inertial Confinement Fusion (ICF) experiments. To create HEDP conditions in laboratories, a sample may be compressed by a smoothly varying pressure ramp with minimal temperature increase, following the isentropic thermodynamic process. Isentropic compression of aluminum targets has been done using magnetic pressure produced by megaampere, pulsed power currents having 100 ns rise times. In this research project, magnetically driven, cylindrical isentropic compression has been numerically studied. In cylindrical geometry, material compression and pressure become higher than in planar geometry due to geometrical effects. Based on a semi-analytical model for the Magnetized Liner Inertial Fusion (MagLIF) concept, a code called "SA" was written to design cylindrical compression experiments on the 1.0 MA Zebra pulsed power generator at the Nevada Terawatt Facility (NTF). To test the physics models in the code, temporal progresses of rod compression and pressure were calculated with SA and compared with 1-D magnetohydrodynamic (MHD) codes. The MHD codes incorporated SESAME tables, for equation of state and resistivity, or the classical Spitzer model. A series of simulations were also run to find optimum rod diameters for 1.0 MA and 1.8 MA Zebra current pulses. For a 1.0 MA current peak and 95 ns rise time, a maximum compression of 2.35 ( 6.3 g/cm3) and a pressure of 900 GPa within a 100 mum radius were found for an initial diameter of 1.05 mm. For 1.8 MA peak simulations with the same rise time, the initial diameter of 1.3 mm was

Magnetic resonance image compression using scalar-vector quantization

NASA Astrophysics Data System (ADS)

Mohsenian, Nader; Shahri, Homayoun

1995-12-01

A new coding scheme based on the scalar-vector quantizer (SVQ) is developed for compression of medical images. SVQ is a fixed-rate encoder and its rate-distortion performance is close to that of optimal entropy-constrained scalar quantizers (ECSQs) for memoryless sources. The use of a fixed-rate quantizer is expected to eliminate some of the complexity issues of using variable-length scalar quantizers. When transmission of images over noisy channels is considered, our coding scheme does not suffer from error propagation which is typical of coding schemes which use variable-length codes. For a set of magnetic resonance (MR) images, coding results obtained from SVQ and ECSQ at low bit-rates are indistinguishable. Furthermore, our encoded images are perceptually indistinguishable from the original, when displayed on a monitor. This makes our SVQ based coder an attractive compression scheme for picture archiving and communication systems (PACS), currently under consideration for an all digital radiology environment in hospitals, where reliable transmission, storage, and high fidelity reconstruction of images are desired.

[Experimental model for the examination of inner pressure tolerance of telescopic anastomosis and other frequently performed anastomosis types of the esophagus].

PubMed

Szúcs, G; Tóth, I; Bráth, E; Gyáni, K; Miko, I

2001-08-01

We have good results with telescopic anastomosis technique in partial oesophagectomies and gastrectomies. As we could not find data about the healing process of telescopic anastomoses so we started experimenting. Inside pressure tolerance was examined immediately after performing anastomoses by measuring the bursting pressure using the organs of pigs slaughtered in the meat industry. Both oesophago-gastrostomies and oesophago-jejunostomies were performed with telescopic, single layer interrupted, single layer continuous, double layer interrupted and double layer continuous-interrupted technique, 9 of each anastomosis. A series of oesophago-jejunostomies were performed with EEA stapler. 99 anastomoses of 11 types were investigated. We found, that the inner pressure tolerance of telescopic oesophago-gastrostomy is better than any other single layer type variant. On the other hand the double layer type variants have much better pressure tolerance than the telescopic and other two type single layer anastomoses. The difference is statistically significant. In oesophago-jejunostomies the pressure tolerance of telescopic anastomosis is better than of the single layer interrupted type but the difference between the telescopic and single layer continuous type anastomoses is not significant. The pressure tolerance of double layer anastomosis is higher than the telescopic one but the difference is significant only in the continuous-interrupted type. The inner pressure tolerance of telescopic and EEA stapler anastomoses are equal. The investigation of additional features in anastomosis healing is in progress.

Anastomosis behavior differs between asymbiotic and symbiotic hyphae of Rhizophagus clarus.

PubMed

Purin, Sonia; Morton, Joseph B

2013-01-01

The life history of arbuscular mycorrhizal fungi (AMF, Glomeromycota) consists of a short asymbiotic phase when spores germinate and a longer symbiotic phase where hyphae form a network within roots and subsequently in the rhizosphere. Hyphal anastomosis contributes to colony formation, yet this process has been studied mostly in the asymbiotic phase rather than in mycorrhizal plants because of methodological limitations. We sought to compare patterns of anastomosis during each phase of fungal growth by measuring hyphal fusions in genetically identical and different single spore isolates of Rhizophagus clarus from different environments and geographic locations. These isolates were genotyped with two anonymous markers of microsatellite-flanking regions. Anastomosis of hyphae from germinating spores was examined in axenic Petri dishes. A rhizohyphatron consisting of agar-coated glass slides bridging single or paired mycorrhizal sorghum plants allowed evaluation of anastomosis of symbiotic hyphae. Anastomosis of hyphae within a colony, defined here as a mycelium from an individual germinating spore or from mycorrhizal roots of one plant, occurred with similar frequencies (8-38%). However, anastomosis between paired colonies was observed in germinating spores from either genetically identical or different isolates, but it was never detected in symbiotic hyphae. The frequency of anastomosis in asymbiotic hyphae from paired interactions was low, occurring in fewer than 6% of hyphal contacts. These data suggest that anastomosis is relatively unconstrained when interactions occur within a colony but is confined to asymbiotic hyphae when interactions occur between paired colonies. This pattern of behavior suggests that asymbiotic and symbiotic phases of mycelium development by R. clarus may differ in function. Anastomosis in the asymbiotic phase may provide brief opportunities for gene flow between populations of this and possibly other AMF species.

Clinical Application of an Original Vascular Anastomosis: A Clinical Multicenter Study.

PubMed

Ren, Zhen-Hu; Wu, Han-Jiang; Ji, Tong; Wang, Kai; Gokavarapu, Sandhya; Zhang, Chen-Ping

2016-11-01

Vascular anastomosis is the most important technical step required for the possibility of free tissue transfer, and mismatch of the donor and recipient vessel size is the most common surgical challenge. As recent reports have described a new method (Ren anastomosis) to resolve this challenge, the goal of this study was to assess these newly described microvascular anastomosis methods. The study was conducted at 2 institutes in China in different periods. Patients were recruited from the Second Xiangya Hospital between February and May 2013 and from the Shanghai Ninth People's Hospital between March and May 2015. All patients who participated in this study needed free flaps for oral and maxillofacial defects. Patients were divided into the experimental group and the control group. In the experimental group, isometric double-notch end-in-end microvascular anastomosis (Ren anastomosis) was performed, whereas end-to-end anastomosis was performed in the control group. Statistical differences were assessed by use of χ 2 and t tests. A total of 148 patients (108 men and 40 women) were treated over the course of this study. There was a statistically significant difference (P < .001) in the operation time for the microscopic artery anastomosis between the experimental group (70 cases; 5.6 ± 1.8 minutes) and the control group (78 cases; 14.6 ± 3.7 minutes). In each group, 1 case of artery compromise was observed. The Ren anastomosis was time-saving, straightforward, efficient, and easy to learn, with a high patency rate. Copyright © 2016. Published by Elsevier Inc.

Effects of melatonin on colonic anastomosis healing following chemotherapy in rats.

PubMed

Akyuz, Cebrail; Yasar, Necdet Fatih; Uzun, Orhan; Peker, Kıvanc Derya; Sunamak, Oguzhan; Duman, Mustafa; Sehirli, Ahmet Ozer; Yol, Sinan

2018-03-19

This study aimed to investigate the effect of melatonin on the healing of colon anastomosis following chemotherapy. 32 rats were randomised into four groups: (a) control group (Group 1), which underwent sigmoid colon transaction and primary anastomosis; (b) melatonin group (Group 2), which received melatonin daily following anastomosis; (c) 5-fluorouracil (5-FU) group (Group 3), which received 5-FU for five days prior to anastomosis; and (d) 5-FU+melatonin group (Group 4), which received 5-FU for five days prior to anastomosis and melatonin daily following anastomosis. Anastomotic bursting pressures of the rats, which were sacrificed on postoperative day 7, were measured. The anastomotic segment was extracted for hydroxyproline, luminol and lucigenin measurements, and histopathological examination. Blood samples were obtained from the vena cava for measurement of tumour necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) plasma levels. Bursting pressures of anastomosis and hydroxyproline levels were significantly higher in Groups 1 and 4 than in Group 3. Luminol and lucigenin levels were significantly lower in Groups 1 and 4 than in Group 3. In addition, TNF-α and IL-1β plasma levels were significantly lower in Groups 1 and 4 than in Group 3. Histopathological examination showed a significant decrease in inflammation and necrosis formation in Group 2 when compared to Group 1. The positive effect of melatonin was also seen in the rats that received 5-FU. Our study results showed that the adverse effects of chemotherapy on the mechanical, biochemical and histopathological parameters of anastomosis healing were attenuated through melatonin treatment.

Precise measurement of a magnetic field generated by the electromagnetic flux compression technique.

PubMed

Nakamura, D; Sawabe, H; Matsuda, Y H; Takeyama, S

2013-04-01

The precision of the values of a magnetic field generated by electromagnetic flux compression was investigated in ultra-high magnetic fields of up to 700 T. In an attempt to calibrate the magnetic field measured by pickup coils, precise Faraday rotation (FR) measurements were conducted on optical (quartz and crown) glasses. A discernible "turn-around" phenomenon was observed in the FR signal as well as the pickup coils before the end of a liner implosion. We found that the magnetic field measured by pickup coils should be corrected by taking into account the high-frequency response of the signal transmission line. Near the peak magnetic field, however, the pickup coils failed to provide reliable values, leaving the FR measurement as the only method to precisely measure extremely high magnetic fields.

[Comparative analysis of mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer].

PubMed

Cayi, Ruijun; Li, Mei; Xiong, Gang; Cai, Kaican; Wang, Wujun

2012-06-01

To compare the complications associated with mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer. From September, 2004 to June, 2007, 227 patients with middle and upper thoracic esophageal cancer underwent cervical esophagogastric anastomosis after esophagectomy. The patients were randomized into two groups and cervical esophagogastric anastomosis was performed using a stapler (n=102) or manually (n=125). The incidence of postoperative complications and operative time were compared between the two groups. In manual anastomosis group, anastomotic leak and anastomotic stricture occurred in 14.4% (18/125) and 8.8.% (11/125) of the patients, significantly higher than the incidences of 2.9% (3/102) and 3.9% (4/102) in the mechanical anastomosis group (P<0.01). Manual anastomosis required a significantly longer operative time than mechanical anastomosis (52∓12 vs 25∓5 min, P<0.01). The use of circular mechanical stapler in cervical esophagogastric anastomosis is associated with a lower rate of anastomotic leak and a shorter operative time, and is easy to learn and standardize to reduce the complications of the anastomosis.

Robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis.

PubMed

Jin, Runsen; Xiang, Jie; Han, Dingpei; Zhang, Yajie; Li, Hecheng

2017-11-01

This video clip demonstrated a performance of robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis. The patient had an esophageal mass located approximately 33 cm away from incisor, and robot-assisted Ivor-Lewis esophagectomy was applied for him. Importantly, a double-layer esophago-gastric anastomosis was made by robotic hand-sewn suture. Our early experience demonstrated that the robot-sewn intrathoracic anastomosis is feasible and safe with a lower complication rate and the absence of anastomotic leakage.

Double 90 Degrees Counterrotated End-to-End-Anastomosis: An Experimental Study of an Intestinal Anastomosis Technique.

PubMed

Holzner, Philipp; Kulemann, Birte; Seifert, Gabriel; Glatz, Torben; Chikhladze, Sophia; Höppner, Jens; Hopt, Ulrich; Timme, Sylvia; Bronsert, Peter; Sick, Olivia; Zhou, Cheng; Marjanovic, Goran

2015-06-01

The aim of the article is to investigate a new anastomotic technique compared with standardized intestinal anastomotic procedures. A total of 32 male Wistar rats were randomized to three groups. In the Experimental Group (n = 10), the new double 90 degrees inversely rotated anastomosis was used, in the End Group (n = 10) a single-layer end-to-end anastomosis, and in the Side Group (n = 12) a single-layer side-to-side anastomosis. All anastomoses were done using interrupted sutures. On postoperative day 4, rats were relaparotomized. Bursting pressure, hydroxyproline concentration, a semiquantitative adhesion score and two histological anastomotic healing scores (mucosal healing according to Chiu and overall anastomotic healing according to Verhofstad) were collected. Most data are presented as median (range). p < 0.05 was considered significant. Anastomotic insufficiency occurred only in one rat of the Side Group. Median bursting pressure in the Experimental Group was 105 mm Hg (range = 72-161 mm Hg), significantly higher in the End Group (164 mm Hg; range = 99-210 mm Hg; p = 0.021) and lower in the Side Group by trend (81 mm Hg; range = 59-122 mm Hg; p = 0.093). Hydroxyproline concentration did not differ significantly in between the groups. The adhesion score was 2.5 (range = 1-3) in the Experimental Group, 2 (range = 1-2) in the End Group, but there were significantly more adhesions in the Side Group (range = 3-4); p = 0.020 versus Experimental Group, p < 0.001 versus End Group. The Chiu Score showed the worst mucosal healing in the Experimental Group. The overall Verhofstad Score was significantly worse (mean = 2.032; standard deviation [SD] = 0.842) p = 0.031 and p = 0.002 in the Experimental Group, compared with the Side Group (mean = 1.729; SD = 0.682) and the End Group (mean = 1.571; SD = 0.612). The new anastomotic technique is feasible and did not show any relevant complication. Even though it was superior to the side-to-side anastomosis by trend with

Direct measurement of magnetic flux compression on the Z pulsed-power accelerator

NASA Astrophysics Data System (ADS)

McBride, R. D.; Bliss, D. E.; Martin, M. R.; Jennings, C. A.; Lamppa, D. C.; Dolan, D. H.; Lemke, R. W.; Rovang, D. C.; Rochau, G. A.; Cuneo, M. E.; Sinars, D. B.; Intrator, T. P.; Weber, T. E.

2016-10-01

We report on the progress made to date for directly measuring magnetic flux compression on Z. Each experiment consisted of an initially solid aluminum liner (a cylindrical tube), which was imploded using Z's drive current (0-20 MA in 100 ns). The imploding liner compresses a 10-20-T axial seed field, Bz(0), supplied by an independently driven Helmholtz coil pair. Assuming perfect flux conservation, the axial field amplification should be well described by Bz(t) =Bz (0)×[R(0)/R(t)]2, where R is the liner's inner surface radius. With perfect flux conservation, Bz and dBz/dt values exceeding 104 T and 1012 T/s, respectively, are expected. These large values, the diminishing liner volume, and the harsh environment on Z, make it particularly challenging to measure these fields directly. We report on our latest efforts to do so using a fiber-optic-based Faraday rotation diagnostic, where the magneto-active portion of the sensor is made from terbium-doped optical fiber. We have now used this diagnostic to measure a flux-compressed magnetic field to over 600 T prior to the imploding liner hitting the on-axis fiber housing. This project was funded in part by Sandia's LDRD program and US DOE-NNSA contract DE-AC04-94AL85000.

Stapled versus handsewn methods for colorectal anastomosis surgery.

PubMed

Lustosa, S A; Matos, D; Atallah, A N; Castro, A A

2001-01-01

Randomized controlled trials comparing stapled with handsewn colorectal anastomosis have not shown either technique to be superior, perhaps because individual studies lacked statistical power. A systematic review, with pooled analysis of results, might provide a more definitive answer. To compare the safety and effectiveness of stapled and handsewn colorectal anastomosis. The following primary hypothesis was tested: the stapled technique is more effective because it decreases the level of complications. The RCT register of the Cochrane Review Group was searched for any trial or reference to a relevant trial (published, in-press, or in progress). All publications were sought through computerised searches of EMBASE, LILACS, MEDLINE, the Cochrane Controlled Clinical Trials Database, and through letters to industrial companies and authors. There were no limits upon language, date, or other criteria. All randomized clinical trials (RCTs) in which stapled and handsewn colorectal anastomosis were compared. Adult patients submitted electively to colorectal anastomosis. Endoluminal circular stapler and handsewn colorectal anastomosis. a) Mortality b) Overall Anastomotic Dehiscence c) Clinical Anastomotic Dehiscence d) Radiological Anastomotic Dehiscence e) Stricture f) Anastomotic Haemorrhage g) Reoperation h) Wound Infection i) Anastomosis Duration j) Hospital Stay. Data were independently extracted by the two reviewers (SASL, DM) and cross-checked. The methodological quality of each trial was assessed by the same two reviewers. Details of the randomization (generation and concealment), blinding, whether an intention-to-treat analysis was done, and the number of patients lost to follow-up were recorded. The results of each RCT were summarised on an intention-to-treat basis in 2 x 2 tables for each outcome. External validity was defined by characteristics of the participants, the interventions and the outcomes. The RCTs were stratified according to the level of colorectal

Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.

PubMed

Smeets, Ralf; Vorwig, Oliver; Wöltje, Michael; Gaudin, Robert; Luebke, Andreas M; Beck-Broichsitter, Benedicta; Rheinnecker, Michael; Heiland, Max; Grupp, Katharina; Gröbe, Alexander; Hanken, Henning

2016-05-01

To evaluate a novel microvascular anastomosis technique using N-fibroin stents. Cylinder stents of 1 mm diameter and 5 mm length were fabricated using N-fibroin from silkworms. In 22 rats, aortas were dissected, and the stent was inserted into the two ends of the aorta and fixed using methylmethacrylate. Stent anastomosis was successful in 21 (96%) rats. The mean ischemia time was 7.4 minutes, significantly shorter than the 15.9 minutes in the control group with conventional sutures (P < .0001). After 4 months, anastomosis was functionally patent in all cases. However, elastic fibers remained interrupted in all stent anastomosis cases, and marked host rejection was evident at the stent anastomosis sites. Around the stents, thrombi were frequent (52%). Our study demonstrated the basic feasibility of stent anastomosis using N-fibroin stents and reduced ischemia time. However, thrombus formation, frequent and severe abdominal infections, and heavy host rejection remain critical issues. Copyright © 2016 Elsevier Inc. All rights reserved.

[Clinical application of biofragmentable anastomosis ring for intestinal anastomosis].

PubMed

Ye, Feng; Lin, Jian-jiang

2006-11-01

To compare the efficacy of the biofragmentable anastomotic ring (BAR) with conventional hand-sutured and stapling techniques,and to evaluate the safety and applicability of the BAR in intestinal anastomosis. The totol of 498 patients performed intestinal anastomosis from January 2000 to November 2005 were allocated to BAR group (n=186), hand-sutured group (n=177) and linear cutter group (n=135). The operative time, postoperative convalescence and corresponding complication were recorded. Postoperative anastomotic inflammation and anastomotic stenosis were observed during half or one year follow-up of 436 patients. The operative time was (102 +/- 16) min in the BAR group, (121 +/- 15) min in the hand-sutured group, and (105 +/- 18 ) min in the linear cutter group. The difference was significant statistically (P <0.05). The operative time in BAR group and linear cutter group was shorter than hand-sutured group. One case of anastomotic leakage was noted in the BAR group, one case in the hand-sutured group, and none in the linear cutter group. They were cured by conservative methods. One case of anastomotic obstruction happened in the BAR group, one case in the hand-sutured group. Two of them were cured by conservative methods. Two cases of anastomotic obstruction happened in the hand-sutured group. However, one of them required reoperation to remove the obstruction. In the BAR, hand-sutured and the linear cutter group, the postoperative first flatus time was (67.2+/- 4.6) h, (70.2 +/- 5.8) h and (69.2 +/- 6.2)h, respectively. No significant differences were observed among three groups(P > 0.05). The rate of postoperative anastomotic inflammation was 3.0 % (5/164) in the BAR group, 47.8 % (76/159) in hand-sutured group and 7.1 % (8/113) in the linear cutter group. The difference was significant statistically (P <0.05). The rate of postoperative anastomotic inflammation in the BAR group and in the linear cutter group was less than that in hand-sutured group. BAR is one

Microsurgical Bypass Training Rat Model: Part 2-Anastomosis Configurations.

PubMed

Tayebi Meybodi, Ali; Lawton, Michael T; Yousef, Sonia; Mokhtari, Pooneh; Gandhi, Sirin; Benet, Arnau

2017-11-01

Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal preclinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery. Thirteen male Sprague-Dawley rats underwent inhalant anesthesia. The abdominal aorta and the CIAs were exposed. The distances between the major branches of the aorta were measured to find the optimal location for an end-to-end anastomosis. Also, the feasibility of performing side-to-side and end-to-side anastomoses between the CIAs was assessed. All bypass configurations could be performed between the left renal artery and the CIA bifurcation. The longest segments of the aorta without major branches were 1) between the left renal and left iliolumbar arteries (16.9 mm ± 4.6), and 2) between the right iliolumbar artery and the aortic bifurcation (9.7 mm ± 4.7). The CIAs could be juxtaposed for an average length of 7.6 mm ± 1.3, for a side-to-side anastomosis. The left CIA could be successfully reimplanted on to the right CIA at an average distance of 9.1 mm ± 1.6 from the aortic bifurcation. Our results show that rat's abdominal aorta and CIAs may be effectively used for all the anastomosis configurations used in cerebral revascularization procedures. We also provide technical nuances and anatomic descriptions to plan for practicing each bypass configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

Transfer of Learning from Practicing Microvascular Anastomosis on Silastic Tubes to Rat Abdominal Aorta.

PubMed

Mokhtari, Pooneh; Tayebi Meybodi, Ali; Lawton, Michael T; Payman, Andre; Benet, Arnau

2017-12-01

Learning to perform microvascular anastomosis is difficult. Laboratory practice models using artificial vessels are frequently used for this purpose. However, the efficacy of such practice models has not been objectively assessed for the performance of microvascular anastomosis during live surgical settings. This study was conducted to assess the transfer of learning from practicing microvascular anastomosis on tubes to anastomosing rat abdominal aorta. Ten surgeons without any experience in microvascular anastomosis were randomly assigned to an experimental or a control group. Both groups received didactic and visual training on end-to-end microvascular anastomosis. The experimental group received 24 sessions of hands-on training on microanastomosis using Silastic tubes. Next, both groups underwent recall tests on weeks 1, 2, and 8 after training. The recall test consisted of completing an end-to-end anastomosis on the rat's abdominal aorta. Anastomosis score, the time to complete the anastomosis, and the average time to place 1 stitch on the vessel perimeter were compared between the 2 groups. Compared with the control group, the experimental group did significantly better in terms of anastomosis score, total time, and per-stitch time. The measured variables showed stability and did not change significantly between the 3 recall tests. The skill of microvascular anastomosis is transferred from practicing on Silastic tubes to rat's abdominal aorta. Considering the relative advantages of Silastic tubes to live rodent surgeries, such as lower cost and absence of ethical issues, our results support the widespread use of Silastic tubes in training programs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

[Cervical mechanical anastomosis by transhiatal approach with a new circular stapler, Ehicon ECS 21].

PubMed

Gasparri, G; Casalegno, P A; Camandona, M; Moffa, F; Oliaro, A; Ferrero, V; Dei Poli, M

1996-12-01

Authors describe a new technique of mechanical cervical anastomosis using a new, particularly long, stapler, the ECS Ethicon. Mechanical anastomosis at neck level is difficult to perform with stapler now in use, so manual anastomosis is usually preferred. However the percentage of leakage is relatively high. The possibility of doing a mechanical anastomosis introducing the stapler through the pylorus is described. At the moment cases are too few to give a full evaluation of this new technique, but certainly it could be a valid alternative, safer and quicker, to manual anastomosis.

[Esophagus-enteric anastomosis ulceration caused by alendronate].

PubMed

Duques, P; Araújo, R S; de Amorim, W P

2001-01-01

Alendronate sodium is an aminobisphosphonate indicated for the treatment of osteoporosis in post-menopausal women and has been associated with esophagitis in many reports. Esophageal stenosis, gastrointestinal symptoms as dyspepsia, nausea, vomiting and abdominal pain could be present. Report a case of a patient who underwent total gastrectomy with Y-en-Roux anastomosis for a gastric carcinoid tumor and developed an esophagus-enteric anastomosis ulceration after the use of alendronate. A 63-year-old woman started medical therapy with alendronate in a dose of 10 mg daily. After a period of one month of medical treatment with this drug she began to complain of dysphagic symptoms and abdominal pain. She was submitted to endoscopic examination that showed an esophageal ulceration, an enteric ulceration of the anastomosis and an esophageal stenosis. Medical treatment with alendronate was discontinued and the symptom of abdominal pain disappeared. The intensity of dysphagia has decreased. The ulcerated lesion remitted although esophageal stenosis did not. The patient was subsequently treated with esophagus-enteric anastomosis dilation. She improved in her general state and nowadays she is free of symptoms. Alendronate sodium could cause lesions of the inferior esophageal portion or in distal segments of the gastrointestinal tube, in patients with a fast gastrointestinal transit. Special attention must be given to gastrectomized patients that use this drug because of the possibility to develop mucosal lesions in the enteric anastomosed part and its fearful complications as stenosis.

Microsurgical techniques of anastomosis of the fallopian tubes.

PubMed

Smith, R N; Minkler, D

1978-01-01

Microsurgical techniques of anastomosis of the fallopian tubes have been studied. This paper considers the present state of the art of sterilization reversal, the training and equipment required, the potential for the diffusion of knowledge concerning reversal techniques, and the implication of current research in reversibility of sterilization for the practicing gynecologist. A preoperative study should be done on any candidate for a procedure to restore patency to the fallopian tubes to rule out other possible causes of infertility. Also, preoperative counseling should include both partners. The operating microscope offers a great advantage in the repair of several types of tubal obstruction. Midsegment end-to-end anastomosis is carried out by 1st injecting a dye into the cavity to locate the area of obstruction. The area is excised using microdissection and the fallopian tube checked for patency with the dye solution. Anastomosis is accomplished by opposing the miscularis of the tube, avoiding the mucosa. 4 sutures are usually adequate for closure. Most feel that postoperative hydrotubation is of some value in monitoring tubal patency. An organized training program in a microsurgical laboratory is the prefered way for learning the techniques. Long-term results of the microsurgical techniques for tubal anastomosis are encouraging and represent an improvement over macroscopic techniques previously reported.

A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training

PubMed Central

Mutoh, Tatsushi; Ishikawa, Tatsuya; Ono, Hidenori; Yasui, Nobuyuki

2010-01-01

Background: Microvascular anastomosis is a challenging neurosurgical technique that requires extensive training for one to master it. We developed a new vascular model (KEZLEX, Ono and Co., Ltd., Tokyo, Japan) as a non-animal, realistic tool for practicing microvascular anastomosis under realistic circumstances. Methods: The model was manufactured from polyvinyl alcohol hydrogel to provide 1.0–3.0 mm diameter (available for 0.5-mm pitch), 6–8 cm long tubes that have qualitatively similar surface characteristics, visibility, and stiffness to human donor and recipient arteries for various bypass surgeries based on three-dimensional computed tomography/magnetic resonance imaging scanning data reconstruction using visible human data set and vessel casts. Results: Trainees can acquire basic microsuturing techniques for end-to-end, end-to-side, and side-to-side anastomoses with handling similar to that for real arteries. To practice standard deep bypass techniques under realistic circumstances, the substitute vessel can be fixed to specific locations of a commercially available brain model with pins. Conclusion: Our vascular prosthesis model is simple and easy to set up for repeated practice, and will contribute to facilitate “off-the-job” training by trainees. PMID:21170365

Stapled versus handsewn methods for colorectal anastomosis surgery.

PubMed

Neutzling, Cristiane B; Lustosa, Suzana A S; Proenca, Igor M; da Silva, Edina M K; Matos, Delcio

2012-02-15

Previous systematic reviews comparing stapled and handsewn colorectal anastomosis that are available in the medical literature have not shown either technique to be superior. An update of this systematic review was performed to find out if there are any data that properly answer this question. To compare the safety and effectiveness of stapled and handsewn colorectal anastomosis surgery. The following primary hypothesis was tested: the stapled technique is more effective because it decreases the level of complications. A computerized search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE according to the strategies of the Colorectal Cancer Group of The Cochrane Collaboration. There were no limits upon language, date or other criteria. A revised search strategy was performed for this updated version of the review May 2011. All randomised controlled trials (RCTs) in which stapled and handsewn colorectal anastomosis techniques were compared. Participants were adult patients undergoing elective colorectal anastomosis surgery. The interventions were endoluminal circular stapler and handsewn colorectal anastomosis surgery. Outcomes considered were a) mortality; b) overall anastomotic dehiscence; c) clinical anastomotic dehiscence; d) radiological anastomotic dehiscence; e) stricture; f) anastomotic haemorrhage; g) reoperation; h) wound infection; i) anastomosis duration; and j) hospital stay. Data were independently analysed by the two review authors (CBN, SASL) and cross-checked. The methodological quality of each trial was assessed by the same two authors. After searching the literature for this update, no study was added to those in the previous version of this review. Details of randomizations (generation and concealment), blinding, whether an intention-to-treat analysis was done or not, and the number of patients lost to follow-up were recorded. The analysis of the risk of bias was updated according to the software

SVD compression for magnetic resonance fingerprinting in the time domain.

PubMed

McGivney, Debra F; Pierre, Eric; Ma, Dan; Jiang, Yun; Saybasili, Haris; Gulani, Vikas; Griswold, Mark A

2014-12-01

Magnetic resonance (MR) fingerprinting is a technique for acquiring and processing MR data that simultaneously provides quantitative maps of different tissue parameters through a pattern recognition algorithm. A predefined dictionary models the possible signal evolutions simulated using the Bloch equations with different combinations of various MR parameters and pattern recognition is completed by computing the inner product between the observed signal and each of the predicted signals within the dictionary. Though this matching algorithm has been shown to accurately predict the MR parameters of interest, one desires a more efficient method to obtain the quantitative images. We propose to compress the dictionary using the singular value decomposition, which will provide a low-rank approximation. By compressing the size of the dictionary in the time domain, we are able to speed up the pattern recognition algorithm, by a factor of between 3.4-4.8, without sacrificing the high signal-to-noise ratio of the original scheme presented previously.

SVD Compression for Magnetic Resonance Fingerprinting in the Time Domain

PubMed Central

McGivney, Debra F.; Pierre, Eric; Ma, Dan; Jiang, Yun; Saybasili, Haris; Gulani, Vikas; Griswold, Mark A.

2016-01-01

Magnetic resonance fingerprinting is a technique for acquiring and processing MR data that simultaneously provides quantitative maps of different tissue parameters through a pattern recognition algorithm. A predefined dictionary models the possible signal evolutions simulated using the Bloch equations with different combinations of various MR parameters and pattern recognition is completed by computing the inner product between the observed signal and each of the predicted signals within the dictionary. Though this matching algorithm has been shown to accurately predict the MR parameters of interest, one desires a more efficient method to obtain the quantitative images. We propose to compress the dictionary using the singular value decomposition (SVD), which will provide a low-rank approximation. By compressing the size of the dictionary in the time domain, we are able to speed up the pattern recognition algorithm, by a factor of between 3.4-4.8, without sacrificing the high signal-to-noise ratio of the original scheme presented previously. PMID:25029380

The influence of non-planar geometry on the flow within a distal end-to-side anastomosis

NASA Astrophysics Data System (ADS)

Sherwin, S. J.; Doorly, D. J.; Peiro, J.; Caro, C. G.

1998-11-01

The pattern of the flow in arteries is strongly influenced by the three-dimensional shape of the geometry. Curvature and torsion of the wall geometry alters the axial velocity distribution, and introduces cross flow velocity components. In this investigation we have considered flow in a model geometry of a fully occluded 45^o distal end-to-side anastomosis. Previous investigations have typically focused on planar end-to-side anastomoses where the bypass and host vessels have a plane of symmetry. We have increased the complexity of the model by considering a non-planar geometry produced by deforming the bypass vessel out of the plane of symmetry. The flows have been numerically and experimentally investigated using a spectral/hp element algorithm and magnetic resonance imaging. The significant effect of the non-planar geometry is to introduce a bulk rotation of the two secondary flow cells present in flow within a planar geometry. A reduction in wall shear stress is observed at the bed of the anastomosis and a larger absolute flux of velocity is seen within the occluded region proximal to the anastomosis. Current investigations have considered the role of pulsatility in the form of a non-reversing sinusoidal oscillation. In this case a separation bubble, not present in the steady case, is seen at the toe of the anastomosis during the systolic part of the cycle. The role of geometry and pulsatility on particle motion has also been addressed with a view to determining the shear exposure on particle within these types of flows.

Magnetic Flux Compression Reactor Concepts for Spacecraft Propulsion and Power (MSFC Center Director's Discretionary Fund; Project No. 99-24). Part 1

NASA Technical Reports Server (NTRS)

Litchford, R. J.; Robertson, G. A.; Hawk, C. W.; Turner, M. W.; Koelfgen, S.; Litchford, Ron J. (Technical Monitor)

2001-01-01

This technical publication (TP) examines performance and design issues associated with magnetic flux compression reactor concepts for nuclear/chemical pulse propulsion and power. Assuming that low-yield microfusion detonations or chemical detonations using high-energy density matter can eventually be realized in practice, various magnetic flux compression concepts are conceivable. In particular, reactors in which a magnetic field would be compressed between an expanding detonation-driven plasma cloud and a stationary structure formed from a high-temperature superconductor are envisioned. Primary interest is accomplishing two important functions: (1) Collimation and reflection of a hot diamagnetic plasma for direct thrust production, and (2) electric power generation for fusion standoff drivers and/or dense plasma formation. In this TP, performance potential is examined, major technical uncertainties related to this concept accessed, and a simple performance model for a radial-mode reactor developed. Flux trapping effectiveness is analyzed using a skin layer methodology, which accounts for magnetic diffusion losses into the plasma armature and the stationary stator. The results of laboratory-scale experiments on magnetic diffusion in bulk-processed type II superconductors are also presented.

Pilot study on preventing anastomotic leakage in stapled gastroesophageal anastomosis

PubMed Central

Huang, Weiming; Liu, Xiangzheng; Li, Jian

2017-01-01

Background This study explored how to improve the surgical technique to reduce or avoid anastomotic leakage. Methods From January 2012 to December 2016, 101 consecutive patients with cancer of the esophagus or gastroesophageal junction underwent stapled gastroesophageal anastomosis. The procedure included creating a tube‐type stomach, fixing an inserted anvil, inspecting mucosa‐to‐mucosa alignment in the lumen under direct vision after firing the stapler, and, if found, manually repairing a rupture of the mucous membrane of the anastomosis. Results A rupture of the mucous membrane of the anastomosis was found in four out of the 101 patients and manually repaired. No postsurgical anastomotic leakage occurred. All patients recovered well and the average postoperative stay was 10.4 days. There was no mortality within 30 days after surgery. Conclusion It is critical to inspect the integrality of the luminal mucous membrane of the anastomosis under direct vision in order to prevent anastomotic leakage in surgical resection of esophageal and gastroesophageal junction malignancies. PMID:29130643

Abdominal aorta anastomosis in rats and stable gastric pentadecapeptide BPC 157, prophylaxis and therapy.

PubMed

Hrelec, M; Klicek, R; Brcic, L; Brcic, I; Cvjetko, I; Seiwerth, S; Sikiric, P

2009-12-01

We focused on abdominal aorta, clamped and transected bellow renal arteries, and aortic termino-terminal anastomosis created in Albino male rats. We suggested stomach cytoprotection theory holding endothelium protection and peptidergic anti-ulcer cytoprotection therapy to improve management of abdominal aorta anastomosis and thrombus formation. The stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419) is a small anti-ulcer peptide efficient in inflammatory bowel disease trials (PL 14736) and various wound treatment, no toxicity reported. After 24 h following aortic termino-terminal anastomosis, we shown that BPC 157 (10 microg/kg) may also decrease formation of cloth after aortic termino-terminal anastomosis and preserved walking ability and muscle strength when given as a bath immediately after aortic anastomosis creation. This may be important since aortic termino-terminal anastomosis is normally presenting in rats with a formed cloth obstructing more than third of aortic lumen, severely impaired walking ability, painful screaming and weak muscle strength. Thereby, the effect of BPC 157 (10 microg/kg) was additionally studied at 24 h following aortic termino-terminal anastomosis. Given at the that point, intraperitoneally, within 3 minutes post-application interval the pentadecapeptide BPC 157 rapidly recovered the function of lower limbs and muscle strength while no cloth could be seen in those rats at the anastomosis site.

Management of post-gastrectomy anastomosis site obstruction with a self-expandable metallic stent.

PubMed

Cha, Ra Ri; Lee, Sang Soo; Kim, Hyunjin; Kim, Hong Jun; Kim, Tae-Hyo; Jung, Woon Tae; Lee, Ok Jae; Bae, Kyung Soo; Jeong, Sang-Ho; Ha, Chang Yoon

2015-04-28

Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy. We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet obstruction. Following the 10(th) postoperative day, the patient complained of abdominal discomfort and vomiting. We diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic examination. We inserted a self-expandable metallic stent (SEMS) at the anastomosis site. The stent was fully expanded after deployment. On the day following the stent insertion, the patient began to eat, and his abdominal discomfort was resolved. This paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.

Characterization of short-pulse laser-produced x-rays for diagnosing magnetically driven cylindrical isentropic compression

NASA Astrophysics Data System (ADS)

Sawada, Hiroshi; Daykin, Tyler; Bauer, Bruno; Beg, Farhat

2017-10-01

We have developed an experimental platform to study material properties of magnetically compressed cylinder using a 1 MA pulsed power generator Zebra and a 50 TW subpicosecond short-pulse laser Leopard at the UNR's Nevada Terawatt Facility. According to a MHD simulation, strong magnetic fields generated by 100 ns rise time Zebra current can quasi-isentropically compress a material to the strongly coupled plasma regime. Taking advantage of the cylindrical geometry, a metal rod can be brought to higher pressures than that in the planar geometry. To diagnose the compressed rod with high precision x-ray measurements, an initial laser-only experiment was carried out to characterize laser-produced x-rays. Interaction of a high-intensity, short-pulse laser with solids produces broadband and monochromatic x-rays with photon energies high enough to probe dense metal rods. Bremsstrahlung was measured with Imaging plate-based filter stack spectrometers and monochromatic 8.0 keV Cu K-alpha was recorded with an absolutely calibrated Bragg crystal spectrometer. The broadband x-ray source was applied to radiography of thick metal objects and different filter materials were tested. The experimental results and a design of a coupled experiment will be presented.

[Extrinsic compression of the hepatocholedocus caused by cavernomatosis of the portal vein. Report of a case].

PubMed

Carpani, M; Guma, C I; Casal, M A

1982-01-01

The extrinsic compression of the hepatocholedochus by a cavernomatosis of the portal vein, is an unusual pathology. The present case begun clinically as an obstructive jaundice, assuming that the vascular origin of the compression increased the litiasic biliary disease. The percutaneous transhepatic cholangiography was the diagnostic method that suggested a double illness of the biliary system. The surgery and the pathology certificated the diagnosis. The correct treatment once confirmed the obstructive trial, must be: the extraction of the biliary gallstones and the bile-digestive derivation (preferently the hepatic-jejunum anastomosis in Y of Roux).

Robot-assisted laparoscopic intracorporeal hand-sewn bowel anastomosis during pediatric bladder reconstructive surgery.

PubMed

Gundeti, Mohan S; Wiltz, Aimee L; Zagaja, Gregory P; Shalhav, Arieh L

2010-08-01

Bowel anastomosis performed during robot-assisted laparoscopic surgery in both adult and pediatric populations has typically been performed using endoscopic staplers or with exteriorization of the bowel. In the pediatric population, no articles have been published that explore the possibility of a completely intracorporeal hand-sewn anastomosis during robot-assisted laparoscopic surgery. We report our series of six children who were undergoing robot-assisted laparoscopic intracorporeal hand-sewn bowel anastomosis during bladder reconstructive surgery for neurogenic bladder. The postoperative course was uncomplicated with regard to the bowel anastomosis, demonstrating the feasibility of the technique in experienced hands.

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.

Use of magnetic compression to support turbine engine rotors

NASA Technical Reports Server (NTRS)

Pomfret, Chris J.

1994-01-01

Ever since the advent of gas turbine engines, their rotating disks have been designed with sufficient size and weight to withstand the centrifugal forces generated when the engine is operating. Unfortunately, this requirement has always been a life and performance limiting feature of gas turbine engines and, as manufacturers strive to meet operator demands for more performance without increasing weight, the need for innovative technology has become more important. This has prompted engineers to consider a fundamental and radical breakaway from the traditional design of turbine and compressor disks which have been in use since the first jet engine was flown 50 years ago. Magnetic compression aims to counteract, by direct opposition rather than restraint, the centrifugal forces generated within the engine. A magnetic coupling is created between a rotating disk and a stationary superconducting coil to create a massive inwardly-directed magnetic force. With the centrifugal forces opposed by an equal and opposite magnetic force, the large heavy disks could be dispensed with and replaced with a torque tube to hold the blades. The proof of this concept has been demonstrated and the thermal management of such a system studied in detail; this aspect, especially in the hot end of a gas turbine engine, remains a stiff but not impossible challenge. The potential payoffs in both military and commercial aviation and in the power generation industry are sufficient to warrant further serious studies for its application and optimization.

Magnetic field effects on ultrafast lattice compression dynamics of Si(111) crystal when excited by linearly-polarized femtosecond laser pulses

NASA Astrophysics Data System (ADS)

Hatanaka, Koji; Odaka, Hideho; Ono, Kimitoshi; Fukumura, Hiroshi

2007-03-01

Time-resolved X-ray diffraction measurements of Si (111) single crystal are performed when excited by linearly-polarized femtosecond laser pulses (780 nm, 260 fs, negatively-chirped, 1 kHz) under a magnetic field (0.47 T). Laser fluence on the sample surface is 40 mJ/cm^2, which is enough lower than the ablation threshold at 200 mJ/cm^2. Probing X-ray pulses of iron characteristic X-ray lines at 0.193604 and 0.193998 nm are generated by focusing femtosecond laser pulses onto audio-cassette tapes in air. Linearly-polarized femtosecond laser pulse irradiation onto Si(111) crystal surface induces transient lattice compression in the picosecond time range, which is confirmed by transient angle shift of X-ray diffraction to higher angles. Little difference of compression dynamics is observed when the laser polarization is changed from p to s-pol. without a magnetic field. On the other hand, under a magnetic field, the lattice compression dynamics changes when the laser is p-polarized which is vertical to the magnetic field vector. These results may be assigned to photo-carrier formation and energy-band distortion.

[Rehbein anterior resection in the treatment of Hirschsprung's congenital megacolon: Manual or stapler anastomosis - a comparative study].

PubMed

Holschneider, A M; Söylet, Y

1989-08-01

A prospective study was performed in 26 patients with Hirschsprung's disease operated on between 1984 and 1988 according to Rehbein but with a deep anterior anastomosis with a stapling device. The patients were compared with a group of 48 children with Hirschsprung's disease, operated on between 1978 and 1988, also according to Rehbein, but with a hand-sutured anastomosis. Postoperatively, the anastomosis performed by a stapling instrument that was larger and more elastic than the one sutured by hand. Early and later complications were less frequent in stapler anastomosis. Postoperatively, children with an autosuture anastomosis need a bouginage for 4 weeks (mean) whereas children with a hand sutured anastomosis had to be dilated for 12 weeks. Electromanometric studies in 10 children with a sutured and 8 with an autosutured anastomosis showed no physiological difference. Problems by performing autosuture-anastomosis in newborn with Hirschsprung's disease are discussed.

Bunch length compression method for free electron lasers to avoid parasitic compressions

DOEpatents

Douglas, David R.; Benson, Stephen; Nguyen, Dinh Cong; Tennant, Christopher; Wilson, Guy

2015-05-26

A method of bunch length compression method for a free electron laser (FEL) that avoids parasitic compressions by 1) applying acceleration on the falling portion of the RF waveform, 2) compressing using a positive momentum compaction (R.sub.56>0), and 3) compensating for aberration by using nonlinear magnets in the compressor beam line.

Laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for middle or lower esophageal carcinoma

PubMed Central

Ai, Bo; Zhang, Zheng

2014-01-01

Thoracoscopic mobilization of esophagus and laparoscopic mobilization of stomach with cervical anastomosis is employed widely in minimally invasive esophagectomy (MIE) for esophageal carcinoma. However, it is associated with high incidence of complications, including recurrent laryngeal nerve injury and anastomotic leak. This paper summarizes the key techniques in total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for MIE in 62 patients of middle or lower esophageal cancer between March 2012 and August 2013. Total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis was performed to treat the middle or lower esophageal cancer. Laparoscopic and thoracoscopic Ivor-Lewis esophagectomy was performed using a circular stapler (Johnson and Johnson) intrathoracically to staple esophagogastric anastomosis and reconstruct the digestive tract. In addition, we performed tension-relieving anastomotic suture and embedded with pedicled omental flap. Compared with the trans-orally inserted anvil (OrVil) approach, the technique reported here is safe, feasible and user-friendly. Total thoracoscopic intrathoracic anastomosis can be performed with a circular stapler (Johnson and Johnson). PMID:25276383

Laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for middle or lower esophageal carcinoma.

PubMed

Ai, Bo; Zhang, Zheng; Liao, Yongde

2014-09-01

Thoracoscopic mobilization of esophagus and laparoscopic mobilization of stomach with cervical anastomosis is employed widely in minimally invasive esophagectomy (MIE) for esophageal carcinoma. However, it is associated with high incidence of complications, including recurrent laryngeal nerve injury and anastomotic leak. This paper summarizes the key techniques in total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis for MIE in 62 patients of middle or lower esophageal cancer between March 2012 and August 2013. Total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis was performed to treat the middle or lower esophageal cancer. Laparoscopic and thoracoscopic Ivor-Lewis esophagectomy was performed using a circular stapler (Johnson and Johnson) intrathoracically to staple esophagogastric anastomosis and reconstruct the digestive tract. In addition, we performed tension-relieving anastomotic suture and embedded with pedicled omental flap. Compared with the trans-orally inserted anvil (OrVil) approach, the technique reported here is safe, feasible and user-friendly. Total thoracoscopic intrathoracic anastomosis can be performed with a circular stapler (Johnson and Johnson).

An Improved Analytical Model of the Local Interstellar Magnetic Field: The Extension to Compressibility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kleimann, Jens; Fichtner, Horst; Röken, Christian, E-mail: jk@tp4.rub.de, E-mail: hf@tp4.rub.de, E-mail: christian.roeken@mathematik.uni-regensburg.de

A previously published analytical magnetohydrodynamic model for the local interstellar magnetic field in the vicinity of the heliopause (Röken et al. 2015) is extended from incompressible to compressible, yet predominantly subsonic flow, considering both isothermal and adiabatic equations of state. Exact expressions and suitable approximations for the density and the flow velocity are derived and discussed. In addition to the stationary induction equation, these expressions also satisfy the momentum balance equation along stream lines. The practical usefulness of the corresponding, still exact, analytical magnetic field solution is assessed by comparing it quantitatively to results from a fully self-consistent magnetohydrodynamic simulationmore » of the interstellar magnetic field draping around the heliopause.« less

Completely staple-free hand-sewn laparoscopic anastomosis in colorectal surgery.

PubMed

Lipski, David; Dapri, Giovanni; Himpens, Jacques

2008-04-01

Colonic continuity following a laparoscopic left hemicolectomy is usually performed by using a circular stapler to achieve end-to-end colorectal anastomosis. However, not much consideration is given to the costs of this technique and the long-term risk of stenosis. In this paper, we report the first case of a completely staple-free hand-sewn laparoscopic colonic anastomosis (CSHLCA) following a laparoscopic left hemicolectomy for cancer. Total operative time was 170 minutes, and the time to perform the anastomosis was 38 minutes. The postoperative stay was uneventful, with a total hospital stay of 6 days. CSHLCA is feasible and can lower the cost of the laparoscopic procedure. It may be considered in countries with limited access to mechanical staplers.

Rectovaginal fistula following colectomy with an end-to-end anastomosis stapler for a colorectal adenocarcinoma.

PubMed

Klein, A; Scotti, S; Hidalgo, A; Viateau, V; Fayolle, P; Moissonnier, P

2006-12-01

An 11-year-old, female neutered Labrador retriever was presented with a micro-invasive differentiated papillar adenocarcinoma at the colorectal junction. A colorectal end-to-end anastomosis stapler device was used to perform resection and anastomosis using a transanal technique. A rectovaginal fistula was diagnosed two days later. An exploratory laparotomy was conducted and the fistula was identified and closed. Early dehiscence of the colon was also suspected and another colorectal anastomosis was performed using a manual technique. Comparison to a conventional manual technique of intestinal surgery showed that the use of an automatic staple device was quicker and easier. To the authors' knowledge, this is the first report of a rectovaginal fistula occurring after end-to-end anastomosis stapler colorectal resection-anastomosis in the dog. To minimise the risk of this potential complication associated with the limited surgical visibility, adequate tissue retraction and inspection of the anastomosis site are essential.

Stenosis of esophago-jejuno anastomosis after gastric surgery.

PubMed

Fukagawa, Takeo; Gotoda, Takuji; Oda, Ichiro; Deguchi, Yasunori; Saka, Makoto; Morita, Shinji; Katai, Hitoshi

2010-08-01

Stenosis of esophago-jejuno anastomosis is one of the postoperative complications of gastric surgery. This complication usually manifests with the symptom of dysphagia and is treated by endoscopic dilatation. No large-scale studies have been conducted to determine the incidence of this complication after surgery. The data of a total of 1478 consecutive patients who underwent total, proximal, or completion gastrectomy, including esophago-jejuno anastomosis, between 2000 and 2008 were analyzed retrospectively with a view to determining the incidence of anastomotic stenosis. Sixty patients (4.1%) developed stenosis of the esophago-jejuno anastomosis which needed to be treated by endoscopic balloon dilatation. The average interval between the surgery and detection of stenosis was 67.4 days (median = 58.0). Multivariate analysis identified female gender, proximal gastrectomy, use of a narrow-sized stapler, and the choice of the stapling device as significant factors influencing the risk of development of anastomotic stenosis. Esophago-jejuno anastomotic stenosis appears to be a common late postoperative complication after gastric surgery. Endoscopic examination and treatment yielded favorable outcomes in patients complaining of dysphagia after gastric surgery.

Strain driven sequential magnetic transitions in strained GdTiO3 on compressive substrates: a first-principles study.

PubMed

Yang, Li-Juan; Weng, Ya-Kui; Zhang, Hui-Min; Dong, Shuai

2014-11-26

The compressive strain effect on the magnetic ground state and electronic structure of strained GdTiO3 has been studied using the first-principles method. Unlike the cases of congeneric YTiO3 and LaTiO3, both of which become the A-type antiferromagnetism on the (0 0 1) LaAlO3 substrate despite their contrastive magnetism, the ground state of strained GdTiO3 on the LaAlO3 substrate changes from the original ferromagnetism to a G-type antiferromagnetim, instead of the A-type one although Gd(3+) is between Y(3+) and La(3+). It is only when the in-plane compressive strain is large enough, e.g. on the (0 0 1) YAlO3 substrate, that the ground state finally becomes the A-type. The band structure calculation shows that the compressive strained GdTiO3 remains insulating, although the band gap changes a little in the strained GdTiO3.

Implementing and diagnosing magnetic flux compression on the Z pulsed power accelerator

DOE Office of Scientific and Technical Information (OSTI.GOV)

McBride, Ryan D.; Bliss, David E.; Gomez, Matthew R.

2015-11-01

We report on the progress made to date for a Laboratory Directed Research and Development (LDRD) project aimed at diagnosing magnetic flux compression on the Z pulsed-power accelerator (0-20 MA in 100 ns). Each experiment consisted of an initially solid Be or Al liner (cylindrical tube), which was imploded using the Z accelerator's drive current (0-20 MA in 100 ns). The imploding liner compresses a 10-T axial seed field, B z ( 0 ) , supplied by an independently driven Helmholtz coil pair. Assuming perfect flux conservation, the axial field amplification should be well described by B z ( tmore » ) = B z ( 0 ) x [ R ( 0 ) / R ( t )] 2 , where R is the liner's inner surface radius. With perfect flux conservation, B z ( t ) and dB z / dt values exceeding 10 4 T and 10 12 T/s, respectively, are expected. These large values, the diminishing liner volume, and the harsh environment on Z, make it particularly challenging to measure these fields. We report on our latest efforts to do so using three primary techniques: (1) micro B-dot probes to measure the fringe fields associated with flux compression, (2) streaked visible Zeeman absorption spectroscopy, and (3) fiber-based Faraday rotation. We also mention two new techniques that make use of the neutron diagnostics suite on Z. These techniques were not developed under this LDRD, but they could influence how we prioritize our efforts to diagnose magnetic flux compression on Z in the future. The first technique is based on the yield ratio of secondary DT to primary DD reactions. The second technique makes use of the secondary DT neutron time-of-flight energy spectra. Both of these techniques have been used successfully to infer the degree of magnetization at stagnation in fully integrated Magnetized Liner Inertial Fusion (MagLIF) experiments on Z [P. F. Schmit et al. , Phys. Rev. Lett. 113 , 155004 (2014); P. F. Knapp et al. , Phys. Plasmas, 22 , 056312 (2015)]. Finally, we present some recent developments for designing and

Endoscopic intestinal bypass creation by using self-assembling magnets in a porcine model.

PubMed

Ryou, Marvin; Agoston, A Tony; Thompson, Christopher C

2016-04-01

A purely endoluminal method of GI bypass would be desirable for the treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets that create large-caliber anastomoses (Incisionless Anastomosis System [IAS]). The aim of this study was to evaluate procedural characteristics of IAS deployment and long-term anastomotic integrity and patency. We performed a 3-month survival study of Yorkshire pigs (5 interventions, 3 controls). Intervention pigs underwent simultaneous enteroscopy/colonoscopy performed with the animals under intravenous sedation. The IAS magnets were deployed and coupled with reciprocal magnets under fluoroscopy. Every 3 to 6 days pigs underwent endoscopy until jejunocolonic anastomosis (dual-path bypass) creation and magnet expulsion. Necropsies and histological evaluation were performed. The primary endpoints were technical success; secondary endpoints of anastomosis integrity, patency, and histological characteristics were weight trends. Under intravenous sedation, endoscopic bypass creation by using IAS magnets was successfully performed in 5 of 5 pigs (100%). Given porcine anatomy, the easiest dual-path bypass to create was between the proximal jejunum and colon. The mean procedure time was 14.7 minutes. Patent, leak-free anastomoses formed by day 4. All IAS magnets were expelled by day 12. All anastomoses were fully patent at 3 months with a mean diameter of 3.5 cm. The mean 3-month weight was 45 kg in bypass pigs and 78 kg in controls (P = .01). At necropsy, adhesions were absent. Histology showed full re-epithelialization across the anastomosis without fibrosis or inflammation. Large-caliber, leak-free, foreign body-free endoscopic intestinal bypass by using IAS magnets can be safely and rapidly performed in the porcine by model using only intravenous sedation. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Reconstruction of the jejunoesophageal anastomosis with a circular mechanical stapler in total laryngopharyngectomy defects.

PubMed

Schneider, Daniel S; Gross, Neil D; Sheppard, Brett C; Wax, Mark K

2012-05-01

The aim of this study was to demonstrate the technical feasibility and potential benefits of using a circular mechanical stapler with free jejunal transfer for jejunoesophageal anastomosis in total laryngopharyngectomy reconstruction while comparing the rates of fistula and stricture. This study was a retrospective review of 12 free jejunal flaps completed with circular mechanical stapler for the jejunoesophageal anastomosis with comparison to 17 jejunal free flaps where all anastomoses were hand sewn. In all, 29 patients underwent free jejunal transfer: 12 had jejunal free flap with circular mechanical stapler for jejunoesophageal anastomosis, whereas 17 patients had hand-sewn anastomosis. Corresponding rates of fistula and stricture were 0/12 fistulas and 3/12 strictures in the stapler cohort and 2/17 fistulas with 0/17 strictures in the hand-sewn cohort. No statistically significant difference in rate of fistula was observed between each cohort, whereas a trend toward increased rate of stricture (p = .06) was observed in the stapled anastomosis cohort. Use of circular mechanical stapler appears to be a safe and effective technique at the jejunoesophageal anastomosis for total laryngopharyngeal defects with comparable fistula and stricture rates to grafts that are hand sewn. Copyright © 2011 Wiley Periodicals, Inc.

Magnetic resonance imaging validation of pituitary gland compression and distortion by typical sellar pathology.

PubMed

Cho, Charles H; Barkhoudarian, Garni; Hsu, Liangge; Bi, Wenya Linda; Zamani, Amir A; Laws, Edward R

2013-12-01

Identification of the normal pituitary gland is an important component of presurgical planning, defining many aspects of the surgical approach and facilitating normal gland preservation. Magnetic resonance imaging is a proven imaging modality for optimal soft-tissue contrast discrimination in the brain. This study is designed to validate the accuracy of localization of the normal pituitary gland with MRI in a cohort of surgical patients with pituitary mass lesions, and to evaluate for correlation between presurgical pituitary hormone values and pituitary gland characteristics on neuroimaging. Fifty-eight consecutive patients with pituitary mass lesions were included in the study. Anterior pituitary hormone levels were measured preoperatively in all patients. Video recordings from the endoscopic or microscopic surgical procedures were available for evaluation in 47 cases. Intraoperative identification of the normal gland was possible in 43 of 58 cases. Retrospective MR images were reviewed in a blinded fashion for the 43 cases, emphasizing the position of the normal gland and the extent of compression and displacement by the lesion. There was excellent agreement between imaging and surgery in 84% of the cases for normal gland localization, and in 70% for compression or noncompression of the normal gland. There was no consistent correlation between preoperative pituitary dysfunction and pituitary gland localization on imaging, gland identification during surgery, or pituitary gland compression. Magnetic resonance imaging proved to be accurate in identifying the normal gland in patients with pituitary mass lesions, and was useful for preoperative surgical planning.

Pure transumbilical SILS gastric bypass with mechanical circular gastrojejunal anastomosis feasibility.

PubMed

Pitot, Denis; Takieddine, Mazen; Abbassi, Ziad; Agrafiotis, Apostolos; Bruyns, Laurence; Ceuterick, Michel; Daoudi, Nabil; Dolimont, Amaury; Soulimani, Abdelak; Vaneukem, Pol

2014-10-01

Since Wittgrove introduced the laparoscopic version of the gastric bypass in 1994, the interest still remains in the decrease of the abdominal wall trauma in order to optimize the benefits of laparoscopy on postoperative pain, cosmesis, hospital stay, and convalescence in bariatric patients. This work is to report the feasibility of gastric bypass surgery by a pure transumbilical single-incision laparoscopic surgery (SILS) with a mechanical circular gastrojejunal anastomosis. Thirty-four patients (10 males and 24 females) were offered to receive gastric bypass with circular mechanical gastrojejunal anastomosis by Single Incision Laparoscopic Surgery (SILS) using pure transumbilical access. Anastomotic leak occurrence was the primary end-point. Patients demographics, operative time, additional trocarts, hemorrhage, intra abdominal abscess, length of post-operative stay, readmission, 30 days death, gastrojejunal anastomosis stricture, marginal ulcers, reflux complains, seromas, incisional hernias, and % excess BMI loss were also recorded in a prospective database. Primary end-point showed no anastomotic leak occurrence during the hospital stay or during the first 30 post-operative days. SILS gastric bypass with a circular mechanical gastrojejunal anastomosis is feasible and seems to be safe.

Microvascular anastomosis guidance and evaluation using real-time three-dimensional Fourier-domain Doppler optical coherence tomography

PubMed Central

Ibrahim, Zuhaib; Tong, Dedi; Zhu, Shan; Mao, Qi; Pang, John; Andrew Lee, Wei Ping; Brandacher, Gerald; Kang, Jin U.

2013-01-01

Abstract. Vascular and microvascular anastomoses are critical components of reconstructive microsurgery, vascular surgery, and transplant surgery. Intraoperative surgical guidance using a surgical imaging modality that provides an in-depth view and three-dimensional (3-D) imaging can potentially improve outcome following both conventional and innovative anastomosis techniques. Objective postoperative imaging of the anastomosed vessel can potentially improve the salvage rate when combined with other clinical assessment tools, such as capillary refill, temperature, blanching, and skin turgor. Compared to other contemporary postoperative monitoring modalities—computed tomography angiograms, magnetic resonance (MR) angiograms, and ultrasound Doppler—optical coherence tomography (OCT) is a noninvasive high-resolution (micron-level), high-speed, 3-D imaging modality that has been adopted widely in biomedical and clinical applications. For the first time, to the best of our knowledge, the feasibility of real-time 3-D phase-resolved Doppler OCT (PRDOCT) as an assisted intra- and postoperative imaging modality for microvascular anastomosis of rodent femoral vessels is demonstrated, which will provide new insights and a potential breakthrough to microvascular and supermicrovascular surgery. PMID:23856833

[Feasibility and effectiveness of laparoscopic right colectomy with extracorporeal anastomosis].

PubMed

Feroci, F; Lenzi, E; Kröning, K C; Moraldi, L; Cantafio, S; Borrelli, A; Giaconi, G; Scatizzi, M

2011-02-01

Despite the laparoscopic right hemicolectomy has been validated by many randomized prospective trials, clear evidences on the validity of the totally mini-invasive technique, namely, through intracorporeal anastomosis, are still lacking. The aim of this study was the assessment of short-term outcome within three months from laparoscopic right colectomy with intra- or extra-corporeal anastomosis. With no exclusion, all patients undergoing laparoscopic right hemicolectomy at our institution have been enrolled in this study. Group A included patients undergoing laparoscopic right hemicolectomy with extracorporeal anastomosis (LAC) and Group B, included patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (TLC). Patients' data, surgery details, results of postoperative period and histological tests have been prospectively recorded in a database and analysed. Between December 2006 and December 2008, 45 patients underwent right hemicolectomy, 21 with extracorporeal anastomosis and 24 had intracorporeal ones. As to patients' characteristics and histopathological results there are no difference between the groups. Anastomotic dehiscence occurred one in group A and one in group B (P>0.05). Both patients underwent reoperation. We recorded 6 postoperative ileus with vomiting in the LAC group and only 1 in the TLC group (P<0.05). The incidence of Non-Surgical Site Complications (NSSC) was of 4.54% in LAC group and 8.33% in TLC group (P>0.05). Hospitalization was of 5 days for both groups. In conclusion, we believe that this technique is feasible in terms of safety; it doesn't significatively affect the length of surgical procedure and guarantees maintenance of oncological radicality standards of reference. Besides it significatively improves quality of the post-operative period.

Robot-assisted vasovasostomy using a single layer anastomosis.

PubMed

Marshall, Michael T; Doudt, Alexander D; Berger, Jonathan H; Auge, Brian K; Christman, Matthew S; Choe, Chong H

2017-09-01

Of all patients who have vasectomies performed in the United States, upwards of 6% will pursue a vasectomy reversal. Currently, the gold-standard reversal procedure is a microscopic vasovasostomy utilizing either a one or two-layer vasal anastomosis. Unfortunately, most urologists do not perform these procedures as they require extensive training and experience in microsurgery. The objective of our study was to evaluate the feasibility and success rate of robot-assisted vasovasostomy performed at our institution. We completed a retrospective review of our experience with vasectomy reversal utilizing the da Vinci ® Surgical System and a single layer vasal anastomosis. A successful reversal was defined as a return of sperm on semen analysis or light microscopy. Since 2009 we have completed 79 robotic vasectomy reversals, 60 of which utilized a single-layer vasal anastomosis. The average obstructive interval was 5.7 ± 2.2 years. Average operative time was 192 min. 42 patients returned for a post-operative semen evaluation at an average time of 4.3 months post-procedure revealing a success rate of 88% (37 out of 42). Post-operative semen parameters were significant for an average sperm density of 31.0 million/mL with an average motility of 29.1%. Robot-assisted vasovasostomy with a single layer anastomosis has overall success rates that are similar to that of reported microscopic vasovasostomy rates. Although more study is warranted with regard to cost, we feel as though our study demonstrates an alternative approach to vasectomy reversal that can be performed successfully by urologists trained in robotic surgery.

Applied axial magnetic field effects on laboratory plasma jets: Density hollowing, field compression, and azimuthal rotation

DOE PAGES

Byvank, T.; Banasek, J. T.; Potter, W. M.; ...

2017-12-07

We experimentally measure the effects of an applied axial magnetic field (B z) on laboratory plasma jets and compare experimental results with numerical simulations using an extended magnetohydrodynamics code. A 1 MA peak current, 100 ns rise time pulse power machine is used to generate the plasma jet. On application of the axial field, we observe on-axis density hollowing and a conical formation of the jet using interferometry, compression of the applied B z using magnetic B-dot probes, and azimuthal rotation of the jet using Thomson scattering. Experimentally, we find densities ≤ 5×10 17 cm -3 on-axis relative to jetmore » densities of ≥ 3×10 18 cm -3. For aluminum jets, 6.5 ± 0.5 mm above the foil, we find on-axis compression of the applied 1.0 ± 0.1 T B z to a total 2.4 ± 0.3 T, while simulations predict a peak compression to a total 3.4 T at the same location. On the aluminum jet boundary, we find ion azimuthal rotation velocities of 15-20 km/s, while simulations predict 14 km/s at the density peak. We discuss possible sources of discrepancy between the experiments and simulations, including: surface plasma on B-dot probes, optical fiber spatial resolution, simulation density floors, and 2D vs. 3D simulation effects. Lastly, this quantitative comparison between experiments and numerical simulations helps elucidate the underlying physics that determine the plasma dynamics of magnetized plasma jets.« less

Applied axial magnetic field effects on laboratory plasma jets: Density hollowing, field compression, and azimuthal rotation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Byvank, T.; Banasek, J. T.; Potter, W. M.

We experimentally measure the effects of an applied axial magnetic field (B z) on laboratory plasma jets and compare experimental results with numerical simulations using an extended magnetohydrodynamics code. A 1 MA peak current, 100 ns rise time pulse power machine is used to generate the plasma jet. On application of the axial field, we observe on-axis density hollowing and a conical formation of the jet using interferometry, compression of the applied B z using magnetic B-dot probes, and azimuthal rotation of the jet using Thomson scattering. Experimentally, we find densities ≤ 5×10 17 cm -3 on-axis relative to jetmore » densities of ≥ 3×10 18 cm -3. For aluminum jets, 6.5 ± 0.5 mm above the foil, we find on-axis compression of the applied 1.0 ± 0.1 T B z to a total 2.4 ± 0.3 T, while simulations predict a peak compression to a total 3.4 T at the same location. On the aluminum jet boundary, we find ion azimuthal rotation velocities of 15-20 km/s, while simulations predict 14 km/s at the density peak. We discuss possible sources of discrepancy between the experiments and simulations, including: surface plasma on B-dot probes, optical fiber spatial resolution, simulation density floors, and 2D vs. 3D simulation effects. Lastly, this quantitative comparison between experiments and numerical simulations helps elucidate the underlying physics that determine the plasma dynamics of magnetized plasma jets.« less

Effects of diosmine-hesperidine on experimental colonic anastomosis.

PubMed

Cengiz, A; Tabak, S; Kuru, S; Demirel, A H; Barlas, A M; Altun, T; Gonultas, M; Celepli, S; Kilicoglu, S S; Aydogan, A; Kilicoglu, B

2012-01-01

Our goal was to determine the effects of a diosmine-hesperidine combination on wound healing in a rat model of colonic anastomosis. In this study, 20 Wistar Albino female rats were randomized into four experimental groups containing five rats in each group. A segment of 1 cm of colon was excised 4 cm proximally to the peritoneal reflection in all rats without carrying out any mechanical or antibacterial bowel preparation. Colonic anastomosis was performed with interrupted, inverting sutures of 6/0 polypropylene. Beginning from the first postoperative day, the rats in Groups II and IV received 100 mg/kg per day of diosmine-hesperidine via orogastic route by 4F fine feeding catheter. A significant difference was detected between groups in terms of their hydroxyproline levels (p<0.05); the hydroxyproline level of Group I was significantly lower than that of the other groups while no significant difference was noted between Groups II and III. The administration of diosmine-hesperidine increased the amount of collagen and bursting pressures at the anastomotic site and thus had favorable influences on the healing of colonic anastomosis (Tab. 1, Fig. 3, Ref. 33).

Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer.

PubMed

Gooszen, J A H; Goense, L; Gisbertz, S S; Ruurda, J P; van Hillegersberg, R; van Berge Henegouwen, M I

2018-04-01

Studies comparing the anastomotic leak rate in patients with an intrathoracic versus a cervical anastomosis after oesophagectomy are equivocal. The aim of this study was to compare clinical outcome after oesophagectomy in patients with an intrathoracic or cervical anastomosis, and to identify predictors of anastomotic leakage in a nationwide audit. Between January 2011 and December 2015, all consecutive patients who underwent oesophagectomy for cancer were identified from the Dutch Upper Gastrointestinal Cancer Audit. For the comparison between an intrathoracic and cervical anastomosis, propensity score matching was used to adjust for potential confounders. Multivariable logistic regression modelling with backward stepwise selection was used to determine independent predictors of anastomotic leakage. Some 3348 patients were included. After propensity score matching, 654 patients were included in both the cervical and intrathoracic anastomosis groups. An intrathoracic anastomosis was associated with a lower leak rate than a cervical anastomosis (17·0 versus 21·9 per cent; P = 0·025). The percentage of patients with recurrent nerve paresis was also lower (0·6 versus 7·0 per cent; P < 0·001) and an intrathoracic anastomosis was associated with a shorter median hospital stay (12 versus 14 days; P = 0·001). Multivariable analysis revealed that ASA fitness grade III or higher, chronic obstructive pulmonary disease, cardiac arrhythmia, diabetes mellitus and proximal oesophageal tumours were independent predictors of anastomotic leakage. An intrathoracic oesophagogastric anastomosis was associated with a lower anastomotic leak rate, lower rate of recurrent nerve paresis and a shorter hospital stay. Risk factors for anastomotic leak were co-morbidities and proximal tumours. © 2018 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Hypoglossal-facial-jump-anastomosis without an interposition nerve graft.

PubMed

Beutner, Dirk; Luers, Jan C; Grosheva, Maria

2013-10-01

The hypoglossal-facial-anastomosis is the most often applied procedure for the reanimation of a long lasting peripheral facial nerve paralysis. The use of an interposition graft and its end-to-side anastomosis to the hypoglossal nerve allows the preservation of the tongue function and also requires two anastomosis sites and a free second donor nerve. We describe the modified technique of the hypoglossal-facial-jump-anastomosis without an interposition and present the first results. Retrospective case study. We performed the facial nerve reconstruction in five patients. The indication for the surgery was a long-standing facial paralysis with preserved portion distal to geniculate ganglion, absent voluntary activity in the needle facial electromyography, and an intact bilateral hypoglossal nerve. Following mastoidectomy, the facial nerve was mobilized in the fallopian canal down to its bifurcation in the parotid gland and cut in its tympanic portion distal to the lesion. Then, a tensionless end-to-side suture to the hypoglossal nerve was performed. The facial function was monitored up to 16 months postoperatively. The reconstruction technique succeeded in all patients: The facial function improved within the average time period of 10 months to the House-Brackmann score 3. This modified technique of the hypoglossal-facial reanimation is a valid method with good clinical results, especially in cases of a preserved intramastoidal facial nerve. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Interchange Method in Compressible Magnetized Couette Flow: Magnetorotational and Magnetoconvective Instabilities

NASA Astrophysics Data System (ADS)

Christodoulou, Dimitris M.; Contopoulos, John; Kazanas, Demosthenes

2003-03-01

We obtain the general forms of the axisymmetric stability criteria in a magnetized compressible Couette flow using an energy variational principle, the so-called interchange or Chandrasekhar's method, which we applied successfully in the incompressible case. This formulation accounts for the simultaneous presence of gravity, rotation, a toroidal magnetic field, a weak axial magnetic field, entropy gradients, and density gradients in the initial equilibrium state. The power of the method lies in its simplicity, which allows us to derive extremely compact and physically clear expressions for the relevant stability criteria despite the inclusion of so many physical effects. In the implementation of the method, all the applicable conservation laws are explicitly taken into account during the variations of a quantity with dimensions of energy that we call the ``free-energy function.'' As in the incompressible case, the presence of an axial field invalidates the conservation laws of angular momentum and azimuthal magnetic flux and introduces instead isorotation and axial current conservation along field lines. Our results are therefore markedly different depending on whether an axial magnetic field is present, and they generalize in two simple expressions all previously known, partial stability criteria for the appearance of magnetorotational instability. Furthermore, the coupling between magnetic tension and buoyancy and its influence to the dynamics of nonhomoentropic magnetized flows become quite clear from our results. In the limits of plane-parallel atmospheres and homoentropic flows, our formulation easily recovers the stability criteria for suppression of convective and Parker instabilities, as well as some related special cases studied over 40 years ago by Newcomb and Tserkovnikov via laborious variational techniques.

Flux Compression Magnetic Nozzle

NASA Technical Reports Server (NTRS)

Thio, Y. C. Francis; Schafer, Charles (Technical Monitor)

2001-01-01

In pulsed fusion propulsion schemes in which the fusion energy creates a radially expanding plasma, a magnetic nozzle is required to redirect the radially diverging flow of the expanding fusion plasma into a rearward axial flow, thereby producing a forward axial impulse to the vehicle. In a highly electrically conducting plasma, the presence of a magnetic field B in the plasma creates a pressure B(exp 2)/2(mu) in the plasma, the magnetic pressure. A gradient in the magnetic pressure can be used to decelerate the plasma traveling in the direction of increasing magnetic field, or to accelerate a plasma from rest in the direction of decreasing magnetic pressure. In principle, ignoring dissipative processes, it is possible to design magnetic configurations to produce an 'elastic' deflection of a plasma beam. In particular, it is conceivable that, by an appropriate arrangement of a set of coils, a good approximation to a parabolic 'magnetic mirror' may be formed, such that a beam of charged particles emanating from the focal point of the parabolic mirror would be reflected by the mirror to travel axially away from the mirror. The degree to which this may be accomplished depends on the degree of control one has over the flux surface of the magnetic field, which changes as a result of its interaction with a moving plasma.

Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses.

PubMed

Naito, Masanori; Miura, Hirohisa; Nakamura, Takatoshi; Sato, Takeo; Yamanashi, Takahiro; Tsutsui, Atsuko; Watanabe, Masahiko

2017-05-01

Gastrointestinal anastomosis remains associated with a considerable burden of morbidity and, in some cases, mortality. Functional end-to-end anastomosis, whilst extremely efficient, is vulnerable to increased intestinal pressure in the immediate postoperative period, which may predispose to development of anastomotic leakage or bleeding. Therefore, there is a requirement for new techniques that facilitate safe and efficacious anastomotic procedures. This study examined the clinical application of functional end-to-end anastomosis with a stapler that automatically applies a bioabsorbable polyglycolic acid sheet (Endo GIA™ Reinforced Reload with Tri-Staple™ Technology). A porcine model was used to examine functional end-to-end anastomosis with and without application of a bioabsorbable polyglycolic acid sheet. As the crotch of the anastomosis is considered the weakest point, a probe was used to test the integrity of these anastomoses. Furthermore, we performed functional end-to-end anastomosis using the Endo GIA™ Reinforced stapler in a clinical series of 20 patients undergoing gastrointestinal tract resection. In all cases, functional end-to-end anastomosis was performed without suture reinforcement. Small intestine anastomoses in the animal study exhibited no weakness at the crotch of the anastomosis, as tested with a probe, suggesting an increased resiliency to conventional complications of functional end-to-end anastomosis. In the clinical population, no postoperative complications were noted. No adhesive intestinal obstruction was noted. Sutureless functional end-to-end anastomosis using the Endo GIA™ Reinforced appears to be safe, efficacious, and straightforward. Reinforcement of the crotch site with a bioabsorbable polyglycolic acid sheet appears to mitigate conventional problems with crotch-site vulnerability.

Primary anastomosis or ostomy in necrotizing enterocolitis?

PubMed

Haricharan, Ramanathapura N; Gallimore, Jade Palazzola; Nasr, Ahmed

2017-11-01

In neonates requiring operation for necrotizing enterocolitis (NEC), the complications due to enterostomy (ES) and the need for another operation to restore continuity have prompted several surgeons to employ primary anastomosis (PA) after resection as the operative strategy of choice. Our objective was to compare primary anastomosis to stoma formation in this population using systematic review and meta-analysis. Publications describing both interventions were identified by searching multiple databases. Appropriate studies that reported outcomes after PA and ES for NEC were included for analysis that was performed using the MedCalc3000 software. Results are reported as odds ratios (OR, 95% CI). No randomized trials were identified. Twelve studies were included for the final analysis. Neonates who underwent PA were associated with significantly less risk of mortality when compared to those who underwent ES (OR 0.34, 95% CI 0.17-0.68, p 0.002), possibly due to differences in severity of NEC. Although the types of complications in these groups were different, there was no significant difference in risk of complication (OR 0.86, 0.55-1.33, p 0.50). In neonates undergoing an operation for severe NEC, there is no significant difference in the risk of complications between primary anastomosis and enterostomy. A definitive suggestion cannot be made regarding the choice of one operative strategy over another.

Computational simulation of breast compression based on segmented breast and fibroglandular tissues on magnetic resonance images.

PubMed

Shih, Tzu-Ching; Chen, Jeon-Hor; Liu, Dongxu; Nie, Ke; Sun, Lizhi; Lin, Muqing; Chang, Daniel; Nalcioglu, Orhan; Su, Min-Ying

2010-07-21

This study presents a finite element-based computational model to simulate the three-dimensional deformation of a breast and fibroglandular tissues under compression. The simulation was based on 3D MR images of the breast, and craniocaudal and mediolateral oblique compression, as used in mammography, was applied. The geometry of the whole breast and the segmented fibroglandular tissues within the breast were reconstructed using triangular meshes by using the Avizo 6.0 software package. Due to the large deformation in breast compression, a finite element model was used to simulate the nonlinear elastic tissue deformation under compression, using the MSC.Marc software package. The model was tested in four cases. The results showed a higher displacement along the compression direction compared to the other two directions. The compressed breast thickness in these four cases at a compression ratio of 60% was in the range of 5-7 cm, which is a typical range of thickness in mammography. The projection of the fibroglandular tissue mesh at a compression ratio of 60% was compared to the corresponding mammograms of two women, and they demonstrated spatially matched distributions. However, since the compression was based on magnetic resonance imaging (MRI), which has much coarser spatial resolution than the in-plane resolution of mammography, this method is unlikely to generate a synthetic mammogram close to the clinical quality. Whether this model may be used to understand the technical factors that may impact the variations in breast density needs further investigation. Since this method can be applied to simulate compression of the breast at different views and different compression levels, another possible application is to provide a tool for comparing breast images acquired using different imaging modalities--such as MRI, mammography, whole breast ultrasound and molecular imaging--that are performed using different body positions and under different compression conditions.

Total mechanical stapled oesophagogastric anastomosis on the neck in oesophageal cancer - prevention of postoperative mediastinal complications.

PubMed

Zieliński, Jacek; Jaworski, Radosław; Irga-Jaworska, Ninela; Haponiuk, Ireneusz; Jaśkiewicz, Janusz

2015-12-01

Oesophagogastric anastomosis after oesophagus resection is commonly performed on the neck. Even though a few different techniques of oesophagogastric anastomosis have been previously detailed, both manual and mechanical procedures have been burdened with leakages and strictures. Our simple technique of oesophagogastric anastomosis is a modification of mechanical anastomosis with the use of a circular stapler in order to prevent postoperative leak and concomitant mediastinal complications. Since 2008, we have performed nine oesophagogastric anastomoses following oesophagus resection. The mean age of the operated patients was 54 years. There was no mortality among the operated patients in the early post-operative period. The mean follow-up period for the patients operated on in our department was 17 months until the time of the analysis. None of the patients showed any leakage or stricture, and no mediastinal complications were reported in the group. Following our own experience, mechanical anastomosis with the use of a circular stapler seems to decrease the time of the operation as well as significantly reducing the incidence of leakages from the anastomosis. This type of anastomosis may decrease the number of postoperative strictures and the most dangerous mediastinal infections.

Strain driven sequential magnetic transitions in strained GdTiO3 on compressive substrates: a first-principles study

NASA Astrophysics Data System (ADS)

Yang, Li-Juan; Weng, Ya-Kui; Zhang, Hui-Min; Dong, Shuai

2014-11-01

The compressive strain effect on the magnetic ground state and electronic structure of strained GdTiO3 has been studied using the first-principles method. Unlike the cases of congeneric YTiO3 and LaTiO3, both of which become the A-type antiferromagnetism on the (0 0 1) LaAlO3 substrate despite their contrastive magnetism, the ground state of strained GdTiO3 on the LaAlO3 substrate changes from the original ferromagnetism to a G-type antiferromagnetim, instead of the A-type one although Gd3+ is between Y3+ and La3+. It is only when the in-plane compressive strain is large enough, e.g. on the (0 0 1) YAlO3 substrate, that the ground state finally becomes the A-type. The band structure calculation shows that the compressive strained GdTiO3 remains insulating, although the band gap changes a little in the strained GdTiO3.

Antireflux Status Post Roux-en-Y anastomosis: An Experimental Study for Optimal Antireflux Technique.

PubMed

Verma, Ajay Kumar; Purbey, Om Prakash; Kureel, Shiv Narain; Gupta, Archika; Pandey, Anand; Sunil, Kanoujia; Chaubey, Digamber

2018-01-01

Roux-en-Y hepaticojejunostomy has been a gold standard to establish biliary-enteric anastomosis for various surgical indications, but associated with variable incidences of cholangitis. This experimental study was conducted to report a modification in Roux-en-Y anastomosis for possible better alternative to provide antireflux procedure after Roux-en-Y biliary-enteric anastomosis with the aim to minimize the possibility of reflux and its consequences. For experimental study, the required fresh segment of Lamb's small intestine was procured. Three sets of Roux-en-Y anastomosis were created for each experiment. In set 1, there was simple Roux-en-Y anastomosis. In set 2, Roux-en-Y anastomosis along with 4-5 cm long spur between the hepatic and duodenal limbs was created. In set 3, in addition to Roux-en-Y with creation of spur, additional antireflux mechanism was created at the junction of upper two-third and lower one-third of the hepatic limb. Saline mixed contrast was infused by infusion pump to raise the intraluminal pressure to more than 10 cm of H 2 O. X-ray was taken at that time. In set 1, all preparations demonstrated reflux of contrast in the hepatic limb. The set 2 also demonstrated the same findings of 100% reflux in the hepatic limb. In set 3, No reflux was observed in 8 (80%) preparations while remaining 2 (20%) preparations reveal partial reflux. This experimental study suggests that the provision of spur and additional valve may be able to decrease the possibility of reflux in Roux-en-Y biliary-enteric anastomosis.

Laser Assisted Microsurgical Anastomosis.

DTIC Science & Technology

1983-09-22

motion exercises of the patient post surgery and for the development of appropriate regimes for nursing and general rehabilitation of the patient...8217AD-Ai4S 48? LASER ASSISTED MICROSUROICAL ANASTOMOSIS(U) MIAMI UNIV i/i FL DEPT OF ORTHOPAEDICS AND REHABILITATION N E BURKHALTER 22 SEP 83 NBBI4-i-K...William E. Burkhalter, M.D. NOO014-81-K-0446 Professor of Orthopaedics and Rehabilitation 0. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM

Automatic aortic anastomosis with an innovative computer-controlled circular stapler for surgical treatment of aortic aneurysm.

PubMed

Takata, Munehisa; Watanabe, Go; Ohtake, Hiroshi; Ushijima, Teruaki; Yamaguchi, Shojiro; Kikuchi, Yujiro; Yamamoto, Yoshitaka

2011-05-01

This study applied a computer-controlled mechanical stapler to vascular end-to-end anastomosis to achieve an automatic aortic anastomosis between the aorta and an artificial graft. In this experimental study, we created a mechanical end-to-end anastomotic model and assessed the strength of the anastomotic site under high pressure. We used a computer-controlled circular stapler named iDrive (Power Medical Interventions, Covidien plc, Dublin, Ireland) for the anastomosis between the porcine aorta and an artificial graft. Then the mechanically stapled group (group A) and the manually sutured group (group B) were compared 10 times, and we assessed the differences at several levels of pressure. To use a mechanical stapler in vascular anastomosis, some special preparations of both the aorta and the artificial graft are necessary to narrow the open end before the procedures. To solve this problem, we established a specially designed purse-string suture for both and finally established end-to-end vascular anastomosis. The anastomosis speed of group A was statistically significantly faster than that of group B (P < .01). The group A anastomotic sites also showed significantly more tolerance to high pressure than those of group B. The computer-controlled stapling device enabled reliable anastomosis of the aorta and the artificial graft. This study showed that mechanical vascular anastomosis with the iDrive was sufficiently strong and safe relative to manual suturing. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Evaluation of Heterogeneous Metabolic Profile in an Orthotopic Human Glioblastoma Xenograft Model Using Compressed Sensing Hyperpolarized 3D 13C Magnetic Resonance Spectroscopic Imaging

PubMed Central

Park, Ilwoo; Hu, Simon; Bok, Robert; Ozawa, Tomoko; Ito, Motokazu; Mukherjee, Joydeep; Phillips, Joanna J.; James, C. David; Pieper, Russell O.; Ronen, Sabrina M.; Vigneron, Daniel B.; Nelson, Sarah J.

2013-01-01

High resolution compressed sensing hyperpolarized 13C magnetic resonance spectroscopic imaging was applied in orthotopic human glioblastoma xenografts for quantitative assessment of spatial variations in 13C metabolic profiles and comparison with histopathology. A new compressed sensing sampling design with a factor of 3.72 acceleration was implemented to enable a factor of 4 increase in spatial resolution. Compressed sensing 3D 13C magnetic resonance spectroscopic imaging data were acquired from a phantom and 10 tumor-bearing rats following injection of hyperpolarized [1-13C]-pyruvate using a 3T scanner. The 13C metabolic profiles were compared with hematoxylin and eosin staining and carbonic anhydrase 9 staining. The high-resolution compressed sensing 13C magnetic resonance spectroscopic imaging data enabled the differentiation of distinct 13C metabolite patterns within abnormal tissues with high specificity in similar scan times compared to the fully sampled method. The results from pathology confirmed the different characteristics of 13C metabolic profiles between viable, non-necrotic, nonhypoxic tumor, and necrotic, hypoxic tissue. PMID:22851374

Evaluation of heterogeneous metabolic profile in an orthotopic human glioblastoma xenograft model using compressed sensing hyperpolarized 3D 13C magnetic resonance spectroscopic imaging.

PubMed

Park, Ilwoo; Hu, Simon; Bok, Robert; Ozawa, Tomoko; Ito, Motokazu; Mukherjee, Joydeep; Phillips, Joanna J; James, C David; Pieper, Russell O; Ronen, Sabrina M; Vigneron, Daniel B; Nelson, Sarah J

2013-07-01

High resolution compressed sensing hyperpolarized (13)C magnetic resonance spectroscopic imaging was applied in orthotopic human glioblastoma xenografts for quantitative assessment of spatial variations in (13)C metabolic profiles and comparison with histopathology. A new compressed sensing sampling design with a factor of 3.72 acceleration was implemented to enable a factor of 4 increase in spatial resolution. Compressed sensing 3D (13)C magnetic resonance spectroscopic imaging data were acquired from a phantom and 10 tumor-bearing rats following injection of hyperpolarized [1-(13)C]-pyruvate using a 3T scanner. The (13)C metabolic profiles were compared with hematoxylin and eosin staining and carbonic anhydrase 9 staining. The high-resolution compressed sensing (13)C magnetic resonance spectroscopic imaging data enabled the differentiation of distinct (13)C metabolite patterns within abnormal tissues with high specificity in similar scan times compared to the fully sampled method. The results from pathology confirmed the different characteristics of (13)C metabolic profiles between viable, non-necrotic, nonhypoxic tumor, and necrotic, hypoxic tissue. Copyright © 2012 Wiley Periodicals, Inc.

Development of compact explosively driven ferromagnetic seed source for helical magnetic flux compression generator

NASA Astrophysics Data System (ADS)

Liu, Peng; Zhang, He; Ma, Shaojie; Shi, Yunlei

2018-05-01

A compact explosively driven ferromagnetic generator (FMG) is developed for seed power source of helical magnetic flux compression generator (HMFCG). The mechanism of FMG is studied by establishing a magnetoelectric conversion model. Analytical calculations and numerical simulations are conducted on the magnetostatic field of open-circuit magnet in FMG. The calculation method for the magnet's cross-sectional magnetic flux is obtained. The pulse sources made of different materials and equipped with different initiation modes are experimentally explored. Besides, the dynamic coupling experiments of FMG and HMFCG are carried out. The results show that, N35 single-ended and double-ended initiating FMGs have an energy conversion efficiency ηt not less than 14.6% and 24.4%, respectively; FMG has an output pulse current not less than 4kA and an energy of about 3J on 320nH inductive load; HMFCG experiences energy gains of about 2-3 times. FMG and HMFCG can be coupled to form a full-blast electrical driving pulse source.

Compressed NMR: Combining compressive sampling and pure shift NMR techniques.

PubMed

Aguilar, Juan A; Kenwright, Alan M

2017-12-26

Historically, the resolution of multidimensional nuclear magnetic resonance (NMR) has been orders of magnitude lower than the intrinsic resolution that NMR spectrometers are capable of producing. The slowness of Nyquist sampling as well as the existence of signals as multiplets instead of singlets have been two of the main reasons for this underperformance. Fortunately, two compressive techniques have appeared that can overcome these limitations. Compressive sensing, also known as compressed sampling (CS), avoids the first limitation by exploiting the compressibility of typical NMR spectra, thus allowing sampling at sub-Nyquist rates, and pure shift techniques eliminate the second issue "compressing" multiplets into singlets. This paper explores the possibilities and challenges presented by this combination (compressed NMR). First, a description of the CS framework is given, followed by a description of the importance of combining it with the right pure shift experiment. Second, examples of compressed NMR spectra and how they can be combined with covariance methods will be shown. Copyright © 2017 John Wiley & Sons, Ltd.

Tomographic Image Compression Using Multidimensional Transforms.

ERIC Educational Resources Information Center

Villasenor, John D.

1994-01-01

Describes a method for compressing tomographic images obtained using Positron Emission Tomography (PET) and Magnetic Resonance (MR) by applying transform compression using all available dimensions. This takes maximum advantage of redundancy of the data, allowing significant increases in compression efficiency and performance. (13 references) (KRN)

Temperature behavior of the magnetoresistance hysteresis in a granular high-temperature superconductor: Magnetic flux compression in the intergrain medium

NASA Astrophysics Data System (ADS)

Semenov, S. V.; Balaev, D. A.

2018-07-01

Granular high-temperature superconductors (HTSs) are characterized by the hysteretic behavior of magnetoresistance. This phenomenon is attributed to the effective field in the intergrain medium of a granular HTS. At the grain boundaries, which are, in fact, weak Josephson couplings, the dissipation is observed. The effective field in the intergrain medium is a superposition of the external field and the field induced by magnetic moments of HTS grains. Meanwhile, analysis of the field width of the R(H) magnetoresistance hysteresis ΔH = Hdec - Hinc at Hdec = const, where Hinc and Hdec are increasing and decreasing branches of the R(H) hysteretic dependence, shows that the effective field in the intergrain medium exceeds by far both the external field and the field induced by magnetic moments of HTS grains. This situation suggests the magnetic flux compression in the intergrain medium because of the small length of grain boundaries, which amounts to ∼1 nm, i.e., is comparable with the coherence length and corresponds to Josephson tunneling in HTS materials. In this work, using the previously developed approach, we examine experimental data on the magnetoresistance and magnetization hysteresis in the granular YBa2Cu3O7 HTS compound in the range from 77 K to the critical temperature. According to the results obtained, the degree of magnetic flux compression determined by the parameter α in the expression for the effective field Beff(H) = H - 4π M(H) α in the intergrain medium remains constant over the investigated temperature range. All the features of the observed evolution of the R(H) hysteretic dependences are explained well within the proposed approach when the expression for Beff(H) contains the experimental M(H) magnetization data and the parameter α of about 20-25. The latter is indicative of the dominant effect of magnetic flux compression in the intergrain medium on the transport properties of granular HTS materials.

In vitro large diameter bowel anastomosis using a temperature controlled laser tissue soldering system and albumin stent.

PubMed

Spector, David; Rabi, Yaron; Vasserman, Irena; Hardy, Amos; Klausner, Joseph; Rabau, Micha; Katzir, Abraham

2009-09-01

In today's age of advancing surgical technology, there is a need for better and simpler methods of tissue bonding. The use of lasers for tissue welding or soldering is one of these sutureless methods. In 30 years of laser tissue bonding (LTB) research, published reports of cylindrical organ anastomosis were limited to small diameters. The tension resisted by the anastomosis, which is caused by the intraluminal pressure, is also proportional to the organ diameter. Therefore the anastomosis of large diameter organs requires significantly stronger mechanical strength. The aim of this study is to demonstrate such an anastomosis. In vitro anastomosis of porcine small bowel was performed by either LTB or sutures. Anastomosis in the laser group (number of samples, n = 15) included two main stages of soldering. The bowel edges were approximated over a solid albumin stent and heated with a temperature controlled GaAs laser system to 75 degrees C. This was followed by spreading liquid albumin on the anastomotic line and heating by the same system again to 75 degrees C. The control group (n = 5) was sutured anastomosis. All anastomoses were assessed by burst pressure measurement. The burst pressure of the laser group attained 170+/-40 mmHg which was significantly higher than that of the sutured group 83+/-37 mmHg (P < 0.001). This report describes the in vitro LTB anastomosis of a large diameter cylindrical organ. The immediate bond strength, as estimated by burst pressure measurements, was double compared to sutured anastomosis.

A novel 3D Cartesian random sampling strategy for Compressive Sensing Magnetic Resonance Imaging.

PubMed

Valvano, Giuseppe; Martini, Nicola; Santarelli, Maria Filomena; Chiappino, Dante; Landini, Luigi

2015-01-01

In this work we propose a novel acquisition strategy for accelerated 3D Compressive Sensing Magnetic Resonance Imaging (CS-MRI). This strategy is based on a 3D cartesian sampling with random switching of the frequency encoding direction with other K-space directions. Two 3D sampling strategies are presented. In the first strategy, the frequency encoding direction is randomly switched with one of the two phase encoding directions. In the second strategy, the frequency encoding direction is randomly chosen between all the directions of the K-Space. These strategies can lower the coherence of the acquisition, in order to produce reduced aliasing artifacts and to achieve a better image quality after Compressive Sensing (CS) reconstruction. Furthermore, the proposed strategies can reduce the typical smoothing of CS due to the limited sampling of high frequency locations. We demonstrated by means of simulations that the proposed acquisition strategies outperformed the standard Compressive Sensing acquisition. This results in a better quality of the reconstructed images and in a greater achievable acceleration.

Advantages and disadvantages of mechanical vs. manual anastomosis in colorectal surgery. A prospective study.

PubMed

Cajozzo, M; Compagno, G; DiTora, P; Spallitta, S I; Bazan, P

1990-02-01

The merits of mechanical versus manual anastomosis were evaluated in a prospective study of 48 patients undergoing resection of colonic or rectal cancer. The analyzed factors included the time required for construction of the anastomosis, the length of hospital stay, the cost/benefit ratio and complications. The anastomosis was manually performed with monolayer polyglactin 910 sutures in 24 cases and mechanically with an E.E.A. stapler in 24. The anastomosis time averaged 14 min in the suture group and 14.3 min in the stapling group, and the respective hospitalization times were 16 and 17 days. The mean cost was 48,000 lire in the manual, and 200,000 lire in the mechanical group. Four complications occurred in each group. Apart from the cost, no intergroup difference was statistically significant.

Role of diclofenac sodium and paracetamol on colonic anastomosis: An experimental rodent model.

PubMed

Gulcicek, Osman Bilgin; Solmaz, Ali; Yigitbas, Hakan; Ercetin, Candas; Yavuz, Erkan; Ozdogan, Kamil; Biricik, Aytac; Akkalp, Asli Kahraman; Uzun, Hafize; Kutnu, Muge; Celebi, Fatih; Celik, Atilla

2018-05-01

Despite many advances in surgery and technology, colonic anastomosis remains a challenge after colonic resection. The purpose of this study is to compare the safety of using diclofenac sodium and paracetamol for analgesia in colonic anastomosis on rats. Wistar-Hannover rats were randomly allocated to four groups: Group 1, sham-operated group; Group 2, control group; Group 3, diclofenac sodium group; Group 4, paracetamol group. After laparotomy, the left colon was transected and a single-layer anastomosis was made with 5/0 vicryl in Groups 2, 3, and 4. Only laparotomy was performed in Group 1. After anastomosis, we administered saline to Group 2, diclofenac sodium to Group 3, and paracetamol to Group 4 for 7 days. Then, all animals were decapitated. The anastomotic region was resected, and bursting pressure was measured. Then, the specimen was sent to the laboratory for histological examination and hydroxyproline analysis. Bursting pressure and hydroxyproline level were significantly higher in the paracetamol group (p<0.05). When we looked at the fibrosis levels of these groups, it was also higher in paracetamol group. Bursting pressure, hydroxyproline levels, and fibrosis levels indicate that the perioperative use of paracetamol for analgesia when undergoing colonic anastomosis is safer than diclofenac sodium. Copyright © 2017. Published by Elsevier Taiwan.

Augmenting pancreatic anastomosis during whipple operation with fibrin glue: a beneficial technical modification?

PubMed

Conaglen, Paul J; Collier, Neil A

2014-04-01

Various techniques have been described to try and reduce the rate of anastomotic leak following pancreaticoduodenectomy, which remains a challenge for pancreatic surgeons worldwide. We outline a technique to reinforce the pancreatic anastomosis with a double layer of fibrin glue between suture lines. Our technique for pancreatic anastomosis is described in detail. A review of consecutive pancreaticoduodenectomies by a single surgeon (NAC) since introduction of fibrin glue anastomosis reinforcement was compared with a historical control cohort performed by the same surgeon. Thirty-two consecutive pancreaticoduodenectomies were undertaken between March 2008 and March 2012 by a single surgeon, 30 patients had fibrin glue augmentation of the pancreatico-gastrostomy anastomosis. Median length of stay was 12 days. There were no pancreatic leaks or mortality since adopting fibrin glue for the pancreatic anastomosis; however; this single surgeon series is not large enough to provide statistical evidence of a difference since glue was adopted. Our results since the incorporation of this step in pancreaticoduodenectomy are encouraging. Selective use of glue is worthy of consideration in difficult cases, although confirmation of a reduction in pancreatic leak rate is not yet established, and we advocate a multi-institution randomized controlled trial to explore this. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

Impact of compressibility and a guide field on Fermi acceleration during magnetic island coalescence

NASA Astrophysics Data System (ADS)

Montag, P.; Egedal, J.; Lichko, E.; Wetherton, B.

2017-06-01

Previous work has shown that Fermi acceleration can be an effective heating mechanism during magnetic island coalescence, where electrons may undergo repeated reflections as the magnetic field lines contract. This energization has the potential to account for the power-law distributions of particle energy inferred from observations of solar flares. Here, we develop a generalized framework for the analysis of Fermi acceleration that can incorporate the effects of compressibility and non-uniformity along field lines, which have commonly been neglected in previous treatments of the problem. Applying this framework to the simplified case of the uniform flux tube allows us to find both the power-law scaling of the distribution function and the rate at which the power-law behavior develops. We find that a guide magnetic field of order unity effectively suppresses the development of power-law distributions.

Results of subscale MTF compression experiments

NASA Astrophysics Data System (ADS)

Howard, Stephen; Mossman, A.; Donaldson, M.; Fusion Team, General

2016-10-01

In magnetized target fusion (MTF) a magnetized plasma torus is compressed in a time shorter than its own energy confinement time, thereby heating to fusion conditions. Understanding plasma behavior and scaling laws is needed to advance toward a reactor-scale demonstration. General Fusion is conducting a sequence of subscale experiments of compact toroid (CT) plasmas being compressed by chemically driven implosion of an aluminum liner, providing data on several key questions. CT plasmas are formed by a coaxial Marshall gun, with magnetic fields supported by internal plasma currents and eddy currents in the wall. Configurations that have been compressed so far include decaying and sustained spheromaks and an ST that is formed into a pre-existing toroidal field. Diagnostics measure B, ne, visible and x-ray emission, Ti and Te. Before compression the CT has an energy of 10kJ magnetic, 1 kJ thermal, with Te of 100 - 200 eV, ne 5x1020 m-3. Plasma was stable during a compression factor R0/R >3 on best shots. A reactor scale demonstration would require 10x higher initial B and ne but similar Te. Liner improvements have minimized ripple, tearing and ejection of micro-debris. Plasma facing surfaces have included plasma-sprayed tungsten, bare Cu and Al, and gettering with Ti and Li.

Total mechanical stapled oesophagogastric anastomosis on the neck in oesophageal cancer – prevention of postoperative mediastinal complications

PubMed Central

Jaworski, Radosław; Irga-Jaworska, Ninela; Haponiuk, Ireneusz; Jaśkiewicz, Janusz

2015-01-01

Oesophagogastric anastomosis after oesophagus resection is commonly performed on the neck. Even though a few different techniques of oesophagogastric anastomosis have been previously detailed, both manual and mechanical procedures have been burdened with leakages and strictures. Our simple technique of oesophagogastric anastomosis is a modification of mechanical anastomosis with the use of a circular stapler in order to prevent postoperative leak and concomitant mediastinal complications. Since 2008, we have performed nine oesophagogastric anastomoses following oesophagus resection. The mean age of the operated patients was 54 years. There was no mortality among the operated patients in the early post-operative period. The mean follow-up period for the patients operated on in our department was 17 months until the time of the analysis. None of the patients showed any leakage or stricture, and no mediastinal complications were reported in the group. Following our own experience, mechanical anastomosis with the use of a circular stapler seems to decrease the time of the operation as well as significantly reducing the incidence of leakages from the anastomosis. This type of anastomosis may decrease the number of postoperative strictures and the most dangerous mediastinal infections. PMID:26855647

MHD simulation of plasma compression experiments

NASA Astrophysics Data System (ADS)

Reynolds, Meritt; Barsky, Sandra; de Vietien, Peter

2017-10-01

General Fusion (GF) is working to build a magnetized target fusion (MTF) power plant based on compression of magnetically-confined plasma by liquid metal. GF is testing this compression concept by collapsing solid aluminum liners onto plasmas formed by coaxial helicity injection in a series of experiments called PCS (Plasma Compression, Small). We simulate the PCS experiments using the finite-volume MHD code VAC. The single-fluid plasma model includes temperature-dependent resistivity and anisotropic heat transport. The time-dependent curvilinear mesh for MHD simulation is derived from LS-DYNA simulations of actual field tests of liner implosion. We will discuss how 3D simulations reproduced instability observed in the PCS13 experiment and correctly predicted stabilization of PCS14 by ramping the shaft current during compression. We will also present a comparison of simulated Mirnov and x-ray diagnostics with experimental measurements indicating that PCS14 compressed well to a linear compression ratio of 2.5:1.

Using external magnet guidance and endoscopically placed magnets to create suture-free gastro-enteral anastomoses.

PubMed

Myers, Christopher; Yellen, Benjamin; Evans, John; DeMaria, Eric; Pryor, Aurora

2010-05-01

To facilitate endolumenal and natural orifice procedures, this study evaluated a novel technique using external and endoscopically placed magnets to create suture-free gastroenteral anastomoses. Seven anesthetized adult swine underwent endoscopic placement of magnets into the small bowel and stomach. Using external magnets, the endoscopically placed internal magnets were brought into opposition under endoscopic view. After 1-2 weeks, the pigs were killed and analyzed. At laparotomy and under sterile conditions, peritoneal cultures were obtained. The anastomoses were evaluated endoscopically and tested using an air insufflation test. Finally, the anastomoses were resected and evaluated microscopically. The average operative time for endoscopic placement of the magnets was 34.3 +/- 14.8 min. Successful placement and creation of anastomoses occurred in six of the pigs. One pig did not form an anastomosis because the magnets were too large to pass through the pylorus at the time of attempted magnet placement. Six swine experienced uncomplicated postoperative courses. One pig's postoperative course involved constipation for several days, requiring additional fluids and fiber supplementation. The findings at endoscopy showed that the magnets were adhered to the anastomosis, which were easily freed, or within the stomach. The air insufflation test results were negative for all the pigs. At laparotomy, there was no evidence of infection, abscess, or leak, but two peritoneal culture results were positive with scant growth of Staphylococcus aureus and coagulase-negative staphylococcus, presumably contaminants. Microscopically, the anastomoses illustrated granulation and fibrous connective tissue without evidence of infection or leak. Endoscopically placed magnets with external magnet guidance is a feasible and novel approach to creating patent gastroenteral anastomoses without abdominal incisions or sutures.

Lumbar spine disc height and curvature responses to an axial load generated by a compression device compatible with magnetic resonance imaging

NASA Technical Reports Server (NTRS)

Kimura, S.; Steinbach, G. C.; Watenpaugh, D. E.; Hargens, A. R.

2001-01-01

STUDY DESIGN: Axial load-dependent changes in the lumbar spine of supine healthy volunteers were examined using a compression device compatible with magnetic resonance imaging. OBJECTIVE: To test two hypotheses: Axial loading of 50% body weight from shoulder to feet in supine posture 1) simulates the upright lumbar spine alignment and 2) decreases disc height significantly. SUMMARY OF BACKGROUND DATA: Axial compression on the lumbar spine has significantly narrowed the lumbar dural sac in patients with sciatica, neurogenic claudication or both. METHODS: Using a device compatible with magnetic resonance imaging, the lumbar spine of eight young volunteers, ages 22 to 36 years, was axially compressed with a force equivalent to 50% of body weight, approximating the normal load on the lumbar spine in upright posture. Sagittal lumbar magnetic resonance imaging was performed to measure intervertebral angle and disc height before and during compression. RESULTS: Each intervertebral angle before and during compression was as follows: T12-L1 (-0.8 degrees +/- 2.5 degrees and -1.5 degrees +/- 2.6 degrees ), L1-L2 (0.7 degrees +/- 1.4 degrees and 3.3 degrees +/- 2.9 degrees ), L2-L3 (4.7 degrees +/- 3.5 degrees and 7.3 degrees +/- 6 degrees ), L3-L4 (7.9 degrees +/- 2.4 degrees and 11.1 degrees +/- 4.6 degrees ), L4-L5 (14.3 degrees +/- 3.3 degrees and 14.9 degrees +/- 1.7 degrees ), L5-S1 (25.8 degrees +/- 5.2 degrees and 20.8 degrees +/- 6 degrees ), and L1-S1 (53.4 degrees +/- 11.9 degrees and 57.3 degrees +/- 16.7 degrees ). Negative values reflect kyphosis, and positive values reflect lordosis. A significant difference between values before and during compression was obtained at L3-L4 and L5-S1. There was a significant decrease in disc height only at L4-L5 during compression. CONCLUSIONS: The axial force of 50% body weight in supine posture simulates the upright lumbar spine morphologically. No change in intervertebral angle occurred at L4-L5. However, disc height at L4-L

Inductively Driven, 3D Liner Compression of a Magnetized Plasma to Megabar Energy Densities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Slough, John

To take advantage of the smaller scale, higher density regime of fusion an efficient method for achieving the compressional heating required to reach fusion gain conditions must be found. What is proposed is a more flexible metallic liner compression scheme that minimizes the kinetic energy required to reach fusion. It is believed that it is possible to accomplish this at sub-megajoule energies. This however will require operation at very small scale. To have a realistic hope of inexpensive, repetitive operation, it is essential to have the liner kinetic energy under a megajoule which allows for the survivability of the vacuummore » and power systems. At small scale the implosion speed must be reasonably fast to maintain the magnetized plasma (FRC) equilibrium during compression. For limited liner kinetic energy, it becomes clear that the thinnest liner imploded to the smallest radius consistent with the requirements for FRC equilibrium lifetime is desired. The proposed work is directed toward accomplishing this goal. Typically an axial (Z) current is employed for liner compression. There are however several advantages to using a θ-pinch coil. With the θ-pinch the liner currents are inductively driven which greatly simplifies the apparatus and vacuum system, and avoids difficulties with the post implosion vacuum integrity. With fractional flux leakage, the foil liner automatically provides for the seed axial compression field. To achieve it with optimal switching techniques, and at an accelerated pace however will require additional funding. This extra expense is well justified as the compression technique that will be enabled by this funding is unique in the ability to implode individual segments of the liner at different times. This is highly advantageous as the liner can be imploded in a manner that maximizes the energy transfer to the FRC. Production of shaped liner implosions for additional axial compression can thus be readily accomplished with the

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. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Paradoxical Impact of Ileal Pouch-Anal Anastomosis on Male and Female Fertility in Patients With Ulcerative Colitis.

PubMed

Pachler, Frederik R; Brandsborg, Søren B; Laurberg, Søren

2017-06-01

Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. This was a retrospective registry-based cohort study that was performed over a 30-year period. Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits. All data were prospectively registered. All patients with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis between 1980 and 2010 were identified in Danish national databases. The primary outcomes measured were birth rates in females and males with ulcerative colitis and ulcerative colitis with ileal pouch-anal anastomosis. We included 27,379 patients with ulcerative colitis (12,812 males and 14,567 females); 1544 had ileal pouch-anal anastomosis (792 males and 752 females). Patients with ulcerative colitis have slightly reduced birth rates (males at 40.8 children/1000 years, background population 43.2, females at 46.2 children/1000 years, background population 49.1). After ileal pouch-anal anastomosis, males had increased birth rates at 47.8 children/1000 years in comparison with males with ulcerative colitis without ileal pouch-anal anastomosis (40.5 children/1000 years), whereas females had reduced birth rates at 27.6 children/1000 years in comparison with females with ulcerative colitis without ileal pouch-anal anastomosis (46.8 children/1000 years). Only birth rates were investigated and not fecundability. Furthermore, there is a question about misattributed paternity, but this has previously been shown to be less than 5%. Ulcerative colitis per se has little impact on birth rates in both sexes, but ileal pouch-anal anastomosis surgery leads to a reduction in birth rates in females and an increase in birth rates in males. This has clinical

Intraoperative colonic lavage and primary anastomosis in peritonitis and obstruction.

PubMed

Biondo, S; Jaurrieta, E; Jorba, R; Moreno, P; Farran, L; Borobia, F; Bettonica, C; Poves, I; Ramos, E; Alcobendas, F

1997-02-01

The surgical management of left colonic emergencies has evolved in the past few decades. Recently, there has been increasing interest in resection with primary anastomosis in selected cases. The aim of this study was to evaluate the differences in outcome in patients with peritonitis or obstruction treated by resection, on-table lavage and primary anastomosis of the left colon. Between January 1992 and August 1995, 212 patients underwent emergency operation for a distal colonic lesion: 97 presented with peritonitis, 113 with obstruction and two with other indications. Intraoperative colonic lavage was performed in 37 patients with obstruction and in 24 with an acute intra-abdominal inflammatory process. The postoperative mortality rate was 5 per cent. The incidence of clinical anastomotic leakage was 5 per cent. Wound infection was observed in ten patients (16 per cent), more often in those with peritonitis (P = 0.03). The overall mean(s.d.) hospital stay was 15(9) days. Resection, on-table lavage and primary anastomosis constitute the operation of choice for selected patients with left colonic emergency.

Development of the apparatus for measuring magnetic properties of electrical steel sheets in arbitrary directions under compressive stress normal to their surface

NASA Astrophysics Data System (ADS)

Maeda, Yoshitaka; Urata, Shinya; Nakai, Hideo; Takeuchi, Yuuya; Yun, Kyyoul; Yanase, Shunji; Okazaki, Yasuo

2017-05-01

In designing motors, one must grasp the magnetic properties of electrical steel sheets considering actual conditions in motors. Especially important is grasping the stress dependence of magnetic power loss. This paper describes a newly developed apparatus to measure two-dimensional (2-D) magnetic properties (properties under the arbitrary alternating and the rotating flux conditions) of electrical steel sheets under compressive stress normal to the sheet surface. The apparatus has a 2-D magnetic excitation circuit to generate magnetic fields in arbitrary directions in the evaluation area. It also has a pressing unit to apply compressive stress normal to the sheet surface. During measurement, it is important to apply uniform stress throughout the evaluation area. Therefore, we have developed a new flux density sensor using needle probe method. It is composed of thin copper foils sputtered on electrical steel sheets. By using this sensor, the stress can be applied to the surface of the specimen without influence of this sensor. This paper described the details of newly developed apparatus with this sensor, and measurement results of iron loss by using are shown.

One-dimensional magnetohydrodynamics of a cylindrical liner imploded by an azimuthal magnetic field and compressing an axial field

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamann, F., E-mail: franck.hamann@cea.fr; Combis, P.; Videau, L.

The one-dimensional magnetohydrodynamics of a plasma cylindrical liner is addressed in the case of a two components magnetic field. The azimuthal component is responsible for the implosion of the liner and the axial field is compressed inside the liner. A complete set of analytical profiles for the magnetic field components, the density, and the local velocity are proposed at the scale of the liner thickness. Numerical simulations are also presented to test the validity of the analytical formulas.

Effects of combined pulse electromagnetic field stimulation plus glutamine on the healing of colonic anastomosis in rats.

PubMed

Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akpolat, Veysi; Akbulut, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih

2009-04-01

An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.

Esophagogastric anastomosis in rats: Improved healing by BPC 157 and L-arginine, aggravated by L-NAME

PubMed Central

Djakovic, Zeljko; Djakovic, Ivka; Cesarec, Vedran; Madzarac, Goran; Becejac, Tomislav; Zukanovic, Goran; Drmic, Domagoj; Batelja, Lovorka; Zenko Sever, Anita; Kolenc, Danijela; Pajtak, Alen; Knez, Nikica; Japjec, Mladen; Luetic, Kresimir; Stancic-Rokotov, Dinko; Seiwerth, Sven; Sikiric, Predrag

2016-01-01

AIM To cure typically life-threatening esophagogastric anastomosis in rats, lacking anastomosis healing and sphincter function rescue, in particular. METHODS Because we assume esophagogastric fistulas represent a particular NO-system disability, we attempt to identify the benefits of anti-ulcer stable gastric pentadecapeptide BPC 157, which was in trials for ulcerative colitis and currently for multiple sclerosis, in rats with esophagocutaneous fistulas. Previously, BPC 157 therapies have promoted the healing of intestinal anastomosis and fistulas, and esophagitis and gastric lesions, along with rescued sphincter function. Additionally, BPC 157 particularly interacts with the NO-system. In the 4 d after esophagogastric anastomosis creation, rats received medication (/kg intraperitoneally once daily: BPC 157 (10 μg, 10 ng), L-NAME (5 mg), or L-arginine (100 mg) alone and/or combined or BPC 157 (10 μg, 10 ng) in drinking water). For rats underwent esophagogastric anastomosis, daily assessment included progressive stomach damage (sum of the longest diameters, mm), esophagitis (scored 0-5), weak anastomosis (mL H2O before leak), low pressure in esophagus at anastomosis and in the pyloric sphincter (cm H2O), progressive weight loss (g) and mortality. Immediate effect assessed blood vessels disappearance (scored 0-5) at the stomach surface immediately after anastomosis creation. RESULTS BPC 157 (all regimens) fully counteracted the perilous disease course from the very beginning (i.e., with the BPC 157 bath, blood vessels remained present at the gastric surface after anastomosis creation) and eliminated mortality. Additionally, BPC 157 treatment in combination with L-NAME nullified any effect of L-NAME that otherwise intensified the regular course. Consistently, with worsening (with L-NAME administration) and amelioration (with L-arginine), either L-arginine amelioration prevails (attenuated esophageal and gastric lesions) or they counteract each other (L-NAME + L

Esophagogastric anastomosis in rats: Improved healing by BPC 157 and L-arginine, aggravated by L-NAME.

PubMed

Djakovic, Zeljko; Djakovic, Ivka; Cesarec, Vedran; Madzarac, Goran; Becejac, Tomislav; Zukanovic, Goran; Drmic, Domagoj; Batelja, Lovorka; Zenko Sever, Anita; Kolenc, Danijela; Pajtak, Alen; Knez, Nikica; Japjec, Mladen; Luetic, Kresimir; Stancic-Rokotov, Dinko; Seiwerth, Sven; Sikiric, Predrag

2016-11-07

To cure typically life-threatening esophagogastric anastomosis in rats, lacking anastomosis healing and sphincter function rescue, in particular. Because we assume esophagogastric fistulas represent a particular NO-system disability, we attempt to identify the benefits of anti-ulcer stable gastric pentadecapeptide BPC 157, which was in trials for ulcerative colitis and currently for multiple sclerosis, in rats with esophagocutaneous fistulas. Previously, BPC 157 therapies have promoted the healing of intestinal anastomosis and fistulas, and esophagitis and gastric lesions, along with rescued sphincter function. Additionally, BPC 157 particularly interacts with the NO-system. In the 4 d after esophagogastric anastomosis creation, rats received medication (/kg intraperitoneally once daily: BPC 157 (10 μg, 10 ng), L-NAME (5 mg), or L-arginine (100 mg) alone and/or combined or BPC 157 (10 μg, 10 ng) in drinking water). For rats underwent esophagogastric anastomosis, daily assessment included progressive stomach damage (sum of the longest diameters, mm), esophagitis (scored 0-5), weak anastomosis (mL H 2 O before leak), low pressure in esophagus at anastomosis and in the pyloric sphincter (cm H 2 O), progressive weight loss (g) and mortality. Immediate effect assessed blood vessels disappearance (scored 0-5) at the stomach surface immediately after anastomosis creation. BPC 157 (all regimens) fully counteracted the perilous disease course from the very beginning ( i.e ., with the BPC 157 bath, blood vessels remained present at the gastric surface after anastomosis creation) and eliminated mortality. Additionally, BPC 157 treatment in combination with L-NAME nullified any effect of L-NAME that otherwise intensified the regular course. Consistently, with worsening (with L-NAME administration) and amelioration (with L-arginine), either L-arginine amelioration prevails (attenuated esophageal and gastric lesions) or they counteract each other (L-NAME + L-arginine); with

[Anorectal continence following manual and mechanical anastomosis suture. Results of a controlled study of rectal surgery].

PubMed

Jostarndt, L; Thiede, A; Lau, G; Hamelmann, H

1984-06-01

In a controlled clinical trial-manual vs. stapler anastomosis in rectal surgery-it was found that both suture techniques per se made no difference in the function of anal continence. The anal pressures at rest and sphincter contraction remained unchanged. A linear reduction of functional reservoir of the "neorectum" could be shown, which depended on the level and healing of the anastomosis. An anastomosis level at 6 cm from anocutaneous line is important for functional reasons. Anastomoses above this level do not cause any consequences for anal continence. Anastomoses below this level result in a reduced functional reservoir for at least 6 months. Within this period a decrease in anal continence is possible, especially in cases of disturbed healing of the anastomosis.

Anastomotic leakage after side-to-end anastomosis for rectal cancer: does leakage location matter?

PubMed

Hain, Elisabeth; Maggiori, Léon; Zappa, Magaly; Prost À la Denise, Justine; Panis, Yves

2018-01-06

To assess outcome according to location of anastomotic leakage (AL) after side-to-end stapler or manual low colorectal or coloanal anastomosis following laparoscopic total mesorectal excision (TME) for rectal cancer. All patients presenting with symptomatic or asymptomatic AL after TME and side-to-end low anastomosis for rectal cancer performed from 2005 to 2014 were identified from our prospective database. CT-scans with contrast enema were reviewed to assess location of AL origin. Among 279 patients who underwent TME with side-to-end anastomosis from 2005 to 2014, 70 patients presented with AL and were included: 43 (61%) patients with AL on the circular anastomosis (CAL) were compared to 27 (39%) with AL on the transverse stapling line of the colonic stump (TAL). CAL and TAL were associated with similar rates of symptomatic AL (63% versus 48%, respectively; p=0.339), severe postoperative morbidity rate (33% versus 18%; p=0.313), and long-term outcomes, including definitive stoma rate (10 versus 11%; p=0.622), and major low anterior resection syndrome rate (56% vs 57%; p=0.961). Our study showed that whatever the location of AL on a side-to-end low colorectal or coloanal anastomosis after TME for cancer, both short and long-term outcomes are similar. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A Longitudinal Mapping Study on Cortical Plasticity of Peripheral Nerve Injury Treated by Direct Anastomosis and Electroacupuncture in Rats.

PubMed

Wu, Jia-Jia; Lu, Ye-Chen; Hua, Xu-Yun; Ma, Shu-Jie; Xu, Jian-Guang

2018-06-01

We used functional magnetic resonance imaging to provide a longitudinal description of cortical plasticity caused by electroacupuncture (EA) of sciatic nerve transection and direct anastomosis in rats. Sixteen rats in a sciatic nerve transection and direct anastomosis model were randomly divided into intervention and control groups. EA intervention in the position of ST-36, GB-30 was conducted continuously for 4 months in the intervention group. Functional magnetic resonance imaging and gait assessment were performed every month after intervention. The somatosensory area was more activated in the first 2 months and then deactivated in the rest 2 months when EA was applied. The pain-related areas had the same activation pattern as the somatosensory area. The limbic/paralimbic areas fluctuated more during the EA intervention, which was not constantly activated or deactivated as previous studies reported. We attributed such changes in somatosensory and pain-related areas to the gradual reduction of sensory afferentation. The alterations in limbic/paralimbic system might be associated with the confrontation between the upregulating effect of paresthesia or pain and the downregulating effect of EA intervention through the autonomic nerve system. The gait analysis showed significantly higher maximum contact mean intensity in the intervention group. The alterations in the brain brought about by the long-term therapeutic effect of EA could be described as a synchronized activation pattern in the somatosensory and pain-related areas and a fluctuating pattern in the limbic/paralimbic system. Copyright © 2018 Elsevier Inc. All rights reserved.

[Mechanical versus manual suture in the jejunal esophageal anastomosis after total gastrectomy in gastric cancer].

PubMed

Celis, J; Ruiz, E; Berrospi, F; Payet, E

2001-01-01

To compare the leakage rate of esophagojejunal anastomosis performed with stapler or hand sutures. We studied a series of 367 patients who underwent total gastrectomy for gastric cancer at the Instituto de Enfermedades Neoplásicas (Lima-Peru) from 1986 to 1999. In 197 patients esophagojejunal anastomosis was performed with stapler and in 170 with manual sutures. There were no differences between both groups with regard to age, TNM stage, operating time and hospital stay. There were 8 anastomotic leakage (4.1%) in the stapler group and 4 (2.4%) in the hand sutures group (p> 0.05). Of these 12 cases, 2 patients (16%) died of causes directly related to the leak of the esophagojejunal anastomosis. There were no statistical differences in the rate of leakage of the esophagojejunal anastomosis performed with stapler or hand sutures, thus both techniques should be accepted as standard procedures.

Increased collagen maturity with sildenafil citrate: experimental high risk colonic anastomosis model.

PubMed

Cakir, Tebessum; Ozer, Ilter; Bostanci, Erdal Birol; Keklik, Tulay Timucin; Ercin, Ugur; Bilgihan, Ayse; Akoglu, Musa

2015-01-01

Inadequate healing and high anastomosis leak rates at rectal anastomosis may be due to lack of supportive serosal layer and technical difficulty of low anterior resections. Positive effects of sildenafil on wound healing were observed. The aim of this study was to simulate rectal anastomosis as a technical insufficient anastomosis and investigate the effects of sildenafil on anastomosis healing. Colonic anastomoses were carried out in 64 rats and randomized into four groups, CA-S, complete anastomoses without sildenafil (10 mg/kg for 5 days); CA+S, complete anastomoses with sildenafil; IA-S, incomplete anastomoses without sildenafil; IA+S, incomplete anastomoses with sildenafil. Half of the rats in every group were sacrificed on post-operative day (POD) 3, half of them sacrificed on POD 7. Tissues from the anastomoses were used for functional, histochemical, biochemical investigations. Sildenafil treatment resulted in increased bursting pressures in IA+S on POD 7 (p=0.010). Collagen maturity was higher in IA+S on POD 3 and POD 7, CA+S on POD 7 (p=0.010; p=0.010; p<0.007). Collagen content was higher in IA+S on POD 7 (p<0.001). Glutathione, hydroxyproline levels were similar. Malondialdehyde levels were lower in IA+S on POD 3 (p<0.001). Epithelization score was higher in IA+S on POD 7 (p=0.007). Inflammation score was higher in CA-S group on POD 3 and POD 7 (p<0.001; p<0.001). Neutrophil score was lower in CA+S on POD 3 (p=0.005). An increase in collagen content, maturity, and epithelization, a decrease in neutrophil infiltration, oxidative stress and better mechanical strength were observed with the administration of sildenafil. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Compressive sensing in medical imaging

PubMed Central

Graff, Christian G.; Sidky, Emil Y.

2015-01-01

The promise of compressive sensing, exploitation of compressibility to achieve high quality image reconstructions with less data, has attracted a great deal of attention in the medical imaging community. At the Compressed Sensing Incubator meeting held in April 2014 at OSA Headquarters in Washington, DC, presentations were given summarizing some of the research efforts ongoing in compressive sensing for x-ray computed tomography and magnetic resonance imaging systems. This article provides an expanded version of these presentations. Sparsity-exploiting reconstruction algorithms that have gained popularity in the medical imaging community are studied, and examples of clinical applications that could benefit from compressive sensing ideas are provided. The current and potential future impact of compressive sensing on the medical imaging field is discussed. PMID:25968400

A stretch/compress scheme for a high temporal resolution detector for the magnetic recoil spectrometer time (MRSt)

DOE PAGES

Hilsabeck, T. J.; Frenje, J. A.; Hares, J. D.; ...

2016-08-02

Here we present a time-resolved detector concept for the magnetic recoil spectrometer for time-resolved measurements of the NIF neutron spectrum. The measurement is challenging due to the time spreading of the recoil protons (or deuterons) as they transit an energy dispersing magnet system. Ions arrive at the focal plane of the magnetic spectrometer over an interval of tens of nanoseconds. We seek to measure the time-resolved neutron spectrum with 20 ps precision by manipulating an electron signal derived from the ions. A stretch-compress scheme is employed to remove transit time skewing while simultaneously reducing the bandwidth requirements for signal recording.more » Simulation results are presented along with design concepts for structures capable of establishing the required electromagnetic fields.« less

A stretch/compress scheme for a high temporal resolution detector for the magnetic recoil spectrometer time (MRSt)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hilsabeck, T. J.; Frenje, J. A.; Hares, J. D.

Here we present a time-resolved detector concept for the magnetic recoil spectrometer for time-resolved measurements of the NIF neutron spectrum. The measurement is challenging due to the time spreading of the recoil protons (or deuterons) as they transit an energy dispersing magnet system. Ions arrive at the focal plane of the magnetic spectrometer over an interval of tens of nanoseconds. We seek to measure the time-resolved neutron spectrum with 20 ps precision by manipulating an electron signal derived from the ions. A stretch-compress scheme is employed to remove transit time skewing while simultaneously reducing the bandwidth requirements for signal recording.more » Simulation results are presented along with design concepts for structures capable of establishing the required electromagnetic fields.« less

Compressed Gas Safety for Experimental Fusion Facilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee C. Cadwallader

2004-09-01

Experimental fusion facilities present a variety of hazards to the operators and staff. There are unique or specialized hazards, including magnetic fields, cryogens, radio frequency emissions, and vacuum reservoirs. There are also more general industrial hazards, such as a wide variety of electrical power, pressurized air, and cooling water systems in use, there are crane and hoist loads, working at height, and handling compressed gas cylinders. This paper outlines the projectile hazard assoicated with compressed gas cylinders and mthods of treatment to provide for compressed gas safety. This information should be of interest to personnel at both magnetic and inertialmore » fusion experiments.« less

Compression Molding and Novel Sintering Treatments for Alnico Type-8 Permanent Magnets in Near-Final Shape with Preferred Orientation

NASA Astrophysics Data System (ADS)

Kassen, Aaron G.; White, Emma M. H.; Tang, Wei; Hu, Liangfa; Palasyuk, Andriy; Zhou, Lin; Anderson, Iver E.

2017-09-01

Economic uncertainty in the rare earth (RE) permanent magnet marketplace, as well as in an expanding electric drive vehicle market that favors permanent magnet alternating current synchronous drive motors, motivated renewed research in RE-free permanent magnets like "alnico," an Al-Ni-Co-Fe alloy. Thus, high-pressure, gas-atomized isotropic type-8H pre-alloyed alnico powder was compression molded with a clean burn- out binder to near-final shape and sintered to density >99% of cast alnico 8 (full density of 7.3 g/cm3). To produce aligned sintered alnico magnets for improved energy product and magnetic remanence, uniaxial stress was attempted to promote controlled grain growth, avoiding directional solidification that provides alignment in alnico 9. Successful development of solid-state powder processing may enable anisotropically aligned alnico magnets with enhanced energy density to be mass-produced.

Quality of life after Brooke ileostomy and ileal pouch-anal anastomosis. Comparison of performance status.

PubMed Central

Pemberton, J H; Phillips, S F; Ready, R R; Zinsmeister, A R; Beahrs, O H

1989-01-01

Although the clinical results of Brooke ileostomy are good, patients are permanently incontinent of stool and gas. Alternative operations designed to restore enteric continence, such as ileal pouch-anal anastomosis, must not only be as safe and effective as Brooke ileostomy, but should provide an improved quality of life in order to establish long-term acceptability. Ileal pouch-anal anastomosis has been performed safely and good functional results have been reported. The quality of life after ileal pouch-anal anastomosis, however, has not been documented. Two hundred ninety-eight ileal pouch patients and 406 Brooke ileostomy patients who had the operations performed for chronic ulcerative colitis or familial adenomatous polyposis formed the basis of the study. After adjusting for age, diagnosis, and reoperation rate, logistic regression analysis of performance scores in seven different categories was used to discriminate between operations. Median follow-up was longer in Brooke ileostomy patients than in ileal pouch patients (104 months vs. 47 months, respectively), and Brooke ileostomy patients were slightly older (38 years vs. 32 years). A great majority of patients in each group were satisfied (93% Brooke ileostomy; 95% ileal pouch-anal anastomosis). Thirty-nine per cent of Brooke ileostomy patients, however, desired a change in the type of ileostomy they had. At 47 months, ileal pouch patients had a median of 5 stools per day and 1 at night, 77% did not experience any daytime incontinence, while 22% reported occasional spotting. In each performance category, the performance score discriminated between operations, with the probability of having had an ileal pouch-anal anastomosis operation increasing with improvement in performance scores (p less than 0.05). We concluded that after ileal pouch-anal anastomosis, patients experienced significant advantages in performing daily activities compared to patients with Brooke ileostomy and thus may experience a better

COMPRESSIBLE RELATIVISTIC MAGNETOHYDRODYNAMIC TURBULENCE IN MAGNETICALLY DOMINATED PLASMAS AND IMPLICATIONS FOR A STRONG-COUPLING REGIME

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takamoto, Makoto; Lazarian, Alexandre, E-mail: mtakamoto@eps.s.u-tokyo.ac.jp, E-mail: alazarian@facstaff.wisc.edu

2016-11-10

In this Letter, we report compressible mode effects on relativistic magnetohydrodynamic (RMHD) turbulence in Poynting-dominated plasmas using three-dimensional numerical simulations. We decomposed fluctuations in the turbulence into 3 MHD modes (fast, slow, and Alfvén) following the procedure of mode decomposition in Cho and Lazarian, and analyzed their energy spectra and structure functions separately. We also analyzed the ratio of compressible mode to Alfvén mode energy with respect to its Mach number. We found the ratio of compressible mode increases not only with the Alfvén Mach number, but also with the background magnetization, which indicates a strong coupling between the fastmore » and Alfvén modes. It also signifies the appearance of a new regime of RMHD turbulence in Poynting-dominated plasmas where the fast and Alfvén modes are strongly coupled and, unlike the non-relativistic MHD regime, cannot be treated separately. This finding will affect particle acceleration efficiency obtained by assuming Alfvénic critical-balance turbulence and can change the resulting photon spectra emitted by non-thermal electrons.« less

Pancreaticojejuno anastomosis after pancreaticoduodenectomy: brief pathophysiological considerations for a rational surgical choice.

PubMed

Caronna, Roberto; Peparini, Nadia; Cosimo Russillo, Gabriele; Antonio Rogano, Adolfo; Dinatale, Giuseppe; Chirletti, Piero

2012-01-01

Introduction. The best pancreatic anastomosis technique after pancreaticoduodenectomy (PD) is still debated. Pancreatic fistula (PF) is the most important complication but is also related to postoperative bleedings and pancreatic remnant involution. We support pancreaticojejuno anastomosis (PJ) advantages describing our technique with brief technical considerations. Materials and Methods. 89 consecutive patients underwent PD with suprapyloric gastric resection and double loop reconstruction. Pancreaticojejunal end-to-end anastomosis was done by simple invagination with a single layer of interrupted pledget-supported Ticron stitches. Results. Pancreatic fistula occurred in seven patients (7.8%): six cases of grade A fistula resolved spontaneously, and in only one case of grade B fistula percutaneous drainage was necessary. Postoperative hemorrhage occurred in only two (2.2%) of 89 patients. Conclusion. Pancreaticojejunostomy with minor changes in anastomotic techniques can contribute to improvement of the outcome of Roux-en-Y reconstruction regarding PF and other related complications. The particular reconstruction reported seems also to preserve the pancreatic exocrine function.

Pancreaticojejuno Anastomosis after Pancreaticoduodenectomy: Brief Pathophysiological Considerations for a Rational Surgical Choice

PubMed Central

Caronna, Roberto; Peparini, Nadia; Cosimo Russillo, Gabriele; Antonio Rogano, Adolfo; Dinatale, Giuseppe; Chirletti, Piero

2012-01-01

Introduction. The best pancreatic anastomosis technique after pancreaticoduodenectomy (PD) is still debated. Pancreatic fistula (PF) is the most important complication but is also related to postoperative bleedings and pancreatic remnant involution. We support pancreaticojejuno anastomosis (PJ) advantages describing our technique with brief technical considerations. Materials and Methods. 89 consecutive patients underwent PD with suprapyloric gastric resection and double loop reconstruction. Pancreaticojejunal end-to-end anastomosis was done by simple invagination with a single layer of interrupted pledget-supported Ticron stitches. Results. Pancreatic fistula occurred in seven patients (7.8%): six cases of grade A fistula resolved spontaneously, and in only one case of grade B fistula percutaneous drainage was necessary. Postoperative hemorrhage occurred in only two (2.2%) of 89 patients. Conclusion. Pancreaticojejunostomy with minor changes in anastomotic techniques can contribute to improvement of the outcome of Roux-en-Y reconstruction regarding PF and other related complications. The particular reconstruction reported seems also to preserve the pancreatic exocrine function. PMID:22489265

Impact of compressibility and a guide field on Fermi acceleration during magnetic island coalescence

NASA Astrophysics Data System (ADS)

Montag, Peter; Egedal, Jan; Lichko, Emily; Wetherton, Blake

2017-10-01

Previous work has shown that Fermi acceleration can be an effective heating mechanism during magnetic island coalescence, where electrons may undergo repeated reflections as the magnetic field lines contract. This energization has the potential to account for the power-law distributions of particle energy inferred from observations of solar flares. Here, we develop a generalized framework for the analysis of Fermi acceleration that can incorporate the effects of compressibility and non-uniformity along field lines, which have commonly been neglected in previous treatments of the problem. Applying this framework to the simplified case of the uniform flux tube allows us to find both the power-law scaling of the distribution function and the rate at which the power-law behavior develops. We find that a guide magnetic field of order unity effectively suppresses the development of power-law distributions. The work was supported by NASA Grant No. NNX14AC68G, NSF GEM Grant No. 1405166, NSF Award 1404166, and NASA Award NNX15AJ73G.

[Terminolateral esophagojejunostomy after gastrectomy with the biofragmentable anastomosis ring in the dog model].

PubMed

Dietz, U A; Araújo, A C F; Czeczko, N G; Lemos, R; Araújo, U; Inácio, C M; Salles, G; Corrêa Neto, M; Repka, J C D; Zanellato, C M F; Malafaia, O; Debus, E S; Thiede, A

2005-06-01

Esophagojejunostomy after total gastrectomy still remains a high risk anastomosis with a considerable morbidity and mortality. The majority of these anastomoses are performed by the intraluminal stapler technique, yet stenoses are a known late complication even after an uneventful postoperative course. In the present study, the osophagojejunostomy with the biofragmentable anastomosis ring (BAR) was examined in dogs. 28 dogs were randomized into a group of manual suture (n = 14) and a BAR-group (n = 14). After gastrectomy, the esophagojejunostomy was performed by hand-suture with polypropylene 4-0 in the manual suture group, and with the 25/1.5 mm BAR in the BAR-group. In both groups the Roux-en-Y jejunojejunostomy was performed by hand-suture. The dogs were evaluated on postoperative days 4, 7 and 14 with regard to macroscopy, bursting strength, tissue hydroxyproline and histology. There was one leakage without clinical effect in the hand-sewn group on postoperative day 4; there was no leak in the BAR-group. In observing fibre-free enteral feeding, neither functional disorders nor obstruction of the BAR were observed. The general anastomosis parameters were matchable between the groups. The infracarinal BAR-esophagojejunostomy is comparable to the hand-sewn anastomosis in the dog-model.

Use of small gap anastomosis for the repair of peripheral nerve injury by cutting and sleeve jointing the epineurium.

PubMed

Wang, Peiji; Zhao, Jiaju; Jiang, Bo; Zhang, Yong

2015-05-01

Although epineurium neurorrhaphy is the most reliable and conventional method for the repair of peripheral nerve injury and is accepted as the gold standard, it is still far from ideal. Many attempts have been made to develop nerve anastomosis techniques. The aim of this study was to investigate the use of small gap anastomosis performed by cutting and sleeve jointing the epineurium for nerve repair. A 12-week study was performed using small gap anastomosis via cutting and sleeve jointing the epineurium, compared with epineurium neurorrhaphy in situ, to repair a rat sciatic nerve rupture. Three experimental groups were included: sham control (n = 8), small gap anastomosis (n = 16), and epineurium neurorrhaphy (n = 16). About 12 weeks after surgery, recovery was assessed with walking track analysis, electrophysiology, hematoxylin and eosin staining, immunohistochemistry, and electron microscopy. The sciatic nerve functional index observed in the small gap anastomosis group was significantly higher than that in the epineurium neurorrhaphy group (p < 0.05). In vivo electrophysiological analysis confirmed that the small gap anastomosis group showed a significantly higher conduction velocity than the epineurium neurorrhaphy group (p < 0.05). Postoperative morphometric analysis revealed better results after small gap anastomosis compared with epineurium neurorrhaphy. Small gap anastomosis via cutting and sleeve jointing the epineurium could be an alternative to epineurium neurorrhaphy for the repair of peripheral nerve injury, particularly, considering that the epineurium originates from native tissue that provides a suitable microenvironment for the selective regeneration of axons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Modified gastroduodenostomy in laparoscopy-assisted distal gastrectomy: a 'tornado' anastomosis.

PubMed

Kubota, Keisuke; Kuroda, Junko; Yoshida, Masashi; Okada, Akihiro; Nitori, Nobuhiro; Kitajima, Masaki

2013-01-01

This study was to examine the utility of a modified double-stapling end-to-end gastroduodenostomy method ('Tornado' anastomosis) compared to a method with an additional gastrotomy ('Anterior Incision' method) in laparoscopy-assisted distal gastrectomy. Forty-two patients with gastric cancer who underwent laparoscopy-assisted distal gastrectomy were analyzed retrospectively. Billroth-I using an additional gastrotomy was performed in 24 patients (AI group) and Billroth-I without an additional gastrotomy was performed in 18 (TOR group). Clinicopathological features, operative outcomes (lymph node dissection, operative time, operative blood loss) and postoperative outcomes (complications, postoperative hospital stay, and body weight loss at one year after surgery) were evaluated and compared between groups. Operative time was significantly shorter in the TOR group (251 min) than in the AI group (282 min) (p < 0.01). There were no statistically significant differences in operative blood loss, postoperative complications, and hospital stay between the 2 study groups. Body weight loss at one year after surgery was -5.8 kg in the TOR group and -6.5 kg in the AI group, without a statistically significant difference. Completion time for Billroth-I anastomosis was significantly shorter with Tornado anastomosis than with the Anterior Incision method, with safety equal between the two methods.

[Proctocolectomy with J pouch. Ileo-anal anastomosis performed with PPH stapler. Our experiences after 88 cases].

PubMed

Berki, Csaba; Mohos, Elemér; Réti, György; Kovács, Tamás; Jánó, Zoltán; Mohay, József; Horváth, Sándor; Bognár, Gábor; Bene, Krisztina; Horzov, Myroslav; Sándor, Gábor; Tornai, Gábor; Mohos, Petra; Szenkovits, Péter; Nagy, Tibor; Orbán, Csaba; Herpai, Vivien; Nagy, Attila

2016-12-01

Ulcerative colitis (CU) or Familiar Polyposis (FAP) can be the indication for proctocolectomy reconstructed with J pouch. The complete removal of the colon mucosa is essential regarding the late complications and at the same time the atraumatic surgical technique is very important concerning on the long term functional results. Both aspects seems to be answered by the stapled ileo-anal anastomosis using a "procedure for prolaps and haemorrhoids (PPH)" stapler applied by us since 2000. 117 proctocolectomies reconstructed with J pouch and ileo-anal anastomosis were performed in our department between March 1990 and September 2016 indicated by CU or by FAP. In the first time period the ileo-anal anastomosis was sutured by hand (29 cases) and since 2000 the PPH stapler was applied as a routine (88 patients). Deviating ileostomy was performed in most cases of us. The data of the 117 patients were collected from the database of our hospital, 45 of them were interviewed personally and another 31 patients were contacted by phone, so 76 patients (65%) were eligible for follow-up. Frequency of stool, use of loperamid, level of incontinence (Wexner score) and perianal dermatitis were detected. The mean follow-up time was 18.6 years in the hand-sewn anastomosis group and 7.6 years in the PPH group. In the hand-sewn anastomosis group in 4/29 cases (13.8%) the removal of the pouch with definite ileostomy were necessary (2 pouchitis, 1 pouch necrosis, 1 recidiv rectum cancer); the mean stool frequency was 4.3 per day; the Wexner incontinence score was 8.5 and 2/15 patients (13.3%) live with ileostomy caused by incontinence. In the PPH stapled ileo-anal anastomosis group in 4/88 cases (4.5%) were the pouch removed (caused by pouchitis), the mean stool frequency was 4.0 per day; the Wexner score was 7.6 and 4/61 patients (6.6%) live with ileostomy caused by incontinence. Based on our experience the ileo-anal anastomosis performed by PPH stapler is technically feasible, seems to be

Compression Molding and Novel Sintering Treatments for Alnico Type-8 Permanent Magnets in Near-Final Shape with Preferred Orientation

DOE PAGES

Kassen, Aaron G.; White, Emma M. H.; Tang, Wei; ...

2017-07-14

We present economic uncertainty in the rare earth (RE) permanent magnet marketplace, as well as in an expanding electric drive vehicle market that favors permanent magnet alternating current synchronous drive motors, motivated renewed research in RE-free permanent magnets like “alnico,” an Al-Ni-Co-Fe alloy. Thus, high-pressure, gas-atomized isotropic type-8H pre-alloyed alnico powder was compression molded with a clean burn-out binder to near-final shape and sintered to density >99% of cast alnico 8 (full density of 7.3 g/cm 3). To produce aligned sintered alnico magnets for improved energy product and magnetic remanence, uniaxial stress was attempted to promote controlled grain growth, avoidingmore » directional solidification that provides alignment in alnico 9. Lastly, successful development of solid-state powder processing may enable anisotropically aligned alnico magnets with enhanced energy density to be mass-produced.« less

A Vascular Anastomosis Simulation Can Provide a Safe and Effective Environment for Resident Skills Development.

PubMed

Heelan Gladden, Alicia A; Conzen, Kendra D; Benge, Michael J; Gralla, Jane; Kennealey, Peter T

2018-04-09

Vascular anastomoses are complex surgical procedures, performed in time-sensitive circumstances, making intraoperative teaching more challenging. We sought to evaluate whether a vascular anastomosis simulation was effective in developing resident skills. General surgery residents participated in a vascular anastomosis simulation for 1 to 2hours during their transplant rotation. An attending transplant surgeon at the University of Colorado guided the resident through end-to-end and end-to-side anastomoses using bovine carotid artery (Artegraft). The residents completed a presimulation and postsimulation survey which quantitated their confidence. They also completed the MiSSES scale, which assessed the validity of the simulation. Twenty residents participated in the simulation and completed the surveys. The residents reported increased understanding in how to set up an end-to-end anastomosis and an end-to-side anastomosis (p = 0.001 and p = 0.009, respectively). They reported increased ability to suture, forehand and backhand with a Castro-Viejo needle driver (both p < 0.001). The residents reported increased ability to manipulate the needle (p = 0.006), and increased ability to manipulate tissue without causing trauma (p = 0.021). They reported increased confidence in tying a surgical knot with 6-0 Prolene and in operating while wearing loupes (p = 0.002, and p < 0.001, respectively). Overall, the residents reported increased confidence when asked to perform part of a vascular anastomosis in the operating room (p < 0.001). Seventeen residents completed the MiSSES scale with median scores of "somewhat agree" to "strongly agree" on all domains of the scale. The use of a simple, inexpensive vascular anastomosis simulation is an effective and safe environment to improve residents' surgical skills and the residents felt that the simulation was valid. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Exteriorized colon anastomosis for unprepared bowel: An alternative to routine colostomy

PubMed Central

Asfar, Sami K; Al-Sayer, Hilal M; Juma, Talib H

2007-01-01

AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self-inflected and iatrogenic colon injuries, stab wounds and blast injury of the colon, volvulus sigmoid, obstructing left colon cancer, and strangulated ventral hernia). Another 17 patients were managed electively for other colon pathologies. During laparotomy, the involved segment was resected and the two ends of the colon were brought out via a separate colostomy wound. One layer of interrupted 3/0 silk was used for colon anastomosis. The exteriorized segment was immediately covered with a colostomy bag. Between the 5th and 7th postoperative day, the colon was easily dropped into the peritoneal cavity. The defect in the abdominal wall was closed with interrupted nonabsorbable suture. The skin was left open for secondary closure. RESULTS: The mean hospital stay (± SD) was 11.5 ± 2.6 d (8-20 d). The exteriorized colon was successfully dropped back into the peritoneal cavity in all patients except two. One developed a leak from oesophago-jejunostomy and from the exteriorized colon. She subsequently died of sepsis and multiple organ failure (MOF). In a second patient the colon proximal to the exteriorized anastomosis prolapsed and developed severe serositis, an elective ileo-colic anastomosis (to the left colon) was successfully performed. CONCLUSION: Exteriorized colon anastomosis is simple, avoids the inconvenience of colostomy and can be an alternative to routine colostomy. It is suitable where colostomy is socially unacceptable or the facilities and care is not available. PMID:17589900

The effect of three different surgical techniques for colon anastomosis on regional postoperative microperfusion: Laser Doppler Flowmetry study in pigs.

PubMed

Kaska, Milan; Blazej, Slavomir; Turek, Zdenek; Ryska, Ales; Jegorov, Boris; Radochova, Vera; Bezouska, Jan; Paral, Jiri

2018-01-01

The optimal surgical approach to reconnecting bowel ends safely after resection is of great importance. This project is focused on assessment of the perianastomotic microcirculation quality in the short postoperative period when using three different anastomosis techniques in experimental animal. The experimental study involved 27 young female domestic pigs divided into three subgroups of 9 animals according to each surgical method of anastomosis construction in the sigmoid colon region: by manual suture, by stapler, or by gluing. Blood microcirculation in the anastomosis region was monitored using Laser Doppler Flowmetry (LDF). Anastomosis healing was evaluated by macroscopic and histological examination. Evaluation of the microcirculation in the anastomosis region showed the smallest decrease in perfusion values in animals reconstructed by suturing (Δ= -38.01%). A significantly more profound drop was observed postoperatively after stapling or gluing (Δ= -52.42% and Δ= -59.53%, respectively). All performed anastomoses healed without any signs of tissue and function pathology. Sewing, stapling, and gluing techniques for bowel anastomosis each have a different effect on regional microcirculation during 120 min. postoperatively. Nevertheless, the final results of anastomosis healing were found without of any pathology in all experimental animals managed by above mentioned anastomotic techniques.

Compressive strength and magnetic properties of calcium silicate-zirconia-iron (III) oxide composite cements

NASA Astrophysics Data System (ADS)

Ridzwan, Hendrie Johann Muhamad; Shamsudin, Roslinda; Ismail, Hamisah; Yusof, Mohd Reusmaazran; Hamid, Muhammad Azmi Abdul; Awang, Rozidawati Binti

2018-04-01

In this study, ZrO2 microparticles and γ-Fe2O3 nanoparticles have been added into calcium silicate based cements. The purpose of this experiment was to investigate the compressive strength and magnetic properties of the prepared composite cement. Calcium silicate (CAS) powder was prepared by hydrothermal method. SiO2 and CaO obtained from rice husk ash and limestone respectively were autoclaved at 135 °C for 8 h and sintered at 950°C to obtain CAS powder. SiO2:CaO ratio was set at 45:55. CAS/ZrO2 sample were prepared with varying ZrO2 microparticles concentrations by 0-40 wt. %. Compressive strength value of CAS/ZrO2 cements range from 1.44 to 2.44 MPa. CAS/ZrO2/γ-Fe2O3 sample with 40 wt. % ZrO2 were prepared with varying γ-Fe2O3 nanoparticles concentrations (1-5 wt. %). The additions of γ-Fe2O3 nanoparticles showed up to twofold increase in the compressive strength of the cement. X-Ray diffraction (XRD) results confirm the formation of mixed phases in the produced composite cements. Vibrating sample magnetometer (VSM) analysis revealed that the ferromagnetic behaviour has been observed in CAS/ZrO2/γ-Fe2O3 composite cements.

The side-to-side fashion for individual distal coronary anastomosis using venous conduit.

PubMed

Kato, Takayoshi; Tsunekawa, Tomohiro; Motoji, Yusuke; Hirakawa, Akihiro; Okawa, Yasuhide; Tomita, Shinji

2017-04-01

Regarding to coronary artery bypass grafting (CABG), the end-to-side anastomosis (ESA) has been performed as a gold standard. Recently, the effectiveness of the distal side-to-side anastomosis (SSA) in CABG using internal mammary artery has been reported. The benefit of SSA comparing to ESA also has been disclosed by computing simulation. However, use of SSA by venous conduit for individual CABG has not been reported. In this study, we investigated feasibility of SSA. From January 2013 to October 2014, we conducted 114 CABGs. There were 92 venous distal anastomoses without sequential anastomotic site (61 SSA and 31 ESA). The anastomosis was evaluated before discharge and at 1 year after the procedure by angiography or multi-detector row computed tomographic coronary angiography. The median values for time to anastomosis were 13 min in the two group (p = 0.89). There was no revision of anastomosis in both groups. Additional stitches for hemostasis were required significantly less in SSA than ESA (18.0 vs 45.2 %, respectively, p < 0.05). Early angiographic patency; 96.6 % for SSA vs 93.5 % for ESA (p = 0.50), and percentage of good anastomotic figure; 91.2 % for SSA vs 87.1 % for ESA (p = 0.54) were similar in both groups. The angiographic patency at 1 year were 92.9 % for SSA and 81.0 % for ESA (p = 0.16). There was no predictive factor for early and late graft failure. Our study showed feasibility of SSA using venous conduit in individual CABG based on early and mid-term angiographic results. This anastomotic fashion is easy to perform and maybe beneficial in blood flow pattern.

Laparoscopic proctocolectomy with ileal j-pouch anal anastomosis in children.

PubMed

Ateş, Ufuk; Ergün, Ergun; Göllü, Gülnur; Küçük, Gönül; Yağmurlu, Aydın

2017-09-01

We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two. None of the children had a major complication. Even though the presented study does not have any comparable data, it seems that laparoscopic total proctocolectomy with ileal J-pouch anal anastomosis (TP IPAA) might be the best choice of surgery because it provides good continence with low complication rates.

Predictive value of magnetic resonance for identifying neurovascular compressions in trigeminal neuralgia.

PubMed

Ruiz-Juretschke, F; Guzmán-de-Villoria, J G; García-Leal, R; Sañudo, J R

2017-05-23

Microvascular decompression (MVD) is accepted as the only aetiological surgical treatment for refractory classic trigeminal neuralgia (TN). There is therefore increasing interest in establishing the diagnostic and prognostic value of identifying neurovascular compressions (NVC) using preoperative high-resolution three-dimensional magnetic resonance (MRI) in patients with classic TN who are candidates for surgery. This observational study includes a series of 74 consecutive patients with classic TN treated with MVD. All patients underwent a preoperative three-dimensional high-resolution MRI with DRIVE sequences to diagnose presence of NVC, as well as the degree, cause, and location of compressions. MRI results were analysed by doctors blinded to surgical findings and subsequently compared to those findings. After a minimum follow-up time of six months, we assessed the surgical outcome and graded it on the Barrow Neurological Institute pain intensity score (BNI score). The prognostic value of the preoperative MRI was estimated using binary logistic regression. Preoperative DRIVE MRI sequences showed a sensitivity of 95% and a specificity of 87%, with a 98% positive predictive value and a 70% negative predictive value. Moreover, Cohen's kappa (CK) indicated a good level of agreement between radiological and surgical findings regarding presence of NVC (CK 0.75), type of compression (CK 0.74) and the site of compression (CK 0.72), with only moderate agreement as to the degree of compression (CK 0.48). After a mean follow-up of 29 months (range 6-100 months), 81% of the patients reported pain control with or without medication (BNI score i-iiiI). Patients with an excellent surgical outcome, i.e. without pain and off medication (BNI score i), made up 66% of the total at the end of follow-up. Univariate analysis using binary logistic regression showed that a diagnosis of NVC on the preoperative MRI was a favorable prognostic factor that significantly increased the odds of

Eversion Bile Duct Anastomosis: A Safe Alternative for Bile Duct Size Discrepancy in Deceased Donor Liver Transplantation.

PubMed

Leal-Leyte, Pilar; McKenna, Greg J; Ruiz, Richard M; Anthony, Tiffany L; Saracino, Giovanna; Giuliano, Testa; Klintmalm, Goran B; Kim, Peter Tw

2018-04-10

Introduction Bile duct size discrepancy in liver transplantation may increase the risk of biliary complications. The aim of this study was to evaluate the safety and outcomes of the eversion bile duct anastomosis technique in deceased donor liver transplantation (DDLT) with duct to duct anastomosis. Methods A total of 210 patients who received a DDLT with duct to duct anastomosis from 2012 to 2017 were divided into two groups: those who had eversion bile duct anastomosis (N=70) and standard bile duct anastomosis (N=140). Biliary complications rates were compared between the two groups. Results There was no difference in the cumulative incidence of biliary strictures (P=0.20) and leaks (P=0.17) between the two groups. The biliary complication rate in the eversion group was 14.3% and 11.4% in the standard anastomosis group. All the biliary complications in the eversion group were managed with endoscopic stenting. A severe size mismatch (≥3:1 ratio) was associated with a significantly higher incidence of biliary strictures (44.4%) compared to 2:1 ratio (8.2%), (P=0.002). Conclusion The use of the eversion technique is a safe alternative for bile duct discrepancy in deceased donor liver transplantation; however, severe bile duct size mismatch may be a risk factor for biliary strictures with such technique. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

A modified uncut Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy: preliminary results and initial experience.

PubMed

Ma, Jun-Jun; Zang, Lu; Yang, Annie; Hu, Wei-Guo; Feng, Bo; Dong, Feng; Wang, Ming-Liang; Lu, Ai-Guo; Li, Jian-Wen; Zheng, Min-Hua

2017-11-01

To investigate the safety and feasibility of totally laparoscopic uncut Roux-en-Y anastomosis in the distal gastrectomy with D2 dissection for gastric cancer. We also summarized the preliminary experience of totally laparoscopic uncut Roux-en-Y anastomosis. A retrospective analysis was done in 51 cases of total laparoscopic uncut Roux-en-Y anastomosis in the distant gastrectomy with D2 dissection for gastric cancer in our hospital from September 2014 to December 2015. All of 51 cases underwent total laparoscopic uncut Roux-en-Y anastomosis. All the procedures were performed successfully. There were neither conversions to open surgery nor intraoperative complications in all 51 cases. In this study, the median operative time was 170 (135-210) min and the median time of anastomosis was 27 (24-41) min. The blood loss was 60 (30-110) ml. The time to flatus and length of postoperative hospital stay were 2 (1-3) days, and 8 (7-12) days, respectively. The mean lymph node harvest was 34 (18-49). One anastomotic bleeding occurred postoperatively which was cured by conservative treatment. No major postoperative complication occurred, such as anastomotic leak, anastomotic stenosis, and Roux stasis syndrome. After a short-term follow-up, no recanalization or reflux gastritis was encountered by endoscopy. The totally laparoscopic uncut Roux-en-Y anastomosis in distal gastrectomy with lymph node dissection for gastric cancer is safe and feasible, with a very low rate of recanalization and reflux gastritis.

Impact of top end anastomosis design on patency and flow stability in coronary artery bypass grafting.

PubMed

Koyama, Sachi; Kitamura, Tadashi; Itatani, Keiichi; Yamamoto, Tadashi; Miyazaki, Shohei; Oka, Norihiko; Nakashima, Kouki; Horai, Tetsuya; Ono, Minoru; Miyaji, Kagami

2016-05-01

For coronary artery bypass grafting (CABG), free grafts such as a saphenous vein or radial artery are often used for grafts to the lateral and posterior walls. However, the relationship between top-end anastomosis design and long-term patency remains unknown. Because coronary artery blood flow is dominant during diastole, top-end anastomosis may work better if the graft is directed towards the apex, whereas the shortest graft pathway appears to be most efficient. Using computational fluid dynamic models, we evaluated the hemodynamic variables that were affected by the angle of the top-end anastomosis. We created three-dimensional geometries of the aortic root with coronary arteries that involved 75 % stenosis in the obtuse marginal and postero-lateral branches. Two bypass models under vasodilator administration were created: in a"Model A", the top-end anastomosis is parallel to the long axis of the ascending aorta and the graft passed over the conus directed towards the apex; in a "Model B", the top-end anastomosis is directed toward the shortest pathway, and form near the right angles to the long axis of the ascending aorta. Wall shear stress (WSS) and its fluctuation, an oscillatory shear index (OSI) were evaluated to predict fibrosis progression at the anastomosis site and graft flow. Graft flow was 197.3 ml/min and 207.3 ml/min in the "Model A" and "Model B", respectively. The minimal WSS value inside the graft with the "Model A" and "Model B" was 0.53 Pa and 4.09 Pa, respectively, and the OSI value was 0.46 and 0.04, respectively. The top-end anastomosis of a free graft should be directed vertically towards the aorta to achieve the shortest graft pathway to maintain a high graft flow rate and to avoid the risks of endothelial fibrosis and plaque progression over the long-term after CABG.

Two-dimensional simulations of thermonuclear burn in ignition-scale inertial confinement fusion targets under compressed axial magnetic fields

DOE Office of Scientific and Technical Information (OSTI.GOV)

Perkins, L. J.; Logan, B. G.; Zimmerman, G. B.

2013-07-15

We report for the first time on full 2-D radiation-hydrodynamic implosion simulations that explore the impact of highly compressed imposed magnetic fields on the ignition and burn of perturbed spherical implosions of ignition-scale cryogenic capsules. Using perturbations that highly convolute the cold fuel boundary of the hotspot and prevent ignition without applied fields, we impose initial axial seed fields of 20–100 T (potentially attainable using present experimental methods) that compress to greater than 4 × 10{sup 4} T (400 MG) under implosion, thereby relaxing hotspot areal densities and pressures required for ignition and propagating burn by ∼50%. The compressed fieldmore » is high enough to suppress transverse electron heat conduction, and to allow alphas to couple energy into the hotspot even when highly deformed by large low-mode amplitudes. This might permit the recovery of ignition, or at least significant alpha particle heating, in submarginal capsules that would otherwise fail because of adverse hydrodynamic instabilities.« less

Interaction of laser beams with magnetized substance in a strong magnetic field

NASA Astrophysics Data System (ADS)

Kuzenov, V. V.

2018-03-01

Laser-driven magneto-inertial fusion assumed plasma and magnetic flux compression by quasisymmetric laser-driven implosion of magnetized target. We develop a 2D radiation magnetohydrodynamic code and a formulation for the one-fluid two-temperature equations for simulating compressible non-equilibrium magnetized target plasma. Laser system with pulse radiation with 10 ns duration is considered for numerical experiments. A numerical study of a scheme of magnetized laser-driven implosion in the external magnetic field is carried out.

Comparison of Liver Tumor Motion With and Without Abdominal Compression Using Cine-Magnetic Resonance Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eccles, Cynthia L.; Patel, Ritesh; Simeonov, Anna K.

2011-02-01

Purpose: Abdominal compression (AC) can be used to reduce respiratory liver motion in patients undergoing liver stereotactic body radiotherapy. The purpose of the present study was to measure the changes in three-dimensional liver tumor motion with and without compression using cine-magnetic resonance imaging. Patients and Methods: A total of 60 patients treated as a part of an institutional research ethics board-approved liver stereotactic body radiotherapy protocol underwent cine T2-weighted magnetic resonance imaging through the tumor centroid in the coronal and sagittal planes. A total of 240 cine-magnetic resonance imaging sequences acquired at one to three images each second for 30-60more » s were evaluated using an in-house-developed template matching tool (based on the coefficient correlation) to measure the magnitude of the tumor motion. The average tumor edge displacements were used to determine the magnitude of changes in the caudal-cranial (CC) and anteroposterior (AP) directions, with and without AC. Results: The mean tumor motion without AC of 11.7 mm (range, 4.8-23.3) in the CC direction was reduced to 9.4 mm (range, 1.6-23.4) with AC. The tumor motion was reduced in both directions (CC and AP) in 52% of the patients and in a single direction (CC or AP) in 90% of the patients. The mean decrease in tumor motion with AC was 2.3 and 0.6 mm in the CC and AP direction, respectively. Increased motion occurred in one or more directions in 28% of patients. Clinically significant (>3 mm) decreases were observed in 40% and increases in <2% of patients in the CC direction. Conclusion: AC can significantly reduce three-dimensional liver tumor motion in most patients, although the magnitude of the reduction was smaller than previously reported.« less

Quasi-neutral limit of Euler–Poisson system of compressible fluids coupled to a magnetic field

NASA Astrophysics Data System (ADS)

Yang, Jianwei

2018-06-01

In this paper, we consider the quasi-neutral limit of a three-dimensional Euler-Poisson system of compressible fluids coupled to a magnetic field. We prove that, as Debye length tends to zero, periodic initial-value problems of the model have unique smooth solutions existing in the time interval where the ideal incompressible magnetohydrodynamic equations has smooth solution. Meanwhile, it is proved that smooth solutions converge to solutions of incompressible magnetohydrodynamic equations with a sharp convergence rate in the process of quasi-neutral limit.

The search for a 100MA RancheroS magnetic flux compression generator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watt, Robert Gregory

2016-09-01

The Eulerian AMR rad-hydro-MHD code Roxane was used to investigate modifications to existing designs of the new RancheroS class of Magnetic Flux Compression Generators (FCGs) which might allow some members of this FCG family to exceed 100 MA driving a 10 nH static load. This report details the results of that study and proposes a specific generator modification which seems to satisfy both the peak current and desired risetime for the current pulse into the load. The details of the study and necessary modifications are presented. For details of the LA43S RancheroS FCG design and predictions for the first usemore » of the generator refer to the relevant publications.« less

Magnetic properties of Fe-Si steel depending on compressive and tensile stresses under sinusoidal and distorted excitations

NASA Astrophysics Data System (ADS)

Permiakov, V.; Pulnikov, A.; Dupré, L.; De Wulf, M.; Melkebeek, J.

2003-05-01

In this article, the magnetic properties of nonoriented electrical steel under sinusoidal and distorted excitations are investigated for the whole range of unidirectional mechanical stresses. The distorted flux obtained from the tooth tip of 3 kW induction machine at no-load test was put into the measurement system. The total losses increase for compressive stress both under sinusoidal and distorted excitations. For tensile elastic stresses, the total losses first decrease and then increase in a very similar way for both excitations. In contrast, the difference between total losses under sinusoidal and distorted magnetic fluxes becomes smaller with increase of the plastic strain. This work is a serious step toward complete characterization of the magnetic properties of electrical steel in the teeth area of induction machines. A deeper insight of that problem can improve the design of induction machines and other electromagnetic devices.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

PubMed

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

2015-01-01

Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

Effectiveness of bilateral tubotubal anastomosis in a large outpatient population

PubMed Central

Berger, Gary S.; Thorp, John M.; Weaver, Mark A.

2016-01-01

STUDY QUESTION Is bilateral tubotubal anastomosis a successful treatment in an outpatient patient population? SUMMARY ANSWER For women wanting children after tubal sterilization, bilateral tubotubal anastomosis is an effective outpatient treatment. WHAT IS KNOWN ALREADY With the current emphasis in reproductive medicine on high technology procedures, the effectiveness of female surgical sterilization reversal is often overlooked. Previous clinical studies of tubal sterilization reversal have been mostly retrospective analyses of small patient populations. STUDY DESIGN, SIZE, DURATION A cohort of women who underwent outpatient bilateral tubotubal anastomosis from January 2000 to June 2013 was followed prospectively until December 2014 to determine the proportions of women undergoing the procedure who became pregnant and who had live births. Data were collected at the time of pregnancy. Differences in pregnancy rates and live birth rates associated with age, race and sterilization method were evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 6692 women, aged 20–51 years, underwent outpatient bilateral tubotubal anastomosis. MAIN RESULTS AND THE ROLE OF CHANCE The crude overall pregnancy rate was 69%. The crude overall birth rate was 35%. Results varied according to age at sterilization reversal and the method of sterilization. Women under 30 years of age at reversal of ring/clip sterilizations had an 88% pregnancy rate and 62% birth rate. Pregnancy and birth rates declined as age increased at sterilization reversal. Coagulation sterilization reversals resulted in the lowest rates of pregnancies and births. Ligation/resection reversals had intermediate success rates. LIMITATIONS, REASONS FOR CAUTION Limitations of our study include probable underreporting of pregnancies based on patient-initiated reports; possible errors in the reporting of pregnancies or early miscarriages that may have been based solely on home pregnancy tests; and probable over

Anastomosis of endothelial sprouts forms new vessels in a tissue analogue of angiogenesis.

PubMed

Song, Jonathan W; Bazou, Despina; Munn, Lance L

2012-08-01

Here we describe a microfluidic device that accurately reproduces the dynamics of vascular anastomosis, the process by which vascular sprouts connect to achieve perfusion during angiogenesis. The micro-device features two parallel endothelial cell-lined vessel analogues separated by a 300 μm wide collagenous matrix into which the vessels can sprout and form perfused bridging connections. By accurately recapitulating anastomosis in vitro, the device will enable a new generation of studies of the mechanisms of angiogenesis and provide a novel and practical platform for drug screening.

Surgical treatment of ulcerative colitis: ileorectal vs ileal pouch-anal anastomosis.

PubMed

Scoglio, Daniele; Ahmed Ali, Usama; Fichera, Alessandro

2014-10-07

Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the current gold standard in the surgical treatment of ulcerative colitis (UC) refractory to medical management. A procedure of significant magnitude carries its own risks including anastomotic failure, pelvic sepsis and a low rate of neoplastic degeneration overtime. Recent studies have shown that total colectomy with ileorectal anastomosis (IRA) has been associated with good long-term functional results in a selected group of UC patients amenable to undergo a strict surveillance for the relatively high risk of cancer in the rectum. This manuscript will review and compare the most recent literature on IRA and IPAA as it pertains to postoperative morbidity and mortality, failure rates, functional outcomes and cancer risk.

A magnetic particle time-of-flight (MagPTOF) diagnostic for measurements of shock- and compression-bang time at the NIF (invited).

PubMed

Rinderknecht, H G; Sio, H; Frenje, J A; Magoon, J; Agliata, A; Shoup, M; Ayers, S; Bailey, C G; Gatu Johnson, M; Zylstra, A B; Sinenian, N; Rosenberg, M J; Li, C K; Sèguin, F H; Petrasso, R D; Rygg, J R; Kimbrough, J R; Mackinnon, A; Bell, P; Bionta, R; Clancy, T; Zacharias, R; House, A; Döppner, T; Park, H S; LePape, S; Landen, O; Meezan, N; Robey, H; Glebov, V U; Hohenberger, M; Stoeckl, C; Sangster, T C; Li, C; Parat, J; Olson, R; Kline, J; Kilkenny, J

2014-11-01

A magnetic particle time-of-flight (MagPTOF) diagnostic has been designed to measure shock- and compression-bang time using D(3)He-fusion protons and DD-fusion neutrons, respectively, at the National Ignition Facility (NIF). This capability, in combination with shock-burn weighted areal density measurements, will significantly constrain the modeling of the implosion dynamics. This design is an upgrade to the existing particle time-of-flight (pTOF) diagnostic, which records bang times using DD or DT neutrons with an accuracy better than ±70 ps [H. G. Rinderknecht et al., Rev. Sci. Instrum. 83, 10D902 (2012)]. The inclusion of a deflecting magnet will increase D(3)He-proton signal-to-background by a factor of 1000, allowing for the first time simultaneous measurements of shock- and compression-bang times in D(3)He-filled surrogate implosions at the NIF.

Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

PubMed Central

Messinger, Lauren B.; Alford, Connie E.; Csokmay, John M.; Henne, Melinda B.; Mumford, Sunni L.; Segars, James H.; Armstrong, Alicia Y.

2016-01-01

Objective To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation. Design Cost-effectiveness analysis. Setting Not applicable. Patient(s) Not applicable. Intervention(s) Not applicable. Main Outcome Measure(s) Cost per ongoing pregnancy. Result(s) Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups <35 and 35–40, years tubal anastomosis was more cost effective than IVF for ongoing pregnancy. Sensitivity analyses validated these findings across a wide range of ongoing pregnancy probabilities as well as costs per procedure. Conclusion(s) Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling. PMID:26006734

Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation.

PubMed

Messinger, Lauren B; Alford, Connie E; Csokmay, John M; Henne, Melinda B; Mumford, Sunni L; Segars, James H; Armstrong, Alicia Y

2015-07-01

To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation. Cost-effectiveness analysis. Not applicable. Not applicable. Not applicable. Cost per ongoing pregnancy. Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups <35 and 35-40, years tubal anastomosis was more cost effective than IVF for ongoing pregnancy. Sensitivity analyses validated these findings across a wide range of ongoing pregnancy probabilities as well as costs per procedure. Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling. Copyright © 2015 American Society for Reproductive Medicine. All rights reserved.

Electromotive force in strongly compressible magnetohydrodynamic turbulence

NASA Astrophysics Data System (ADS)

Yokoi, N.

2017-12-01

Variable density fluid turbulence is ubiquitous in geo-fluids, not to mention in astrophysics. Depending on the source of density variation, variable density fluid turbulence may be divided into two categories: the weak compressible (entropy mode) turbulence for slow flow and the strong compressible (acoustic mode) turbulence for fast flow. In the strong compressible turbulence, the pressure fluctuation induces a strong density fluctuation ρ ', which is represented by the density variance <ρ'2> (<·> denotes the ensemble average). The turbulent effect on the large-scale magnetic-field B induction is represented by the turbulent electromotive force (EMF) (u': velocity fluctuation, b': magnetic-field fluctuation). In the usual treatment in the dynamo theory, the expression for the EMF has been obtained in the framework of incompressible or weak compressible turbulence, where only the variation of the mean density <ρ>, if any, is taken into account. We see from the equation of the density fluctuation ρ', the density variance <ρ'2> is generated by the large mean density variation ∂<ρ> coupled with the turbulent mass flux <ρ'u'>. This means that in the region where the mean density steeply changes, the density variance effect becomes relevant for the magnetic field evolution. This situation is typically the case for phenomena associated with shocks and compositional discontinuities. With the aid of the analytical theory of inhomogeneous compressible magnetohydrodynamic (MHD) turbulence, the expression for the turbulent electromotive force is investigated. It is shown that, among others, an obliqueness (misalignment) between the mean density gradient ∂<ρ> and the mean magnetic field B may contribute to the EMF as ≈χ B×∂<ρ> with the turbulent transport coefficient χ proportional to the density variance (χ <ρ'2>). This density variance effect is expected to strongly affect the EMF near the interface, and changes the transport

[Intraoperational and postoperational complications of colo-rectal anastomosis prepared by classical and stapler techniques].

PubMed

Pasić, Fuad; Hasukić, Sefik; Serak, S; Mehmedagić, I; Mesić, Deso

2008-01-01

Resectional surgery on rectum, finishing with continued colo-rectal anastomosis by the classical manual technique, were burdened by a great number of post surgery complications of dehiscentio over 60%. If we take into reconsideration a high number of mortality 5-20% then we have valid reasons for developing modern and safer methods of surgical intervention of these patients. Two groups of 60 patients each, have been analyzed. They have been operated at the Surgical clinic University Clinical Center Tuzla because of rectum malignancy. The first group of patients where the colo-rectal anastomosis was manually operated was done between 1995-1998. In the second group of the patients being operated, colorectal continuity was done by stapler. The patients were operated in time period 2001-2002. The medium evaluation time was 20 months, for each group. All the patients were operated in elective programme, after endoscopic treatment and ph diagnosis done. The patients from the both analyzed groups were operated by the same surgeons. Preoperational procedure and postoperational observation was fullfilled according to the unified protocol. The patients with their colo-rectal continuity having been by stapler had a shorter surgery time, and less transfusion of blood. They had less ureter lesion. Also they have got a shorter hospitalization time with less number of anastomotic complications. Dehiscenc as well as bleeding. The patients with colorectal anastomosis made manually had more repeated surgeries. The patients from the manual group of the surgeries had more anastomotic relapses. The difference in the number of post operational strictures in both analyzed groups was not noticed. The patients with stapler colorectal anastomosis had no mortality. The manual group had one lethal case. The important thing that is noticed is a larger number of stapler colorectal anastomosis, not because of the illnes incidence increase but decrease of abdominoperineal rectum amputation. The

Ivor Lewis esophagectomy with manual esogastric anastomosis by thoracoscopy in prone position and laparoscopy.

PubMed

Cadière, G B; Dapri, G; Himpens, J; Fodderie, L; Rajan, A

2010-06-01

Only a few authors have reported the technique of Ivor Lewis esophagectomy by minimally invasive means, and anastomosis was usually performed by a circular stapler. We report an Ivor Lewis esophagogastrectomy with manual esogastric anastomosis performed by thoracoscopy in the prone position. An adenocarcinoma of the distal esophagus without lymph nodes invasion was diagnosed in a 51-year-old man. General anesthesia and double-lumen endotracheal tube intubation were used. First the patient was placed in the supine position, and five abdominal trocars were placed. Celiac lymphadenectomy was performed with section of the left gastric vessels. A wide Kocher maneuver and pyloroplasty were performed. A wide gastric tube was performed and advanced through the hiatus into the right chest. Subsequently the patient was placed in the prone position. Three trocars (two 5-mm and one 11-mm) were placed on the posterior axillary line in the fifth, seventh, and ninth right intercostal space. The intrathoracic esophagus was dissected. Mediastinal lymphadenectomy with en bloc resection of the left inferior mediastinal pleura was performed. The azygos vein was sectioned, and the esophagus was transected by scissors 1-cm cranial to the azygos vein. A completely thoracoscopic manual double-layer anastomosis was performed by using running sutures with PDS 2/0 externally and Maxon 4/0 internally. Finally the patient was replaced in the supine position to retrieve the specimen through a suprapubic incision, and the gastric tube was fixed to the hiatus. Thoracoscopy lasted 157' (anastomosis 40'), laparoscopy 160', and second laparoscopy 20'. Blood loss was estimated at 170 ml. The gastrograffin swallow on postoperative day 4 showed absence of stenosis and leak. The patient was discharged on postoperative day 6. Thoracoscopy in the prone position allows the surgeon to perform a thoracoscopic esogastric anastomosis completely handsewn without selective lung desufflation, and using only three

EARLY AND LATE COMPLICATIONS AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMY OR ANASTOMOSIS

PubMed Central

Liu, Liyan; Herrinton, Lisa J.; Hornbrook, Mark C.; Wendel, Christopher S.; Grant, Marcia; Krouse, Robert S.

2012-01-01

Purpose Among long-term (≥5 years) colorectal cancer survivors with permanent ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life. Background The incidence and effects of complications on long-term health-related quality of life among colorectal cancer survivors are not adequately understood. Methods Participants (284 ostomy/395 anastomosis) were long-term colorectal cancer survivors enrolled in an integrated health plan. Health-related quality of life was assessed via mailed survey questionnaire in 2002–2005. Information on colorectal cancer, surgery, co-morbidities, and complications was obtained from computerized data and analyzed using survival analysis and logistic regression. Results Ostomy and anastomosis survivors were followed an average 12.1 and 11.2 years, respectively. Within 30 days of surgery, 19% of ostomy and 10% of anastomosis survivors experienced complications (p<0.01). From 31 days on, the percentages were 69% and 67% (after adjustment, p<0.001). Bleeding and post-operative infection were common early complications. Common long-term complications included hernia, urinary retention, hemorrhage, skin conditions, and intestinal obstruction. Ostomy was associated with long-term fistula (odds ratio 5.4; 95% CI 1.4–21.2), and among ostomy survivors, fistula was associated with reduced health-related quality of life (p<0.05). Conclusions Complication rates remain high despite recent advances in surgical treatment methods. Survivors with ostomy have more complications early in their survivorship period, but complications among anastomosis survivors catch up after 20 years, when the two groups have convergent complication rates. Among colorectal cancer survivors with ostomy, fistula has especially important implications for health-related quality of life. PMID:20087096

Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis.

PubMed

Alavi, Mubarika; Wendel, Christopher S; Krouse, Robert S; Temple, Larissa; Hornbrook, Mark C; Bulkley, Joanna E; McMullen, Carmit K; Grant, Marcia; Herrinton, Lisa J

2017-11-01

Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is associated with patient, disease, and treatment characteristics. The cohort study included Kaiser Permanente members who were long-term (≥5 years) rectal cancer survivors with anastomosis. Bowel function was scored using the self-administered, 14-item Memorial Sloan-Kettering Cancer Center Bowel Function Index. Patient, cancer, and treatment variables were collected from the electronic medical chart. We used multiple regression to assess the relationship of patient- and treatment-related variables with the bowel function score. The study included 381 anastomosis patients surveyed an average 12 years after their rectal cancer surgeries. The total bowel function score averaged 53 (standard deviation, 9; range, 31-70, higher scores represent better function). Independent factors associated with worse total bowel function score included receipt of radiation therapy (yes vs. no: 5.3-unit decrement, p < 0.0001), tumor distance from the anal verge (≤6 cm vs. >6 cm: 3.2-unit decrement, p < 0.01), and history of a temporary ostomy (yes vs. no: 4.0-unit decrement, p < 0.01). One factor measured at time of survey was also associated with worse total bowel function score: ever smoking (2.3-unit decrement, p < 0.05). The regression model explained 20% of the variation in the total bowel function score. Low tumor location, radiation therapy, temporary ostomy during initial treatment, and history of smoking were linked with decreased long-term bowel function following an anastomosis. These results should improve decision-making about surgical options.

The effect of Amifostine (Ethyol) on intestinal anastomosis in rats with radiation enteritis.

PubMed

Ozdemir, C S; Burgazli, K M; Beken-Ozdemir, E; Akdere, H; Mericliler, M; Ozcelik, M F

2013-05-01

Preoperative radiotherapy in colorectal cancers is being used as an adjuvant therapy with increasing frequency. Postoperative complications in early and late periods in various ratios are reported. It has also been shown that radiation has a delaying effect on wound healing and this effect is dose-dependent. This study investigated the effects of the Amifostine on healing of the irradiated colonic anastomosis. 30 female Wistar rats were divided randomly into three groups equally (n=10). Colonic anastomosis were performed to all rats. Group I served as a control. 800 rad abdominopelvic irradiation on the 5th day of preoperation was given to group II and III. Rats in the group III, prior to radiation, were given Amifostine at a dose of 200 mg/kg. On the 5th postoperative day all the rats were sacrificed and the healing of anastomosis was measured with bursting pressure, hydroxyproline levels and histopathological evaluations. Statistical analyses were expressed by analysis of variance (ANOVA) test and p < 0.05 was regarded as significant. In group II, all parameters were found lower compared with control group and Amifostine+Radiation group. As compared with hydroxyproline values and the anastomotic wound healing scores, except group II, no significantly difference were determined between the two other groups. In bursting pressure levels, Group I and III were higher than group II, but not statistically significant (p > 0.05). In group III (Amifostine+Radiation group), the hydroxyproline levels and anastomotic wound healing scores were found significantly higher than group II (p < 0.05), and no significant difference were found between the control group. It is determined that radiation given on the 5th preoperative day has a negative effect on anastomotic wound healing and administered Amifostine prevent this negative effect. In the light of these data, the Amifostine may have a positive effect on preoperative irradiated colonic anastomosis and may play an important

Comparison of anastomotic leakage and stricture formation following layered and stapler oesophagogastric anastomosis for cancer: a prospective randomized controlled trial.

PubMed

Zhang, Y S; Gao, B R; Wang, H J; Su, Y F; Yang, Y Z; Zhang, J H; Wang, C

2010-01-01

The objective of this prospective, randomized, controlled trial, conducted from May 2002 to December 2007, was to compare post-operative anastomotic leakage and stricture formation following layered manual versus stapler oesophagogastric anastomosis in patients who underwent resection of oesophageal or gastric cardia carcinoma. Patients (n = 516) were randomized to receive either layered manual or circular stapled oesophagogastric anastomosis. Mean follow-up time was > 12 months. Anastomotic leakage occurred in one (0.4%) patient in the layered group and six (2.2%) in the stapler group; no statistically significant between-group difference. After operation, two (0.8%) patients in the layered group and 13 (5.0%) in the stapler group developed a benign oesophageal stricture; the difference between the groups was statistically significant. Compared with stapler anastomosis, layered manual anastomosis may significantly reduce the incidence of anastomotic strictures. This method is easy to apply and could be used as an alternative procedure for oesophagogastric anastomosis after resection for oesophageal or cardia carcinoma.

Similar Outcome After Colonic Pouch and Side-to-End Anastomosis in Low Anterior Resection for Rectal Cancer

PubMed Central

Machado, Mikael; Nygren, Jonas; Goldman, Sven; Ljungqvist, Olle

2003-01-01

Objectives To compare a colonic J-pouch or a side-to-end anastomosis after low-anterior resection for rectal cancer with regard to functional and surgical outcome. Summary Background Data: A complication after restorative rectal surgery with a straight anastomosis is low- anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis. Methods: One-hundred patients with rectal cancer undergoing total mesorectal excision and colo-anal anastomosis were randomized to receive either a colonic pouch or a side-to-end anastomosis using the descending colon. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. Results: Fifty patients were randomized to each group. Patient characteristics in both groups were very similar regarding age, gender, tumor level, and Dukes’ stages. A large proportion of the patients received short-term preoperative radiotherapy (78%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height (4 cm), perioperative blood loss (500 ml), hospital stay (11 days), postoperative complications, reoperations or pelvic sepsis rates. Comparing functional results in the 2 study groups, only the ability to evacuate the bowel in <15 minutes at 6 months reached a significant difference in favor of the pouch procedure. Conclusions: The data from this study show that either a colonic J-pouch or a side-to-end anastomosis performed on the descending colon in low-anterior resection with total mesorectal excision are methods that can be used with similar expected functional and surgical results. PMID:12894014

Vesicopreputial anastomosis for the treatment of obstructive urolithiasis in goats.

PubMed

Cypher, Elizabeth Erin; van Amstel, Sarel R; Videla, Ricardo; Force Clark, Kyle; Anderson, David E

2017-02-01

To describe a novel surgical technique for the correction of recurrent obstructive urolithiasis in male goats. Clinical case series. Castrated male goats (n = 4). Medical records of male goats having undergone vesicopreputial anastomosis (VPA) as a treatment for obstructive urolithiasis were reviewed for history, signalment, clinical signs, and intraoperative and postoperative complications. Long-term follow-up (≥12 months) was obtained by telephone interview with owners or by clinical examination. All goats had undergone at least one surgical procedure (median, 2.5, range 2-4) to correct obstructive urolithiasis before undergoing VPA. Postoperative complications included premature removal of the tube from the bladder (1 goat), bacterial cystitis (2), and abscess formation (1). One goat suffered stricture of the anastomosis site 3 months following the original procedure and underwent a second VPA and 1 goat died 7 months after surgery due to severe, acute hydronephrosis and renal failure. Long-term survival ≥12 months was good with 3/4 goats (75%) or 3/5 VPA procedures (60%) having unobstructed urine flow at 12 months. Vesicopreputial anastomosis is a feasible surgical procedure for the correction of recurrent obstructive urolithiasis in male goats and one that can result in a favorable clinical outcome. Further investigation in a larger population of goats is warranted for the evaluation of the suitability of VPA in male goats with obstructive urolithiasis. © 2017 The American College of Veterinary Surgeons.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

PubMed Central

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; de Araújo, Thiago Cavalcante Vila Nova; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S.

2015-01-01

OBJECTIVE Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art. PMID:26735604

Surgical treatment of ulcerative colitis: Ileorectal vs ileal pouch-anal anastomosis

PubMed Central

Scoglio, Daniele; Ahmed Ali, Usama; Fichera, Alessandro

2014-01-01

Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the current gold standard in the surgical treatment of ulcerative colitis (UC) refractory to medical management. A procedure of significant magnitude carries its own risks including anastomotic failure, pelvic sepsis and a low rate of neoplastic degeneration overtime. Recent studies have shown that total colectomy with ileorectal anastomosis (IRA) has been associated with good long-term functional results in a selected group of UC patients amenable to undergo a strict surveillance for the relatively high risk of cancer in the rectum. This manuscript will review and compare the most recent literature on IRA and IPAA as it pertains to postoperative morbidity and mortality, failure rates, functional outcomes and cancer risk. PMID:25309058

A magnetic particle time-of-flight (MagPTOF) diagnostic for measurements of shock- and compression-bang time at the NIF (invited)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rinderknecht, H. G., E-mail: hgr@mit.edu; Sio, H.; Frenje, J. A.

A magnetic particle time-of-flight (MagPTOF) diagnostic has been designed to measure shock- and compression-bang time using D{sup 3}He-fusion protons and DD-fusion neutrons, respectively, at the National Ignition Facility (NIF). This capability, in combination with shock-burn weighted areal density measurements, will significantly constrain the modeling of the implosion dynamics. This design is an upgrade to the existing particle time-of-flight (pTOF) diagnostic, which records bang times using DD or DT neutrons with an accuracy better than ±70 ps [H. G. Rinderknecht et al., Rev. Sci. Instrum. 83, 10D902 (2012)]. The inclusion of a deflecting magnet will increase D{sup 3}He-proton signal-to-background by amore » factor of 1000, allowing for the first time simultaneous measurements of shock- and compression-bang times in D{sup 3}He-filled surrogate implosions at the NIF.« less

Absence of the genicular arterial anastomosis as generally depicted in textbooks.

PubMed

Sabalbal, M; Johnson, M; McAlister, V

2013-09-01

Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: 'direct communication', 'approaching communication' or 'no evident communication'. A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray's Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to normal arterial flow, which may be important if the LDAT

Absence of the genicular arterial anastomosis as generally depicted in textbooks

PubMed Central

Sabalbal, M; Johnson, M

2013-01-01

Introduction Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Methods Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: ‘direct communication’, ‘approaching communication’ or ‘no evident communication’. Results A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Conclusions Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray’s Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to

Recovery after intracorporeal anastomosis in laparoscopic right hemicolectomy: a systematic review and meta-analysis.

PubMed

Milone, Marco; Elmore, Ugo; Vignali, Andrea; Gennarelli, Nicola; Manigrasso, Michele; Burati, Morena; Milone, Francesco; De Palma, Giovanni Domenico; Delrio, Paolo; Rosati, Riccardo

2018-02-01

Although intracorporeal anastomosis (IA) appears to guarantee a faster recovery compared to extracorporeal anastomosis (EA), the data are still unclear. Thus, we performed a systematic review of the literature with meta-analysis to evaluate the recovery benefits of intracorporeal anastomosis. A systematic search was performed in electronic databases (PubMed, Web of Science, Scopus, EMBASE) using the following search terms in all possible combinations: "laparoscopic," "right hemicolectomy," "right colectomy," "intracorporeal," "extracorporeal," and "anastomosis." According to the pre-specified protocol, all studies evaluating the impact of choice of intra- or extracorporeal anastomosis after right hemicolectomy on time to first flatus and stools, hospital stay, and postoperative complications according to Clavien-Dindo classification were included. Sixteen articles were included in the final analysis, including 1862 patients who had undergone right hemicolectomy: 950 cases (IA) and 912 controls (EA). Patients who underwent IA reported a significantly shorter time to first flatus (MD = - 0.445, p = 0.013, Z = - 2.494, 95% CI - 0.795, 0.095), to first stools (MD = - 0.684, p < 0.001, Z = - 4.597, 95% CI - 0.976, 0.392), and a shorter hospital stay (MD = - 0.782, p < 0.001, Z = -3.867, 95% CI - 1.178, - 0.385) than those who underwent EA. No statistically significant differences in complications between the IA and EA patients were observed in the Clavien-Dindo I-II group (RD = - 0.014, p = 0.797, Z = - 0.257, 95% CI - 0.117, 0.090, number needed to treat (NNT) 74) or in the Clavien-Dindo IV-V (RD = - 0.005, p = 0.361, Z = - 0.933, 95% CI - 0.017, 0.006, NNT 184). The IA procedure led to fewer complications in the Clavien-Dindo III group (RD = - 0.041, p = 0.006, Z = - 2.731, 95% CI - 0.070, 0.012, NNT 24). Although intracorporeal anastomosis appears to be safe in terms of

PS1-09: Comparing the Greatest Challenges of Long-Term Rectal Cancer Survivors with Anastomosis Versus Ostomy

PubMed Central

McMullen, Carmit; Altschuler, Andrea; Bulkley, Joanna; Grant, Marcia; Hornbrook, Mark; Krouse, Robert

2012-01-01

Background Patients surgically treated for rectal cancer receive either an intestinal ostomy (externalization of the bowel to the abdominal wall) or, more frequently, an anastomosis (reconnection) of the rectum. While the challenges of intestinal ostomies have been previously described by this research team, much less is known about the long-term challenges of living with an anastomosis. Understanding the challenges of long-term rectal cancer survivors with both types of surgeries is important for informing and improving current practice. Methods We mailed our survey to 1000 long-term (at least 5 years post-diagnosis) rectal cancer survivors in KP Northern California and KP Northwest during 2010–2011. Our overall response rate was 57.7% (577/1000). The survey contained an open-ended question that asked respondents to write about the greatest challenge they experienced after their cancer surgery. Seventy-three percent of respondents provided a response to this “greatest challenge” question. Responses were analyzed qualitatively to compare the challenges reported by patients with anastomosis vs. ostomy. Results Challenges related to managing bowel function and output were found in both groups. Ostomy patients reported challenges to managing ostomy equipment that were unique to their condition—ostomy appliance failures, skin breakdown around the ostomy, and finding suitable places to empty, clean, and reconnect their appliance. Other notable differences in the greatest challenges among ostomy and anastomosis patients included: patients with an ostomy reported a range of psychosocial challenges relating to depression, shame, stigma, and post-operative psychological trauma about having an ostomy and such psychosocial impacts were notably absent among anastomosis patients; patients with ostomies reported regret about having an ostomy, but patients with anastomosis did not report regret about the surgery they received; and, anastomosis patients mentioned more

Role of plastic surgeons in hepatic artery anastomosis in living donor liver transplantation: our experience of 10 cases.

PubMed

Mangal, Mahesh; Gambhir, Swaroop; Gupta, Anubhav; Shah, Amiti

2012-07-01

To understand the practical difficulties encountered while performing hepatic artery anastomosis by microsurgical technique in living donor liver transplantation. We undertook a retrospective study of 10 cases of hepatic artery anastomosis done at the level of bifurcation of the right hepatic artery and proximal when the plastic surgery team was called in for assistance. All the anastomoses were performed under an operating microscope (up to 24× magnification). In seven of these cases, anterior wall anastomosis was performed primarily, and in three cases, posterior wall approach was chosen. The main indications of calling in the plastic surgery team were to overcome these technical hurdles: (1) in cases where the caliber of the vessel was less than 2 mm in size; (2) dissection (separation of mucosa and adventitia) of the recipient vessel wall; (3) donor pedicle being so short that possibility of revision of the anastomosis seemed unlikely, necessitating single, sure-shot anastomosis without a chance of revision. The problems encountered by our microsurgical team were: (1) a special set of instruments was warranted because of the depth of the hepatic artery; (2) anastomosis had to be done in standing, stooped position with unsupported hands; (3) excessive movements due to respiration and profuse fluid collection in the field added to the hurdles encountered. All patients were prospectively followed by color Doppler ultrasound protocol for the first 5 days after surgery. Hepatic artery thrombosis was encountered in one case on postoperative day 10, which was successfully treated by thrombolytic therapy, but unfortunately the patient died of multiorgan failure on posttransplant day 30. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Rectosigmoidectomy and end to end coloanal anastomosis with mechanical stapler for treatement of Hirschsprung disease].

PubMed

Gaztambide Casellas, J; Sánchez Díaz, F; García Soldevilla, N; Argos Rodríguez, M D; Pérez Rodríguez, J

2004-04-01

The experience of the Pediatric Surgical Service of the Materno Infantil University Hospital from Málaga on surgical treatment of the Hirschsprung disease by means of a modified technique of Swenson and Rehbein operations is presented. Between 1992 and 2001 25 patients were operated of a rectosigmoidectomy. Of them, 23 were diagnosed of Hirschsprung's disease, one suffered a rectal angiodisplasia and the other one presented with a rectal stenosis secondary to a previous rectosigmoidectomy. In all of them a transabdominal rectosigmoidectomy with coloanal end to end anastomosis by means of a circular intraluminal stapler was performed. In 10 of them (group A), a modified Rehbein operation with intraabdominal anastomosis was performed. In the remaining 15 patients (group B), a modified Swenson operation with exteriorization of the aganglionic colon through the anus and extrabdominal anastomosis was performed. The postoperative course was evaluated by measuring the postoperative fasting time and the first spontaneous deposition. The medium hospital stay was of 9 days, nevertheless in 16 patients (64%) was lower than 7 days. The postoperative complications are presented. It consists in 1 anastomotic leakage (4%), postoperative enterocolitis 1 case (4%) and transient anastomotic stenosis in 4 patients (16%). All of them were treated with conservative treatment except one case of stenosis which needed a sphincterotomy. The rectosigmoidectomy and coloanal end to end anastomosis with endoluminal stapler is a safe and easy to do technique to treat the Hirschsprung's disease allowing a deep rectal resection which is very difficult to achieve by manual suture. The anastomosis is located in and extraperitoneal position, with a minimum risk of peritoneal involvement in case of anastomotic leakage. The patients presented a fast recovery, a minimum of complications and good functional result.

A Bunch Compression Method for Free Electron Lasers that Avoids Parasitic Compressions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benson, Stephen V.; Douglas, David R.; Tennant, Christopher D.

2015-09-01

Virtually all existing high energy (>few MeV) linac-driven FELs compress the electron bunch length though the use of off-crest acceleration on the rising side of the RF waveform followed by transport through a magnetic chicane. This approach has at least three flaws: 1) it is difficult to correct aberrations--particularly RF curvature, 2) rising side acceleration exacerbates space charge-induced distortion of the longitudinal phase space, and 3) all achromatic "negative compaction" compressors create parasitic compression during the final compression process, increasing the CSR-induced emittance growth. One can avoid these deficiencies by using acceleration on the falling side of the RF waveformmore » and a compressor with M 56>0. This approach offers multiple advantages: 1) It is readily achieved in beam lines supporting simple schemes for aberration compensation, 2) Longitudinal space charge (LSC)-induced phase space distortion tends, on the falling side of the RF waveform, to enhance the chirp, and 3) Compressors with M 56>0 can be configured to avoid spurious over-compression. We will discuss this bunch compression scheme in detail and give results of a successful beam test in April 2012 using the JLab UV Demo FEL« less

Hybrid fluid-particle simulation of whistler-mode waves in a compressed dipole magnetic field: Implications for dayside high-latitude chorus

NASA Astrophysics Data System (ADS)

da Silva, C. L.; Wu, S.; Denton, R. E.; Hudson, M. K.; Millan, R. M.

2017-01-01

In this work we present a methodology for simulating whistler-mode waves self-consistently generated by electron temperature anisotropy in the inner magnetosphere. We present simulation results using a hybrid fluid/particle-in-cell code that treats the hot, anisotropic (i.e., ring current) electron population as particles and the background (i.e., the cold and inertialess) electrons as fluid. Since the hot electrons are only a small fraction of the total population, warm (and isotropic) particle electrons are added to the simulation to increase the fraction of particles with mass, providing a more accurate characterization of the wave dispersion relation. Ions are treated as a fixed background of positive charge density. The plasma transport equations are coupled to Maxwell's equations and solved in a meridional plane (a 2-D simulation with 3-D fields). We use a curvilinear coordinate system that follows the topological curvature of Earth's geomagnetic field lines, based on an analytic expression for a compressed dipole magnetic field. Hence, we are able to simulate whistler wave generation at dawn (pure dipole field lines) and dayside (compressed dipole) by simply adjusting one scalar quantity. We demonstrate how, on the dayside, whistler-mode waves can be locally generated at a range of high latitudes, within pockets of minimum magnetic field, and propagate equatorward. The obtained dayside waves (in a compressed dipole field) have similar amplitude and frequency content to their dawn sector counterparts (in a pure dipole field) but tend to propagate more field aligned.

MEMS-Based Handheld Fourier Domain Doppler Optical Coherence Tomography for Intraoperative Microvascular Anastomosis Imaging

PubMed Central

Huang, Yong; Furtmüller, Georg J.; Tong, Dedi; Zhu, Shan; Lee, W. P. Andrew; Brandacher, Gerald; Kang, Jin U.

2014-01-01

Purpose To demonstrate the feasibility of a miniature handheld optical coherence tomography (OCT) imager for real time intraoperative vascular patency evaluation in the setting of super-microsurgical vessel anastomosis. Methods A novel handheld imager Fourier domain Doppler optical coherence tomography based on a 1.3-µm central wavelength swept source for extravascular imaging was developed. The imager was minimized through the adoption of a 2.4-mm diameter microelectromechanical systems (MEMS) scanning mirror, additionally a 12.7-mm diameter lens system was designed and combined with the MEMS mirror to achieve a small form factor that optimize functionality as a handheld extravascular OCT imager. To evaluate in-vivo applicability, super-microsurgical vessel anastomosis was performed in a mouse femoral vessel cut and repair model employing conventional interrupted suture technique as well as a novel non-suture cuff technique. Vascular anastomosis patency after clinically successful repair was evaluated using the novel handheld OCT imager. Results With an adjustable lateral image field of view up to 1.5 mm by 1.5 mm, high-resolution simultaneous structural and flow imaging of the blood vessels were successfully acquired for BALB/C mouse after orthotopic hind limb transplantation using a non-suture cuff technique and BALB/C mouse after femoral artery anastomosis using a suture technique. We experimentally quantify the axial and lateral resolution of the OCT to be 12.6 µm in air and 17.5 µm respectively. The OCT has a sensitivity of 84 dB and sensitivity roll-off of 5.7 dB/mm over an imaging range of 5 mm. Imaging with a frame rate of 36 Hz for an image size of 1000(lateral)×512(axial) pixels using a 50,000 A-lines per second swept source was achieved. Quantitative vessel lumen patency, lumen narrowing and thrombosis analysis were performed based on acquired structure and Doppler images. Conclusions A miniature handheld OCT imager that can be used for

Laparoscopic Gastric Bypass for Morbid Obesity–a Randomized Controlled Trial Comparing Two Gastrojejunal Anastomosis Techniques

PubMed Central

Llopis, Salvador Navarrete; Isaac, Jose; Aulestia, Salvador Navarrete; Bravo, Carlos; Obregon, Francisco

2008-01-01

Objectives: We present a randomized controlled trial of laparoscopic gastric bypass comparing 2 techniques of gastrojejunostomy in patients with morbid obesity. Methods: Eighty consecutive patients underwent laparoscopic Roux-en-Y gastric bypass between September 2005 and August 2006. Patients were randomly assigned to 2 groups by the use of sealed envelopes. In group A, the gastrojejunal anastomosis was performed with a 21-mm circular-stapler, and in group B, this anastomosis was performed with a 45-mm linear-stapler. The rest of the procedure was identical in both groups. Variables evaluated were complications involving the gastrojejunostomy, operative time, length of stay, and percentage of excess weight loss. Results: Both groups were similar in age and body mass index. No patients experienced leakage or gastrojejunal anastomosis fistula, but group A patients had a more frequent stricture rate (P<0.05). Operative time and hospital stay were comparable in both groups (P>0.05). Percentage excess weight loss at one year following surgery was satisfactory in both groups, without a statistically significant difference (P>0.05). Conclusion: Gastrojejunal anastomosis does not seem to be a critical factor in excess weight loss for morbidly obese patients who underwent laparoscopic gastric bypass. The 2 techniques used in this experience are safe and effective; however, the 45-mm liner-stapler is preferable because it has a lower stricture rate. PMID:19275854

Compression-induced texture change in NiMnGa-polymer composites observed by synchrotron radiation

NASA Astrophysics Data System (ADS)

Scheerbaum, Nils; Hinz, Dietrich; Gutfleisch, Oliver; Skrotzki, Werner; Schultz, Ludwig

2007-05-01

Composites consisting of magnetic shape memory (MSM) particles embedded in a polyester matrix were prepared. Single-crystalline MSM particles were obtained by mortar grinding of melt-extracted and subsequently annealed Ni50.9Mn27.1Ga22.0 (at. %) fibers. The crystal structure of the martensite is tetragonal (5M) with c Magnetic characterization of these composites shows indirect evidence for stress induced twin boundary motion in the MSM particles, as the compressed composite is easy to magnetize in the direction of compression and more difficult to magnetize in the perpendicular directions. The texture of all the embedded MSM particles is investigated before and after compression by means of synchrotron radiation. In the initial state, the MSM particles in the composite have a random texture, i.e., there is no preferred orientation of the c axis. After a 30% compression (height reduction), the MSM particles have a (004)-fiber texture in the direction of compression. This is unambiguous evidence for stress induced twin boundary motion within the MSM particles.

Esophagojejunal anastomosis leakage after total gastrectomy for esophagogastric junction adenocarcinoma: options of treatment.

PubMed

Carboni, Fabio; Valle, Mario; Federici, Orietta; Levi Sandri, Giovanni Battista; Camperchioli, Ida; Lapenta, Rocco; Assisi, Daniela; Garofalo, Alfredo

2016-08-01

Esophagojejunal anastomosis leakage after total gastrectomy (TG) for esophagogastric junction (EGJ) adenocarcinoma (ADC) constitutes one of the most serious and sometimes life-threatening complications. Management remains controversial and still challenging. A total of 198 patients operated for type I and II EGJ ADC were reviewed. Diagnosis of leakage was based on a combination of clinical and radiological findings. It was classified including objective endoscopic and clinical parameters requiring different type of treatment. Anastomotic leakage was diagnosed in 14 patients (7%). Two cases recovered with conservative therapy. Six cases underwent endoscopy with clips placement in 2 and partially covered self-expandable metal stent placement in 4. Other two cases underwent reoperation with reconstruction of anastomosis and primary repair respectively. In the last four cases emergency surgery with total esophagectomy and diversion was required. Mortality occurred only in 3 of these patients and overall treatment was successful in 11 patients (78.5%). No consensus has been reached on the best method of esophagojejunal anastomosis leakage management and the rate of failure remains significant. Different options of treatment are available but early detection and multidisciplinary approaches are the keys to obtain successful results irrespective of the employed strategy.

Outcomes after 1.9-microm diode laser-assisted anastomosis in reconstructive microsurgery: results in 27 patients.

PubMed

Leclère, Franck M P; Schoofs, Michel; Buys, Bruno; Mordon, Serge R

2010-04-01

Microvascular surgery has become an important method for reconstructing surgical defects resulting from trauma, tumors, or burns. The most important factor for successful free flap transfer is a well-executed anastomosis. This study was performed to review the authors' experience with a 1.9-microm diode laser in microsurgery, with special attention to outcomes and performance of the technique. Between January of 2005 and December of 2007, 27 patients underwent microsurgery with a 1.9-microm diode laser at the authors' institute. The patients had a mean age of 31 years (range, 2 to 59 years); 14 patients were women and 13 patients were men. This technique was used for digital replantations (n = 2) and for free flap transfer (n = 27). Causes of the defects were trauma (n = 14), tumor (n = 9), congenital (n = 2), burn (n = 1), infection (n = 1), arthritis (n = 1), and dog bite (n = 1). Laser-assisted microvascular anastomosis was performed with a 1.9-microm diode laser after placement of equidistant stitches. The following parameters were used: spot size, 400 microm; power, 125 mW; time depending on vessel size (0.8 to 1.8 mm); and fluence varying from 70 to 200 J/cm. Three surgical revisions following hematoma and one rupture of the arterial anastomosis leading to a free deep inferior epigastric perforator flap necrosis resulting from high-dose radiotherapy before surgery occurred after laser-assisted microvascular anastomosis, accounting for an overall success rate of 96.6 percent. This study reports the numerous benefits of the technique: easier performance of vascular anastomosis with difficult access, decrease of reperfusion bleeding and complications, and a short learning curve.

A Safe and Reproducible Anastomotic Technique for Minimally Invasive Ivor Lewis Esophagectomy: The Circular Stapled Anastomosis with the Transoral Anvil

PubMed Central

Campos, Guilherme M; Jablons, David; Brown, Lisa M; Ramirez, René M; Rabl, Charlotte; Theodore, Pierre

2010-01-01

Objectives In expert hands, the intra-thoracic esophago-gastric anastamosis usually provides a low rate of strictures and leaks. However, anastomoses can be technically challenging and time consuming when minimally invasive techniques are used. We present our preliminary results of a standardized 25mm/4.8mm circular stapled anastomosis using a trans-orally placed anvil. Materials and Methods We evaluated a prospective cohort of 37 consecutive patients offered minimally invasive Ivor Lewis Esophagectomy at a tertiary referral center. The esophagogastric anastomosis was created using a 25mm anvil (Orvil, Autosuture, Norwalk, CT) passed trans-orally, in a tilted position, and connected to a 90cm long PVC delivery tube through an opening in the esophageal stump. The anastomosis was completed by joining the anvil to a circular stapler (EEA XL 25mm with 4.8mm Staples, Autosuture, Norwalk, CT) inserted into the gastric conduit. Primary outcomes were leak and stricture rates. Results Thirty-seven patients (mean age 65 yrs) with distal esophageal adenocarcinoma (n=29), squamous cell cancer (n=5), or high-grade dysplasia in Barrett's Esophagus (n=3) underwent an Ivor Lewis Esophagectomy between October 2007 and August 2009. The abdominal portion of the operation was completed laparoscopically in 30 patients (81.1%). The thoracic portion was done using a muscle sparing mini-thoracotomy in 23 patients (62.2%) and thoracoscopic techniques in 14 patients (37.8%). There were no intra-operative technical failures of the anastomosis or deaths. Five patients had strictures (13.5%) and all were successfully treated with endoscopic dilations. One patient had an anastomotic leak (2.7%) that was successfully treated by re-operation and endoscopic stenting of the anastomosis. Discussion The circular stapled anastomosis with the transoral anvil allows for an efficient, safe and reproducible anastomosis. This straightforward technique is particularly suited to the completely minimally

Applications of nuclear magnetic resonance in paediatric surgery: magnetic resonance cholangiopancreatography and new sequences.

PubMed

Ragazzi, S; Vanzulli, A; Del Maschio, A; Tomaselli, V; Dell' Agnola, C A

2007-12-01

The aim of the study was to evaluate fast magnetic resonance cholangio-pancreatography (MRCP) sequences as an alternative and safe investigation method for neonatal and children's pancreaticobiliary diseases. Between January 2000 and December 2000, five children (age: 1 month 14 years; mean: 7 years) affected by pancreaticobiliary diseases or already operated for biliary pathologies were studied. Patients were evaluated by 1.5 T magnet single shot T2-weighted sequences (1 image per s, TR = infinite, TE = 150-180 ms). T1-weighted conventional sequences were obtained to study parenchymal tissue. No patient needed general anaesthetic. Only in one case was sedation necessary. Fast MRCP sequences provided very precise information on biliary tract anatomy. They revealed the intra and extrahepatic bile ducts, the gallbladder, the common bile duct and the bilio-pancreatic junction in all cases investigated. MRCP allowed us to evaluate Roux-en-Y type bilio-enteric anastomosis as accurately as percutaneous transhepatic cholangiography (PTC). In addition MRCP was the only reliable study in evaluating Roux-en-Y type anastomosis where ultrasonography (US) and endoscopic retrograde cholangiography (ERCP) could not be used. In conclusion MRCP is an accurate and non-invasive method with which to investigate the anatomy of the pancreaticobiliary tract in children. It could become the investigation of choice after US in the case of biliary and pancreatic diseases.

Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

PubMed Central

Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

2015-01-01

Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA). PMID:26195886

Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

PubMed

Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

2015-01-01

Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA).

Hypoglossal-facial nerve anastomosis and rehabilitation in patients with complete facial palsy: cohort study of 30 patients followed up for three years

PubMed Central

Toffola, Elena Dalla; Pavese, Chiara; Cecini, Miriam; Petrucci, Lucia; Ricotti, Susanna; Bejor, Maurizio; Salimbeni, Grazia; Biglioli, Federico; Klersy, Catherine

2014-01-01

Summary Our study evaluates the grade and timing of recovery in 30 patients with complete facial paralysis (House-Brackmann grade VI) treated with hypoglossal-facial nerve (XII-VII) anastomosis and a long-term rehabilitation program, consisting of exercises in facial muscle activation mediated by tongue movement and synkinesis control with mirror feedback. Reinnervation after XII-VII anastomosis occurred in 29 patients, on average 5.4 months after surgery. Three years after the anastomosis, 23.3% of patients had grade II, 53.3% grade III, 20% grade IV and 3.3% grade VI ratings on the House-Brackmann scale. Time to reinnervation was associated with the final House-Brackmann grade. Our study demonstrates that patients undergoing XII-VII anastomosis and a long-term rehabilitation program display a significant recovery of facial symmetry and movement. The recovery continues for at least three years after the anastomosis, meaning that prolonged follow-up of these patients is advisable. PMID:25473738

The interrupted serosubmucosal anastomosis - still the gold standard.

PubMed

Leslie, A; Steele, R J C

2003-07-01

The single-layer appositional serosubmucosal anastomosis is a well established technique and appears to have a favourable record. Over a 15-year period the senior author of this paper has performed or directly supervised 553 anastomoses using this technique. This report describes the results of these operations, the results of stapled anastomoses carried out during the same period and discusses the utility of the handsewn technique. From August 1986 to July 2001, 553 intestinal anastomoses in 550 patients were fashioned using single-layer, interrupted serosubmucosal 3/0 braided polyamide and 131 anastomoses in 131 patients were performed using a circular anastomosing stapler. One anastomotic leakage occurred in the group of patients whose anastomosis was handsewn (0.2%) and 11 leaks occurred in those who had a stapled anastomoses (8.4%). The mortality rate in each group was similar (2% and 2.3%, respectively). There were no deaths attributable to anastomotic dehiscence in either group. In this prospectively audited series of 553 handsewn anastomoses the leakage rate was 0.2%. These results compare favourably with other published series and continue to support a single layer of interrupted serosubmucosal sutures as the gold standard for anastomoses involving the large or small bowel.

Fever and Diarrhea after Laparoscopic Bilioenteric Anastomosis

PubMed Central

Fazeli, Mohammad S.; Kazemeini, Alireza; Safari, Saeed; Larti, Farnoosh

2011-01-01

Bile duct injuries are well-known complications of laparoscopic and open cholecystectomies. Here, we report anastomosis of the common bile duct to the transverse colon that occurred as a complication of laparoscopic cholecystectomy. To the best of our knowledge, a similar case has not been reported in the literature so far. As in our patient, persistent diarrhea (in addition to fever and icterus) can be a warning sign of complication after these procedures. Surgeons who do advanced laparoscopic techniques must be familiar with this complication. PMID:21912066

A safe and reproducible anastomotic technique for minimally invasive Ivor Lewis oesophagectomy: the circular-stapled anastomosis with the trans-oral anvil.

PubMed

Campos, Guilherme M; Jablons, David; Brown, Lisa M; Ramirez, René M; Rabl, Charlotte; Theodore, Pierre

2010-06-01

In expert hands, the intrathoracic oesophago-gastric anastamosis usually provides a low rate of strictures and leaks. However, anastomoses can be technically challenging and time consuming when minimally invasive techniques are used. We present our preliminary results of a standardised 25 mm/4.8mm circular-stapled anastomosis using a trans-orally placed anvil. We evaluated a prospective cohort of 37 consecutive patients offered minimally invasive Ivor Lewis oesophagectomy at a tertiary referral centre. The oesophago-gastric anastomosis was created using a 25-mm anvil (Orvil, Autosuture, Norwalk, CT, USA) passed trans-orally, in a tilted position, and connected to a 90-cm long polyvinyl chloride delivery tube through an opening in the oesophageal stump. The anastomosis was completed by joining the anvil to a circular stapler (end-to-end anastomosis stapler (EEA XL) 25 mm with 4.8-mm staples, Autosuture, Norwalk, CT, USA) inserted into the gastric conduit. Primary outcomes were leak and stricture rates. Thirty-seven patients (mean age 65 years) with distal oesophageal adenocarcinoma (n=29), squamous cell cancer (n=5) or high-grade dysplasia in Barrett's oesophagus (n=3) underwent an Ivor Lewis oesophagectomy between October 2007 and August 2009. The abdominal portion was operated laparoscopically in 30 patients (81.1%). The thoracic portion was done using a muscle-sparing mini-thoracotomy in 23 patients (62.2%) and thoracoscopic techniques in 14 patients (37.8%). There were no intra-operative technical failures of the anastomosis or deaths. Five patients had strictures (13.5%) and all were successfully treated with endoscopic dilations. One patient had an anastomotic leak (2.7%) that was successfully treated by re-operation and endoscopic stenting of the anastomosis. The circular-stapled anastomosis with the trans-oral anvil allows for an efficient, safe and reproducible anastomosis. This straightforward technique is particularly suited to the completely minimally

Electromagnetic ion cyclotron waves stimulated by modest magnetospheric compressions

NASA Technical Reports Server (NTRS)

Anderson, B. J.; Hamilton, D. C.

1993-01-01

AMPTE/CCE magnetic field and particle data are used to test the suggestion that increased hot proton temperature anisotropy resulting from convection during magnetospheric compression is responsible for the enhancement in Pc 1 emission via generation of electromagnetic ion cyclotron (EMIC) waves in the dayside outer equatorial magnetosphere. The relative increase in magnetic field is used to gauge the strength of the compression, and an image dipole model is used to estimate the motion of the plasma during compression. Proton data are used to analyze the evolution of the proton distribution and the corresponding changes in EMIC wave activity expected during the compression. It is suggested that enhancements in dynamic pressure pump the energetic proton distributions in the outer magnetosphere, driving EMIC waves. Waves are expected to be generated most readily close to the magnetopause, and transient pressure pulses may be associated with bursts of EMIC waves, which would be observed on the ground in association with ionospheric transient signatures.

Probing off-Hugoniot states in Ta, Cu, and Al to 1000 GPa compression with magnetically driven liner implosions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lemke, R. W.; Dolan, D. H.; Dalton, D. G.

We report on a new technique for obtaining off-Hugoniot pressure vs. density data for solid metals compressed to extreme pressure by a magnetically driven liner implosion on the Z-machine (Z) at Sandia National Laboratories. In our experiments, the liner comprises inner and outer metal tubes. The inner tube is composed of a sample material (e.g., Ta and Cu) whose compressed state is to be inferred. The outer tube is composed of Al and serves as the current carrying cathode. Another aluminum liner at much larger radius serves as the anode. A shaped current pulse quasi-isentropically compresses the sample as itmore » implodes. The iterative method used to infer pressure vs. density requires two velocity measurements. Photonic Doppler velocimetry probes measure the implosion velocity of the free (inner) surface of the sample material and the explosion velocity of the anode free (outer) surface. These two velocities are used in conjunction with magnetohydrodynamic simulation and mathematical optimization to obtain the current driving the liner implosion, and to infer pressure and density in the sample through maximum compression. This new equation of state calibration technique is illustrated using a simulated experiment with a Cu sample. Monte Carlo uncertainty quantification of synthetic data establishes convergence criteria for experiments. Results are presented from experiments with Al/Ta, Al/Cu, and Al liners. Symmetric liner implosion with quasi-isentropic compression to peak pressure ~1000 GPa is achieved in all cases. Lastly, these experiments exhibit unexpectedly softer behavior above 200 GPa, which we conjecture is related to differences in the actual and modeled properties of aluminum.« less

Probing off-Hugoniot states in Ta, Cu, and Al to 1000 GPa compression with magnetically driven liner implosions

DOE PAGES

Lemke, R. W.; Dolan, D. H.; Dalton, D. G.; ...

2016-01-07

We report on a new technique for obtaining off-Hugoniot pressure vs. density data for solid metals compressed to extreme pressure by a magnetically driven liner implosion on the Z-machine (Z) at Sandia National Laboratories. In our experiments, the liner comprises inner and outer metal tubes. The inner tube is composed of a sample material (e.g., Ta and Cu) whose compressed state is to be inferred. The outer tube is composed of Al and serves as the current carrying cathode. Another aluminum liner at much larger radius serves as the anode. A shaped current pulse quasi-isentropically compresses the sample as itmore » implodes. The iterative method used to infer pressure vs. density requires two velocity measurements. Photonic Doppler velocimetry probes measure the implosion velocity of the free (inner) surface of the sample material and the explosion velocity of the anode free (outer) surface. These two velocities are used in conjunction with magnetohydrodynamic simulation and mathematical optimization to obtain the current driving the liner implosion, and to infer pressure and density in the sample through maximum compression. This new equation of state calibration technique is illustrated using a simulated experiment with a Cu sample. Monte Carlo uncertainty quantification of synthetic data establishes convergence criteria for experiments. Results are presented from experiments with Al/Ta, Al/Cu, and Al liners. Symmetric liner implosion with quasi-isentropic compression to peak pressure ~1000 GPa is achieved in all cases. Lastly, these experiments exhibit unexpectedly softer behavior above 200 GPa, which we conjecture is related to differences in the actual and modeled properties of aluminum.« less

Tracheal anastomosis with the diode laser and fibrin tissue adhesive: an in vitro and in vivo investigation.

PubMed

Gleich, L L; Wang, Z; Pankratov, M M; Aretz, H T; Shapshay, S M

1995-05-01

Absorbable sutures have been advocated for tracheal anastomosis to reduce fibrosis and foreign body reaction leading to recurrent stenosis. Fibrin tissue adhesive (FTA) and diode laser welding with indocyanine green-dyed fibrinogen were evaluated in tracheal anastomosis to reduce the number of sutures and to improve healing. In vitro studies demonstrated strong anastomoses with a combination of laser welding and FTA with minimal tissue damage. In a controlled in vivo study, circumferential resections of canine tracheas were repaired with laser welding and FTA augmented with a few stay sutures. These anastomoses had less fibrosis and tissue damage than anastomoses in control animals repaired with sutures alone. This study supports investigation of laser welding and FTA in human beings for tracheal anastomosis and other procedures in which suturing may be difficult.

Laser welding for vascular anastomosis using albumin solder: an approach for MID-CAB.

PubMed

Phillips, A B; Ginsburg, B Y; Shin, S J; Soslow, R; Ko, W; Poppas, D P

1999-01-01

To improve minimally invasive direct coronary artery bypass surgery (MID-CAB), new techniques of vascular anastomosis that are faster and more reliable need to be developed. Common carotids in a canine model were transected and an end-to-end anastomosis was performed by using one of four techniques (1) continuous 6-0 polypropylene closure (suture; n=6), (2) vascular clip (VCS; n=6), laser welding using 50% albumin solder with (3) a 1.32-micro laser (1.32las; n=6), and (4) a 1.9-micro diode laser (1.9las; n=4). Times for anastomosis (TA) were compared between groups by t-test. Pressures at which anastomosis failed (leak point pressure, LPP) were determined and compared by analysis of variance. TA was faster for 1.32las and 1.9las at 8.4+/-0.7 and 7.8+/-0.3 min, respectively, when compared with suture at 13.8+/-1.0 min (P=0.001, confidence interval [CI]-8.1, -2.6 for 1.32las and CI -8.9, -3.1 for 1.9las). There was no statistical difference between VCS (8.3+/-3.3 min) and any other group (P > 0.17). LPPs (mm Hg) were similar for all groups: 350+/-37 for 1.32las, 280+/-31 for 1.9las, 347+/-46 for suture, and 358+/-53 for VCS, P=0.68. In this study, laser welding using 50% human albumin solder resulted in faster anastomotic times. Anastomoses were equivalent to conventional sutured anastomoses in failing at similar pressures. Laser welding using human albumin solder may be advantageous in improving coronary anastomoses during MID-CAB, but long-term anastomotic strength and histologic evaluation need to be investigated.

Sulfasalazine in Prevention of Pouchitis After Proctocolectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis.

PubMed

Scaioli, Eleonora; Sartini, Alessandro; Liverani, Elisa; Digby, Richard John; Ugolini, Giampaolo; Rosati, Giancarlo; Poggioli, Gilberto; Festi, Davide; Bazzoli, Franco; Belluzzi, Andrea

2017-04-01

Pouchitis is the most frequent complication after ileal pouch-anal anastomosis for refractory ulcerative colitis. A non-standardized preventative treatment exists. Sulfasalazine has proved effective in acute pouchitis therapy. The aim of this study was to retrospectively evaluate the effect of sulfasalazine in primary prophylaxis of pouchitis after proctocolectomy with ileal pouch-anal anastomosis. Data files of patients who underwent total proctocolectomy with ileal pouch-anal anastomosis for refractory ulcerative colitis and/or dysplasia from January 2007 to December 2014, with a follow-up until August 2015, were analyzed. After closure of loop ileostomy, on a voluntary basis, patients received a primary prophylaxis of pouchitis with sulfasalazine (2000 mg per day) continually until acute pouchitis flare and/or drop out due to side effects. Follow-up data were available for 51 of the 55 surgical patients. Median follow-up time was 68 months (range 10-104). Thirty postoperative complications occurred in 25 patients. 45% of patients developed pouchitis. Sulfasalazine prophylaxis was administered in 39.2% of patients; 15% of the these developed pouchitis versus 64.5% (20/31) of the non-sulfasalazine patients (p < 0.001). Pouchitis-free survival curves were 90.55 months in sulfasalazine patients and 44.46 in non-sulfasalazine patients (log-rank test p = 0.001, Breslow p = 0.001). Sulfasalazine may be potentially administered in pouchitis prophylaxis after proctocolectomy with ileal pouch-anal anastomosis, but large prospectively controlled trials are needed.

[Successful endoscopic dilatation of a stenosis in relation to an ileorectal anastomosis by acute ileus].

PubMed

Kjærgaard, Jane Christensen; Hendel, Jakob; Gügenur, Ismail

2014-02-17

Endoscopic dilatation is a treatment option for patients with Crohns disease suffering from stenosis in relation to an ileorectal anastomosis. We present a case of a patient with Crohns disease who was admitted with acute obstructive symptoms due to a stensosis of the ileorectal anastomosis. The patient was septic. We performed a successful endoscopic dilatation in the acute phase and the patient was discharged few days after an uneventful recovery. Endoscopic dilatation of an ileorectal anastomsis in patients with Crohns disease is a treatment option in the acute setting when performed by experienced endoscopists.

Dynamic magnetic resonance imaging method based on golden-ratio cartesian sampling and compressed sensing.

PubMed

Li, Shuo; Zhu, Yanchun; Xie, Yaoqin; Gao, Song

2018-01-01

Dynamic magnetic resonance imaging (DMRI) is used to noninvasively trace the movements of organs and the process of drug delivery. The results can provide quantitative or semiquantitative pathology-related parameters, thus giving DMRI great potential for clinical applications. However, conventional DMRI techniques suffer from low temporal resolution and long scan time owing to the limitations of the k-space sampling scheme and image reconstruction algorithm. In this paper, we propose a novel DMRI sampling scheme based on a golden-ratio Cartesian trajectory in combination with a compressed sensing reconstruction algorithm. The results of two simulation experiments, designed according to the two major DMRI techniques, showed that the proposed method can improve the temporal resolution and shorten the scan time and provide high-quality reconstructed images.

A meta-analysis of aneurysm formation in laser assisted vascular anastomosis (LAVA)

NASA Astrophysics Data System (ADS)

Chen, Chen; Peng, Fei; Xu, Dahai; Cheng, Qinghua

2009-08-01

Laser assisted vascular anastomosis (LAVA) is looked as a particularly promising non-suture method in future. However, aneurysm formation is one of the main reasons delay the clinical application of LAVA. Some scientists investigated the incidence of aneurysms in animal model. To systematically analyze the literature on reported incidence of aneurysm formation in LAVA therapy, we performed a meta-analysis comparing LAVA with conventional suture anastomosis (CSA) in animal model. Data were systematically retrieved and selected from PUBMED. In total, 23 studies were retrieved. 18 studies were excluded, and 5 studies involving 647 animals were included. Analysis suggested no statistically significant difference between LAVA and CSA (OR 1.24, 95%CI 0.66-2.32, P=0.51). Result of meta analysis shows that the technology of LAVA is very close to clinical application.

Outcomes for jejunal interposition reconstruction compared with Roux-en-Y anastomosis: A meta-analysis.

PubMed

Fan, Kai-Xi; Xu, Zhong-Fa; Wang, Mei-Rong; Li, Dao-Tang; Yang, Xiang-Shan; Guo, Jing

2015-03-14

To compare the clinical outcomes between jejunal interposition reconstruction and Roux-en-Y anastomosis after total gastrostomy in patients with gastric cancer. A systematic literature search was conducted by two independent researchers on PubMed, EMBASE, the Cochrane Library, Google Scholar, and other English literature databases, as well as the Chinese Academic Journal, Chinese Biomedical Literature Database, and other Chinese literature databases using "Gastrostomy", "Roux-en-Y", and "Interposition" as keywords. Data extraction and verification were performed on the literature included in this study. RevMan 5.2 software was used for data processing. A fixed-effects model was applied in the absence of heterogeneity between studies. A random effects model was applied in the presence of heterogeneity between studies. Ten studies with a total of 762 gastric cancer patients who underwent total gastrostomy were included in this study. Among them, 357 received jejunal interposition reconstruction after total gastrostomy, and 405 received Roux-en-Y anastomosis. Compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR = 0.18, 95%CI: 0.10-0.31; P < 0.001), increased the prognostic nutritional index [weighted mean difference (WMD) = 6.02, 95%CI: 1.82-10.22; P < 0.001], and improved the degree of postoperative weight loss [WMD = 2.47, 95%CI: -3.19-(-1.75); P < 0.001]. However, there is no statistically significant difference in operative time, hospital stay, or incidence of reflux esophagitis. Compared with Roux-en-Y anastomosis, patients who underwent jejunal interposition reconstruction after total gastrostomy had a lower risk of postoperative long-term complications and improved life quality.

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

NASA Astrophysics Data System (ADS)

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

1990-06-01

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

Laser or charged-particle-beam fusion reactor with direct electric generation by magnetic flux compression

DOEpatents

Lasche, G.P.

1983-09-29

The invention is a laser or particle-beam-driven fusion reactor system which takes maximum advantage of both the very short pulsed nature of the energy release of inertial confinement fusion (ICF) and the very small volumes within which the thermonuclear burn takes place. The pulsed nature of ICF permits dynamic direct energy conversion schemes such as magnetohydrodynamic (MHD) generation and magnetic flux compression; the small volumes permit very compact blanket geometries. By fully exploiting these characteristics of ICF, it is possible to design a fusion reactor with exceptionally high power density, high net electric efficiency, and low neutron-induced radioactivity. The invention includes a compact blanket design and method and apparatus for obtaining energy utilizing the compact blanket.

Early cavopulmonary anastomosis in very young infants after the Norwood procedure: impact on oxygenation, resource utilization, and mortality.

PubMed

Jaquiss, Robert D B; Ghanayem, Nancy S; Hoffman, George M; Fedderly, Raymond T; Cava, Joseph R; Mussatto, Kathleen A; Tweddell, James S

2004-04-01

The optimal timing of second-stage palliation after Norwood operations remains undefined. Advantages of early cavopulmonary anastomosis are early elimination of volume load and shortening the high-risk interstage period. Potential disadvantages include severe cyanosis, prolonged pleural drainage and hospitalization, and excess mortality. We reviewed our recent experience to evaluate the safety of early cavopulmonary anastomosis. Eighty-five consecutive patients undergoing post-Norwood operation cavopulmonary anastomosis were divided into group I (cavopulmonary anastomosis at <4 months; n = 33) and group II (cavopulmonary anastomosis at >4 months; n = 52). Groups were compared for age; size; early and late mortality; preoperative, initial postoperative, and discharge oxygen saturation; and duration of mechanical ventilation, intensive care unit stay, pleural drainage, and hospitalization. Group I patients were younger than group II patients (94 +/- 21 days vs 165 +/- 44 days, respectively; P <.001) and smaller (4.8 +/- 0.8 kg vs 5.8 +/- 0.9 kg; P <.001). The preoperative oxygen saturation was not different (group I, 75% +/- 10%; group II, 78% +/- 8%; P =.142). The oxygen saturation was lower immediately after surgery in group I compared with group II (75% +/- 7% vs 81% +/- 7%, respectively; P <.001) but not by discharge (group I, 79% +/- 4%; group II, 80% +/- 4%). Younger patients were ventilated longer (62 +/- 86 hours vs 19 +/- 42 hours; P =.001), in the intensive care unit longer (130 +/- 111 hours vs 104 +/- 94 hours; P =.049), hospitalized longer (12.5 +/- 11.5 days vs 10.3 +/- 14.8 days; P =.012), and required longer pleural drainage (106 +/- 45 hours vs 104 +/- 93 hours; P =.046). Hospital survival was 100% in both groups. Actuarial survival to 12 months was 96% +/- 4% for group I and 96% +/- 3% for group II. Early cavopulmonary anastomosis after the Norwood operation is safe. Younger patients are more cyanotic initially after surgery and have a longer

A web-based overview, systematic review and meta-analysis of pancreatic anastomosis techniques following pancreatoduodenectomy.

PubMed

Daamen, Lois A; Smits, F Jasmijn; Besselink, Marc G; Busch, Olivier R; Borel Rinkes, Inne H; van Santvoort, Hjalmar C; Molenaar, I Quintus

2018-05-14

Many pancreatic anastomoses have been proposed to reduce the incidence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, but a complete overview is lacking. This systematic review and meta-analysis aims to provide an online overview of all pancreatic anastomosis techniques and to evaluate the incidence of clinically relevant POPF in randomized controlled trials (RCTs). A literature search was performed to December 2017. Included were studies giving a detailed description of the pancreatic anastomosis after open pancreatoduodenectomy and RCTs comparing techniques for the incidence of POPF (International Study Group of Pancreatic Surgery [ISGPS] Grade B/C). Meta-analyses were performed using a random-effects model. A total of 61 different anastomoses were found and summarized in 19 subgroups (www.pancreatic-anastomosis.com). In 6 RCTs, the POPF rate was 12% after pancreaticogastrostomy (n = 69/555) versus 20% after pancreaticojejunostomy (n = 106/531) (RR0.59; 95%CI 0.35-1.01, P = 0.05). Six RCTs comparing subtypes of pancreaticojejunostomy showed a pooled POPF rate of 10% (n = 109/1057). Duct-to-mucosa and invagination pancreaticojejunostomy showed similar results, respectively 14% (n = 39/278) versus 10% (n = 27/278) (RR1.40, 95%CI 0.47-4.15, P = 0.54). The proposed online overview can be used as an interactive platform, for uniformity in reporting anastomotic techniques and for educational purposes. The meta-analysis showed no significant difference in POPF rate between pancreatic anastomosis techniques. Copyright © 2018 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Laparoscopic subtotal colectomy with transrectal extraction of the colon and ileorectal anastomosis.

PubMed

Awad, Ziad T

2012-03-01

Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Five trocars (one 12 mm and four 5 mm) were used. The video describes the technique of performing laparoscopic subtotal colectomy, laparoscopic cholecystectomy, transrectal removal of the gallbladder and the entire colon, and intracorporeal stapled ileorectal anastomosis in a 27-year-old female with colonic inertia and biliary dyskinesia. There were no intraoperative complications. The operating time was 180 min. Blood loss was 10 cc. The patient was discharged home on postoperative day 4. Laparoscopic subtotal colectomy with transrectal removal of the colon is a safe and effective procedure that can be added to the armamentarium of surgeons performing laparoscopic colon surgery. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to NOTES colon surgery.

Bunch Compression of Flat Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Halavanau, A.; Piot, P.; Edstrom Jr., D.

Flat beams can be produced via a linear manipulation of canonical-angular-momentum (CAM) dominated beams using a set of skew-quadrupole magnets. Recently, such beams were produced at Fermilab Accelerator Science and Technology (FAST) facility 1. In this paper we report the results of flat beam compression study in a magnetic chicane at an energy E ~ 32 MeV. Additionally, we investigate the effect of energy chirp in the round-to-flat beam transform. The experimental results are compared with numerical simulations.

Efficacy of gradual pressure-decline compressing stockings in Asian patients with lower leg varicose veins: analysis by general measurements and magnetic resonance image.

PubMed

Leung, T K; Lin, J M; Chu, C L; Wu, Y S; Chao, Y J

2012-12-01

Most applications of gradual pressure-decline compressing stockings (GPDCS) are used in the United States and Western European countries, with over a decade of clinical experiments. Up to know, there is no standard establishment of gradual pressure-decline compressing stockings for Asian patients with venous insufficiency and varicose vein formations. We collected data on volunteer candidates of varicose vein for general measurements and assessments and magnetic resonance imaging (MRI) by non-contrast enhanced MRV techniques, and for post processing data analysis. Clinical use of GPCDS provide a mild to moderate improvement in the varicose vein conditions of patients with deep venous insufficiency by improving their deep vein circulation, by general measurements; recording major symptoms and complaint; comfort and stretching/flexibility to the candidates after using GPDCS; and area changes/flow velocity changes/available hemoglobin changes in deep veins monitored by MRI. The benefits and data collected in these results may help in developing compression stockings standards in Taiwanese and Asian countries, and to establishing criterias for product sizes, compression levels, and related parameters.

Magnetic power piston fluid compressor

NASA Technical Reports Server (NTRS)

Gasser, Max G. (Inventor)

1994-01-01

A compressor with no moving parts in the traditional sense having a housing having an inlet end allowing a low pressure fluid to enter and an outlet end allowing a high pressure fluid to exit is described. Within the compressor housing is at least one compression stage to increase the pressure of the fluid within the housing. The compression stage has a quantity of magnetic powder within the housing, is supported by a screen that allows passage of the fluid, and a coil for selectively providing a magnetic field across the magnetic powder such that when the magnetic field is not present the individual particles of the powder are separated allowing the fluid to flow through the powder and when the magnetic field is present the individual particles of the powder pack together causing the powder mass to expand preventing the fluid from flowing through the powder and causing a pressure pulse to compress the fluid.

Laparoscopic Band-Separated One Anastomosis Gastric Bypass.

PubMed

Ospanov, Oral B

2016-09-01

This video demonstrates laparoscopic band-separated one anastomosis gastric bypass-combining the advantages of banding and gastric bypass without stapler and cutter use. This is basically a gastrojejunal loop bypass above an obstructive band in the upper stomach. An adjustable low pressure "Medsil" gastric band was introduced in the abdomen and retracted through the retrogastric tunnel. The front wall of the stomach below the band was displaced in the upward direction through the ring band, increasing the size of the anterior portion of the stomach pouch so that a gastroenteroanastomosis could be created at this point. Gastro-gastric sutures were placed to create a gastro-gastric plication around the band and hold it in position. The band tubing was exteriorized and connected to a special port, which was secured to the abdominal wall fascia. A jejunal loop was created about 200 cm from the ligament of Treitz and anastomosed to the gastric pouch by hand using Vicryl 2/0 sutures. Between November 2015 and February 2016, the study was performed on 10 patients. The average operating time for all cases was 75 min (range 63-87). There was no morbidity or mortality. No complications were observed, including band erosion and band infection. Operation costs were about $2000 lower with this method than with standard gastric bypass surgery. Postop the patients lost weight by 3-4 kg per month. Preliminary results show that laparoscopic band-separated one anastomosis gastric bypass have feasibility, safety, efficacy, and reduced operating costs.

Probing off-Hugoniot states in Ta, Cu, and Al to 1000 GPa compression with magnetically driven liner implosions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lemke, R. W., E-mail: rwlemke@sandia.gov; Dolan, D. H.; Dalton, D. G.

We report on a new technique for obtaining off-Hugoniot pressure vs. density data for solid metals compressed to extreme pressure by a magnetically driven liner implosion on the Z-machine (Z) at Sandia National Laboratories. In our experiments, the liner comprises inner and outer metal tubes. The inner tube is composed of a sample material (e.g., Ta and Cu) whose compressed state is to be inferred. The outer tube is composed of Al and serves as the current carrying cathode. Another aluminum liner at much larger radius serves as the anode. A shaped current pulse quasi-isentropically compresses the sample as itmore » implodes. The iterative method used to infer pressure vs. density requires two velocity measurements. Photonic Doppler velocimetry probes measure the implosion velocity of the free (inner) surface of the sample material and the explosion velocity of the anode free (outer) surface. These two velocities are used in conjunction with magnetohydrodynamic simulation and mathematical optimization to obtain the current driving the liner implosion, and to infer pressure and density in the sample through maximum compression. This new equation of state calibration technique is illustrated using a simulated experiment with a Cu sample. Monte Carlo uncertainty quantification of synthetic data establishes convergence criteria for experiments. Results are presented from experiments with Al/Ta, Al/Cu, and Al liners. Symmetric liner implosion with quasi-isentropic compression to peak pressure ∼1000 GPa is achieved in all cases. These experiments exhibit unexpectedly softer behavior above 200 GPa, which we conjecture is related to differences in the actual and modeled properties of aluminum.« less

Bunch compression efficiency of the femtosecond electron source at Chiang Mai University

NASA Astrophysics Data System (ADS)

Thongbai, C.; Kusoljariyakul, K.; Saisut, J.

2011-07-01

A femtosecond electron source has been developed at the Plasma and Beam Physics Research Facility (PBP), Chiang Mai University (CMU), Thailand. Ultra-short electron bunches can be produced with a bunch compression system consisting of a thermionic cathode RF-gun, an alpha-magnet as a magnetic bunch compressor, and a linear accelerator as a post acceleration section. To obtain effective bunch compression, it is crucial to provide a proper longitudinal phase-space distribution at the gun exit matched to the subsequent beam transport system. Via beam dynamics calculations and experiments, we investigate the bunch compression efficiency for various RF-gun fields. The particle distribution at the RF-gun exit will be tracked numerically through the alpha-magnet and beam transport. Details of the study and results leading to an optimum condition for our system will be presented.

Improving the side-to-side stapled anastomosis: comparison of staplers for robust crotch formation.

PubMed

Kimura, Masahiro; Kuwabara, Yoshiyuki; Taniwaki, Satoshi; Mitsui, Akira; Shibata, Yasuyuki; Ueno, Shuhei

2018-01-01

Few studies have investigated the burst pressure of side-to-side anastomoses comparing different stapling devices that are commercially available. We conducted side-to-side anastomoses with a variety of staplers and compared burst pressure in the crotch of the anastomoses. Nagoya City East Medical Center. We conducted side-to-side anastomoses with 9 staplers with different shapes and forms. Fresh pig small intestines were used. A side-to-side anastomosis was performed between 2 intestine specimens using a linear stapler. The burst pressure of the anastomosis was recorded. In total, 45 staplers were used for this experiment. The site of leakage in all cases was the crotch. Regarding the influence of the number of staple rows, the burst pressure in 3-row staplers was significantly higher than in 2-row staplers. With regard to the relationship between staple height and burst pressure, staples with a height slightly shorter than the intestinal thickness showed the highest burst pressure. In a comparison of staplers with uniform staple heights and stamplers with staples of 3 different heights, the latter had significantly lower burst pressures. Neoveil significantly increased the burst pressure in the crotch and contributed to the highest burst pressure of all the staplers used in this experiment. In this experiment, we defined the important factors that influence burst pressure at the crotch of a stapled, side-to-side anastomosis. These factors include the number of staple rows, the height of the staple compared with the thickness of the tissue, uniformity of staple height, and reinforcement of the staple line. In any surgical case requiring intestinal anastomosis, selection of a stapler is a critical step. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Early and late complications among long-term colorectal cancer survivors with ostomy or anastomosis.

PubMed

Liu, Liyan; Herrinton, Lisa J; Hornbrook, Mark C; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S

2010-02-01

Among long-term (>or=5 y) colorectal cancer survivors with permanent ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life. The incidence and effects of complications on long-term health-related quality of life among colorectal cancer survivors are not adequately understood. Participants (284 survivors with ostomies and 395 survivors with anastomoses) were long-term colorectal cancer survivors enrolled in an integrated health plan. Health-related quality of life was assessed via mailed survey questionnaires from 2002 to 2005. Information on colorectal cancer, surgery, comorbidities, and complications was obtained from computerized data and analyzed by use of survival analysis and logistic regression. Ostomy and anastomosis survivors were followed up for an average of 12.1 and 11.2 years, respectively. Within 30 days of surgery, 19% of ostomy survivors and 10% of anastomosis survivors experienced complications (P < .01). From 31 days on, the percentages were 69% and 67% (after adjustment, P < .001). Bleeding and postoperative infection were common early complications. Common long-term complications included hernia, urinary retention, hemorrhage, skin conditions, and intestinal obstruction. Ostomy was associated with long-term fistula (odds ratio, 5.4; 95% CI 1.4-21.2), and among ostomy survivors, fistula was associated with reduced health-related quality of life (P < .05). Complication rates remain high despite recent advances in methods of surgical treatment. Survivors with ostomy have more complications early in their survivorship period, but complications among anastomosis survivors catch up after 20 years, when the 2 groups have convergent complication rates. Among colorectal cancer survivors with ostomy, fistula has especially important implications for health-related quality of life.

Magnetic force micropiston: an integrated force/microfluidic device for the application of compressive forces in a confined environment.

PubMed

Fisher, J K; Kleckner, N

2014-02-01

Cellular biology takes place inside confining spaces. For example, bacteria grow in crevices, red blood cells squeeze through capillaries, and chromosomes replicate inside the nucleus. Frequently, the extent of this confinement varies. Bacteria grow longer and divide, red blood cells move through smaller and smaller passages as they travel to capillary beds, and replication doubles the amount of DNA inside the nucleus. This increase in confinement, either due to a decrease in the available space or an increase in the amount of material contained in a constant volume, has the potential to squeeze and stress objects in ways that may lead to changes in morphology, dynamics, and ultimately biological function. Here, we describe a device developed to probe the interplay between confinement and the mechanical properties of cells and cellular structures, and forces that arise due to changes in a structure's state. In this system, the manipulation of a magnetic bead exerts a compressive force upon a target contained in the confining space of a microfluidic channel. This magnetic force microfluidic piston is constructed in such a way that we can measure (a) target compliance and changes in compliance as induced by changes in buffer, extract, or biochemical composition, (b) target expansion force generated by changes in the same parameters, and (c) the effects of compression stress on a target's structure and function. Beyond these issues, our system has general applicability to a variety of questions requiring the combination of mechanical forces, confinement, and optical imaging.

Magnetic force micropiston: An integrated force/microfluidic device for the application of compressive forces in a confined environment

NASA Astrophysics Data System (ADS)

Fisher, J. K.; Kleckner, N.

2014-02-01

Cellular biology takes place inside confining spaces. For example, bacteria grow in crevices, red blood cells squeeze through capillaries, and chromosomes replicate inside the nucleus. Frequently, the extent of this confinement varies. Bacteria grow longer and divide, red blood cells move through smaller and smaller passages as they travel to capillary beds, and replication doubles the amount of DNA inside the nucleus. This increase in confinement, either due to a decrease in the available space or an increase in the amount of material contained in a constant volume, has the potential to squeeze and stress objects in ways that may lead to changes in morphology, dynamics, and ultimately biological function. Here, we describe a device developed to probe the interplay between confinement and the mechanical properties of cells and cellular structures, and forces that arise due to changes in a structure's state. In this system, the manipulation of a magnetic bead exerts a compressive force upon a target contained in the confining space of a microfluidic channel. This magnetic force microfluidic piston is constructed in such a way that we can measure (a) target compliance and changes in compliance as induced by changes in buffer, extract, or biochemical composition, (b) target expansion force generated by changes in the same parameters, and (c) the effects of compression stress on a target's structure and function. Beyond these issues, our system has general applicability to a variety of questions requiring the combination of mechanical forces, confinement, and optical imaging.

Multi-scale analysis of compressible fluctuations in the solar wind

NASA Astrophysics Data System (ADS)

Roberts, Owen W.; Narita, Yasuhito; Escoubet, C.-Philippe

2018-01-01

Compressible plasma turbulence is investigated in the fast solar wind at proton kinetic scales by the combined use of electron density and magnetic field measurements. Both the scale-dependent cross-correlation (CC) and the reduced magnetic helicity (σm) are used in tandem to determine the properties of the compressible fluctuations at proton kinetic scales. At inertial scales the turbulence is hypothesised to contain a mixture of Alfvénic and slow waves, characterised by weak magnetic helicity and anti-correlation between magnetic field strength B and electron density ne. At proton kinetic scales the observations suggest that the fluctuations have stronger positive magnetic helicities as well as strong anti-correlations within the frequency range studied. These results are interpreted as being characteristic of either counter-propagating kinetic Alfvén wave packets or a mixture of anti-sunward kinetic Alfvén waves along with a component of kinetic slow waves.

THE TURBULENT DYNAMO IN HIGHLY COMPRESSIBLE SUPERSONIC PLASMAS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Federrath, Christoph; Schober, Jennifer; Bovino, Stefano

The turbulent dynamo may explain the origin of cosmic magnetism. While the exponential amplification of magnetic fields has been studied for incompressible gases, little is known about dynamo action in highly compressible, supersonic plasmas, such as the interstellar medium of galaxies and the early universe. Here we perform the first quantitative comparison of theoretical models of the dynamo growth rate and saturation level with three-dimensional magnetohydrodynamical simulations of supersonic turbulence with grid resolutions of up to 1024{sup 3} cells. We obtain numerical convergence and find that dynamo action occurs for both low and high magnetic Prandtl numbers Pm = ν/ηmore » = 0.1-10 (the ratio of viscous to magnetic dissipation), which had so far only been seen for Pm ≥ 1 in supersonic turbulence. We measure the critical magnetic Reynolds number, Rm{sub crit}=129{sub −31}{sup +43}, showing that the compressible dynamo is almost as efficient as in incompressible gas. Considering the physical conditions of the present and early universe, we conclude that magnetic fields need to be taken into account during structure formation from the early to the present cosmic ages, because they suppress gas fragmentation and drive powerful jets and outflows, both greatly affecting the initial mass function of stars.« less

Electronic compressibility of bilayer graphene

NASA Astrophysics Data System (ADS)

Henriksen, Erik

2011-03-01

We have recently measured the electronic compressibility of bilayer graphene, allowing exploration of the thermodynamic density of states as a function of applied electric and magnetic fields. Utilizing dual-gated field-effect devices, we can independently vary both the carrier density and the size of the tunable band gap. An oscillating voltage applied to a back gate generates corresponding signals in the top gate via electric fields lines which penetrate the graphene, thereby allowing a direct measurement of the inverse compressibility, K-1 , of the bilayer. We have mapped K-1 , which is proportional to the inverse density of states, as a function of the top and back gate voltages in zero and finite magnetic field. A sharp increase in K-1 near zero density is observed with increasing electric field strength, signaling the controlled opening of a band gap. At high magnetic fields, broad Landau level (LL) oscillations are observed, directly revealing the doubled degeneracy of the lowest LL and allowing for a determination of the disorder broadening of the levels. We compare our results to tight-binding calculations of the bilayer band structure, and to recent theoretical studies of the compressibility of bilayer graphene. Together, these clearly illustrate the unusual hyperbolic nature of the low energy band structure, reveal a sizeable electron-hole asymmetry, and suggest that many-body interactions play only a small role in bilayer-on-substrate devices. This work is a collaboration with J. P. Eisenstein of Caltech, and is supported by the NSF under Grant No. DMR-0552270 and the DOE under Grant No. DE-FG03-99ER45766.

Method for obtaining large levitation pressure in superconducting magnetic bearings

DOEpatents

Hull, John R.

1997-01-01

A method and apparatus for compressing magnetic flux to achieve high levitation pressures. Magnetic flux produced by a magnetic flux source travels through a gap between two high temperature superconducting material structures. The gap has a varying cross-sectional area to compress the magnetic flux, providing an increased magnetic field and correspondingly increased levitation force in the gap.

Method for obtaining large levitation pressure in superconducting magnetic bearings

DOEpatents

Hull, John R.

1996-01-01

A method and apparatus for compressing magnetic flux to achieve high levitation pressures. Magnetic flux produced by a magnetic flux source travels through a gap between two high temperature superconducting material structures. The gap has a varying cross-sectional area to compress the magnetic flux, providing an increased magnetic field and correspondingly increased levitation force in the gap.

Strain-dependent dynamic compressive properties of magnetorheological elastomeric foams

NASA Astrophysics Data System (ADS)

Wereley, Norman M.; Perez, Colette; Choi, Young T.

2018-05-01

This paper addresses the strain-dependent dynamic compressive properties (i.e., so-called Payne effect) of magnetorheological elastomeric foams (MREFs). Isotropic MREF samples (i.e., no oriented particle chain structures), fabricated in flat square shapes (nominal size of 26.5 mm x 26.5 mm x 9.5 mm) were synthesized by randomly dispersing micron-sized iron oxide particles (Fe3O4) into a liquid silicone foam in the absence of magnetic field. Five different Fe3O4 particle concentrations of 0, 2.5, 5.0, 7.5, and 10 percent by volume fraction (hereinafter denoted as vol%) were used to investigate the effect of particle concentration on the dynamic compressive properties of the MREFs. The MREFs were sandwiched between two multi-pole flexible plate magnets in order to activate the magnetorheological (MR) strengthening effect. Under two different pre-compression conditions (i.e., 35% and 50%), the dynamic compressive stresses of the MREFs with respect to dynamic strain amplitudes (i.e., 1%-10%) were measured by using a servo-hydraulic testing machine. The complex modulus (i.e., storage modulus and loss modulus) and loss factors of the MREFs with respect to dynamic strain amplitudes were presented as performance indices to evaluate their strain-dependent dynamic compressive behavior.

Hand-sewn versus stapler esophagogastric anastomosis after esophageal ressection: systematic review and meta-analysis.

PubMed

Castro, Paula Marcela Vilela; Ribeiro, Felipe Piccarone Gonçalves; Rocha, Amanda de Freitas; Mazzurana, Mônica; Alvarez, Guines Antunes

2014-01-01

Postoperative anastomotic leak and stricture are dramatic events that cause increased morbidity and mortality, for this reason it's important to evaluate which is the best way to perform the anastomosis. To compare the techniques of manual (hand-sewn) and mechanic (stapler) esophagogastric anastomosis after resection of malignant neoplasm of esophagus, as the occurrence of anastomotic leak, anastomotic stricture, blood loss, cardiac and pulmonary complications, mortality and surgical time. A systematic review of randomized clinical trials, which included studies from four databases (Medline, Embase, Cochrane and Lilacs) using the combination of descriptors (anastomosis, surgical) and (esophagectomy) was performed. Thirteen randomized trials were included, totaling 1778 patients, 889 in the hand-sewn group and 889 in the stapler group. The stapler reduced bleeding (p <0.03) and operating time (p<0.00001) when compared to hand-sewn after esophageal resection. However, stapler increased the risk of anastomotic stricture (NNH=33), pulmonary complications (NNH=12) and mortality (NNH=33). There was no significant difference in relation to anastomotic leak (p=0.76) and cardiac complications (p=0.96). After resection of esophageal cancer, the use of stapler shown to reduce blood loss and surgical time, but increased the incidence of anastomotic stricture, pulmonary complications and mortality.

HAND-SEWN VERSUS STAPLER ESOPHAGOGASTRIC ANASTOMOSIS AFTER ESOPHAGEAL RESSECTION: SISTEMATIC REVIEW AND META-ANALYSIS

PubMed Central

CASTRO, Paula Marcela Vilela; RIBEIRO, Felipe Piccarone Gonçalves; ROCHA, Amanda de Freitas; MAZZURANA, Mônica; ALVAREZ, Guines Antunes

2014-01-01

Introduction Postoperative anastomotic leak and stricture are dramatic events that cause increased morbidity and mortality, for this reason it's important to evaluate which is the best way to perform the anastomosis. Aim To compare the techniques of manual (hand-sewn) and mechanic (stapler) esophagogastric anastomosis after resection of malignant neoplasm of esophagus, as the occurrence of anastomotic leak, anastomotic stricture, blood loss, cardiac and pulmonary complications, mortality and surgical time. Methods A systematic review of randomized clinical trials, which included studies from four databases (Medline, Embase, Cochrane and Lilacs) using the combination of descriptors (anastomosis, surgical) and (esophagectomy) was performed. Results Thirteen randomized trials were included, totaling 1778 patients, 889 in the hand-sewn group and 889 in the stapler group. The stapler reduced bleeding (p <0.03) and operating time (p<0.00001) when compared to hand-sewn after esophageal resection. However, stapler increased the risk of anastomotic stricture (NNH=33), pulmonary complications (NNH=12) and mortality (NNH=33). There was no significant difference in relation to anastomotic leak (p=0.76) and cardiac complications (p=0.96). Conclusion After resection of esophageal cancer, the use of stapler shown to reduce blood loss and surgical time, but increased the incidence of anastomotic stricture, pulmonary complications and mortality. PMID:25184776

Neuroanatomical study of Galen's anastomosis (nervus laryngeus) in the dog.

PubMed

Henry, C; Cazals, Y; Gioux, M; Didier, A; Aran, J M; Traissac, L

1988-01-01

To further knowledge of the laryngeal nerves, the nerve fibers of Galen's anastomosis were studied using two neuroanatomical methods, namely nerve degeneration and horseradish peroxidase labeling. It is demonstrated that the superior laryngeal nerve forms part of the tracheal and esophageal nervous system. The value of the results in relation to physiological laryngeal studies and to human laryngeal diseases is discussed.

What is the optimal management of an intra-operative air leak in a colorectal anastomosis?

PubMed

Mitchem, J B; Stafford, C; Francone, T D; Roberts, P L; Schoetz, D J; Marcello, P W; Ricciardi, R

2018-02-01

An airtight anastomosis on intra-operative leak testing has been previously demonstrated to be associated with a lower risk of clinically significant postoperative anastomotic leak following left-sided colorectal anastomosis. However, to date, there is no consistently agreed upon method for management of an intra-operative anastomotic leak. Therefore, we powered a noninferiority study to determine whether suture repair alone was an appropriate strategy for the management of an intra-operative air leak. This is a retrospective cohort analysis of prospectively collected data from a tertiary care referral centre. We included all consecutive patients with left-sided colorectal or ileorectal anastomoses and evidence of air leak during intra-operative leak testing. Patients were excluded if proximal diversion was planned preoperatively, a pre-existing proximal diversion was present at the time of surgery or an anastomosis was ultimately unable to be completed. The primary outcome measure was clinically significant anastomotic leak, as defined by the Surgical Infection Study Group at 30 days. From a sample of 2360 patients, 119 had an intra-operative air leak during leak testing. Sixty-eight patients underwent suture repair alone and 51 underwent proximal diversion or anastomotic reconstruction. The clinically significant leak rate was 9% (6/68; 95% CI: 2-15%) in the suture repair alone arm and 0% (0/51) in the diversion or reconstruction arm. Suture repair alone does not meet the criteria for noninferiority for the management of intra-operative air leak during left-sided colorectal anastomosis. Further repair of intra-operative air leak by suture repair alone should be reconsidered given these findings. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

Negative viscosity from negative compressibility and axial flow shear stiffness in a straight magnetic field

DOE PAGES

Li, J. C.; Diamond, P. H.

2017-03-23

Here, negative compressibility ITG turbulence in a linear plasma device (CSDX) can induce a negative viscosity increment. However, even with this negative increment, we show that the total axial viscosity remains positive definite, i.e. no intrinsic axial flow can be generated by pure ITG turbulence in a straight magnetic field. This differs from the case of electron drift wave (EDW) turbulence, where the total viscosity can turn negative, at least transiently. When the flow gradient is steepened by any drive mechanism, so that the parallel shear flow instability (PSFI) exceeds the ITG drive, the flow profile saturates at a level close to the value above which PSFI becomes dominant. This saturated flow gradient exceeds the PSFI linear threshold, and grows withmore » $$\

Dynamic fracture of sintered Nd-Fe-B magnet under uniaxial compression

NASA Astrophysics Data System (ADS)

Wang, Huanran; Wan, Yin; Chen, Danian; Lei, Guohua; Ren, Chunying

2018-06-01

The dynamic fracture of the Nd-Fe-B magnets under uniaxial compression is investigated using a split Hopkinson pressure bar (SHPB). The surface deformation and fracture processes of the Nd-Fe-B specimens are recorded adopting a high-speed photography (HSP) with digital image correlation (DIC). The load and work applied to the specimens in the SHPB tests are determined with the strain signals of the transmitted and reflected waves. The surface strain distributions of the Nd-Fe-B specimen during the SHPB testing are revealed with DIC. It is shown by the HSP with DIC that when the load is near the maximum, the cracks at some positions on the surface of the expanding Nd-Fe-B specimen are formed and ran along certain directions. The work applied to the specimen per unit volume which corresponds to the maximal load is used to characterize the impact stability of the Nd-Fe-B specimen. The localized fracture strains at some positions on the surface of the expanding specimens at some characteristic times are determined with DIC, which are the projections of the strains onto the DIC plane.

Measurement of Dead Space Fraction Upon ICU Admission Predicts Length of Stay and Clinical Outcomes Following Bidirectional Cavopulmonary Anastomosis.

PubMed

Cigarroa, Claire L; van den Bosch, Sarah J; Tang, Xiaoqi; Gauvreau, Kimberlee; Baird, Christopher W; DiNardo, James A; Kheir, John Nagi

2018-01-01

Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis. In a retrospective case-control study, we examined for associations between alveolar dead space fraction ([PaCO2 - end-tidal CO2]/PaCO2), arterial oxyhemoglobin saturation, and transpulmonary gradient upon postoperative ICU admission with a composite primary outcome (requirement for surgical or catheter-based intervention, death, or transplant prior to hospital discharge, defining cases) and several secondary endpoints in infants following bidirectional cavopulmonary anastomosis. Cardiac ICU in a tertiary care pediatric hospital. Patients undergoing bidirectional cavopulmonary anastomosis at our institution between 2011 and 2016. None. Of 191 patients undergoing bidirectional cavopulmonary anastomosis, 28 patients were cases and 163 were controls. Alveolar dead space fraction was significantly higher in the case (0.26 ± 0.09) versus control group (0.17 ± 0.09; p < 0.001); alveolar dead space fraction at admission was less than 0.12 in 0% of cases and was greater than 0.28 in 35% of cases. Admission arterial oxyhemoglobin saturation was significantly lower in the case (77% ± 12%) versus control group (83% ± 9%; p < 0.05). Sensitivity and specificity for future case versus control assignment was best when prebidirectional cavopulmonary anastomosis risk factors, admission alveolar dead space fraction (AUC, 0.74), and arterial oxyhemoglobin saturation (AUC, 0.65) were combined in a summarial model (AUC, 0.83). For a given arterial oxyhemoglobin

The Recipient Venule in Supermicrosurgical Lymphaticovenular Anastomosis: Flow Dynamic Classification and Correlation with Surgical Outcomes.

PubMed

Visconti, Giuseppe; Salgarello, Marzia; Hayashi, Akitatsu

2018-05-12

 Venules have been usually neglected in the literature on lymphaticovenular anastomosis (LVA). The aim of this study was to analyze the flow dynamic of recipient venules in LVA and their impact on the surgical outcomes.  Data from 128 patients affected by extremity lymphedema, who underwent LVA, were collected in two institutions from August 2014 to May 2016. Recipient venules were classified according to their flow dynamic into backflow, slack, and outlet (BSO classification). Quantitative (lower extremity lymphedema/upper extremity lymphedema index) and qualitative outcomes (needing of compression garment and compression garment class) were evaluated. Chi-square test or Fisher's exact test was used for categorical variables and independent-samples t -test for continuous variables. The association between lymphatic collector degeneration status (normal, ectasis, contractile, sclerotic type [NECST]) and BSO classification with the outcomes was analyzed by the Mantel-Haenszel test.  On a total of 128 patients, 37 suffered from upper and 91 from lower limb lymphedema. An average number of four LVA were performed for each patient (range: 2-8). A significant association was observed between NECST and BSO categories and the outcomes were evaluated. Patients with contractile and sclerotic collectors had 2.24 times the odd of having poor composite outcome compared with those with normal-to-ectasis collectors ( p  < 0.05). Patients with backflow venules had 3.32 times the odd of having poor composite outcome compared with those without outlet or slack pattern ( p  < 0.05).  The subtype of recipient venule flow dynamic has a significant impact on the surgical outcome of patients undergoing LVA for the treatment of lymphedema, regardless of the lymphatic collector degeneration status. Locating favorable venules in the preoperative mapping might enhance the surgical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Method for obtaining large levitation pressure in superconducting magnetic bearings

DOEpatents

Hull, J.R.

1997-08-05

A method and apparatus are disclosed for compressing magnetic flux to achieve high levitation pressures. Magnetic flux produced by a magnetic flux source travels through a gap between two high temperature superconducting material structures. The gap has a varying cross-sectional area to compress the magnetic flux, providing an increased magnetic field and correspondingly increased levitation force in the gap. 4 figs.

Method for obtaining large levitation pressure in superconducting magnetic bearings

DOEpatents

Hull, J.R.

1996-10-08

A method and apparatus are disclosed for compressing magnetic flux to achieve high levitation pressures. Magnetic flux produced by a magnetic flux source travels through a gap between two high temperature superconducting material structures. The gap has a varying cross-sectional area to compress the magnetic flux, providing an increased magnetic field and correspondingly increased levitation force in the gap. 4 figs.

Strain-assisted magnetization reversal in Co/Ni multilayers with perpendicular magnetic anisotropy

PubMed Central

Gopman, D. B.; Dennis, C. L.; Chen, P. J.; Iunin, Y. L.; Finkel, P.; Staruch, M.; Shull, R. D.

2016-01-01

Multifunctional materials composed of ultrathin magnetic films with perpendicular magnetic anisotropy combined with ferroelectric substrates represent a new approach toward low power, fast, high density spintronics. Here we demonstrate Co/Ni multilayered films with tunable saturation magnetization and perpendicular anisotropy grown directly on ferroelectric PZT [Pb(Zr0.52Ti0.48)O3] substrate plates. Electric fields up to ±2 MV/m expand the PZT by 0.1% and generate at least 0.02% in-plane compression in the Co/Ni multilayered film. Modifying the strain with a voltage can reduce the coercive field by over 30%. We also demonstrate that alternating in-plane tensile and compressive strains (less than 0.01%) can be used to propagate magnetic domain walls. This ability to manipulate high anisotropy magnetic thin films could prove useful for lowering the switching energy for magnetic elements in future voltage-controlled spintronic devices. PMID:27297638

Opened end-to-side technique for end-to-side anastomosis and analyses by an elastic true-to-scale silicone rubber model.

PubMed

Mücke, Thomas; Ritschl, Lucas M; Balasso, Andrea; Wolff, Klaus-Dietrich; Mitchell, David A; Liepsch, Dieter

2014-01-01

The end-to-side anastomosis is frequently used in microvascular free flap transfer, but detailed rheological analyses are not available. The purpose of this study was to introduce a new modified end-to-side (Opened End-to-Side, OES-) technique and compare the resulting flow pattern to a conventional technique. The new technique was based on a bi-triangulated preparation of the branching-vessel end, resulting in a "fish-mouthed" opening. We performed two different types of end-to-side anastomoses in forty pig coronary arteries and produced one elastic, true-to-scale silicone rubber model of each anastomosis. Then we installed the transparent models in a circulatory experimental setup that simulated the physiological human blood flow. Flow velocity was measured with the one-component Laser-Doppler-Anemometer system, recording flow axial and perpendicular to the model at four defined cross-sections for seven heart cycles in each model. Maximal and minimal axial velocities ranged in the conventional model between 0.269 and -0.122 m/s and in the experimental model between 0.313 and -0.153 m/s. A less disturbed flow velocity distribution was seen in the experimental model distal to the anastomosis. The OES-technique showed superior flow profiles distal to the anastomosis with minor tendencies of flow separation and represents a new alternative for end-to-side anastomosis. Copyright © 2013 Wiley Periodicals, Inc.

Magnetized Target Fusion At General Fusion: An Overview

NASA Astrophysics Data System (ADS)

Laberge, Michel; O'Shea, Peter; Donaldson, Mike; Delage, Michael; Fusion Team, General

2017-10-01

Magnetized Target Fusion (MTF) involves compressing an initial magnetically confined plasma on a timescale faster than the thermal confinement time of the plasma. If near adiabatic compression is achieved, volumetric compression of 350X or more of a 500 eV target plasma would achieve a final plasma temperature exceeding 10 keV. Interesting fusion gains could be achieved provided the compressed plasma has sufficient density and dwell time. General Fusion (GF) is developing a compression system using pneumatic pistons to collapse a cavity formed in liquid metal containing a magnetized plasma target. Low cost driver, straightforward heat extraction, good tritium breeding ratio and excellent neutron protection could lead to a practical power plant. GF (65 employees) has an active plasma R&D program including both full scale and reduced scale plasma experiments and simulation of both. Although pneumatic driven compression of full scale plasmas is the end goal, present compression studies use reduced scale plasmas and chemically accelerated aluminum liners. We will review results from our plasma target development, motivate and review the results of dynamic compression field tests and briefly describe the work to date on the pneumatic driver front.

The Impact Induced Demagnetization Mechanism in NdFeB Permanent Magnets

NASA Astrophysics Data System (ADS)

Li, Yan-Feng; Zhu, Ming-Gang; Li, Wei; Zhou, Dong; Lu, Feng; Chen, Lang; Wu, Jun-Ying; Qi, Yan; Du, An

2013-09-01

Compression of unmagnetized Nd2Fe14B permanent magnets is executed by using shock waves with different pressures in a one-stage light gas gun system. The microstructure, crystal structure, and magnetic properties of the magnets are examined with scanning electronic microscopy, x-ray diffraction, hysteresis loop instruments, and a vibrating sample magnetometer, respectively. The NdFeB magnets display a demagnetization phenomenon after shock wave compression. The coercivity dropped from about 21.4 kOe to 3.2 kOe. The critical pressure of irreversible demagnetization of NdFeB magnets should be less than 4.92 GPa. The coercivity of the NdFeB magnets compressed by shock waves could be recovered after annealing at 900°C and 520°C for 2 h, sequentially. The chaotic orientation of Nd2Fe14B grains in the compressed magnets is the source of demagnetization.

T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Yong, E-mail: cheny102@163.com; Ye, Peng, E-mail: thomas19871223@163.com; Jiang, Wen-jin, E-mail: 18653501187@163.com

Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

High Order Filter Methods for the Non-ideal Compressible MHD Equations

NASA Technical Reports Server (NTRS)

Yee, H. C.; Sjoegreen, Bjoern

2003-01-01

The generalization of a class of low-dissipative high order filter finite difference methods for long time wave propagation of shock/turbulence/combustion compressible viscous gas dynamic flows to compressible MHD equations for structured curvilinear grids has been achieved. The new scheme is shown to provide a natural and efficient way for the minimization of the divergence of the magnetic field numerical error. Standard divergence cleaning is not required by the present filter approach. For certain non-ideal MHD test cases, divergence free preservation of the magnetic fields has been achieved.

Divergence Free High Order Filter Methods for the Compressible MHD Equations

NASA Technical Reports Server (NTRS)

Yea, H. C.; Sjoegreen, Bjoern

2003-01-01

The generalization of a class of low-dissipative high order filter finite difference methods for long time wave propagation of shock/turbulence/combustion compressible viscous gas dynamic flows to compressible MHD equations for structured curvilinear grids has been achieved. The new scheme is shown to provide a natural and efficient way for the minimization of the divergence of the magnetic field numerical error. Standard diver- gence cleaning is not required by the present filter approach. For certain MHD test cases, divergence free preservation of the magnetic fields has been achieved.

Circular stapler introducer: a novel device to facilitate stapled colorectal anastomosis.

PubMed

Guweidhi, Ahmed; Steffen, Rudolf; Metzger, Alejandro; Teuscher, Jürg; Flückiger, Petra; Z'graggen, Kaspar

2009-04-01

A circular stapler introducer was developed to protect the head of the circular stapler and enable atraumatic introduction and advancement of the circular stapler without interfering with the application and safety of an anastomosis. In a Phase I prospective study, we tested the feasibility and safety of the novel circular stapler introducer device in 60 consecutive patients undergoing left-sided colorectal resections. The median distance of the anastomoses from the anal verge was 12 cm (7-20, n = 60). Total morbidity was 15 percent. No mortality was observed. Handling of the circular stapler introducer was considered nonproblematic by all surgeons who participated in the study. No interference of the circular stapler introducer with the circular stapling devices used was encountered. The advancement of the stapler into the end of the colorectal stump was always possible with the aid of the circular stapler introducer. Use of the circular stapler introducer facilitates the double-stapling technique of colorectal anastomosis. The circular stapler introducer has great potential and should be tested in larger studies.

[Results of using composite bypass grafts with infragenicular distal anastomosis].

PubMed

Pokrovskiĭ, A V; Iakhontov, D I

2014-01-01

The authors share herein their experience with composite bypass grafts and PTFE synthetic prostheses used for treatment of obliterating diseases of the infrainguinal-segment arteries. The data of the study were based on the outcomes obtained in 92 patients. The authors assessed the condition of the outflow pathways and their effect on patency of composite bypass grafts in the immediate and remote postoperative periods, followed by comparative analysis of the short- and long-term therapeutic outcomes after using composite bypass grafts and PTFE synthetic prostheses in the infragenicular position for femoropopliteal and femorotibial reconstructions, also assessing the effect of the localization of the distal anastomosis on the immediate and remote therapeutic outcomes. Based on the obtained findings it was determined that the immediate results of patency depended upon the state of the outflow pathways and localization of the distal anastomosis. Thus, by the 1st, 3rd and 5th year of follow up patency of transplants in patients with the runoff score less than 7.0 amounted to 78.3, 21.7 and 4.3%, respectively. Analogous indices of patency in patients with the runoff score equalling or greater than 7.0 amounted to 60.7 and 3.6% for the 1st and 3rd year, respectively. The remote results of patency turned out to depend on the type of a vascular transplant and the state of the outflow pathways and did not depend on the localization of the distal anastomosis. Thus, the remote results of patency for the composite bypass graft for the 1st, 3rd and 5th year of follow up amounted to 74.5, 19.6 and 5.9%, respectively, versus 60.8 and 8.6% by the first and third year for the PTFE prosthesis. The limb salvage rate at the same terms for the composite bypass graft amounted to 94.1, 84.3 and 78.4% versus 73.9, 56.5 and 52.2% for the PTFE prosthesis.

A pilot study demonstrating the feasibility of supermicrosurgical end-to-side anastomosis onto large recipient vessels in head and neck reconstruction.

PubMed

Iida, Takuya; Yoshimatsu, Hidehiko; Yamamoto, Takumi; Koshima, Isao

2016-12-01

In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent. We have introduced supermicrosurgical end-to-side anastomosis to such arteries in 12 cases of head and neck reconstruction. Double-needle, short-thread microsutures were used to facilitate this procedure, and indocyanine green intraoperative angiography was used to confirm patency. All patients, except one with partial necrosis, survived. We believe that our method is a safe and reliable option for cases in which there is a discrepancy between the flap pedicle and recipient arteries. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Outcomes after aortic graft-to-graft anastomosis with an automated circular stapler: A novel approach.

PubMed

Idrees, Jay J; Yazdchi, Farhang; Soltesz, Edward G; Vekstein, Andrew M; Rodriguez, Christopher; Roselli, Eric E

2016-10-01

Patients with complex aortic disease often require multistaged repairs with numerous anastomoses. Manual suturing can be time consuming. To reduce ischemic time, a circular stapling device has been used to facilitate prosthetic graft-to-graft anastomoses. Objectives are to describe this technique and assess outcomes. From February 2009 to May 2014, 44 patients underwent complex aortic repair with a circular end-to-end anastomosis (EEA) stapler at Cleveland Clinic. All patients had extensive aneurysms: 17 after ascending dissection repair, 10 chronic type B dissections, and 17 degenerative aneurysms. Stapler was used during total arch repair as an end-to-side anastomosis (n = 36; including first stage elephant trunk [ET] in 32, frozen ET in 3) and an end-to-end anastomosis during redo thoracoabdominal repair (n = 11). Three patients had the stapler used during both stages of repair. Patients underwent early and annual follow-ups with computed tomography analysis. There were no bleeds, ruptures, or leaks at the stapled site, but 2 patients died. Complications included 7 reoperations not related to the site of stapled anastomosis and 6 tracheostomies, but there was no paralysis or renal failure. Mean circulatory arrest time was 16 ± 5 minutes. Mean follow-up was 26 ± 17 months and consisted of imaging before discharge, at 3 to 6 months, and at 1 year. Planned reinterventions included 21 second-stage ET completion: Endovascular (n = 18) and open (n = 3). There were 4 late deaths. Use of an end-to-end anastomotic automated circular stapler is safe, effective, and durable in performing graft-to-graft anastomoses during complex thoracic aortic surgery. Further evaluation and refinement of this technique are warranted. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Effectiveness of fibrin adhesive in facial nerve anastomosis in dogs compared with standard microsuturing technique.

PubMed

Attar, Bijan Movahedian; Zalzali, Haidar; Razavi, Mohammad; Ghoreishian, Mehdi; Rezaei, Majid

2012-10-01

Epineural suturing is the most common technique used for peripheral nerve anastomosis. In addition to the foreign body reaction to the suture material, the surgical duration and difficulty of suturing in confined anatomic locations are major problems. We evaluated the effectiveness of fibrin glue as an acceptable alternative for nerve anastomosis in dogs. Eight adult female dogs weighing 18 to 24 kg were used in the present study. The facial nerve was transected bilaterally. On the right side, the facial nerve was subjected to epineural suturing; and on the left side, the nerve was anastomosed using fibrin adhesive. After 16 weeks, the nerve conduction velocity and proportion of the nerve fibers that crossed the anastomosis site were evaluated and compared for the epineural suture (right side) and fibrin glue (left side). The data were analyzed using the paired t test and univariate analysis of variance. The mean postoperative nerve conduction velocity was 29.87 ± 7.65 m/s and 26.75 ± 3.97 m/s on the right and left side, respectively. No statistically significant difference was found in the postoperative nerve conduction velocity between the 2 techniques (P = .444). The proportion of nerve fibers that crossed the anastomotic site was 71.25% ± 7.59% and 72.25% ± 8.31% on the right and left side, respectively. The histologic evaluation showed no statistically significant difference in the proportion of the nerve fibers that crossed the anastomotic site between the 2 techniques (P = .598). The results suggest that the efficacies of epineural suturing and fibrin gluing in peripheral nerve anastomosis are similar. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Hypersonic Magneto-Fluid-Dynamic Compression in Cylindrical Inlet

NASA Technical Reports Server (NTRS)

Shang, Joseph S.; Chang, Chau-Lyan

2007-01-01

Hypersonic magneto-fluid-dynamic interaction has been successfully performed as a virtual leading-edge strake and a virtual cowl of a cylindrical inlet. In a side-by-side experimental and computational study, the magnitude of the induced compression was found to be depended on configuration and electrode placement. To better understand the interacting phenomenon the present investigation is focused on a direct current discharge at the leading edge of a cylindrical inlet for which validating experimental data is available. The present computational result is obtained by solving the magneto-fluid-dynamics equations at the low magnetic Reynolds number limit and using a nonequilibrium weakly ionized gas model based on the drift-diffusion theory. The numerical simulation provides a detailed description of the intriguing physics. After validation with experimental measurements, the computed results further quantify the effectiveness of a magnet-fluid-dynamic compression for a hypersonic cylindrical inlet. At a minuscule power input to a direct current surface discharge of 8.14 watts per square centimeter of electrode area produces an additional compression of 6.7 percent for a constant cross-section cylindrical inlet.

DNABIT Compress - Genome compression algorithm.

PubMed

Rajarajeswari, Pothuraju; Apparao, Allam

2011-01-22

Data compression is concerned with how information is organized in data. Efficient storage means removal of redundancy from the data being stored in the DNA molecule. Data compression algorithms remove redundancy and are used to understand biologically important molecules. We present a compression algorithm, "DNABIT Compress" for DNA sequences based on a novel algorithm of assigning binary bits for smaller segments of DNA bases to compress both repetitive and non repetitive DNA sequence. Our proposed algorithm achieves the best compression ratio for DNA sequences for larger genome. Significantly better compression results show that "DNABIT Compress" algorithm is the best among the remaining compression algorithms. While achieving the best compression ratios for DNA sequences (Genomes),our new DNABIT Compress algorithm significantly improves the running time of all previous DNA compression programs. Assigning binary bits (Unique BIT CODE) for (Exact Repeats, Reverse Repeats) fragments of DNA sequence is also a unique concept introduced in this algorithm for the first time in DNA compression. This proposed new algorithm could achieve the best compression ratio as much as 1.58 bits/bases where the existing best methods could not achieve a ratio less than 1.72 bits/bases.

[Embolization of the feeding artery of a meningioma with dangerous vascular anastomosis between the middle meningeal artery and the ophthalmic artery].

PubMed

Meguro, Toshinari; Tomita, Yusuke; Tanabe, Tomoyuki; Muraoka, Kenichiro; Terada, Kinya; Hirotsune, Nobuyuki; Nishino, Shigeki

2013-11-01

Preoperative embolization of intracranial meningioma has been applied to reduce intraoperative blood loss and to facilitate microsurgical removal of a tumor. It is well known that one of the reasons of the neurological risk of embolization is due to dangerous anastomosis between the extracranial and the intracranial arteries. One of the most known and dangerous case of anastomosis is between the middle meningeal artery to the ophthalmic artery. A 48-year-old woman underwent preoperative embolization of a large right middle cranial fossa meningioma. The right external carotid angiogram showed that the tumor was fed by the right middle meningeal artery and there was no branch to the right orbital region. The right internal carotid angiogram showed that the right ophthalmic artery originated from the right internal carotid artery and there was no branch to the tumor. The selective angiogram of the anterior branch of the middle meningeal artery disclosed the anastomosis to the right ophthalmic artery. Following embolization of the anterior branch of the middle meningeal artery, the patient underwent embolization of the main feeding branch of the meningioma. She successfully underwent surgical removal of the tumor without any blood transfusion and was discharged without neurological deficit. In addition, to avoid complication in embolization of the feeding artery of a skull base meningioma, clinicians must be aware of the dangerous anastomosis between the middle meningeal artery and the ophthalmic artery, even if conventional external and internal carotid angiograms do not show any anastomosis.

Pancreaticojejunostomy - Risk Anastomosis after Cephalic Pancreaticoduodenectomy.

PubMed

Straja, N D; Daha, C; Brătucu, E; Cirimbei, C; Prunoiu, V; Alecu, M; Ionescu, S; Mareş, T; Simion, L

2015-01-01

The authors bring to attention pancreaticojejunalanastomosis (PJA) performed after cephalic pancreaticoduodenectomy(CPD). This type of anastomosis is renowned forits high risk of complications. Among these complications, pancreatic fistula (PF) is distinguishable due to a significant frequency, averaging 10%. It is perhaps the most unsafe type of anastomosis in digestive surgery, due to its pancreatic partnership. Performing a sealed APJ can be considered a great achievement: a digestive lumen is set in contact with a brittleparenchymal structure, centred by a delicate excretory channel, difficult to anastomose in itself. We studied two distinct groups of patients undergoing CPD. A first group - 58 cases operated on between 1967 and 1983, and the second one - 70 cases operated on between 1984 - 2013. In all cases we performed PJA; by in-continuity loop technique in the first group, and with separate loop in the second group. In the second group we used a variant own technique that does not allow anastomotic loss of pancreatic fluid. Thus, a decline in the incidence of PF from 20% to 8% was obtained, the final percentage corresponding to group two. Of the 8% of patients with PF losses were recorded strictly at pancreatic level, with no bile or food contamination. Stenting was recorded for biliary- and pancreaticojejunal anastomoses in group two. The percentage of PF after CPD did not show anynotable revival when comparing the 1980s period to the present. Also, mortality due to FP is approaching 40%, adaunting figure. The multitude of technical options for restoring bowel movement after CPD, over 80 procedures, further confirms the lack of safety and trust in relation to PJA.The authors bring forward several surgical gestures addressing PJA, gestures capable of providing an 8% frequency of PF,percentage which we consider to be reasonable. The authors consider PJA stenting mandatory.Placing an isolated PJA on the short branch of the "Y", separate from the biliary and

Microvascular anastomosis using the vascular closure device in free flap reconstructive surgery: A 13-year experience.

PubMed

Reddy, Chaitan; Pennington, David; Stern, Harvey

2012-02-01

The achievement of patency of the microvascular anastomosis in free flap surgery is dependent on a number of factors, central to which is atraumatic handling of the vessel lumen, and intimal apposition. Initial laboratory studies demonstrating the superiority of the non-penetrating vascular closure staple (VCS - Anastoclip ®) were followed by our report in 1999 on a series of free flaps. There is still a paucity of data in the literature on the use of non-penetrating devices for microvascular anastomosis, and our review gives evidence to support the routine use of the VCS in microsurgical free flap surgery. We now report on its successful use over a thirteen year period in 819 free flap reconstructions. Our data indicates the VCS device to be as effective as sutured anastomoses in free tissue transfer surgery. There is also statistically significant data (Barnard's Exact Test) to demonstrate a higher vascular patency rate of the VCS device over sutured anastomoses when sub group analysis is performed. 'Take-back' revision rates were lower amongst flaps that employed VCS use. For arterial anastomoses, this equated to 3/654(0.05%) vs 4/170(2.4%) with hand-sewn anastomoses (p = 0.02). Similarly, for venous anastomoses the 'take-back' revision rate was 7/661(1.1%) vs 8/165(4.8%) with hand-sewn anastomoses (p = 0.003). Furthermore, the major advantage of the VCS is reduction in anastomosis time, from approximately 25 min per anastomosis for sutures to between five and 10 min for staples. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Totally laparoscopic gastrectomy using intracorporeally stapler or hand-sewn anastomosis for gastric cancer: a single-center experience of 478 consecutive cases and outcomes.

PubMed

Chen, Ke; Wu, Di; Pan, Yu; Cai, Jia-Qin; Yan, Jia-Fei; Chen, Ding-Wei; Maher, Hendi; Mou, Yi-Ping

2016-04-19

Totally laparoscopic gastrectomy (TLG) using intracorporeal anastomosis has gradually become mature thanks to the advancements of laparoscopic surgical instruments and the accumulation of operative experience. The goal of this study is to review our institution's experience with TLG for the treatment of gastric cancer. A retrospective study was conducted to examine the short-term outcomes of TLG using intracorporeally stapler or hand-sewn anastomosis performed at Sir Run Run Shaw Hospital between March 2007 and June 2015. The details of intracorporeal anastomosis were described, and the clinicopathological data, surgical outcomes, and postoperative complications were evaluated. Four hundred seventy-eight patients were included in the study. Generally speaking, the patients could be divided into stapler or hand-sewn groups according to whether intracorporeal anastomosis was performed by only hand-sewn technique (n = 97) or only stapling devices (n = 381). For overall patients, the mean operation time and anastomotic time were 225.7 and 30.0 min, respectively. Postoperative complications were observed in 65 patients. All of the patients recovered well without perioperative death by conservative or surgical management. TLG using intracorporeally stapler or hand-sewn anastomosis is a reasonable option for the treatment of gastric cancer, with early data showing acceptable perioperative outcomes.

Development of 1D Liner Compression Code for IDL

NASA Astrophysics Data System (ADS)

Shimazu, Akihisa; Slough, John; Pancotti, Anthony

2015-11-01

A 1D liner compression code is developed to model liner implosion dynamics in the Inductively Driven Liner Experiment (IDL) where FRC plasmoid is compressed via inductively-driven metal liners. The driver circuit, magnetic field, joule heating, and liner dynamics calculations are performed at each time step in sequence to couple these effects in the code. To obtain more realistic magnetic field results for a given drive coil geometry, 2D and 3D effects are incorporated into the 1D field calculation through use of correction factor table lookup approach. Commercial low-frequency electromagnetic fields solver, ANSYS Maxwell 3D, is used to solve the magnetic field profile for static liner condition at various liner radius in order to derive correction factors for the 1D field calculation in the code. The liner dynamics results from the code is verified to be in good agreement with the results from commercial explicit dynamics solver, ANSYS Explicit Dynamics, and previous liner experiment. The developed code is used to optimize the capacitor bank and driver coil design for better energy transfer and coupling. FRC gain calculations are also performed using the liner compression data from the code for the conceptual design of the reactor sized system for fusion energy gains.

A Case of 2-Year-Old Child with Entero-Enteric Fistula Following Ingestion of 25 Magnets.

PubMed

Pogorelić, Zenon; Borić, Matija; Markić, Joško; Jukić, Miro; Grandić, Leo

Magnet ingestion usually does not cause serious complications, but in case of multiple magnet ingestion or ingestion of magnet with other metal it could cause intestinal obstruction, fistula formation or even perforation. We report case of intestinal obstruction and fistula formation following ingestion of 25 magnets in a 2-year-old girl. Intraoperatively omega shaped intestinal loop with fistula caused by two magnetic balls was found. Intestine trapped with magnetic balls was edematous and inflamed. Resection of intestinal segment was performed, followed by entero-enteric anastomosis. A total of 25 magnets were removed from resected intestine. Single magnet ingestion is treated as non-magnetic foreign body. Multiple magnet ingestion should be closely monitored and surgical approach could be the best option to prevent or to cure its complications.

Laparoscopic Conversion of One Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass for Chronic Bile Reflux.

PubMed

Facchiano, Enrico; Leuratti, Luca; Veltri, Marco; Lucchese, Marcello

2016-03-01

One anastomosis gastric bypass (OAGB) demonstrated similar results to traditional Roux-en-Y procedures. A possible concern is how to manage a chronic bile reflux when medical therapy results ineffective. Revision of the gastro-jejunal anastomosis, obtaining a Roux-en-Y reconstruction, has already been proposed, but technical details have not been elucidated yet. This video shows how to revise a 200-cm OAGB to treat chronic bile reflux, by converting the procedure to Roux-en-Y, having a short gastric pouch and a long efferent limb. A 51-year-old patient complained of recurrent heartburns 2 months after OAGB. A gastroscopy witnessed the presence of a 6-cm long gastric pouch with pouchitis and bile reflux in esophagus. Specific medications were ineffective. He underwent a revisional laparoscopic procedure. The efferent limb was measured and consisted of 650 cm. The afferent limb was then divided next to the previous gastro-jejunal anastomosis and a jejuno-jejunal anastomosis was performed distally at 70 cm on the alimentary limb. Total operative time was 50 min. The postoperative stay was uneventful and the patient was discharged in postoperative day four. At 6 months follow-up he is still free of medications without symptoms. The ideal scenario for the presented technique is the finding of a long efferent limb, in order to fashion a Roux-en-Y limb without the risk of postoperative malabsorption. To reach this goal, we suggest the measurement of the whole small bowel intra-operatively, in order to assess the length of the common channel left in place.

Intraluminal tissue welding for anastomosis

DOEpatents

Glinsky, M.; London, R.; Zimmerman, G.; Jacques, S.

1998-10-27

A method and device are provided for performing intraluminal tissue welding for anastomosis of a hollow organ. A retractable catheter assembly is delivered through the hollow organ and consists of a catheter connected to an optical fiber, an inflatable balloon, and a biocompatible patch mounted on the balloon. The disconnected ends of the hollow organ are brought together on the catheter assembly, and upon inflation of the balloon, the free ends are held together on the balloon to form a continuous channel while the patch is deployed against the inner wall of the hollow organ. The ends are joined or ``welded`` using laser radiation transmitted through the optical fiber to the patch. A thin layer of a light-absorbing dye on the patch can provide a target for welding. The patch may also contain a bonding agent to strengthen the bond. The laser radiation delivered has a pulse profile to minimize tissue damage. 8 figs.

Intraluminal tissue welding for anastomosis

DOEpatents

Glinsky, Michael; London, Richard; Zimmerman, George; Jacques, Steven

1998-10-27

A method and device are provided for performing intraluminal tissue welding for anastomosis of a hollow organ. A retractable catheter assembly is delivered through the hollow organ and consists of a catheter connected to an optical fiber, an inflatable balloon, and a biocompatible patch mounted on the balloon. The disconnected ends of the hollow organ are brought together on the catheter assembly, and upon inflation of the balloon, the free ends are held together on the balloon to form a continuous channel while the patch is deployed against the inner wall of the hollow organ. The ends are joined or "welded" using laser radiation transmitted through the optical fiber to the patch. A thin layer of a light-absorbing dye on the patch can provide a target for welding. The patch may also contain a bonding agent to strengthen the bond. The laser radiation delivered has a pulse profile to minimize tissue damage.

Optimal dye concentration and irradiance for laser-assisted vascular anastomosis.

PubMed

Ren, Zhen; Xie, Hua; Lagerquist, Kathryn A; Burke, Allen; Prahl, Scott; Gregory, Kenton W; Furnary, Anthony P

2004-04-01

This investigation was done in order to find optimal indocyanine green (ICG) concentration and energy irradiance in laser vascular welding. Many studies have shown that laser tissue welding with albumin solder/ICG may be an effective technique in surgical reconstruction. However, there are few reports regarding optimal laser settings and concentrations of ICG within the albumin solder in laser-assisted vascular anastomosis. Porcine carotid artery strips (n = 120) were welded in end-to-end by diode laser with 50% albumin solder of 0.01, 0.1, and 1.0 mM ICG at irradiance of 27.7, 56.7, and 76.9 W/cm(2), respectively. Temperature was measured by inserting thermocouples outside and inside the vessel. Tensile strength and histology were studied. Temperature and strength of the anastomosis significantly decreased (all p < 0.05) with increasing ICG concentration at 56.7 W/cm(2). Histological study showed minimal thermal injury limited to adventitia and no appreciable difference between all groups. ICG concentration within solder is the most important factor affecting both vascular temperature and tensile strength. The optimal balance between strength and minimal thermal injury may be achieved primarily at 56.7 W/cm(2) and 0.01 mM ICG.

Derivation of Inviscid Quasi-geostrophic Equation from Rotational Compressible Magnetohydrodynamic Flows

NASA Astrophysics Data System (ADS)

Kwon, Young-Sam; Lin, Ying-Chieh; Su, Cheng-Fang

2018-04-01

In this paper, we consider the compressible models of magnetohydrodynamic flows giving rise to a variety of mathematical problems in many areas. We derive a rigorous quasi-geostrophic equation governed by magnetic field from the rotational compressible magnetohydrodynamic flows with the well-prepared initial data. It is a first derivation of quasi-geostrophic equation governed by the magnetic field, and the tool is based on the relative entropy method. This paper covers two results: the existence of the unique local strong solution of quasi-geostrophic equation with the good regularity and the derivation of a quasi-geostrophic equation.

[Stapler reconstruction after total gastrectomy contrasted with manual anastomosis].

PubMed

Gullà, P; Serafini, S; Micheletti, M; Gullà, N; Tristaino, B

1989-09-15

A personal series (1985-1987) of 22 cases of total gastrectomy for cancer is analysed, a comparison being made between 11 cases treated with manual anastomosis and 11 reconstructed using a stapler. The advantages and disadvantages of the various techniques are examined and although no substantial difference is noted between the two reconstructive modalities, at least as regards morbidity and mortality, stress is laid on the unquestionable advantages of mechanical staplers. These are essentially speed of execution, suture perfection and excellent long-term results.

Development and evaluation of a novel lossless image compression method (AIC: artificial intelligence compression method) using neural networks as artificial intelligence.

PubMed

Fukatsu, Hiroshi; Naganawa, Shinji; Yumura, Shinnichiro

2008-04-01

This study was aimed to validate the performance of a novel image compression method using a neural network to achieve a lossless compression. The encoding consists of the following blocks: a prediction block; a residual data calculation block; a transformation and quantization block; an organization and modification block; and an entropy encoding block. The predicted image is divided into four macro-blocks using the original image for teaching; and then redivided into sixteen sub-blocks. The predicted image is compared to the original image to create the residual image. The spatial and frequency data of the residual image are compared and transformed. Chest radiography, computed tomography (CT), magnetic resonance imaging, positron emission tomography, radioisotope mammography, ultrasonography, and digital subtraction angiography images were compressed using the AIC lossless compression method; and the compression rates were calculated. The compression rates were around 15:1 for chest radiography and mammography, 12:1 for CT, and around 6:1 for other images. This method thus enables greater lossless compression than the conventional methods. This novel method should improve the efficiency of handling of the increasing volume of medical imaging data.

Internal or External Stenting of the Ureterovesical Anastomosis in Renal Transplantation.

PubMed

Fockens, M Matthijs; Alberts, Victor P; Bemelman, Frederike J; Laguna Pes, M Pilar; Idu, Mirza M

2016-01-01

Stenting of the ureterovesical anastomosis reduces the incidence of urological complications (UCs) after renal transplantation, but there are multiple stenting techniques, and there is no consensus regarding which technique is preferred. The aim of this study was to compare an internal versus an external stenting technique on the incidence of UCs. This is a retrospective analysis of 419 deceased donor renal transplantations performed between January 2008 and December 2013. Until 2011, 183 patients received an external stent through the ureterovesical anastomosis placed by suprapubic bladder puncture (SP stent). From 2011, 236 recipients received an internal double-J (JJ) stent. The rate of UC was 3.8% in JJ stents, compared to 9.3% in SP stents (p = 0.021). No difference in surgical ureter revision rate was observed between the groups (2.1 vs. 5.5%; p = 0.068). Urinary tract infection (UTI) rate and graft function were comparable between both groups. Internal JJ stenting significantly decreased the incidence of UC compared to an external SP stent. There was no difference in surgical ureter revision rate, UTI or graft function. © 2015 S. Karger AG, Basel.

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.

[Cervical tracheal resection with primary anastomosis for benign tracheal stricture in adult].

PubMed

Ye, Jin; Hu, Yan-Ming; Liu, Hui; Li, Jing-Jia; Wang, Zhi-Yuan; Li, Yuan

2013-07-01

To introduce the outcomes of tracheal resection with primary end to end anastomosis for benign cervical tracheal stenosis, and to discuss the strategy for prevention of surgical complications. A retrospective analysis was performed in 12 patients diagnosed as benign cervical tracheal stenosis from October 2009 to June 2012. Laryngo-tracheal endoscopic examination and computed tomography (CT) were used to assess the degree of stenosis, the grade of inflammation and edema of the subglottis and trachea, and the extent of stenosis and the remaining linear amount of normal airway. The Meyer and Cotton grading system was used to categorise the clinical severity of the stenoses. All patients underwent tracheal resection with primary end to end anastomosis. The length of cervical tracheal stenosis ranged from 2.3 to 4.1 cm. Grade II stenosis was present in three patients, Grade III stenosis was present in seven patients and grade IV stenosis in two patients. Successful extubation was achieved in all 12 cases. After surgery, temporary hoarseness occurred in 1 patient (8.3%); unilateral pulmonary atelectasis with pleural effusion occurred in 1 patient (8.3%); subcutaneous emphysema with infection occurred in 1 patient (8.3%); mild dysphagia occurred in 3 patients (25.0%); a slight deepening of the tone of voice occurred in 5 patients (41.7%), granulation tissue growth near the suture occurred in 3 patients (25.0%), and suture dehiscence did not occur in any patient. The follow-up period ranged from 6 months to 38 months, no patient developed restenosis. It presents a high success rate and good functional result of tracheal resection with primary end-to-end anastomosis. Therefore, it is an effective and reliable approach for the management of benign cervical tracheal stenosis. To avoid complications, the preoperative assessment, patients selection and postoperative management should be emphasized.

Colovaginal anastomosis: an unusual complication of stapler use in restorative procedure after Hartmann operation

PubMed Central

Yan, Zhongshu; Liao, Guoqing

2005-01-01

Background Rectovaginal fistula is uncommon after lower anterior resection for rectal cancer. The most leading cause of this complication is involvement of the posterior wall of the vagina into the staple line when firing the circular stapler. Case presentation A 50-year-old women underwent resection for obstructed carcinoma of the sigmoid colon with Hartmann procedure. Four months later she underwent restorative surgery with circular stapler. Following which she developed rectovaginal fistula. A transvaginal repair was performed but stool passing from vagina not per rectum. Laporotomy revealed colovaginal anastomosis, which was corrected accordingly. Patient had an uneventful recovery. Conclusion Inadvertent formation of colovaginal anastomosis associated with a rectovaginal fistula is a rare complication caused by the operator's error. The present case again highlights the importance of ensuring that the posterior wall of vagina is away from the staple line. PMID:16285887

Slow, Fast and Mixed Compressible Modes near the Magnetopause

NASA Astrophysics Data System (ADS)

Scudder, J. D.; Maynard, N. C.; Burke, W. J.

2003-12-01

We motivate and illustrate a new technique to certify time variations, observed in spacecraft frame of reference, as compressible slow or fast magnetosonic waves. Like the Walén test for Alfvén waves, our method for identifying compressible modes requires no Galilean transformation. Unlike the Walén test, we use covariance techniques with magnetic field time series to select three special projections of B(t). The projections of magnetic fluctuations are associated with three, usually non-orthogonal, wavevectors that, in principle, contribute to the locally sampled density fluctuations. Wavevector directions ({\\hat k}(CoV)) are derived from eigenvectors of covariance matrices and mean field directions, Bo. Linear theory for compressible modes indicates that these projections are proportional to the density fluctuations. Regression techniques are then applied to observed density and magnetic field profiles to specify coefficients of proportionality. Signs of proportionality constants, connecting the three projections of δ B and δ ρ , determine whether the compressional modes are of the fast (+) or slow (-) type. Within a polytropic-closure framework, the proportionality between magnetic and density fluctuations can be computed by relating {\\hat k}, the polytropic index, γ , and the plasma β . Our certification program validates the direct interpretation of proportionality constants comparing their best-fit and error values with the directions of wavevectors required by the dispersion relation, {\\hat k}(Disp) inferred from experimental measurements of β and γ . Final certification requires that for each mode retained in the correlation, the scalar product of wavevectors determined through covariance and dispersion-relation analyses are approximately unity \\hat k (CoV)\\cdot \\hat k (Disp)≈ 1. This quality check is the compressible-mode analogue to slope-one tests in the Walén test expressed in Elsässer [1950] variables. By products of completed

The Neural Architecture of Discourse Compression

ERIC Educational Resources Information Center

Lillywhite, L. M.; Saling, M. M.; Demutska, A.; Masterton, R.; Farquharson, S.; Jackson, G. D.

2010-01-01

Re-telling a story is thought to produce a progressive refinement in the mental representation of the discourse. A neuroanatomical substrate for this compression effect, however, has yet to be identified. We used a discourse re-listening task and functional magnetic resonance imaging (fMRI) to identify brain regions responsive to repeated…

Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis.

PubMed

Nasmyth, D G; Johnston, D; Williams, N S; King, R F; Burkinshaw, L; Brooks, K

1989-03-01

Bile acid absorption was investigated using 75Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P less than .05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P less than .01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy, but bacterial metabolism of bile acids was greater in the pouches.

Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.

PubMed

Amor, Imed Ben; Petrucciani, Niccolo; Kassir, Radwan; Al Munifi, Abdullah; Piche, Thierry; Debs, Tarek; Gugenheim, Jean

2017-05-01

One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the esophagus. Medical treatment of gastroesophageal reflux disease was ineffective. We decided to convert the OAGB to a Roux-en-Y gastric bypass (RYGB). In this video, we show how to revise an OAGB to treat chronic bile reflux, by converting the procedure to a standard RYGB. The intervention starts by restoring the normal anatomy of the small bowel, with the resection of the gastrojejunal anastomosis, which was located at 250-cm du Treitz's ligament. Then, the gastric pouch is created. A standard Roux-en-Y gastric bypass is performed. The resection of the gastrojejunal anastomosis allows fashioning the Roux-en-Y limb with the classical measures. This technique allows a conversion to a standard RYGB and is effective in treating the biliary reflux.

Numerical simulation of the compressible Orszag-Tang vortex 2. Supersonic flow

NASA Technical Reports Server (NTRS)

Picone, J. M.; Dahlburg, Russell B.

1990-01-01

The numerical investigation of the Orszag-Tang vortex system in compressible magnetofluids will consider initial conditions with embedded supersonic regions. The simulations have initial average Mach numbers 1.0 and 1.5 and beta 10/3 with Lundquist numbers 50, 100, or 200. The behavior of the system differs significantly from that found previously for the incompressible and subsonic analogs. Shocks form at the downstream boundaries of the embedded supersonic regions outside the central magnetic X-point and produce strong local current sheets which dissipate appreciable magnetic energy. Reconnection at the central X-point, which dominates the incompressible and subsonic systems, peaks later and has a smaller impact as M increases from 0.6 to 1.5. Similarly, correlation between the momentum and magnetic field begins significant growth later than in subsonic and incompressible flows. The shocks bound large compression regions, which dominate the wavenumber spectra of autocorrelations in mass density, velocity, and magnetic field.

The Complete Genome of a New Betabaculovirus from Clostera anastomosis

PubMed Central

Yin, Feifei; Zhu, Zheng; Liu, Xiaoping; Hou, Dianhai; Wang, Jun; Zhang, Lei; Wang, Manli; Kou, Zheng; Wang, Hualin; Deng, Fei; Hu, Zhihong

2015-01-01

Clostera anastomosis (Lepidoptera: Notodontidae) is a defoliating forest insect pest. Clostera anastomosis granulovirus-B (ClasGV-B) belonging to the genus Betabaculovirus of family Baculoviridae has been used for biological control of the pest. Here we reported the full genome sequence of ClasGV-B and compared it to other previously sequenced baculoviruses. The circular double-stranded DNA genome is 107,439 bp in length, with a G+C content of 37.8% and contains 123 open reading frames (ORFs) representing 93% of the genome. ClasGV-B contains 37 baculovirus core genes, 25 lepidopteran baculovirus specific genes, 19 betabaculovirus specific genes, 39 other genes with homologues to baculoviruses and 3 ORFs unique to ClasGV-B. Hrs appear to be absent from the ClasGV-B genome, however, two non-hr repeats were found. Phylogenetic tree based on 37 core genes from 73 baculovirus genomes placed ClasGV-B in the clade b of betabaculoviruses and was most closely related to Erinnyis ello GV (ErelGV). The gene arrangement of ClasGV-B also shared the strongest collinearity with ErelGV but differed from Clostera anachoreta GV (ClanGV), Clostera anastomosis GV-A (ClasGV-A, previously also called CaLGV) and Epinotia aporema GV (EpapGV) with a 20 kb inversion. ClasGV-B genome contains three copies of polyhedron envelope protein gene (pep) and phylogenetic tree divides the PEPs of betabaculoviruses into three major clades: PEP-1, PEP-2 and PEP/P10. ClasGV-B also contains three homologues of P10 which all harbor an N-terminal coiled-coil domain and a C-terminal basic sequence. ClasGV-B encodes three fibroblast growth factor (FGF) homologues which are conserved in all sequenced betabaculoviruses. Phylogenetic analysis placed these three FGFs into different groups and suggested that the FGFs were evolved at the early stage of the betabaculovirus expansion. ClasGV-B is different from previously reported ClasGV-A and ClanGV isolated from Notodontidae in sequence and gene arrangement

Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center.

PubMed

Soh, Jae Seung; Yang, Dong-Hoon; Lee, Sang Soo; Lee, Seohyun; Bae, Jungho; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun

2015-09-01

Patients with altered anatomy such as a Roux-en-Y anastomosis often present with various pancreaticobiliary problems requiring therapeutic intervention. However, a conventional endoscopic approach to the papilla is very difficult owing to the long afferent limb and acute angle of a Roux-en-Y anastomosis. Balloon-assisted enteroscopy can be used for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered anatomy. We experienced six cases of Roux-en-Y anastomosis with biliary problems, and attempted ERCP using single balloon enteroscopy (SBE). SBE insertion followed by replacement with a conventional endoscope was attempted in five of six patients. The papilla was successfully approached using SBE in all cases. However, therapeutic intervention was completed in only three cases because of poor maneuverability caused by postoperative adhesion. We conclude that in patients with Roux-en-Y anastomosis, the ampulla can be readily accessed with SBE, but longer dedicated accessories are necessary to improve this therapeutic intervention.

Outcomes of Prosthetic Hemodialysis Grafts after Deployment of Bare Metal versus Covered Stents at the Venous Anastomosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Charles Y., E-mail: charles.kim@duke.edu; Tandberg, Daniel J.; Rosenberg, Michael D.

2012-08-15

Purpose: To compare postintervention patency rates after deployment of bare metal versus covered stents across the venous anastomosis of prosthetic arteriovenous (AV) grafts. Methods: Review of our procedural database over a 6 year period revealed 377 procedures involving stent deployment in an AV access circuit. After applying strict inclusion criteria, our study group consisted of 61 stent deployments in 58 patients (median age 58 years, 25 men, 33 women) across the venous anastomosis of an upper extremity AV graft circuit that had never been previously stented. Both patent and thrombosed AV access circuits were retrospectively analyzed. Within the bare metalmore » stent group, 20 of 32 AV grafts were thrombosed at initial presentation compared to 18 of 29 AV grafts in the covered stent group. Results: Thirty-two bare metal stents and 29 covered stents were deployed across the venous anastomosis. The 3, 6, and 12 months primary access patency rates for bare metal stents were not significantly different than for covered stents: 50, 41, and 22 % compared to 59, 52, and 29 %, respectively (p = 0.21). The secondary patency rates were also not significantly different: 78, 78, and 68 % for bare metal stents compared to 76, 69, and 61 % for covered stents, respectively (p = 0.85). However, covered stents demonstrated a higher primary stent patency rate than bare metal stents: 100, 85, and 70 % compared to 75, 67, and 49 % at 3, 6, and 12 months (p < 0.01). Conclusion: The primary and secondary access patency rates after deployment of bare metal versus covered stents at the venous anastomosis were not significantly different. However, bare metal stents developed in-stent stenoses significantly sooner.« less

Slide Esophagoplasty vs End-to-End Anastomosis for Recalcitrant Esophageal Stricture after Esophageal Atresia Repair.

PubMed

Kamran, Ali; Smithers, Charles J; Manfredi, Michael A; Hamilton, Thomas E; Ngo, Peter D; Zurakowski, David; Jennings, Russell W

2018-06-01

Anastomotic stricture is a common complication after esophageal atresia (EA) repair. Patients with a recalcitrant stricture may require surgical intervention. The technique of reanastomosis after stricture resection can affect patient outcomes. Patients with EA who underwent anastomotic stricture resection, from July 2010 to February 2017, were reviewed. After stricture resection, patients who had slide esophagoplasty performed were compared with those having conventional end-to-end anastomosis. Fifty patients underwent stricture repair surgery by slide esophagoplasty (n = 12) or end-to-end (n = 38) anastomosis technique at a median age of 14 months (interquartile range [IQR] 6 to 23 months). Significantly fewer patients required dilation therapy after slide esophagoplasty: 6 of 12 (50%) compared with 32 of 38 (84%) in the end-to-end group (p = 0.02). The number of dilation sessions was significantly lower in the slide group vs the end-to-end (p = 0.004) group, with a risk ratio confirming the approximately half the number of dilations for the slide approach (risk ratio 0.57, 95% CI 0.38 to 0.86). Steroid injection was combined with dilation in 3 of 12 (25%) vs 22 of 38 (58%) in the slide and end-to-end groups, respectively (p = 0.10). Stent placement was used in none of slide cases vs 8 of 38 (21%) in the end-to-end group (p = 0.17). Stricture incision was performed in 1 of 12 (8%) in the slide group and 11 of 38 (29%) in the end-to-end group (p = 0.25). There were leak complications in fewer patients after slide esophagoplasty compared with end-to-end anastomosis: 1 of 12 (8%) vs 8 of 38 (21%) (p = 0.43). Slide esophagoplasty may be a useful technique of anastomotic configuration for selected patients with recalcitrant esophageal stricture, offering more favorable outcomes compared with end-to-end anastomosis. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Myofibroblasts and colonic anastomosis healing in Wistar rats.

PubMed

Kosmidis, Christophoros; Efthimiadis, Christoforos; Anthimidis, Georgios; Basdanis, George; Apostolidis, Stylianos; Hytiroglou, Prodromos; Vasiliadou, Kalliopi; Prousalidis, John; Fahantidis, Epameinondas

2011-03-02

The myofibroblasts play a central role in wound healing throughout the body. The process of wound healing in the colon was evaluated with emphasis on the role of myofibroblasts. One hundred male Wistar rats weighing 274 ± 9.1 g (mean age: 3.5 months) were used. A left colonic segment was transected and the colon was re-anastomosed. Animals were randomly divided into two groups. The first group experimental animals (n = 50) were sacrificed on postoperative day 3, while the second group rats (n = 50) were sacrificed on postoperative day 7. Healing of colonic anastomosis was studied in terms of anastomotic bursting pressure, as well as myofibroblastic reaction and expression of α-smooth muscle actin (α-SMA), adhesion formation, inflammatory reaction and neovascularization. The mean anastomotic bursting pressure increased from 20.6 ± 3.5 mmHg on the 3rd postoperative day to 148.8 ± 9.6 Hg on the 7th postoperative day. Adhesion formation was increased on the 7th day, as compared to the 3rd day. In addition, the myofibroblastic reaction was more profound on the 7th postoperative day in comparison with the 3rd postoperative day. The staining intensity for α-SMA was progressive from the 3rd to the 7th postoperative day. On the 7th day the α-SMA staining in the myofibroblats reached the level of muscular layer cells. Our study emphasizes the pivotal role of myofibroblasts in the process of colonic anastomosis healing. The findings provide an explanation for the reduction in the incidence of wound dehiscence after the 7th postoperative day.

Efficacy of single-layer continuous suture of the posterior wall in anastomosis involving a difficult location of the digestive tract

PubMed Central

LI, GUO-CAI; XU, YONG; ZHANG, YU-CHUN; ZHANG, FANG-CHENG; WANG, QI; MA, QING-JIU

2014-01-01

Surgery for digestive tract disease predominantly consists of reconstruction and anastomosis. Due to the difficult location, anastomosis is extremely challenging and the risk of complication increases accordingly. Traditional manual anastomosis and the application of a stapling device are insufficient. Therefore, the aim of this study was to investigate the feasibility and safety of a novel manual method in a difficult anastomotic location, consisting of a single-layer continuous suture in the posterior wall. In total, 15 beagle dogs were included in the study; eight underwent surgery with the novel manual method for reconstruction and anastomosis of the digestive tract, while seven underwent surgery with the stapler device as a control. The subsequent postoperative complications were observed and, three months later, the anastomotic ports were excised, and the pathological formation and morphological changes were evaluated. No statistically significant differences were identified between the total (50.0 vs. 57.1%; P=0.782) and anastomotic (0.0 vs. 28.6%; P=0.200) complication rates in the manual suture and staple suture groups, respectively. Compared with the control group, the operative expenditure was lower in the manual group (1726.7±33.5 vs. 2135.7±43.1 renminbi; P=0.001), the diameter of the anastomotic port was larger in the manual group (3.04±0.07 vs. 2.24±0.25 cm; P=0.004) and the thickness of the anastomotic port (in cm) was thinner in the manual group (2.94±0.06 vs. 5.07±0.85; P=0.002). Furthermore, the pathological formation of the anastomositic port in the manual group was improved. The results of the current study suggest single-layer continuous suture of the posterior wall in anastomosis of the digestive tract to be a novel method with feasibility and safety, particularly in difficult anastomotic locations. PMID:25202369

Efficacy of single-layer continuous suture of the posterior wall in anastomosis involving a difficult location of the digestive tract.

PubMed

Li, Guo-Cai; Xu, Yong; Zhang, Yu-Chun; Zhang, Fang-Cheng; Wang, Qi; Ma, Qing-Jiu

2014-10-01

Surgery for digestive tract disease predominantly consists of reconstruction and anastomosis. Due to the difficult location, anastomosis is extremely challenging and the risk of complication increases accordingly. Traditional manual anastomosis and the application of a stapling device are insufficient. Therefore, the aim of this study was to investigate the feasibility and safety of a novel manual method in a difficult anastomotic location, consisting of a single-layer continuous suture in the posterior wall. In total, 15 beagle dogs were included in the study; eight underwent surgery with the novel manual method for reconstruction and anastomosis of the digestive tract, while seven underwent surgery with the stapler device as a control. The subsequent postoperative complications were observed and, three months later, the anastomotic ports were excised, and the pathological formation and morphological changes were evaluated. No statistically significant differences were identified between the total (50.0 vs. 57.1%; P=0.782) and anastomotic (0.0 vs. 28.6%; P=0.200) complication rates in the manual suture and staple suture groups, respectively. Compared with the control group, the operative expenditure was lower in the manual group (1726.7±33.5 vs. 2135.7±43.1 renminbi; P=0.001), the diameter of the anastomotic port was larger in the manual group (3.04±0.07 vs. 2.24±0.25 cm; P=0.004) and the thickness of the anastomotic port (in cm) was thinner in the manual group (2.94±0.06 vs. 5.07±0.85; P=0.002). Furthermore, the pathological formation of the anastomositic port in the manual group was improved. The results of the current study suggest single-layer continuous suture of the posterior wall in anastomosis of the digestive tract to be a novel method with feasibility and safety, particularly in difficult anastomotic locations.

Anisotropic Mechanical Properties of Magnetically Aligned Fibrin Gels Measured by Magnetic Resonance Elastography

PubMed Central

Namani, Ravi; Wood, Matthew D.; Sakiyama-Elbert, Shelly E.; Bayly, Philip V.

2009-01-01

The anisotropic mechanical properties of magnetically aligned fibrin gels were measured by magnetic resonance elastography (MRE) and by a standard mechanical test: unconfined compression. Soft anisotropic biomaterials are notoriously difficult to characterize, especially in vivo. MRE is well-suited for efficient, non-invasive, and nondestructive assessment of shear modulus. Direction-dependent differences in shear modulus were found to be statistically significant for gels polymerized at magnetic fields of 11.7T and 4.7T compared to control gels. Mechanical anisotropy was greater in the gels polymerized at the higher magnetic field. These observations were consistent with results from unconfined compression tests. Analysis of confocal microscopy images of gels showed measurable alignment of fibrils in gels polymerized at 11.7T. This study provides direct, quantitative measurements of the anisotropy in mechanical properties that accompanies fibril alignment in fibrin gels. PMID:19656516

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

Numerical simulation of the compressible Orszag-Tang vortex. Interim report, June 1988-February 1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dahlburg, R.B.; Picone, J.M.

Results of fully compressible, Fourier collocation, numerical simulations of the Orszag-Tang vortex system are presented. Initial conditions consist of a nonrandom, periodic field in which the magnetic and velocity fields contain X-points but differ in modal structure along one spatial direction. The velocity field is initially solenoidal, with the total initial pressure-field consisting of the superposition of the appropriate incompressible pressure distribution upon a flat pressure field corresponding to the initial, average flow Mach number of the flow. In the numerical simulations, this initial Mach number is varied from 0.2 to 0.6. These values correspond to average plasma beta valuesmore » ranging from 30.0 to 3.3, respectively. Compressible effects develop within one or two Alfven transit times, as manifested in the spectra of compressible quantities such as mass density and nonsolenoidal flow field. These effects include (1) retardation of growth of correlation between the magnetic field and the velocity field, (2) emergence of compressible small-scale structure such as massive jets, and (3) bifurcation of eddies in the compressible-flow field. Differences between the incompressible and compressible results tend to increase with increasing initial average Mach number.« less

DNABIT Compress – Genome compression algorithm

PubMed Central

Rajarajeswari, Pothuraju; Apparao, Allam

2011-01-01

Data compression is concerned with how information is organized in data. Efficient storage means removal of redundancy from the data being stored in the DNA molecule. Data compression algorithms remove redundancy and are used to understand biologically important molecules. We present a compression algorithm, “DNABIT Compress” for DNA sequences based on a novel algorithm of assigning binary bits for smaller segments of DNA bases to compress both repetitive and non repetitive DNA sequence. Our proposed algorithm achieves the best compression ratio for DNA sequences for larger genome. Significantly better compression results show that “DNABIT Compress” algorithm is the best among the remaining compression algorithms. While achieving the best compression ratios for DNA sequences (Genomes),our new DNABIT Compress algorithm significantly improves the running time of all previous DNA compression programs. Assigning binary bits (Unique BIT CODE) for (Exact Repeats, Reverse Repeats) fragments of DNA sequence is also a unique concept introduced in this algorithm for the first time in DNA compression. This proposed new algorithm could achieve the best compression ratio as much as 1.58 bits/bases where the existing best methods could not achieve a ratio less than 1.72 bits/bases. PMID:21383923

Cardiovascular causes of airway compression.

PubMed

Kussman, Barry D; Geva, Tal; McGowan, Francis X

2004-01-01

Compression of the paediatric airway is a relatively common and often unrecognized complication of congenital cardiac and aortic arch anomalies. Airway obstruction may be the result of an anomalous relationship between the tracheobronchial tree and vascular structures (producing a vascular ring) or the result of extrinsic compression caused by dilated pulmonary arteries, left atrial enlargement, massive cardiomegaly, or intraluminal bronchial obstruction. A high index of suspicion of mechanical airway compression should be maintained in infants and children with recurrent respiratory difficulties, stridor, wheezing, dysphagia, or apnoea unexplained by other causes. Prompt diagnosis is required to avoid death and minimize airway damage. In addition to plain chest radiography and echocardiography, diagnostic investigations may consist of barium oesophagography, magnetic resonance imaging (MRI), computed tomography, cardiac catheterization and bronchoscopy. The most important recent advance is MRI, which can produce high quality three-dimensional reconstruction of all anatomic elements allowing for precise anatomic delineation and improved surgical planning. Anaesthetic technique will depend on the type of vascular ring and the presence of any congenital heart disease or intrinsic lesions of the tracheobronchial tree. Vascular rings may be repaired through a conventional posterolateral thoracotomy, or utilizing video-assisted thoracoscopic surgery (VATS) or robotic endoscopic surgery. Persistent airway obstruction following surgical repair may be due to residual compression, secondary airway wall instability (malacia), or intrinsic lesions of the airway. Simultaneous repair of cardiac defects and vascular tracheobronchial compression carries a higher risk of morbidity and mortality.

Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model

PubMed Central

Oner, Osman Zekai; Oruc, Mehmet Tahir; Bulbuller, Nurullah; Ozdem, Sebahat; Ozdemir, Sukru; Alikanooglu, Arsenal Sezgin; Karakoyun, Rojbin; Dogan, Ugur; Ongen, Ayper; Koc, Umit

2015-01-01

Purpose Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model. Methods Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis. Results Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined. Conclusion Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice. PMID:26817016

Transitioning to an Intramedullary Lengthening and Compression Nail

PubMed Central

2017-01-01

Summary: The magnetic intramedullary lengthening nail is an innovative technology that allows for creative ways to treat difficult problems. The lengthening option has revolutionized femur fracture management with bone loss and malunion therapy. The compression version of this nail has provided a gradual method to compress nonunions and difficult fractures that may obviate the need for many current uses of external fixation. Three cases are presented in this manuscript demonstrating a new paradigm in the management of bone loss/shortening of the tibia and femur, and recalcitrant nonunions. PMID:28486284

Development, validation and operating room-transfer of a six-step laparoscopic training program for the vesicourethral anastomosis.

PubMed

Klein, Jan; Teber, Dogu; Frede, Tom; Stock, Christian; Hruza, Marcel; Gözen, Ali; Seemann, Othmar; Schulze, Michael; Rassweiler, Jens

2013-03-01

Development and full validation of a laparoscopic training program for stepwise learning of a reproducible application of a standardized laparoscopic anastomosis technique and integration into the clinical course. The training of vesicourethral anastomosis (VUA) was divided into six simple standardized steps. To fix the objective criteria, four experienced surgeons performed the stepwise training protocol. Thirty-eight participants with no previous laparoscopic experience were investigated in their training performance. The times needed to manage each training step and the total training time were recorded. The integration into the clinical course was investigated. The training results and the corresponding steps during laparoscopic radical prostatectomy (LRP) were analyzed. Data analysis of corresponding operating room (OR) sections of 793 LRP was performed. Based on the validity, criteria were determined. In the laboratory section, a significant reduction of OR time for every step was seen in all participants. Coordination: 62%; longitudinal incision: 52%; inverted U-shape incision: 43%; plexus: 47%. Anastomosis catheter model: 38%. VUA: 38%. The laboratory section required a total time of 29 hours (minimum: 16 hours; maximum: 42 hours). All participants had shorter execution times in the laboratory than under real conditions. The best match was found within the VUA model. To perform an anastomosis under real conditions, 25% more time was needed. By using the training protocol, the performance of the VUA is comparable to that of an surgeon with experience of about 50 laparoscopic VUA. Data analysis proved content, construct, and prognostic validity. The use of stepwise training approaches enables a surgeon to learn and reproduce complex reconstructive surgical tasks: eg, the VUA in a safe environment. The validity of the designed system is given at all levels and should be used as a standard in the clinical surgical training in laparoscopic reconstructive urology.

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.

Spinal cord compression in two related Ursus arctos horribilis.

PubMed

Thomovsky, Stephanie A; Chen, Annie V; Roberts, Greg R; Schmidt, Carrie E; Layton, Arthur W

2012-09-01

Two 15-yr-old grizzly bear littermates were evaluated within 9 mo of each other with the symptom of acute onset of progressive paraparesis and proprioceptive ataxia. The most significant clinical examination finding was pelvic limb paresis in both bears. Magnetic resonance examinations of both bears showed cranial thoracic spinal cord compression. The first bear had left-sided extradural, dorsolateral spinal cord compression at T3-T4. Vertebral canal stenosis was also observed at T2-T3. Images of the second bear showed lateral spinal cord compression from T2-T3 to T4-T5. Intervertebral disk disease and associated spinal cord compression was also observed at T2-T3 and T3-T4. One grizzly bear continued to deteriorate despite reduced exercise, steroid, and antibiotic therapy. The bear was euthanized, and a necropsy was performed. The postmortem showed a spinal ganglion cyst that caused spinal cord compression at the level of T3-T4. Wallerian-like degeneration was observed from C3-T6. The second bear was prescribed treatment that consisted of a combination of reduced exercise and steroid therapy. He continued to deteriorate with these medical therapies and was euthanized 4 mo after diagnosis. A necropsy showed hypertrophy and protrusion of the dorsal longitudinal ligament at T2-T3 and T3-T4, with resulting spinal cord compression in this region. Wallerian-like degeneration was observed from C2-L1. This is one of few case reports that describes paresis in bears. It is the only case report, to the authors' knowledge, that describes spinal magnetic resonance imaging findings in a grizzly bear and also the only report that describes a cranial thoracic myelopathy in two related grizzly bears with neurologic signs.

Compressible Analysis of Bénard Convection of Magneto Rotatory Couple-Stress Fluid

NASA Astrophysics Data System (ADS)

Mehta, C. B.; Singh, M.

2018-02-01

Thermal Instability (Benard's Convection) in the presence of uniform rotation and uniform magnetic field (separately) is studied. Using the linearized stability theory and normal mode analyses the dispersion relation is obtained in each case. In the case of rotatory Benard's stationary convection compressibility and rotation postpone the onset of convection whereas the couple-stress have duel character onset of convection depending on rotation parameter. While in the absence of rotation couple-stress always postpones the onset of convection. On the other hand, magnetic field on thermal instability problem on couple-stress fluid for stationary convection couple-stress parameter and magnetic field postpones the onset of convection. The effect of compressibility also postpones the onset of convection in both cases as rotation and magnetic field. Graphs have been plotted by giving numerical values to the parameters to depict the stationary characteristics. Further, the magnetic field and rotation are found to introduce oscillatory modes which were non-existent in their absence and then the principle of exchange of stability is valid. The sufficient conditions for non-existence of overstability are also obtained.

Laser-Plasma Interactions in Magnetized Environment

NASA Astrophysics Data System (ADS)

Shi, Yuan

2017-10-01

Propagation and scattering of lasers present new phenomena and applications when the plasma medium becomes magnetized. Starting from mega-Gauss magnetic fields, laser scattering becomes manifestly anisotropic [arXiv 1705.09758]. By arranging beams at special angles, one may be able to optimize laser-plasma coupling in magnetized environment. In stronger giga-Gauss magnetic field, laser propagation becomes modified by relativistic quantum effects [PRA 94.012124]. The modified wave dispersion relation enables correct interpretation of Faraday rotation measurements of strong magnetic fields, as well as correct extraction of plasma parameters from the X-ray spectra of pulsars. In addition, magnetized plasmas can be utilized to mediate laser pulse compression [PRE 95.023211]. Using magnetic resonances, it is not only possible to produce optic pulses of higher intensity, but also possible to amplify UV and soft X-ray pulses that cannot be compressed using existing technology. This research is supported by NNSA Grant No. DE-NA0002948 and DOE Research Grant No. DEAC02- 09CH11466.

A new training model for robot-assisted urethrovesical anastomosis and posterior muscle-fascial reconstruction: the Verona training technique.

PubMed

Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W

2017-06-01

A training model is usually needed to teach robotic surgical technique successfully. In this way, an ideal training model should mimic as much as possible the "in vivo" procedure and allow several consecutive surgical simulations. The goal of this study was to create a "wet lab" model suitable for RARP training programs, providing the simulation of the posterior fascial reconstruction. The second aim was to compare the original "Venezuelan" chicken model described by Sotelo to our training model. Our training model consists of performing an anastomosis, reproducing the surgical procedure in "vivo" as in RARP, between proventriculus and the proximal portion of the esophagus. A posterior fascial reconstruction simulating Rocco's stitch is performed between the tissues located under the posterior surface of the esophagus and the tissue represented by the serosa of the proventriculus. From 2014 to 2015, during 6 different full-immersion training courses, thirty-four surgeons performed the urethrovesical anastomosis using our model and the Sotelo's one. After the training period, each surgeon was asked to fill out a non-validated questionnaire to perform an evaluation of the differences between the two training models. Our model was judged the best model, in terms of similarity with urethral tissue and similarity with the anatomic unit urethra-pelvic wall. Our training model as reported by all trainees is easily reproducible and anatomically comparable with the urethrovesical anastomosis as performed during radical prostatectomy in humans. It is suitable for performing posterior fascial reconstruction reported by Rocco. In this context, our surgical training model could be routinely proposed in all robotic training courses to develop specific expertise in urethrovesical anastomosis with the reproducibility of the Rocco stitch.

Apple-peel intestinal atresia: enteroplasty for intestinal lengthening and primary anastomosis.

PubMed

Onofre, Luciano Silveira; Maranhão, Renato Frota de Albuquerque; Martins, Elaine Cristina Soares; Fachin, Camila Girardi; Martins, Jose Luiz

2013-06-01

Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis. Copyright © 2013 Elsevier Inc. All rights reserved.

CO2-laser-assisted microsurgical anastomosis in reconstructive microsurgery

NASA Astrophysics Data System (ADS)

Kiyoshige, Yoshiro

1996-01-01

Since 1984, the author used a low output carbon dioxide laser for microsurgical anastomoses in the experimental investigation with rats. The series of experiments demonstrates the following characteristics, in comparison with conventional microsurgical anastomoses: ease in technique; less time consumption; equivalency of patency rate and bursting pressure; but only about 50% of the tensile strength of manual suture anastomosis. These findings suggested that low output carbon dioxide laser has the potential for clinical application. Then this technique has been applied in six clinical cases with digital replantations and free vascularized flap since 1988. The procedure offers increased safety and speed in reconstructive microsurgery.

Magnetic pinch compression of silica glass

NASA Technical Reports Server (NTRS)

Bless, S. J.

1974-01-01

SiO2 glass has been irreversibly densified by pressures up to 250 kbar produced in a magnetic pinch apparatus. The threshold for significant densification was about 60 kbar. The recovered densities agree better with published shock wave results than with static results.

Different surgical strategies in the treatment of familial adenomatous polyposis: what's the role of the ileal pouch-anal anastomosis?

PubMed

Leonard, D; Wolthuis, A; D'Hoore, A; Bruyninx, L; Van De Stadt, J; Van Cutsem, E; Kartheuser, A

2011-09-01

Restorative coloproctectomy (RCP) with ileal pouch-anal anastomosis (IPAA), is one of the surgical responses to the crucial question of prophylactic treatment in familial adenomatous polyposis (FAP). No consensus has been reached, until now, to choose between IPAA and ileo-rectal anastomosis (IRA), the rectal sparing prophylactic colectomy. This paper aims to review the latest issues related to IPAA and highlights its specificities compared to IRA. PubMed database was searched using the following search items: familial adenomatous polyposis, surgery, ileal pouch-anal anastomosis, ileo-rectal anastomosis. Papers published between 1978 and 2010 were selected. Absence of mortality, acceptable morbidity and good functional results combined to high quality of life have promoted the IPAA technique. New technical issues such as the double stapled technique, mesenteric lengthening, omission of temporary protective stoma can be addressed almost systematically for these patients. A laparoscopic approach, lessening the body image impact, has proven to be as effective and safe as the open approach to perform IPAA. Further advantages of laparoscopic IPAA rely on the lower adhesion formation resulting in less small bowel occlusion. Sexuality, fertility and childbirth are important functional issues often cited as threatened by the pelvic manoeuvres of the IPAA technique which can be prevented by close rectal wall dissection and a laparoscopic approach. IPAA offers the best available prophylaxis in FAP patients. Technical enhancements in IPAA will most probably decrease the functional risks. Thus IPAA remains the alternative to IRA for the prophylactic treatment of FAP.Nevertheless, based on the latest evidence, the choice between both procedures is still matter of debate.

Progress In Magnetized Target Fusion Driven by Plasma Liners

NASA Technical Reports Server (NTRS)

Thio, Francis Y. C.; Kirkpatrick, Ronald C.; Knapp, Charles E.; Cassibry, Jason; Eskridge, Richard; Lee, Michael; Smith, James; Martin, Adam; Wu, S. T.; Schmidt, George;

Ostomy or intestinal anastomosis in cases of peritonitis.

PubMed

Rasslan, S; Margutti Fonoff, A; Soldá, S C; Angelo Casaroli, A

1995-01-01

Twenty-six patients showing peritonitis due to nontraumatic acute abdomen were submitted to ostomy. Mean age was 51 years (range 25-83), being 13 males and 13 females. Bowel obstruction (BO) was the most frequent cause of peritonitis (11 cases), followed by intestinal perforation (IP) (8 cases), acute mesenteric infarction (AMI) (5 cases), and acute abdomen of inflammatory/infectious origin (AAIO) (2 cases). Brook's ileostomy was performed on 65% of the patients. Jejunostomy was performed only in 4 patients, leading to a bad evolution. Overall mortality was 54%. Primary ostomy or anastomosis in cases of peritonitis constitute a highly controversial theme. Indications and problems involving the intestinal exteriorization in emergency surgery urgency are herein discussed.

Energy transfer in compressible magnetohydrodynamic turbulence for isothermal self-gravitating fluids

NASA Astrophysics Data System (ADS)

Banerjee, Supratik; Kritsuk, Alexei G.

2018-02-01

Three-dimensional, compressible, magnetohydrodynamic turbulence of an isothermal, self-gravitating fluid is analyzed using two-point statistics in the asymptotic limit of large Reynolds numbers (both kinetic and magnetic). Following an alternative formulation proposed by Banerjee and Galtier [Phys. Rev. E 93, 033120 (2016), 10.1103/PhysRevE.93.033120; J. Phys. A: Math. Theor. 50, 015501 (2017), 10.1088/1751-8113/50/1/015501], an exact relation has been derived for the total energy transfer. This approach results in a simpler relation expressed entirely in terms of mixed second-order structure functions. The kinetic, thermodynamic, magnetic, and gravitational contributions to the energy transfer rate can be easily separated in the present form. By construction, the new formalism includes such additional effects as global rotation, the Hall term in the induction equation, etc. The analysis shows that solid-body rotation cannot alter the energy flux rate of compressible turbulence. However, the contribution of a uniform background magnetic field to the flux is shown to be nontrivial unlike in the incompressible case. Finally, the compressible, turbulent energy flux rate does not vanish completely due to simple alignments, which leads to a zero turbulent energy flux rate in the incompressible case.

Energy transfer in compressible magnetohydrodynamic turbulence for isothermal self-gravitating fluids.

PubMed

Banerjee, Supratik; Kritsuk, Alexei G

2018-02-01

Three-dimensional, compressible, magnetohydrodynamic turbulence of an isothermal, self-gravitating fluid is analyzed using two-point statistics in the asymptotic limit of large Reynolds numbers (both kinetic and magnetic). Following an alternative formulation proposed by Banerjee and Galtier [Phys. Rev. E 93, 033120 (2016)2470-004510.1103/PhysRevE.93.033120; J. Phys. A: Math. Theor. 50, 015501 (2017)1751-811310.1088/1751-8113/50/1/015501], an exact relation has been derived for the total energy transfer. This approach results in a simpler relation expressed entirely in terms of mixed second-order structure functions. The kinetic, thermodynamic, magnetic, and gravitational contributions to the energy transfer rate can be easily separated in the present form. By construction, the new formalism includes such additional effects as global rotation, the Hall term in the induction equation, etc. The analysis shows that solid-body rotation cannot alter the energy flux rate of compressible turbulence. However, the contribution of a uniform background magnetic field to the flux is shown to be nontrivial unlike in the incompressible case. Finally, the compressible, turbulent energy flux rate does not vanish completely due to simple alignments, which leads to a zero turbulent energy flux rate in the incompressible case.

[Microvascular injury effects and possibility of early anastomosis in the maxillofacial region following high velocity missile wound: an experimental study in dogs].

PubMed

Yan, Y

1990-02-01

In order to provide the basis of microvascular anastomosis for reconstruction of maxillofacial defects from firearm injury by using vascularized free tissue transplantation, we studied the mechanism and pathology of microvascular injuries and the possibility of their early anastomosis. The dogs' face were wounded by 0.7 g or 1.03 g steel spheres whose muzzle velocity were 1300 m/s or 1500 m/s. The injury effects of microvascular angiograms were recorded through high speed X-ray camera at the impacting moment the specimens of small vessel were collected for light and electron microscopy at different times after wound. Some dogs were used for performing microvascular anastomosis in the wound region at different times after wound. We found that there were temporary cavity effects in maxillofacial firearm wounds, in and around which small vessel blunt injuries were found, which spread 3 cm from the wound edge. Microvascular anastomosis 3 days after the wound could get higher shortterm patency rate. These results support the conclusion that if we use microsurgical methods to repair defects in maxillofacial firearm wound region, the pedicles of the flap should be laid beyond 3 cm from the wound edge, and the reconstructive operation should be done 3 days after the wound.

Air Conditioning with Magnetic Refrigeration : An Efficient, Green Compact Cooling System Using Magnetic Refrigeration

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2010-09-01

BEETIT Project: Astronautics is developing an air conditioning system that relies on magnetic fields. Typical air conditioners use vapor compression to cool air. Vapor compression uses a liquid refrigerant to circulate within the air conditioner, absorb the heat, and pump the heat out into the external environment. Astronautics’ design uses a novel property of certain materials, called “magnetocaloric materials”, to achieve the same result as liquid refrigerants. These magnetocaloric materials essentially heat up when placed within a magnetic field and cool down when removed, effectively pumping heat out from a cooler to warmer environment. In addition, magnetic refrigeration uses nomore » ozone-depleting gases and is safer to use than conventional air conditioners which are prone to leaks.« less

Comparison of manual and mechanical cervical esophagogastric anastomosis after esophageal resection for squamous cell carcinoma: a prospective randomized controlled trial.

PubMed

Hsu, Hsao-Hsun; Chen, Jin-Shing; Huang, Pei-Ming; Lee, Jang-Ming; Lee, Yung-Chie

2004-06-01

The use of a circular stapler in cervical esophagogastric anastomosis remains controversial. This study was to compare the postoperative and long-term results of manual and mechanical techniques for cervical esophagogastric anastomosis after resection for squamous cell carcinoma. A prospective randomized controlled trial was undertaken in 63 patients with curatively resectable squamous cell cancer of the thoracic esophagus between 1996 and 1999. Patients were randomized to receive either a hand-sewn (32 patients) or circular stapled (31 patients) cervical esophagogastric anastomosis. The mean operating time was longer when the hand-sewn method was used (524 vs. 447 min, P < 0.001). Anastomotic leakage was noted in seven patients (22%) in the hand-sewn group and eight patients (26%) in the stapler group (P = NS). Hospital mortality occurred in four patients (13%) of the hand-sewn group and in three patients (10%) of the stapler group (P = NS). After the operation, four patients (14%) in the hand-sewn group and five patients (18%) in the stapler group developed a benign esophageal stricture (P = NS). The mean follow-up time was 24 months, and the rates of freedom from benign stricture and survival were comparable in each group. Performing cervical esophagogastric anastomoses using a circular mechanical stapler had a shorter operating time and a comparable outcome to the hand-sewn method. The circular mechanical stapler could be used as an alternative for cervical esophagogastric anastomosis after resection for esophageal squamous cell cancer.

Influence of proximal end diverting colostomy on the healing of left-sided colonic anastomosis: an experimental study in rats.

PubMed

Bielecki, K; Grotowski, M; Kalczak, M

1995-01-01

The purpose of this study was to evaluate the healing of an experimental left-sided colonic anastomosis in rats protected by an end diverting proimal colostomy. The anastomoses were studied by radiological and biochemical examination and breaking strength was estimated. The results were compared with a non-operated group and with a group of rats having a non-defunctional anastomosis constructed in the same manner. In animals with an end diverting colostomy, anastomotic protein levels and enzymic activity were lower than in those with a colostomy, and the development of anastomotic strength was delayed compared with those not defunctioned.

Magnetic Flux Compression Using Detonation Plasma Armatures and Superconductor Stators: Integrated Propulsion and Power Applications

NASA Technical Reports Server (NTRS)

Litchford, Ron; Robertson, Tony; Hawk, Clark; Turner, Matt; Koelfgen, Syri

1999-01-01

This presentation discusses the use of magnetic flux compression for space flight applications as a propulsion and other power applications. The qualities of this technology that make it suitable for spaceflight propulsion and power, are that it has high power density, it can give multimegawatt energy bursts, and terawatt power bursts, it can produce the pulse power for low impedance dense plasma devices (e.g., pulse fusion drivers), and it can produce direct thrust. The issues of a metal vs plasma armature are discussed, and the requirements for high energy output, and fast pulse rise time requires a high speed armature. The plasma armature enables repetitive firing capabilities. The issues concerning the high temperature superconductor stator are also discussed. The concept of the radial mode pulse power generator is described. The proposed research strategy combines the use of computational modeling (i.e., magnetohydrodynamic computations, and finite element modeling) and laboratory experiments to create a demonstration device.

Magnetic flux conservation in an imploding plasma.

PubMed

García-Rubio, F; Sanz, J; Betti, R

2018-01-01

The theory of magnetic flux conservation is developed for a subsonic plasma implosion and used to describe the magnetic flux degradation in the MagLIF concept [S. A. Slutz et al., Phys. Plasmas 17, 056303 (2010)10.1063/1.3333505]. Depending on the initial magnetic Lewis and Péclet numbers and the electron Hall parameter, the implosion falls into either a superdiffusive regime in which the magnetization decreases or a magnetized regime in which the magnetization increases. Scaling laws for magnetic field, temperature, and magnetic flux losses in the hot spot of radius R are obtained for both regimes. The Nernst velocity convects the magnetic field outwards, pushing it against the liner and enhancing the magnetic field diffusion, thereby reducing the magnetic field compression and degrading the implosion performance. However, in the magnetized regime, the core of the hot spot becomes magnetically insulated and undergoes an ideal adiabatic compression (T∼R^{-4/3} compared to T∼R^{-2/3} without magnetic field), while the detrimental Nernst term is confined to the outer part of the hot spot. Its effect is drastically reduced, improving the magnetic flux conservation.

Magnetic flux conservation in an imploding plasma

NASA Astrophysics Data System (ADS)

García-Rubio, F.; Sanz, J.; Betti, R.

2018-01-01

The theory of magnetic flux conservation is developed for a subsonic plasma implosion and used to describe the magnetic flux degradation in the MagLIF concept [S. A. Slutz et al., Phys. Plasmas 17, 056303 (2010), 10.1063/1.3333505]. Depending on the initial magnetic Lewis and Péclet numbers and the electron Hall parameter, the implosion falls into either a superdiffusive regime in which the magnetization decreases or a magnetized regime in which the magnetization increases. Scaling laws for magnetic field, temperature, and magnetic flux losses in the hot spot of radius R are obtained for both regimes. The Nernst velocity convects the magnetic field outwards, pushing it against the liner and enhancing the magnetic field diffusion, thereby reducing the magnetic field compression and degrading the implosion performance. However, in the magnetized regime, the core of the hot spot becomes magnetically insulated and undergoes an ideal adiabatic compression (T ˜R-4 /3 compared to T ˜R-2 /3 without magnetic field), while the detrimental Nernst term is confined to the outer part of the hot spot. Its effect is drastically reduced, improving the magnetic flux conservation.

Measurements of lunar magnetic field interaction with the solar wind.

NASA Technical Reports Server (NTRS)

Dyal, P.; Parkin, C. W.; Snyder, C. W.; Clay, D. R.

1972-01-01

Study of the compression of the remanent lunar magnetic field by the solar wind, based on measurements of remanent magnetic fields at four Apollo landing sites and of the solar wind at two of these sites. Available data show that the remanent magnetic field at the lunar surface is compressed as much as 40% above its initial value by the solar wind, but the total remanent magnetic pressure is less than the stagnation pressure by a factor of six, implying that a local shock is not formed.

Stable gastric pentadecapeptide BPC 157 in trials for inflammatory bowel disease (PL-10, PLD-116, PL14736, Pliva, Croatia) heals ileoileal anastomosis in the rat.

PubMed

Vuksic, Tihomir; Zoricic, Ivan; Brcic, Luka; Sever, Marko; Klicek, Robert; Radic, Bozo; Cesarec, Vedran; Berkopic, Lidija; Keller, Neike; Blagaic, Alenka Boban; Kokic, Neven; Jelic, Ivan; Geber, Juraj; Anic, Tomislav; Seiwerth, Sven; Sikiric, Predrag

2007-01-01

Gastric pentadecapeptide BPC 157 (BPC 157), which has been shown to be safe in clinical trials for inflammatory bowel disease (PL-10, PLD-116, PL14736, Pliva, Croatia), may be able to cure intestinal anastomosis dehiscence. This antiulcer peptide shows no toxicity, is limit test negative, and a lethal dose is not achieved. It is stable in human gastric juice. In comparison with other standard treatments it is more effective for ulcers and various wounds, and can be used without a carrier needed for other peptides, both locally and systemically (i.e., perorally, parenterally). We studied the effectiveness of BPC 157 for ileoileal anastomosis healing in rats. We assessed ileoileal anastomosis dehiscence macroscopically, histologically, and biomechanically (volume [ml] infused through a syringe-perfusion pump system (1 ml/10 s), and pressure [mmHg] to leak induction [catheter connected to a chamber and a monitor, at 10 cm proximal to anastomosis]), at 1, 2, 3, 4, 5, 6, 7, and 14 days. BPC 157 (10 microg, 10 ng, 10 pg/kg i.p. (or saline [5 ml/kg]) was first administered after surgery, while it was last given 24 h before either assessment or sacrifice. Throughout the experiment, both higher doses of BPC 157 were shown to improve all parameters of anastomotic wound healing. The formation of adhesions remained slight, the blood vessels were filled with blood, and a mild intestinal passage obstruction was only temporarily observed. Anastomosis without leakage induces markedly higher volume and pressure values, with a continuous increase toward healthy values. From day 1, edema was markedly attenuated and the number of granulocytes decreased, while from days 4 or 5 necrosis decreased and granulation tissue, reticulin, and collagen formation substantially increased, thus resulting in increased epithelization. This study showed BPC 157 to have a beneficial effect on ileoileal anastomosis healing in the rat.

Computational Simulation of Breast Compression Based on Segmented Breast and Fibroglandular Tissues on Magnetic Resonance Images

PubMed Central

Shih, Tzu-Ching; Chen, Jeon-Hor; Liu, Dongxu; Nie, Ke; Sun, Lizhi; Lin, Muqing; Chang, Daniel; Nalcioglu, Orhan; Su, Min-Ying

2010-01-01

This study presents a finite element based computational model to simulate the three-dimensional deformation of the breast and the fibroglandular tissues under compression. The simulation was based on 3D MR images of the breast, and the craniocaudal and mediolateral oblique compression as used in mammography was applied. The geometry of whole breast and the segmented fibroglandular tissues within the breast were reconstructed using triangular meshes by using the Avizo® 6.0 software package. Due to the large deformation in breast compression, a finite element model was used to simulate the non-linear elastic tissue deformation under compression, using the MSC.Marc® software package. The model was tested in 4 cases. The results showed a higher displacement along the compression direction compared to the other two directions. The compressed breast thickness in these 4 cases at 60% compression ratio was in the range of 5-7 cm, which is the typical range of thickness in mammography. The projection of the fibroglandular tissue mesh at 60% compression ratio was compared to the corresponding mammograms of two women, and they demonstrated spatially matched distributions. However, since the compression was based on MRI, which has much coarser spatial resolution than the in-plane resolution of mammography, this method is unlikely to generate a synthetic mammogram close to the clinical quality. Whether this model may be used to understand the technical factors that may impact the variations in breast density measurements needs further investigation. Since this method can be applied to simulate compression of the breast at different views and different compression levels, another possible application is to provide a tool for comparing breast images acquired using different imaging modalities – such as MRI, mammography, whole breast ultrasound, and molecular imaging – that are performed using different body positions and different compression conditions. PMID:20601773

Imaging Local Magnetic Domain Rearrangement in Strained LaCoO3 Thin Films Using Magnetic Force Microscopy

NASA Astrophysics Data System (ADS)

Berg, Morgann; Leon, Neliza; Posadas, Agham; Lee, Alfred; Kim, Jeehoon; de Lozanne, Alex; Demkov, Alex

2012-02-01

Previous studies we have conducted on thin films of lanthanum cobaltate (LCO) under tensile strain have revealed a tendency toward local magnetic domain rearrangement into streak-like configurations near the ferromagnetic to paramagnetic phase transition. Moreover, the persistence of these streak-like characteristics to lower temperatures after field-cooling appears to be linked to the strength of the applied magnetic field in which these films are field-cooled. This tendency has not yet been verified for thin films of LCO under compressive strain which could indicate whether this magnetic domain rearrangement is intrinsic to thin film samples of LCO or is merely an effect of tensile strain. Using magnetic force microscopy, we investigate the microscale magnetic properties of a thin film of LCO under compressive strain, prepared by molecular beam epitaxy and deposited on a lanthanum aluminate substrate. We observe these properties across a wide temperature range and compare our results to global magnetic characteristics of this film as measured by a SQUID magnetometer.

Numerical simulation of the compressible Orszag-Tang vortex. II. Supersonic flow. Interim report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Picone, J.M.; Dahlburg, R.B.

The numerical investigation of the Orszag-Tang vortex system in compressible magnetofluids will consider initial conditions with embedded supersonic regions. The simulations have initial average Mach numbers M = 1.0 and 1.5 and beta = 10/3 with Lundquist numbers S = 50, 100, or 200. The behavior of the system differs significantly from that found previously for the incompressible and subsonic analogs. Shocks form at the downstream boundaries of the embedded supersonic regions outside the central magnetic X-point and produce strong local current sheets which dissipate appreciable magnetic energy. Reconnection at the central X-point, which dominates the incompressible and subsonic systems,more » peaks later and has a smaller impact as M increases from 0.6 to 1.5. Similarly, correlation between the momentum and magnetic field begins significant growth later than in subsonic and incompressible flows. The shocks bound large compression regions, which dominate the wavenumber spectra of autocorrelations in mass density, velocity, and magnetic field.« less

Progression from laparoscopic-assisted to totally laparoscopic distal gastrectomy: comparison of circular stapler (i-DST) and linear stapler (BBT) for intracorporeal anastomosis.

PubMed

Ikeda, Tetsuo; Kawano, Hiroyuki; Hisamatsu, Yuichi; Ando, Koji; Saeki, Hiroshi; Oki, Eiji; Ohga, Takefumi; Kakeji, Yoshihiro; Tsujitani, Shunichi; Kohnoe, Shunji; Maehara, Yoshihiko

2013-01-01

Billroth I (B-I) gastroduodenostomy is an anastomotic procedure that is widely performed after gastric resection for distal gastric cancer. A circular stapler often is used for B-I gastroduodenostomy in open and laparoscopic-assisted distal gastrectomy. Recently, totally laparoscopic distal gastrectomy (TLDG) has been considered less invasive than laparoscopic-assisted gastrectomy, and many institutions performing laparoscopic-assisted distal gastrectomy are trying to progress to TLDG without markedly changing the anastomosis method. The purpose of this report is to introduce the technical details of new methods of intracorporeal gastroduodenostomy using either a circular or linear stapler and to evaluate their technical feasibility and safety. Seventeen patients who underwent TLDG with the intracorporeal double-stapling technique using a circular stapler (n = 7) or the book-binding technique (BBT) using a linear stapler (n = 10) between February 2010 and April 2011 were enrolled in the study. Clinicopathological data, surgical data, and postoperative outcomes were analyzed. There were no intraoperative complications or conversions to open surgery in any of the 17 patients. The usual postoperative complications following gastroduodenostomy, such as anastomotic leakage and stenosis, were not observed. Anastomosis took significantly longer to complete with DST (64 ± 24 min) than with BBT (34 ± 7 min), but more stapler cartridges were needed with BBT than with DST. TLDG using a circular or linear stapler is feasible and safe to perform. DST will enable institutions performing laparoscopic-assisted distal gastrectomy with circular staplers to progress to TLDG without problems, and this progression may be more economical because fewer stapler cartridges are used during surgery. However, if an institution has already been performing δ anastomosis in TLDG but has been experiencing certain issues with δ anastomosis, converting from δ anastomosis to BBT should be

Decay of the compressible magneto-micropolar fluids

NASA Astrophysics Data System (ADS)

Zhang, Peixin

2018-02-01

This paper considers the large-time behavior of solutions to the Cauchy problem on the compressible magneto-micropolar fluid system under small perturbation in regular Sobolev space. Based on the time-weighted energy estimate, the asymptotic stability of the steady state with the strictly positive constant density, vanishing velocity, micro-rotational velocity, and magnetic field is established.

Investigation of Spheromak Plasma Cooling through Metallic Liner Spallation during Compression

NASA Astrophysics Data System (ADS)

Ross, Keeton; Mossman, Alex; Young, William; Ivanov, Russ; O'Shea, Peter; Howard, Stephen

2016-10-01

Various magnetic-target fusion (MTF) reactor concepts involve a preliminary magnetic confinement stage, followed by a metallic liner implosion that compresses the plasma to fusion conditions. The process is repeated to produce a pulsed, net-gain energy system. General Fusion, Inc. is pursuing one scheme that involves the compression of spheromak plasmas inside a liner formed by a collapsing vortex of liquid Pb-Li. The compression is driven by focused acoustic waves launched by gas-driven piston impacts. Here we describe a project to exploring the effects of possible liner spallation during compression on the spheromaks temperature, lifetime, and stability. We employ a 1 J, 10 ns pulsed YAG laser at 532nm focused onto a thin film of Li or Al to inject a known quantity of metallic impurities into a spheromak plasma and then measure the response. Diagnostics including visible and ultraviolet spectrometers, ion Doppler, B-probes, and Thomson scattering are used for plasma characterization. We then plan to apply the trends measured under these controlled conditions to evaluate the role of wall impurities during `field shots', where spheromaks are compressed through a chemically driven implosion of an aluminum flux conserver. The hope is that with further study we could more accurately include the effect of wall impurities on the fusion yield of a reactor-scale MTF system. Experimental procedures and results are presented, along with their relation to other liner-driven, MTF schemes. -/a

Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations.

PubMed

Li, Guo-Cai; Zhang, Yu-Chun; Xu, Yong; Zhang, Fang-Cheng; Huang, Wei-Hua; Xu, Jian-Qing; Ma, Qing-Jiu

2014-01-01

The key point of digestive cancer surgery is reconstruction and anastomosis of the digestive tract. Traditional anastomoses involve double-layer interrupted suturing, manually or using a surgical stapler. In special anatomical locations, however, suturing may become increasingly difficult and the complication rate increases accordingly. In this study, we aimed to investigate the feasibility and safety of a new manual suturing method, the single-layer continuous suture in the posterior wall of the anastomosis. Between January, 2007 and August, 2012, 101 patients with digestive cancer underwent surgery in Xi'an Gaoxin Hospital. Of those patients, 27 underwent surgery with the new manual method and the remaining 74 underwent surgery using traditional methods of anastomosis of the digestive tract. Surgical time, intraoperative blood loss, drainage duration, complications, blood tests, postoperative quality of life (QOL) and overall expenditure were recorded and analyzed. No significant differences were observed in surgical time, intraoperative blood loss, temperature, blood tests and postoperative QOL between the two groups. However, compared with the control group, the new manual suture group exhibited a lower surgical complication rate (7.40 vs. 31.08%; P=0.018), lower blood transfusion volume (274.07±419.33 vs. 646.67±1,146.06 ml; P=0.053), shorter postoperative hospital stay (14.60±4.19 vs. 17.60±6.29 days; P=0.038) and lower overall expenditure (3,509.85±768.68 vs. 6,141.83±308.90 renminbi; P=0.001). Our results suggested that single-layer continuous suturing for the anastomosis of the digestive tract is feasible and safe and may contribute to the reduction of surgical complications and overall expenditure.

Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations

PubMed Central

LI, GUO-CAI; ZHANG, YU-CHUN; XU, YONG; ZHANG, FANG-CHENG; HUANG, WEI-HUA; XU, JIAN-QING; MA, QING-JIU

2014-01-01

The key point of digestive cancer surgery is reconstruction and anastomosis of the digestive tract. Traditional anastomoses involve double-layer interrupted suturing, manually or using a surgical stapler. In special anatomical locations, however, suturing may become increasingly difficult and the complication rate increases accordingly. In this study, we aimed to investigate the feasibility and safety of a new manual suturing method, the single-layer continuous suture in the posterior wall of the anastomosis. Between January, 2007 and August, 2012, 101 patients with digestive cancer underwent surgery in Xi’an Gaoxin Hospital. Of those patients, 27 underwent surgery with the new manual method and the remaining 74 underwent surgery using traditional methods of anastomosis of the digestive tract. Surgical time, intraoperative blood loss, drainage duration, complications, blood tests, postoperative quality of life (QOL) and overall expenditure were recorded and analyzed. No significant differences were observed in surgical time, intraoperative blood loss, temperature, blood tests and postoperative QOL between the two groups. However, compared with the control group, the new manual suture group exhibited a lower surgical complication rate (7.40 vs. 31.08%; P=0.018), lower blood transfusion volume (274.07±419.33 vs. 646.67±1,146.06 ml; P=0.053), shorter postoperative hospital stay (14.60±4.19 vs. 17.60±6.29 days; P=0.038) and lower overall expenditure (3,509.85±768.68 vs. 6,141.83±308.90 renminbi; P=0.001). Our results suggested that single-layer continuous suturing for the anastomosis of the digestive tract is feasible and safe and may contribute to the reduction of surgical complications and overall expenditure. PMID:24649327

The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection.

PubMed

Hong, Youngki; Nam, Soomin; Kang, Jung Gu

2017-06-01

The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate. This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes. Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8-39 days). Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.

Reconnection in Compressible Plasmas: Extended Conversion Region

NASA Technical Reports Server (NTRS)

Birn, J.; Hesse, M.; Zenitani, S.

2011-01-01

The classical Sweet-Parker approach to steady-state magnetic reconnection is extended into the regime of large resistivity (small magnetic Reynolds or Lundquist number) when the aspect ratio between the outflow and inflow scale, delta = d/L, approaches unity. In a previous paper the vicinity of the dissipation site ("diffusion region") was investigated. In this paper, the approach is extended to cover larger sites, in which the energy transfer and conversion is not confined to the diffusion region. Consistent with the results of Paper I, we find that increasing aspect ratio delta is associated with increasing compression, increasing reconnect ion rate for low Beta, but slightly decreasing rate for higher Beta, decreasing outflow speed, and increasing outflow magnetic field. These trends are stronger for lower Beta. Deviations from the traditional Sweet-Parker limit delta approaches 0 become significant for R(sub m) approx < 10, where R(sub m) is the magnetic Reynolds number (Lundquist number) based on the half-thickness of the current layer responsible for the Ohmic dissipation. They are also more significant for small gamma, that is, for increasing compressibility. In contrast to the results of Paper I, but consistent with earlier results for delta much < 1,nu(sub A) we find that in this limit the outflow speed is given by the Alfven speed nu(sub A) in the inflow region and the energy conversion is given by an even split of Poynting flux into enthalpy flux and bulk kinetic energy flux. However, with increasing delta the conversion to enthalpy flux becomes more and more dominant.

Method and device for supporting blood vessels during anastomosis

DOEpatents

Doss, J.D.

1985-05-20

A device and method for preventing first and second severed blood vessels from collapsing during attachment to each other. The device comprises a dissolvable non-toxic stent that is sufficiently rigid to prevent the blood vessels from collapsing during anastomosis. The stent can be hollow or have passages to permit blood flow before it dissolves. A single stent can be inserted with an end in each of the two blood vessels or separate stents can be inserted into each blood vessel. The stent may include a therapeutically effective amount of a drug which is slowly released into the blood stream as the stent dissolves. 12 figs.

Beam dynamics performances and applications of a low-energy electron-beam magnetic bunch compressor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prokop, C. R.; Piot, P.; Carlsten, B. E.

2013-08-01

Many front-end applications of electron linear accelerators rely on the production of temporally compressed bunches. The shortening of electron bunches is often realized with magnetic bunch compressors located in high-energy sections of accelerators. Magnetic compression is subject to collective effects including space charge and self interaction via coherent synchrotron radiation. In this paper we explore the application of magnetic compression to low-energy (~40MeV), high-charge (nC) electron bunches with low normalized transverse emittances (<5@mm).

Water soluble contrast enema examination of the integrity of the rectal anastomosis prior to loop ileostomy reversal may be superfluous.

PubMed

Larsson, Anna; Lindmark, Gudrun; Syk, Ingvar; Buchwald, Pamela

2015-03-01

Defunctioning loop ileostomy in low anterior resection (LAR) is routinely used to reduce consequences of anastomotic leakage. The purpose of this study was to analyze which examination technique is optimal for evaluating the integrity of the anastomosis prior to loop ileostomy reversal. Retrospective analysis of 95 patients who had been subjected to LAR at Helsingborg Hospital and Skåne University Hospital, Sweden, was undertaken between January 2007 and June 2009. The examination techniques of the rectal anastomosis prior to reversal and the clinical outcome after reversal were studied. Radiologic anastomosis control using water soluble contrast enema, digital rectal examination (DRE), and rectoscopy were performed in 53 % (50/95), 98 % (93/95), and 69 % (66/95), respectively. In two patients, no control of the anastomosis was performed before reversal. Fifty-two percent (49/95) of the patients were examined using all techniques. Six patients demonstrated leakage detected before reversal of which two were only radiological leakages. These two patients underwent loop ileostomy reversal after delay without complications. They were the only ones where the three examination techniques did not prove coherence. Four patients had symptomatic leakage; these were detected with rectoscopy and DRE and verified with enema. Three patients developed anastomotic leakage after loop ileostomy reversal despite normal preoperative examinations. Two of these patients had rectovaginal fistulas (AVFs). This retrospective study indicates that contrast enema does not provide additional information if rectoscopy and DRE are normal. Despite negative examinations, three of nine leakages were diagnosed after loop ileostomy reversal. Especially, AVFs seem difficult to diagnose.

The anastomosis between renal polar arteries and arteria epigastrica inferior in kidney transplantation: an option to decrease the risk of ureter necrosis?

PubMed

Wolters, H H; Schult, M; Heidenreich, S; Chariat, M; Senninger, N; Dietl, K H

2001-12-01

Ureteral necrosis after renal transplantation is often the result of impaired perfusion due to loss of donor polar arteries. A way of preserving polar arteries is their anastomosis with the A. epigastrica inferior. In three cases (aged 49-, 58-, and 63 years), 9.3 % of 33 living donors, we detected donor polar arteries on both sides, and anastomosed the polar artery to the A. epigastrica inferior with microsurgical methods. Intraoperatively, the flow was measured by flowmeter, in the postoperative course duplexsonography and MR-angiography was performed. In all three cases we noted a bluish, ischemic parenchym mass of 10-25 % of the kidney and ureter. It recovered immediately, however, after the polar artery had been reconstructed. Intraoperative measurement showed a high flow on the polar- and the main renal artery. Duplexsonography and MR-angiography documented a good flow on the A. epigastrica anastomosis. There have been no signs of ureteral problems at all. After a mean follow-up time of 26 months, the mean creatinine level is 1.46 mg/ml. Ureteral necrosis after kidney transplantation is mostly the result of a lack of perfusion of the polar arteries of the lower kidney pole. If arteriosclerotic lesions inhibit an anastomosis with the renal artery, the anastomosis with the A. epigastrica inferior seems to be a useful alternative.

Liver transplantation with piggyback anastomosis using a linear stapler: a case report.

PubMed

Akbulut, S; Wojcicki, M; Kayaalp, C; Yilmaz, S

2013-04-01

The so-called piggyback technique of liver transplantation (PB-LT) preserves the recipient's caval vein, shortening the warm ischemic time. It can be reduced even further by using a linear stapler for the cavocaval anastomosis. Herein, we have presented a case of a patient undergoing a side-to-side, whole-organ PB-LT for cryptogenic cirrhosis. Upper and lower orifices of the donor caval vein were closed at the back table using a running 5-0 polypropylene suture. Three stay sutures were then placed on caudal parts of both the recipient and donor caval with a 5-mm venotomies. The endoscopic linear stapler was placed upward through the orifices and fired. A second stapler was placed more cranially and fired resulting in a 8-9 cm long cavocavostomy. Some loose clips were flushed away from the caval lumen. The caval anastomosis was performed within 4 minutes; the time needed to close the caval vein stapler insertion orifices (4-0 polypropylene running suture) before reperfusion was 1 minute. All other anastomoses were performed as typically sutured. The presented technique enables one to reduce the warm ischemic time, which can be of particular importance with marginal grafts. Copyright © 2013 Elsevier Inc. All rights reserved.

Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer.

PubMed

Zhao, Ping; Xiao, Shuo-Meng; Tang, Ling-Chao; Ding, Zhi; Zhou, Xiang; Chen, Xiao-Dong

2014-07-07

To compare the short-term outcomes of patients who underwent proximal gastrectomy with jejunal interposition (PGJI) with those undergoing total gastrectomy with Roux-en-Y anastomosis (TGRY). From January 2009 to January 2011, thirty-five patients underwent PGJI, and forty-one patients underwent TGRY. The surgical efficacy and short-term follow-up outcomes were compared between the two groups. There were no differences in the demographic and clinicopathological characteristics. The mean operation duration and postoperative hospital stay in the PGJI group were statistically longer than those in the TGRY group (P = 0.00). No anastomosis leakage was observed in two groups. No statistically significant difference was found in endoscopic findings, Visick grade or serum albumin level. The single-meal food intake in the PGJI group was more than that in the TGRY group (P = 0.00). The PG group showed significantly better hemoglobin levels in the second year (P = 0.02). The two-year survival rate was not significantly different (PGJI vs TGRY, 93.55% vs 92.5%, P = 1.0). PGJI is a safe, radical surgical method for proximal gastric cancer and leads to better outcomes in terms of the single-meal food intake and hemoglobin level, compared with TGRY in the short term.

Compressed quantum simulation of the Ising model.

PubMed

Kraus, B

2011-12-16

Jozsa et al. [Proc. R. Soc. A 466, 809 2009)] have shown that a match gate circuit running on n qubits can be compressed to a universal quantum computation on log(n)+3 qubits. Here, we show how this compression can be employed to simulate the Ising interaction of a 1D chain consisting of n qubits using a universal quantum computer running on log(n) qubits. We demonstrate how the adiabatic evolution can be realized on this exponentially smaller system and how the magnetization, which displays a quantum phase transition, can be measured. This shows that the quantum phase transition of very large systems can be observed experimentally with current technology. © 2011 American Physical Society

Laparoscopic colorectal anastomosis using the novel Chex(®) circular stapler: a case-control study.

PubMed

Maggiori, L; Bretagnol, F; Ferron, M; Chevalier, Y; Panis, Y

2011-06-01

The purpose of this study was to assess the safety and effectiveness of a new cost-effective circular stapler for colorectal anastomosis, the Chex(®) CS. From 2007 to 2009, a case-control study was conducted of 54 patients who underwent left colectomy with stapled anastomosis using the Chex stapler. The patients were matched to 64 patients in whom the anastomoses were performed using the CDH(®) stapler or the EEA(®) stapler. The following criteria were matched: sex, age, body mass index, American Society of Anesthesiology grade, diagnosis, formation of a temporary stoma and surgical approach. Primary end-points were postoperative mortality and morbidity. The surgeon was asked to fill out a questionnaire to assess the ergonomics of the device using an analogue visual scale. A cost analysis was performed to compare the cost of the different devices. There were no postoperative deaths. Morbidity, including anastomotic leakage (9%vs 8%, P = 1.000), was similar in the two groups. The surgeon's overall appreciation was scored at 8.1/10 (3-9.5), including the best score for stapler removal (9.5). No major device failure was observed during the study. Mean surgical costs were significantly lower in the Chex group: € 903 ± 73 (885-1192) vs the control group € 971 ± 61 (956-1263) (P < 0.0001). This study suggests that colorectal anastomosis using the Chex circular stapler is safe and does not increase overall morbidity. In particular, this device did not have a higher rate of anastomotic leakage in our patients than more expensive models currently used in our hospital. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Thermoelectric effects and magnetic field amplification in magnetogasdynamic turbulence

NASA Technical Reports Server (NTRS)

Shebalin, John V.

1991-01-01

It will be shown that thermoelectric effects amplify magnetic fields in compressible magnetogasdynamic turbulence (though not nearly as much as occurs across a curved reently bowshock). The importance of this result lies in the recognition that thermoelectric effects (in addition to kinetic effects) provide a real mechanism for the amplification of magnetic field strength (and total energy dissipation through ohmic losses) in a compressible, turbulent plasma.

Edge-preserving image compression for magnetic-resonance images using dynamic associative neural networks (DANN)-based neural networks

NASA Astrophysics Data System (ADS)

Wan, Tat C.; Kabuka, Mansur R.

1994-05-01

With the tremendous growth in imaging applications and the development of filmless radiology, the need for compression techniques that can achieve high compression ratios with user specified distortion rates becomes necessary. Boundaries and edges in the tissue structures are vital for detection of lesions and tumors, which in turn requires the preservation of edges in the image. The proposed edge preserving image compressor (EPIC) combines lossless compression of edges with neural network compression techniques based on dynamic associative neural networks (DANN), to provide high compression ratios with user specified distortion rates in an adaptive compression system well-suited to parallel implementations. Improvements to DANN-based training through the use of a variance classifier for controlling a bank of neural networks speed convergence and allow the use of higher compression ratios for `simple' patterns. The adaptation and generalization capabilities inherent in EPIC also facilitate progressive transmission of images through varying the number of quantization levels used to represent compressed patterns. Average compression ratios of 7.51:1 with an averaged average mean squared error of 0.0147 were achieved.

Interleaved EPI diffusion imaging using SPIRiT-based reconstruction with virtual coil compression.

PubMed

Dong, Zijing; Wang, Fuyixue; Ma, Xiaodong; Zhang, Zhe; Dai, Erpeng; Yuan, Chun; Guo, Hua

2018-03-01

To develop a novel diffusion imaging reconstruction framework based on iterative self-consistent parallel imaging reconstruction (SPIRiT) for multishot interleaved echo planar imaging (iEPI), with computation acceleration by virtual coil compression. As a general approach for autocalibrating parallel imaging, SPIRiT improves the performance of traditional generalized autocalibrating partially parallel acquisitions (GRAPPA) methods in that the formulation with self-consistency is better conditioned, suggesting SPIRiT to be a better candidate in k-space-based reconstruction. In this study, a general SPIRiT framework is adopted to incorporate both coil sensitivity and phase variation information as virtual coils and then is applied to 2D navigated iEPI diffusion imaging. To reduce the reconstruction time when using a large number of coils and shots, a novel shot-coil compression method is proposed for computation acceleration in Cartesian sampling. Simulations and in vivo experiments were conducted to evaluate the performance of the proposed method. Compared with the conventional coil compression, the shot-coil compression achieved higher compression rates with reduced errors. The simulation and in vivo experiments demonstrate that the SPIRiT-based reconstruction outperformed the existing method, realigned GRAPPA, and provided superior images with reduced artifacts. The SPIRiT-based reconstruction with virtual coil compression is a reliable method for high-resolution iEPI diffusion imaging. Magn Reson Med 79:1525-1531, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Lower limb vascular disease in diabetic patients: a study with calf compression contrast-enhanced magnetic resonance angiography at 3.0 Tesla.

PubMed

Li, Jie; Zhao, Jun-Gong; Li, Ming-Hua

2011-06-01

To retrospectively analyze the significance of 3.0-T contrast-enhanced (CE) magnetic resonance angiography (MRA) with calf compression in the lower limbs of diabetic patients with peripheral vascular disease. Sixty-one type 2 diabetes patients underwent both MRA and digital subtraction angiography (DSA) within 1 week. The patients were divided into two groups: one with (pressure) and one without (conventional) calf compression during MRA. Two radiologists evaluated the quality of MRA images and compared the two groups. Cohen's kappa statistic was used to determine the concordance between MRA and DSA. Image quality in the calf and foot was better in the group with calf pressure than the conventional group without applied pressure (P = .001 [calf], 0.008 [foot]). Significantly more runoff vessels in the calf were detected with MRA than with DSA (P = .0043 [conventional], 0.0031 [pressure]). The kappa values were 0.928 in the conventional group and 0.979 in the pressure group, but in the conventional group, the diagnostic accuracy of CE-MRA was lower than that of DSA (P = .002). Diagnostic accuracy in the pressure group was significantly higher than that in the conventional group (P = .009). The overall sensitivity and specificity for >50% stenosis or occlusion was 93.8% and 98.5%, respectively, in the conventional group and 98.7% and 99.6%, respectively, in the pressure group. With calf compression, venous overlap (P = .0396, .0425) and deep vein overlap (P = .022, .022) were significantly reduced in the leg and foot. Calf compression with 3.0-T CE-MRA was convenient and practical and could improve image quality and diagnostic accuracy in diabetic patients with peripheral vascular disease by reducing venous overlap. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

The influence of surgical transection and anastomosis on the rate of cell proliferation in the colonic epithelium of normal and DMH-treated rats.

PubMed

Barkla, D H; Tutton, P M

1983-10-01

Normal and DMH-treated male rats aged 18-20 weeks underwent surgical transection and anastomosis of the transverse colon. Animals were subsequently killed at intervals of 14, 30 and 72 days. Three hours prior to sacrifice animals were injected with vinblastine sulphate and mitotic indices were subsequently estimated in histological sections. Possible differences between experimental and control groups were tested using a Student's t-test. The results show that the accumulated mitotic indices in normal and DMH-treated colon are statistically similar. The results also show that transection and anastomosis stimulates cell division in both normal and DMH-treated colon and that the increase is of greater amplitude and more prolonged duration in the DMH-treated rats. Carcinomas developed close to the line of anastomosis in DMH-treated but not in control rats. The results support the hypothesis that non-specific injury to hyperplastic colonic epithelium promotes carcinogenesis.

Left colectomy with intracoporeal anastomosis: technical aspects

PubMed Central

Araujo, Sérgio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney; Bertoncini, Alexandre Bruno

2014-01-01

Oncologic laparoscopic colectomy represents a fully validated surgical approach to the management of colorectal cancer. However, laparoscopic surgery for distal transverse and descending colon lesions remains a challenging procedure. A total laparoscopic approach to the left colectomy is an interesting option for critically ill patients although reports in the literature on this subject are scarce and its approach still not standardized because of its selective nature for indication. There are several advantages associated with conduction of totally laparoscopic approach to the left colon. Intracorporeal vessel sealing ensures an adequate lymph node dissection. Moreover, it enables the construction of a well-vascularized anastomosis. Ultimately, the occurrence of late wound complications are possibly reduced for the placement of a low abdominal incision exclusively used for specimen extraction. This paper aimed at describing our technique for a totally laparoscopic left colectomy for distal transverse and descending colon lesions. PMID:25295460

Electromagnetic valve for controlling the flow of molten, magnetic material

DOEpatents

Richter, Tomas

1998-01-01

An electromagnetic valve for controlling the flow of molten, magnetic material is provided, which comprises an induction coil for generating a magnetic field in response to an applied alternating electrical current, a housing, and a refractory composite nozzle. The nozzle is comprised of an inner sleeve composed of an erosion resistant refractory material (e.g., a zirconia ceramic) through which molten, magnetic metal flows, a refractory outer shell, and an intermediate compressible refractory material, e.g., unset, high alumina, thermosetting mortar. The compressible refractory material is sandwiched between the inner sleeve and outer shell, and absorbs differential expansion stresses that develop within the nozzle due to extreme thermal gradients. The sandwiched layer of compressible refractory material prevents destructive cracks from developing in the refractory outer shell.

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

PubMed

Palermo, Mariano; Serra, Edgardo

Gastric bypass is a restrictive and malabsorptive surgery. The restrictive part consists in the creation of a small gastric pouch. The gastrointestinal bypass serves as the malabsorptive element. To describe a simplified gastric bypass approach for morbid obese patients, showing our results, and also remarking the importance of this technique for reducing the learning curve. The patient is positioned in a split legs position and carefully strapped to the operating room table, with the surgeon between the patient's legs. Five trocars are inserted after pneumoperitoneum at the umbilicus. Dissection of the esophagogastric angle and lesser curvature is mandatory before the gastric pouch manufacturing. This pouch is done with two blue load staplers. Using a blue load linear stapler inserted only half way into the hole in the pouch is used to perform the gastrojejunal anastomosis and in order to create an anastomosis that is about 2 cm in length. A side-to-side jejunojejunostomy is done with a white load linear stapler. The last step of the gastric bypass consists in the cut of the jejunum between the two anastomosis with a white load linear stapler. Blue test is performed in order to detect leaks. From January 2012 to December 2015, 415 simplified RYGB were performed. Gender: 67% female and 33 % males. Average of BMI 44.7. Mean age was 42 years old. Mean operative time 79 min. 39 % of this sample had T2 diabetes. Regarding complications were observed, one fistula, one gastrojejunal stenosis and one obstruction due to a bezoar. The described technique is a simplified approach in which all the anastomosis are performed in the upper part of the abdomen, allowing the surgeons to be more systematized and avoiding them to make mistakes in the confection of the Roux-en-Y anastomosis. This simplified gastric bypass is a safe and reproducible technique. Bypass gástrico é cirurgia restritiva e malabsortiva. A parte restritiva consiste na criação de uma pequena bolsa g

Safety of Performing a Delayed Anastomosis During Damage Control Laparotomy in Patients with Destructive Colon Injuries

PubMed Central

Ordoñez, Carlos A; Pino, Luis F; Badiel, Marisol; Sánchez, Alvaro I; Loaiza, Jhon; Ballestas, Leonardo; Puyana, Juan Carlos

2011-01-01

Background Recent studies report the safety and feasibility of performing delayed anastomosis (DA) in patients undergoing damage control laparotomy (DCL) for destructive colon injuries (DCI). Despite accumulating experience in both civilian and military trauma, questions regarding how to best identify high risk patients and minimize the number of anastomosis-associated complications remain. Our current practice is to perform a definitive closure of the colon during DCL, unless there is persistent acidosis, bowel wall edema, or evidence of intra-abdominal abscess. In this study, we evaluated the safety of this approach by comparing outcomes of patients with DCI who underwent definitive closure of the colon during DCL versus patients managed with colostomy with or without DCL. Methods We performed a retrospective chart review of patients with penetrating DCI during 2003–2009. Severity of injury, surgical management, and clinical outcome were assessed. Results Sixty patients with severe gunshot wounds (GSW) and 3 patients with stab wounds were included in the analysis. DCL was required in 30 patients, all with GSW. Three patients died within the first 48 hours, 3 underwent colostomy, and 24 were managed with DA. Thirty-three patients were managed with standard laparotomy: 26 patients with primary anastomosis, and 7 with colostomy. Overall mortality rate was 9.5%. Three late deaths occurred in the DCL group, and only one death was associated with an anastomotic leak. Conclusions Performing a DA in DCI during DCL is a reliable and feasible approach as long as severe acidosis, bowel wall edema, and/or persistent intra-abdominal infections are not present. PMID:22182861

Safety of performing a delayed anastomosis during damage control laparotomy in patients with destructive colon injuries.

PubMed

Ordoñez, Carlos A; Pino, Luis F; Badiel, Marisol; Sánchez, Alvaro I; Loaiza, Jhon; Ballestas, Leonardo; Puyana, Juan Carlos

2011-12-01

Recent studies report the safety and feasibility of performing delayed anastomosis (DA) in patients undergoing damage control laparotomy (DCL) for destructive colon injuries (DCIs). Despite accumulating experience in both civilian and military trauma, questions regarding how to best identify high-risk patients and minimize the number of anastomosis-associated complications remain. Our current practice is to perform a definitive closure of the colon during DCL, unless there is persistent acidosis, bowel wall edema, or evidence of intra-abdominal abscess. In this study, we evaluated the safety of this approach by comparing outcomes of patients with DCI who underwent definitive closure of the colon during DCL versus patients managed with colostomy with or without DCL. We performed a retrospective chart review of patients with penetrating DCI during 2003 to 2009. Severity of injury, surgical management, and clinical outcome were assessed. Sixty patients with severe gunshot wounds and three patients with stab wounds were included in the analysis. DCL was required in 30 patients, all with gunshot wounds. Three patients died within the first 48 hours, three underwent colostomy, and 24 were managed with DA. Thirty-three patients were managed with standard laparotomy: 26 patients with primary anastomosis and 7 with colostomy. Overall mortality rate was 9.5%. Three late deaths occurred in the DCL group, and only one death was associated with an anastomotic leak. Performing a DA in DCI during DCL is a reliable and feasible approach as long as severe acidosis, bowel wall edema, and/or persistent intra-abdominal infections are not present.

The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection

PubMed Central

Hong, Youngki; Nam, Soomin

2017-01-01

Purpose The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate. Methods This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes. Results Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8–39 days). Conclusion Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation. PMID:28761871

Uterovaginal Anastomosis for Cases of Cryptomenorrhea Due to Cervical Atresia with Vaginal Aplasia: Benefits and Risks.

PubMed

Zayed, M; Fouad, R; Elsetohy, K A; Hashem, A T; AbdAllah, A A; Fathi, A I

2017-12-01

The objective of this study was to assess short-term benefits and risks of utero-vaginal anastomosis done for cases of cryptomenorrhea due to cervical atresia with vaginal aplasia. Prospective study. Surgical procedures were done between December 2013 and September 2015 at the department of Obstetrics and Gynecology, Cairo University Hospital. Five patients who had cryptomenorrhea due to cervical atresia associated with vaginal aplasia were included. Utero-vaginal anastomoses were performed in 2 stages; a stage of McIndoe vaginoplasty and a stage of excision of the atretic cervical tissue and anastomosing the uterus to the neovagina. Follow-up was done by gynecological and ultrasound examination in a duration ranged from 12 to 36 months. Occurrence of regular menstrual flow and relief of the severe cyclic pain. All patients had relief of the severe cyclic pain. Four patients had regular menstrual flow. One patient developed occlusion of the track after 1 year and needed dilatation once. Three patients developed low vaginal stenosis without occlusion of the track. One patient had rectal injury repaired without causing postoperative morbidity. Uterovaginal anastomosis is a promising conservative management option for cervical atresia with vaginal aplasia, which has benefits but is not free of risks. Long-term follow-up is still needed to judge its feasibility. We recommend performing McIndoe vaginoplasty as a starting stage before the anastomosis preferably in a separate setting. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Full robot-assisted gastrectomy with intracorporeal robot-sewn anastomosis produces satisfying outcomes

PubMed Central

Liu, Xin-Xin; Jiang, Zhi-Wei; Chen, Ping; Zhao, Yan; Pan, Hua-Feng; Li, Jie-Shou

2013-01-01

AIM: To evaluate the feasibility and safety of full robot-assisted gastrectomy with intracorporeal robot hand-sewn anastomosis in the treatment of gastric cancer. METHODS: From September 2011 to March 2013, 110 consecutive patients with gastric cancer at the authors’ institution were enrolled for robotic gastrectomies. According to tumor location, total gastrectomy, distal or proximal subtotal gastrectomy with D2 lymphadenectomy was fully performed by the da Vinci Robotic Surgical System. All construction, including Roux-en-Y jejunal limb, esophagojejunal, gastroduodenal and gastrojejunal anastomoses were fully carried out by the intracorporeal robot-sewn method. At the end of surgery, the specimen was removed through a 3-4 cm incision at the umbilicus trocar point. The details of the surgical technique are well illustrated. The benefits in terms of surgical and oncologic outcomes are well documented, as well as the failure rate and postoperative complications. RESULTS: From a total of 110 enrolled patients, radical gastrectomy could not be performed in 2 patients due to late stage disease; 1 patient was converted to laparotomy because of uncontrollable hemorrhage, and 1 obese patient was converted due to difficult exposure; 2 patients underwent extra-corporeal anastomosis by minilaparotomy to ensure adequate tumor margin. Robot-sewn anastomoses were successfully performed for 12 proximal, 38 distal and 54 total gastrectomies. The average surgical time was 272.52 ± 53.91 min and the average amount of bleeding was 80.78 ± 32.37 mL. The average number of harvested lymph nodes was 23.1 ± 5.3. All specimens showed adequate surgical margin. With regard to tumor staging, 26, 32 and 46 patients were staged as I, II and III, respectively. The average hospitalization time after surgery was 6.2 d. One patient experienced a duodenal stump anastomotic leak, which was mild and treated conservatively. One patient was readmitted for intra-abdominal infection and was

Lumbar spine disc heights and curvature: upright posture vs. supine compression harness

NASA Technical Reports Server (NTRS)

Lee, Shi-Uk; Hargens, Alan R.; Fredericson, Michael; Lang, Philipp K.

2003-01-01

INTRODUCTION: Spinal lengthening in microgravity is thought to cause back pain in astronauts. A spinal compression harness can compress the spine to eliminate lengthening but the loading condition with harness is different than physiologic conditions. Our purpose was to compare the effect of spine compression with a harness in supine position on disk height and spinal curvature in the lumbar spine to that of upright position as measured using a vertically open magnetic resonance imaging system. METHODS: Fifteen healthy subjects volunteered. On day 1, each subject lay supine for an hour and a baseline scan of the lumbar spine was performed. After applying a load of fifty percent of body weight with the harness for thirty minutes, the lumbar spine was scanned again. On day 2, after a baseline scan, a follow up scan was performed after kneeling for thirty minutes within the gap between two vertically oriented magnetic coils. Anterior and posterior disk heights, posterior disk bulging, and spinal curvature were measured from the baseline and follow up scans. RESULTS: Anterior disk heights increased and posterior disk heights decreased compared with baseline scans both after spinal compression with harness and upright posture. The spinal curvature increased by both loading conditions of the spine. DISCUSSION: The spinal compression with specially designed harness has the same effect as the physiologic loading of the spine in the kneeling upright position. The harness shows some promise as a tool to increase the diagnostic capabilities of a conventional MR system.

The in situ side-to-side bypass technique: a comprehensive review of the technical characteristics, current anastomosis approaches and surgical experience.

PubMed

Wang, Long; Cai, Li; Qian, Hai; Lawton, Michael T; Shi, Xiang'en

2018-05-02

In situ side-to-side (STS) revascularization is an intracranial-intracranial (IC-IC) bypass technique that is increasingly used to treat complex aneurysms and cerebral ischemia. This sophisticated technique involves connecting two proximal parallel vessels to create an artificial conduit for blood flow. This study aims to provide a detailed description of the configuration of the STS bypass technique and extensive information regarding its technical characteristics, current anastomosis approaches and surgical significance. A literature search was performed using the PubMed, Medline, ScienceDirect, Embase, Wiley Online Library, Cambridge Journals, SAGE Journals, Oxford Journals, Research Gate, and Google Scholar databases. The terms "intracranial-intracranial bypass", "in situ bypass", "communicating bypass" and "STS anastomosis" were searched to identify pertinent articles. Articles involving in situ STS anastomosis combined with other bypass methods were excluded. Computer tablet-drawn illustrations of this technique are provided to enhance comprehension. In total, seventy articles that met our search and inclusion criteria were identified. Overall, the radiographical and clinical outcomes of one-hundred and thirty-two (125 aneurysm and 7 cerebral ischemia) patients who underwent in situ STS revascularization were analyzed. IC-IC bypass in the STS fashion can be a safe and effective strategy for the management of complex intracranial aneurysms and cerebral ischemia and is particularly attractive in rescue, anticipated and troubleshooting cases. Despite its extreme rarity, a de novo aneurysm may be observed following STS anastomosis; thus, long-term follow-up is mandatory. Vascular neurosurgeons should consider including this procedure in their treatment armamentarium. Copyright © 2018. Published by Elsevier Inc.

Antroduodenectomy with Gastroduodenal Anastomosis: Salvage Emergency Surgery for Complicated Peptic Ulcer Disease--Results of a Double Institution Study of 35 Patients.

PubMed

Chereau, Nathalie; Chandeze, Marie-Maëlle; Tantardini, Camille; Trésallet, Christophe; Lefevre, Jérémie H; Parc, Yann; Menegaux, Fabrice

2016-03-01

Endoscopic and interventional techniques are currently the mainstay of management of bleeding duodenal ulcer. As well, for patients with perforated duodenal ulcer, laparoscopic simple closure is nowadays usually performed. Although indications for emergency antroduodenectomy have declined, this procedure is still necessary as a salvage option when conservative management has failed or is not practicable. Our study aimed to evaluate indications and results of antroduodenectomy with gastroduodenal anastomosis in current practice and to examine the factors that predict operative outcomes. All patients who underwent emergency antroduodenectomy with gastroduodenal anastomosis in two surgical care departments specialized in emergency digestive surgery were studied from 2000 to 2015. Thirty-five patients (27 males, 77 %) with a median age of 68 years (20-90) underwent emergency antroduodenectomy with gastroduodenal anastomosis. Indications were bleeding and perforated duodenal ulcer in 24 and 11 patients, respectively. The overall complication rate was 69 %, especially because of a high rate of medical complications (57 %). Only two patients (6 %) required reoperation for anastomotic leakage. The overall mortality rate was 40 % (n = 14). According to the univariate analysis, age >70, >3 comorbidities, ASA score >2, and postoperative medical complications were associated with an increased risk of in-hospital mortality. In the multivariate analysis, age and ASA score remained independent risk factors. No recurrence of complicated duodenal disease was observed. Antroduodenectomy with gastroduodenal anastomosis is a safe and effective long-term strategy, with a low and acceptable rate of surgical complications, for complicated duodenal ulcer not responding to conservative measures.

Isoperistaltic versus antiperistaltic side-to-side anastomosis after right laparoscopic hemicolectomy for cancer (ISOVANTI) trial: study protocol for a randomised clinical trial.

PubMed

Ibañez, N; Abrisqueta, J; Luján, J; Hernández, Q; Parrilla, P

2017-09-01

It is believed that loosing ileocecal valve is well tolerated in patients who do not have short bowel syndrome or Crohn disease. From the hypothesis of colonic peristalsis and transit is regulated by that ileocecal valvular mechanism, we try to find out if the creation of a new pseudo-valvular mechanism as antiperistaltic anastomosis could be considered after right hemicolectomy can cause any short- or long-term changes in gastrointestinal habits. The purpose of the study at primary endpoint is to compare early (occurring within 30 days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups. The ISOVANTI trial is a randomized controlled single-centre trial comparing isoperistaltic versus antiperistaltic side-to-side anastomosis after right laparoscopic hemicolectomy. It is designed as a parallel group superiority trial. It is unknown if a pseudo-valvular mechanism as antiperistaltic anastomosis can be considered has short- or long-term consequences in gastrointestinal habit. Considering the impact that ileocolic anastomosis configuration could have on the restitution of bowel transit after right hemicolectomy, we think it is indicated and necessary a randomized trial comparing iso- and antiperistaltic modalities. NCT02309931.

Evolution of the Orszag-Tang vortex system in a compressible medium. I - Initial average subsonic flow

NASA Technical Reports Server (NTRS)

Dahlburg, R. B.; Picone, J. M.

1989-01-01

The results of fully compressible, Fourier collocation, numerical simulations of the Orszag-Tang vortex system are presented. The initial conditions for this system consist of a nonrandom, periodic field in which the magnetic and velocity field contain X points but differ in modal structure along one spatial direction. The velocity field is initially solenoidal, with the total initial pressure field consisting of the superposition of the appropriate incompressible pressure distribution upon a flat pressure field corresponding to the initial, average Mach number of the flow. In these numerical simulations, this initial Mach number is varied from 0.2-0.6. These values correspond to average plasma beta values ranging from 30.0 to 3.3, respectively. It is found that compressible effects develop within one or two Alfven transit times, as manifested in the spectra of compressible quantities such as the mass density and the nonsolenoidal flow field. These effects include (1) a retardation of growth of correlation between the magnetic field and the velocity field, (2) the emergence of compressible small-scale structure such as massive jets, and (3) bifurcation of eddies in the compressible flow field. Differences between the incompressible and compressible results tend to increase with increasing initial average Mach number.

Evolution of the Orszag--Tang vortex system in a compressible medium. I. Initial average subsonic flow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dahlburg, R.B.; Picone, J.M.

In this paper the results of fully compressible, Fourier collocation, numerical simulations of the Orszag--Tang vortex system are presented. The initial conditions for this system consist of a nonrandom, periodic field in which the magnetic and velocity field contain X points but differ in modal structure along one spatial direction. The velocity field is initially solenoidal, with the total initial pressure field consisting of the superposition of the appropriate incompressible pressure distribution upon a flat pressure field corresponding to the initial, average Mach number of the flow. In these numerical simulations, this initial Mach number is varied from 0.2--0.6. Thesemore » values correspond to average plasma beta values ranging from 30.0 to 3.3, respectively. It is found that compressible effects develop within one or two Alfven transit times, as manifested in the spectra of compressible quantities such as the mass density and the nonsolenoidal flow field. These effects include (1) a retardation of growth of correlation between the magnetic field and the velocity field, (2) the emergence of compressible small-scale structure such as massive jets, and (3) bifurcation of eddies in the compressible flow field. Differences between the incompressible and compressible results tend to increase with increasing initial average Mach number.« less

Effects of recombinant human growth hormone and nandrolone phenylpropionate on the healing of ischemic colon anastomosis in rats.

PubMed

Yarimkaya, Ali; Apaydin, Berat; Unal, Ethem; Karabicak, Ilhan; Aydogan, Fatih; Uslu, Ezel; Erginoz, Ethem; Artis, Tarik; Eyuboglu, Erhun

2003-12-01

Recombinant human growth hormone and nandrolone phenylpropionate are two different anabolic agents. This study was designed to investigate the effects of these anabolic agents on the healing of ischemic colon anastomosis in rats. Seventy adult male Wistar rats were divided into five groups (n = 14). Group I was the sham laparotomy group. In the other groups, surgical procedures consisting of transsection and anastomosis were made at a distance 3 cm from the peritoneal reflection. Group II was the nonischemic control group. Ischemic colon model was produced in the remaining groups. Group III was the untreated control group. Groups IV and V received recombinant human growth hormone and nandrolone phenylpropionate, respectively. Bursting pressure and hydroxyproline levels were measured on the third and seventh postoperative days to evaluate anastomotic healing. Recombinant human growth hormone increased both collagen deposition and bursting pressure significantly at postoperative Days 3 and 7 compared with the sham and untreated control groups (P < 0.005). When compared with the untreated control, nandrolone phenylpropionate significantly increased collagen deposition at postoperative Days 3 and 7 (P < 0.005) and bursting pressure only at postoperative Day 3 (P < 0.005). Recombinant human growth hormone has more favorable therapeutic effects on the healing of ischemic colonic anastomoses than nandrolone phenylpropionate. Recombinant human growth hormone also improves healing of nonischemic colonic anastomosis.

Method of controlling coherent synchroton radiation-driven degradation of beam quality during bunch length compression

DOEpatents

Douglas, David R [Newport News, VA; Tennant, Christopher D [Williamsburg, VA

2012-07-10

A method of avoiding CSR induced beam quality defects in free electron laser operation by a) controlling the rate of compression and b) using a novel means of integrating the compression with the remainder of the transport system: both are accomplished by means of dispersion modulation. A large dispersion is created in the penultimate dipole magnet of the compression region leading to rapid compression; this large dispersion is demagnified and dispersion suppression performed in a final small dipole. As a result, the bunch is short for only a small angular extent of the transport, and the resulting CSR excitation is small.

Electrophysical properties of water and ice under isentropic compression to megabar pressures

NASA Astrophysics Data System (ADS)

Belov, S. I.; Boriskov, G. V.; Bykov, A. I.; Dolotenko, M. I.; Egorov, N. I.; Korshunov, A. S.; Kudasov, Yu. B.; Makarov, I. V.; Selemir, V. D.; Filippov, A. V.

2017-02-01

The relative permittivity and specific conductivity of water and ice are measured under isentropic compression to pressures above 300 GPa. Compression is initiated by a pulse of an ultrahigh magnetic field generated by an MK-1 magnetocumulative generator. The sample is placed in a coaxial compression chamber with an initial volume of about 40 cm3. The complex relative permittivity was measured by a fast-response reflectometer at a frequency of about 50 MHz. At the compression of water, its relative permittivity increases to ɛ = 350 at a pressure of 8 GPa, then drops sharply to ɛ = 140, and further decreases smoothly. It is shown that measurements of the relative permittivity under isentropic compression make it possible to determine interfaces between ordered and disordered phases of water and ice, as well as to reveal features associated with a change in the activation energy of defects.

JP3D compressed-domain watermarking of volumetric medical data sets

NASA Astrophysics Data System (ADS)

Ouled Zaid, Azza; Makhloufi, Achraf; Olivier, Christian

2010-01-01

Increasing transmission of medical data across multiple user systems raises concerns for medical image watermarking. Additionaly, the use of volumetric images triggers the need for efficient compression techniques in picture archiving and communication systems (PACS), or telemedicine applications. This paper describes an hybrid data hiding/compression system, adapted to volumetric medical imaging. The central contribution is to integrate blind watermarking, based on turbo trellis-coded quantization (TCQ), to JP3D encoder. Results of our method applied to Magnetic Resonance (MR) and Computed Tomography (CT) medical images have shown that our watermarking scheme is robust to JP3D compression attacks and can provide relative high data embedding rate whereas keep a relative lower distortion.

Treatment of a partially thrombosed giant aneurysm of the vertebral artery by aneurysm trapping and direct vertebral artery-posterior inferior cerebellar artery end-to-end anastomosis: technical case report.

PubMed

Benes, Ludwig; Kappus, Christoph; Sure, Ulrich; Bertalanffy, Helmut

2006-07-01

The purpose of this article is to focus for the first time on the operative management of a direct vertebral artery (VA)-posterior inferior cerebellar artery (PICA) end-to-end anastomosis in a partially thrombosed giant VA-PICA-complex aneurysm and to underline its usefulness as an additional treatment option. The operative technique of a direct VA-PICA end-to-end anatomosis is described in detail. The VA was entering the large aneurysm sack. Distally, the PICA originated from the aneurysm sack-VA-complex. The donor and recipient vessel were cut close to the aneurysm. Whereas the VA was cut in a straight manner, the PICA was cut at an oblique 45-degree angle to enlarge the vascular end diameter. Vessel ends were flushed with heparinized saline and sutured. The thrombotic material inside the aneurysm sack was removed and the distal VA clipped, leaving the anterior spinal artery and brainstem perforators free. The patient regained consciousness without additional morbidity. Magnetic resonance imaging scans revealed a completely decompressed brainstem without infarction. The postoperative angiograms demonstrated a good filling of the anastomosed PICA. Despite the caliber mistmatch of these two vessels the direct VA-PICA end-to-end anastomosis provides an accurate alternative in addition to other anastomoses and bypass techniques, when donor and recipient vessels are suitable and medullary perforators do not have to be disrupted.

A new compression format for fiber tracking datasets.

PubMed

Presseau, Caroline; Jodoin, Pierre-Marc; Houde, Jean-Christophe; Descoteaux, Maxime

2015-04-01

A single diffusion MRI streamline fiber tracking dataset may contain hundreds of thousands, and often millions of streamlines and can take up to several gigabytes of memory. This amount of data is not only heavy to compute, but also difficult to visualize and hard to store on disk (especially when dealing with a collection of brains). These problems call for a fiber-specific compression format that simplifies its manipulation. As of today, no fiber compression format has yet been adopted and the need for it is now becoming an issue for future connectomics research. In this work, we propose a new compression format, .zfib, for streamline tractography datasets reconstructed from diffusion magnetic resonance imaging (dMRI). Tracts contain a large amount of redundant information and are relatively smooth. Hence, they are highly compressible. The proposed method is a processing pipeline containing a linearization, a quantization and an encoding step. Our pipeline is tested and validated under a wide range of DTI and HARDI tractography configurations (step size, streamline number, deterministic and probabilistic tracking) and compression options. Similar to JPEG, the user has one parameter to select: a worst-case maximum tolerance error in millimeter (mm). Overall, we find a compression factor of more than 96% for a maximum error of 0.1mm without any perceptual change or change of diffusion statistics (mean fractional anisotropy and mean diffusivity) along bundles. This opens new opportunities for connectomics and tractometry applications. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Engineering anastomosis between living capillary networks and endothelial cell-lined microfluidic channels.

PubMed

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

2016-01-21

This paper reports a method for generating an intact and perfusable microvascular network that connects to microfluidic channels without appreciable leakage. This platform incorporates different stages of vascular development including vasculogenesis, endothelial cell (EC) lining, sprouting angiogenesis, and anastomosis in sequential order. After formation of a capillary network inside the tissue chamber via vasculogenesis, the adjacent microfluidic channels are lined with a monolayer of ECs, which then serve as the high-pressure input ("artery") and low pressure output ("vein") conduits. To promote a tight interconnection between the artery/vein and the capillary network, sprouting angiogenesis is induced, which promotes anastomosis of the vasculature inside the tissue chamber with the EC lining along the microfluidic channels. Flow of fluorescent microparticles confirms the perfusability of the lumenized microvascular network, and minimal leakage of 70 kDa FITC-dextran confirms physiologic tightness of the EC junctions and completeness of the interconnections between artery/vein and the capillary network. This versatile device design and its robust construction methodology establish a physiological transport model of interconnected perfused vessels from artery to vascularized tissue to vein. The system has utility in a wide range of organ-on-a-chip applications as it enables the physiological vascular interconnection of multiple on-chip tissue constructs that can serve as disease models for drug screening.

[Neurovascular compression of the medulla oblongata: a rare cause of secondary hypertension].

PubMed

Nádas, Judit; Czirják, Sándor; Igaz, Péter; Vörös, Erika; Jermendy, György; Rácz, Károly; Tóth, Miklós

2014-05-25

Compression of the rostral ventrolateral medulla oblongata is one of the rarely identified causes of refractory hypertension. In patients with severe, intractable hypertension caused by neurovascular compression, neurosurgical decompression should be considered. The authors present the history of a 20-year-old man with severe hypertension. After excluding other possible causes of secondary hypertension, the underlying cause of his high blood pressure was identified by the demonstration of neurovascular compression shown by magnetic resonance angiography and an increased sympathetic activity (sinus tachycardia) during the high blood pressure episodes. Due to frequent episodes of hypertensive crises, surgical decompression was recommended, which was performed with the placement of an isograft between the brainstem and the left vertebral artery. In the first six months after the operation, the patient's blood pressure could be kept in the normal range with significantly reduced doses of antihypertensive medication. Repeat magnetic resonance angiography confirmed the cessation of brainstem compression. After six months, increased blood pressure returned periodically, but to a smaller extent and less frequently. Based on the result of magnetic resonance angiography performed 22 months after surgery, re-operation was considered. According to previous literature data long-term success can only be achieved in one third of patients after surgical decompression. In the majority of patients surgery results in a significant decrease of blood pressure, an increased efficiency of antihypertensive therapy as well as a decrease in the frequency of highly increased blood pressure episodes. Thus, a significant improvement of the patient's quality of life can be achieved. The case of this patient is an example of the latter scenario.

Tokamak with mechanical compression of toroidal magnetic field

DOEpatents

Ohkawa, Tihiro

1981-01-01

A tokamak apparatus includes a pressure vessel for defining a reservoir and confining liquid therein. A collapsible toroidal liner disposed within the pressure vessel defines a toroidal space within the liner. Liquid metal fills the reservoir outside said liner. A toroidal magnetic field is developed within the toroidal space about the major axis thereof. A toroidal plasma is developed within the toroidal space about the major axis thereof. Pressure is applied to the liquid metal to collapse the liner and reduce the volume of the toroidal space, thereby increasing the toroidal magnetic flux density therein.

Evolution of the Orszag--Tang vortex system in a compressible medium. II. Supersonic flow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Picone, J.M.; Dahlburg, R.B.

The numerical investigation of Orszag--Tang vortex system in compressible magnetofluids continues, this time using initial conditions with embedded supersonic regions. The simulations have initial average Mach numbers M=1.0 and 1.5 and {beta}=10/3 with Lundquist numbers {ital S}=50, 100, or 200. Depending on the particular set of parameters, the numerical grid contains 256{sup 2} or 512{sup 2} collocation points. The behavior of the system differs significantly from that found previously for the incompressible and subsonic analogs. Shocks form at the downstream boundaries of the embedded supersonic regions outside the central magnetic X point and produce strong local current sheets that dissipatemore » appreciable magnetic energy. Reconnection at the central X point, which dominates the incompressible and subsonic systems, peaks later and has a smaller impact as {ital M} increases from 0.6 to 1.5. Reconnection becomes significant only after shocks reach the central region, compressing the weak current sheet there. Similarly, the correlation between the momentum and magnetic field begins significant growth later than in subsonic and incompressible flows. The shocks bound large compression regions, which dominate the wave-number spectra of autocorrelations in mass density, velocity, and magnetic field. The normalized spectral amplitude of the cross helicity is almost zero over the middle and upper portions of the wave-number domain, unlike the incompressible and subsonic flows. The thermal and magnetic pressures are anticorrelated over a wide wave-number range during the earlier portion of the calculations, consistent with the presence of quasistationary structures bounded by shocks.« less

Electromagnetic valve for controlling the flow of molten, magnetic material

DOEpatents

Richter, T.

1998-06-16

An electromagnetic valve for controlling the flow of molten, magnetic material is provided, which comprises an induction coil for generating a magnetic field in response to an applied alternating electrical current, a housing, and a refractory composite nozzle. The nozzle is comprised of an inner sleeve composed of an erosion resistant refractory material (e.g., a zirconia ceramic) through which molten, magnetic metal flows, a refractory outer shell, and an intermediate compressible refractory material, e.g., unset, high alumina, thermosetting mortar. The compressible refractory material is sandwiched between the inner sleeve and outer shell, and absorbs differential expansion stresses that develop within the nozzle due to extreme thermal gradients. The sandwiched layer of compressible refractory material prevents destructive cracks from developing in the refractory outer shell. 5 figs.

Large-scale energy budget of impulsive magnetic reconnection: Theory and simulation.

PubMed

Kiehas, S A; Volkonskaya, N N; Semenov, V S; Erkaev, N V; Kubyshkin, I V; Zaitsev, I V

2017-03-01

We evaluate the large-scale energy budget of magnetic reconnection utilizing an analytical time-dependent impulsive reconnection model and a numerical 2-D MHD simulation. With the generalization to compressible plasma, we can investigate changes in the thermal, kinetic, and magnetic energies. We study these changes in three different regions: (a) the region defined by the outflowing plasma (outflow region, OR), (b) the region of compressed magnetic fields above/below the OR (traveling compression region, TCR), and (c) the region trailing the OR and TCR (wake). For incompressible plasma, we find that the decrease inside the OR is compensated by the increase in kinetic energy. However, for the general compressible case, the decrease in magnetic energy inside the OR is not sufficient to explain the increase in thermal and kinetic energy. Hence, energy from other regions needs to be considered. We find that the decrease in thermal and magnetic energy in the wake, together with the decrease in magnetic energy inside the OR, is sufficient to feed the increase in kinetic and thermal energies in the OR and the increase in magnetic and thermal energies inside the TCR. That way, the energy budget is balanced, but consequently, not all magnetic energy is converted into kinetic and thermal energies of the OR. Instead, a certain fraction gets transfered into the TCR. As an upper limit of the efficiency of reconnection (magnetic energy → kinetic energy) we find η eff =1/2. A numerical simulation is used to include a finite thickness of the current sheet, which shows the importance of the pressure gradient inside the OR for the conversion of kinetic energy into thermal energy.

Potential role of small noncoding RNAs in regulating hypovirulence in Rhizoctonia solani anastomosis group 3

USDA-ARS?s Scientific Manuscript database

Double-stranded RNA (dsRNA) elements are frequently associated with fungi. In Rhizoctonia solani anastomosis group-3 (AG3), the 3.6 kb dsRNA element M2 has been associated with the hypovirulence of Rhs1A1 strain, enabling its use as a biological control agent. Previous studies that examined the rol...

Merging-compression formation of high temperature tokamak plasma

NASA Astrophysics Data System (ADS)

Gryaznevich, M. P.; Sykes, A.

2017-07-01

Merging-compression is a solenoid-free plasma formation method used in spherical tokamaks (STs). Two plasma rings are formed and merged via magnetic reconnection into one plasma ring that then is radially compressed to form the ST configuration. Plasma currents of several hundred kA and plasma temperatures in the keV-range have been produced using this method, however until recently there was no full understanding of the merging-compression formation physics. In this paper we explain in detail, for the first time, all stages of the merging-compression plasma formation. This method will be used to create ST plasmas in the compact (R ~ 0.4-0.6 m) high field, high current (3 T/2 MA) ST40 tokamak. Moderate extrapolation from the available experimental data suggests the possibility of achieving plasma current ~2 MA, and 10 keV range temperatures at densities ~1-5  ×  1020 m-3, bringing ST40 plasmas into a burning plasma (alpha particle heating) relevant conditions directly from the plasma formation. Issues connected with this approach for ST40 and future ST reactors are discussed

Individual surgeon is an independent risk factor for leak after double-stapled colorectal anastomosis: An institutional analysis of 800 patients.

PubMed

García-Granero, Eduardo; Navarro, Francisco; Cerdán Santacruz, Carlos; Frasson, Matteo; García-Granero, Alvaro; Marinello, Franco; Flor-Lorente, Blas; Espí, Alejandro

2017-11-01

Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons. The main outcome variable was anastomotic leak, defined as leak of luminal contents from a colorectal anastomosis between 2 hollow viscera diagnosed radiologically, clinically, endoscopically, or intraoperatively. Pelvic abscesses were also considered to be an anastomotic leak. Radiologic examination was performed when there was clinical suspicion of leak. Anastomotic leak occurred in 6.1% of patients, of which 33 (67%) were treated operatively, 6 (12%) with radiologic drains, and 10 (21%) by medical treatment. Postoperative mortality rate was 2.9% for the whole group of 800 patients. In patients with anastomotic leak, mortality rate increased up to 16% vs 2.0% in patients without anastomotic leak (P < .0001). At multivariate analysis, rectal location of tumor, male sex, bowel obstruction preoperatively, tobacco use, diabetes, perioperative transfusion, and the individual surgeon were independent risk factors for anastomotic leak. The surgeon was the most important factor (mean odds ratio 4.9; range 1.0 to 13.5). The variance of anastomotic leak between the different surgeons was 0.56 in the logit scale. The individual surgeon is an independent risk factor for leakage in double-stapled, colorectal, end-to-end anastomosis after oncologic left-sided colorectal resection. Copyright © 2017 Elsevier Inc. All rights reserved.

Prospects for x-ray polarimetry measurements of magnetic fields in magnetized liner inertial fusion plasmas.

PubMed

Lynn, Alan G; Gilmore, Mark

2014-11-01

Magnetized Liner Inertial Fusion (MagLIF) experiments, where a metal liner is imploded to compress a magnetized seed plasma may generate peak magnetic fields ∼10(4) T (100 Megagauss) over small volumes (∼10(-10)m(3)) at high plasma densities (∼10(28)m(-3)) on 100 ns time scales. Such conditions are extremely challenging to diagnose. We discuss the possibility of, and issues involved in, using polarimetry techniques at x-ray wavelengths to measure magnetic fields under these extreme conditions.

Early application of an intermittent pneumatic compression device is safe and results in proximal arteriovenous fistula enlargement.

PubMed

Desai, Sanjay; Mitra, Amit; Arkans, Ed; Singh, Tej M

2018-05-01

Delays in arteriovenous fistula maturation can cause care delays and increased costs. Increased distention pressure and intermittent wall shear stress may dilate veins based on prior research. Early use of non-invasive devices may help assist clinical arteriovenous fistula dilation. This was an Institutional Review Board approved study. After arteriovenous fistula creation, a novel, intermittent pneumatic compression device (Fist Assist ® ) was applied 15 cm proximal to arteriovenous fistula enabling 60 mmHg of cyclic compression for 6 h daily for 30 days. Among the patients who completed 1 month follow-up, 30 (n = 30) arteriovenous fistula patients were in the study arm to test vein dilation with Fist Assist. Controls (n = 16) used a sham device. Vein size was measured and recorded at baseline and after 30 days by duplex measurement. Clinical results (percentage increase) were recorded and tested for significance. No patients experienced thrombosis or adverse effects. Patient compliance and satisfaction was high. After 1 month, the mean percentage increase in vein diameter in the Fist Assist treatment group was significantly larger (p = 0.026) than controls in the first 5 mm segment of the fistula after the anastomosis. All fistulas treated with Fist Assist are still functional with no reported thrombosis or extravasations. Early application of an intermittent pneumatic compression device may assist in arteriovenous fistula dilation and are safe. Non-invasive devices like Fist Assist may have clinical utility to help fistulae development and decrease costs as they may eventually assist maturation.

Mini-mastoidectomía para anastomosis hipogloso-facial con sección parcial del nervio hipogloso

PubMed Central

Campero, Álvaro; Ajler, Pablo; Socolovsky, Mariano; Martins, Carolina; Rhoton, Albert

2012-01-01

Introducción: La anastomosis hipogloso-facial es la técnica de elección para la reparación de la parálisis facial cuando no se dispone de un cabo proximal sano del nervio facial. La técnica de anastomosis mediante fresado mastoideo y sección parcial del hipogloso minimiza la atrofia lingual sin sacrificar resultados a nivel facial. Método: La porción mastoidea del nervio facial transcurre por la pared anterior de la AM, a un promedio de 18+/-3 mm de profundidad respecto de la pared lateral. Se debe reconocer la cresta supramastoidea, desde la cual se marca una línea vertical paralela al eje mayor de la AM, 1 cm por detrás de la pared posterior del CAE El fresado se comienza desde la línea medio mastoidea hasta la pared posterior del CAE. Una vez encontrado el nervio facial en el tercio medio del canal mastoideo, el mismo es seguido hacia proximal y distal. Resultados: El abordaje descripto permite acceder al nervio facial intratemporal en su porción mastoidea, y efectuar un fresado óseo sin poner en riesgo al nervio o a estructuras vasculares cercanas. Se trata de un procedimiento técnicamente más sencillo que los abordajes amplios habitualmente utilizados al hueso temporal; no obstante su uso debe ser restringido mayormente a la anastomosis hipogloso-facial. Conclusión: Esta es una técnica relativamente sencilla, que puede ser reproducida por cirujanos sin mayor experiencia en el tema, luego de su paso por el laboratorio de anatomía. PMID:23596555

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

In the first posttransplant month, the most frequent complications are due to technical problems related to complex vascular and bile duct reconstructions during the operation. Moreover, despite great improvements in suturing technique and materials, severe organ ischemia-reperfusion caused by time-consuming hand suturing is still an important factor in graft survival. During the operation, severe hypotension, hypoxic acidosis, hyperkalemia, and renal dysfunction may occur during the anhepatic phase due to the prolonged venous clamping time required for hand suturing. Therefore, hand suturing is a handicap in the development of further advancements in liver transplantation. In this study, we aimed to test a new "mechanical installation method" for rapid vascular reconstruction. The magnetic pinning-ring device was developed consisting of paired magnetic rings coated with titanium oxide and embedded in a polypropylene shell. The rings were equipped with alternately spaced holes and titanium pins. Forty adult mongrel dogs were randomly divided into groups: A (n = 16), all vascular and bile duct reconstruction by magnetic ring without venous bypass; B (n = 16), all vascular and bile duct reconstruction by hand suturing with venous bypass; C (n = 8), sham transplantation group, transection of all vessels and common bile duct followed by anastomosis with the magnetic rings without liver transplantation. From groups A and B, dogs were randomly selected as donors (n = 8) or recipients (n = 8) of liver transplantations. We recorded operation time, vascular and bile duct anastomosis time, anhepatic time, administration of supplemental fluids during operation, and survival; blood samples were collected for the detection of liver damage (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and tumor necrosis factor α level. Patency was confirmed using ultrasound scans at various time points as late as 24 wk after surgery. Angiography was used to evaluate the

Magnetohydrodynamic simulation of the interaction between two interplanetary magnetic clouds and its consequent geoeffectiveness

NASA Astrophysics Data System (ADS)

Xiong, Ming; Zheng, Huinan; Wu, S. T.; Wang, Yuming; Wang, Shui

2007-11-01

Numerical studies of the interplanetary "multiple magnetic clouds (Multi-MC)" are performed by a 2.5-dimensional ideal magnetohydrodynamic (MHD) model in the heliospheric meridional plane. Both slow MC1 and fast MC2 are initially emerged along the heliospheric equator, one after another with different time intervals. The coupling of two MCs could be considered as the comprehensive interaction between two systems, each comprising of an MC body and its driven shock. The MC2-driven shock and MC2 body are successively involved into interaction with MC1 body. The momentum is transferred from MC2 to MC1. After the passage of MC2-driven shock front, magnetic field lines in MC1 medium previously compressed by MC2-driven shock are prevented from being restored by the MC2 body pushing. MC1 body undergoes the most violent compression from the ambient solar wind ahead, continuous penetration of MC2-driven shock through MC1 body, and persistent pushing of MC2 body at MC1 tail boundary. As the evolution proceeds, the MC1 body suffers from larger and larger compression, and its original vulnerable magnetic elasticity becomes stiffer and stiffer. So there exists a maximum compressibility of Multi-MC when the accumulated elasticity can balance the external compression. This cutoff limit of compressibility mainly decides the maximally available geoeffectiveness of Multi-MC because the geoeffectiveness enhancement of MCs interacting is ascribed to the compression. Particularly, the greatest geoeffectiveness is excited among all combinations of each MC helicity, if magnetic field lines in the interacting region of Multi-MC are all southward. Multi-MC completes its final evolutionary stage when the MC2-driven shock is merged with MC1-driven shock into a stronger compound shock. With respect to Multi-MC geoeffectiveness, the evolution stage is a dominant factor, whereas the collision intensity is a subordinate one. The magnetic elasticity, magnetic helicity of each MC, and compression

Impact of compressibility on heat transport characteristics of large terrestrial planets

NASA Astrophysics Data System (ADS)

Čížková, Hana; van den Berg, Arie; Jacobs, Michel

2017-07-01

We present heat transport characteristics for mantle convection in large terrestrial exoplanets (M ⩽ 8M⊕) . Our thermal convection model is based on a truncated anelastic liquid approximation (TALA) for compressible fluids and takes into account a selfconsistent thermodynamic description of material properties derived from mineral physics based on a multi-Einstein vibrational approach. We compare heat transport characteristics in compressible models with those obtained with incompressible models based on the classical- and extended Boussinesq approximation (BA and EBA respectively). Our scaling analysis shows that heat flux scales with effective dissipation number as Nu ∼Dieff-0.71 and with Rayleigh number as Nu ∼Raeff0.27. The surface heat flux of the BA models strongly overestimates the values from the corresponding compressible models, whereas the EBA models systematically underestimate the heat flux by ∼10%-15% with respect to a corresponding compressible case. Compressible models are also systematically warmer than the EBA models. Compressibility effects are therefore important for mantle dynamic processes, especially for large rocky exoplanets and consequently also for formation of planetary atmospheres, through outgassing, and the existence of a magnetic field, through thermal coupling of mantle and core dynamic systems.

Compressive myelopathy of the cervical spine in Komodo dragons (Varanus komodoensis).

PubMed

Zimmerman, Dawn M; Douglass, Michael; Sutherland-Smith, Meg; Aguilar, Roberto; Schaftenaar, Willem; Shores, Andy

2009-03-01

Cervical subluxation and compressive myelopathy appears to be a cause of morbidity and mortality in captive Komodo dragons (Varanus komodoensis). Four cases of cervical subluxation resulting in nerve root compression or spinal cord compression were identified. Three were presumptively induced by trauma, and one had an unknown inciting cause. Two dragons exhibited signs of chronic instability. Cervical vertebrae affected included C1-C4. Clinical signs on presentation included ataxia, ambulatory paraparesis or tetraparesis to tetraplegia, depression to stupor, cervical scoliosis, and anorexia. Antemortem diagnosis of compression was only confirmed with magnetic resonance imaging or computed tomography. Treatment ranged from supportive care to attempted surgical decompression. All dragons died or were euthanatized, at 4 days to 12 mo postpresentation. Studies to define normal vertebral anatomy in the species are necessary to determine whether the pathology is linked to cervical malformation, resulting in ligament laxity, subsequent instability, and subluxation.

Controls on anastomosis in lowland river systems: Towards process-based solutions to habitat conservation.

PubMed

Marcinkowski, Paweł; Grabowski, Robert C; Okruszko, Tomasz

2017-12-31

Anastomosing rivers were historically common around the world before extensive agricultural and industrial development in river valleys. Few lowland anastomosing rivers remain in temperate zones, and the protection of these river-floodplain systems is an international conservation priority. However, the mechanisms that drive the creation and maintenance of multiple channels, i.e. anabranches, are not well understood, particularly for lowland rivers, making it challenging to identify effective management strategies. This study uses a novel multi-scale, process-based hydro-geomorphological approach to investigate the natural and anthropogenic controls on anastomosis in lowland river reaches. Using a wide range of data (hydrologic, cartographic, remote-sensing, historical), the study (i) quantifies changes in the planform of the River Narew, Poland over the last 100years, (ii) documents changes in the natural and anthropogenic factors that could be driving the geomorphic change, and (iii) develops a conceptual model of the controls of anastomosis. The results show that 110km of anabranches have been lost from the Narew National Park (6810ha), a 42% reduction in total anabranch length since 1900. The rates of anabranch loss have increased as the number of pressures inhibiting anabranch creation and maintenance has multiplied. The cessation of localized water level and channel management (fishing dams, water mills and timber rafting), the loss of traditional floodplain activities (seasonal mowing) and infrastructure construction (embanked roads and an upstream dam) are contributing to low water levels and flows, the deposition of sediment at anabranch inlets, the encroachment of common reed (Phragmites australis), and the eventual loss of anabranches. By identifying the processes driving the loss of anabranches, this study provides transferable insights into the controls of anastomosis in lowland rivers and the management solutions needed to preserve the unique

Versatile strain-tuning of modulated long-period magnetic structures

DOE PAGES

Fobes, D. M.; Luo, Yongkang; León-Brito, N.; ...

2017-05-10

In this paper, we report a detailed small-angle neutron scattering (SANS) study of the skyrmion lattice phase of MnSi under compressive and tensile strain. In particular, we demonstrate that tensile strain applied to the skyrmion lattice plane, perpendicular to the magnetic field, acts to destabilize the skyrmion lattice phase. Finally, this experiment was enabled by our development of a versatile strain cell, unique in its ability to select the application of either tensile or compressive strain in-situ by using two independent helium-actuated copper pressure transducers, whose design has been optimized for magnetic SANS on modulated long-period magnetic structures and vortexmore » lattices, and is compact enough to fit in common sample environments such as cryostats and superconducting magnets.« less

SOME NEW DATA ON SELF-COMPRESSED DISCHARGES (in Russian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kvartskhava, I.F.; Kervalidze, K.N.; Gvaladze, Yu.C.

1962-01-01

The theory of self-constricted discharges, which predicts the possibiiity of the appearance of various types of instabilities, does not reflect fully the multiple phenoniena which are experimentally observed. The models used in the theory evidentiy do not consider the presence of some processes in self- constricted discharges which materially determine the real behavior of the plasma. The experiments showed a number of such processes. Basically, they consist of an unequal heating of the discharge near the walls of the chamber. Thereby the discharge currents fiow along distorted threadlike channels which, in theta - pinches mostly follow either the z-direction ormore » the theta -direction, and in z- pinches they basically follow the theta -direction. In the process of plasma compression the above mentioned thread formations experience unequal accelerations. Having a high conductivity, these formations facilitate the capture of magnetic fieids which obstructs the thermaiization of the kinetic energy of the plasma's radial motion. As a result of this process the plasma is far from thermial equilibrium when in the stage of maximum compression. It is encompassed by a motion of turbulent character. After the maximum compression of the plasma, various kinds of plasma formation are ejected from the surface of the pinch. The magnetic field is more effectively trapped than in zpinches. Consequently, a greater variety of types of instability is observed in theta - pinches than in z-pinches. Highspeed photography of the discharge turned out to be the most practical and fruitful method of studying the processes of formation and the subsequent motion of the plasma. Photographs of the discharges obtained by streak photography and by framing camera are discussed. The results of probe measurements of magnetic and electric fields as well as the results of measurements of currents by means of Rogovsky belts are given. (auth)« less

[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.

Large magnetic entropy change and magnetoresistance in a Ni 41Co 9Mn 40Sn 10 magnetic shape memory alloy

DOE PAGES

Huang, L.; Cong, D. Y.; Ma, L.; ...

2015-07-02

A polycrystalline Ni 41Co 9Mn 40Sn 10 (at. %) magnetic shape memory alloy was prepared by arc melting and characterized mainly by magnetic measurements, in-situ high-energy X-ray diffraction (HEXRD), and mechanical testing. A large magnetoresistance of 53.8% (under 5 T) and a large magnetic entropy change of 31.9 J/(kg K) (under 5 T) were simultaneously achieved. Both of these values are among the highest values reported so far in Ni-Mn-Sn-based Heusler alloys. The large magnetic entropy change, closely related to the structural entropy change, is attributed to the large unit cell volume change across martensitic transformation as revealed by ourmore » in-situ HEXRD experiment. Furthermore, good compressive properties were also obtained. Lastly, the combination of large magnetoresistance, large magnetic entropy change, and good compressive properties, as well as low cost makes this alloy a promising candidate for multifunctional applications.« less

Dynamic alteration of regional cerebral blood flow during carotid compression and proof of reversibility.

PubMed

Asahi, Kouichi; Hori, M; Hamasaki, N; Sato, S; Nakanishi, H; Kuwatsuru, R; Sasai, K; Aoki, S

2012-01-01

It is difficult to non-invasively visualize changes in regional cerebral blood flow caused by manual compression of the carotid artery. To visualize dynamic changes in regional cerebral blood flow during and after manual compression of the carotid artery. Two healthy volunteers were recruited. Anatomic features and flow directions in the circle of Willis were evaluated with time-of-flight magnetic resonance angiography (MRA) and two-dimensional phase-contrast (2DPC) MRA, respectively. Regional cerebral blood flow was visualized with territorial arterial spin-labeling magnetic resonance imaging (TASL-MRI). TASL-MRI and 2DPC-MRA were performed in three states: at rest, during manual compression of the right carotid artery, and after decompression. In one volunteer, time-space labeling inversion pulse (Time-SLIP) MRA was performed to confirm collateral flow. During manual carotid compression, in one volunteer, the right thalamus changed to be fed only by the vertebrobasilar system, and the right basal ganglia changed to be fed by the left internal carotid artery. In the other volunteer, the right basal ganglia changed to be fed by the vertebrobasilar system. 2DPC-MRA showed that the flow direction changed in the right A1 segment of the anterior cerebral artery and the right posterior communicating artery. Perfusion patterns and flow directions recovered after decompression. Time-SLIP MRA showed pial vessels and dural collateral circulation when the right carotid artery was manually compressed. Use of TASL-MRI and 2DPC-MRA was successful for non-invasive visualization of the dynamic changes in regional cerebral blood flow during and after manual carotid compression.

The in vitro biological properties of Mg-Zn-Sr alloy and superiority for preparation of biodegradable intestinal anastomosis rings

PubMed Central

Liu, Ling; Li, Nianfeng; Lei, Ting; Li, Kaimo; Zhang, Yangde

2014-01-01

Background Magnesium (Mg) alloy is a metal-based biodegradable material that has received increasing attention in the field of clinical surgery, but it is currently seldom used in intestinal anastomosis. This study was conducted to comprehensively assess a ternary magnesium (Mg)-zinc (Zn)-strontium (Sr) alloy’s biological superiorities as a preparation material for intestinal anastomosis ring. Material/Methods Mouse L-929 fibroblasts were cultured with Mg-Zn-Sr alloy extract and compared with both positive (0.64% phenol) and negative (original broth culture) controls. The cell morphology of different groups was examined using microscopy, and a cytotoxicity assessment was performed. Fresh anticoagulated human blood was mixed with Mg-Zn-Sr alloy extract and compared with both positive (distilled water) and negative (normal saline) controls. The absorbance of each sample at 570 nm was used to calculate the Mg-Zn-Sr alloy hemolysis ratio in order to test the Mg alloy’s blood compatibility. Bacterial cultures of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were added to Mg-Zn-Sr alloy block samples and compared with positive (Ceftazidime), negative (316LSS stainless steel), and blank controls. The broth cultures were sampled to compare their bacterial colony counts so as to evaluate the antibacterial properties of the Mg-Zn-Sr alloy. The Mg-Zn-Sr alloy was surface-coated with a layer of poly(lactic-co-glycolic acid) carrying everolimus. The surface morphology and degradability of the coating were examined so as to demonstrate feasibility of coating, which can release the drug evenly. Results The experiments proved that Mg-Zn-Sr alloy has good biocompatible, antibacterial, and drug-loaded coating performances, which are lacking in existing intestinal anastomosis devices/materials. Conclusions The Mg-Zn-Sr alloy increases biocompatibility, and yields a safer and better therapeutic effect; therefore, it is a novel biomaterial that is feasible for

Compression embedding

DOEpatents

Sandford, M.T. II; Handel, T.G.; Bradley, J.N.

1998-07-07

A method and apparatus for embedding auxiliary information into the digital representation of host data created by a lossy compression technique and a method and apparatus for constructing auxiliary data from the correspondence between values in a digital key-pair table with integer index values existing in a representation of host data created by a lossy compression technique are disclosed. The methods apply to data compressed with algorithms based on series expansion, quantization to a finite number of symbols, and entropy coding. Lossy compression methods represent the original data as ordered sequences of blocks containing integer indices having redundancy and uncertainty of value by one unit, allowing indices which are adjacent in value to be manipulated to encode auxiliary data. Also included is a method to improve the efficiency of lossy compression algorithms by embedding white noise into the integer indices. Lossy compression methods use loss-less compression to reduce to the final size the intermediate representation as indices. The efficiency of the loss-less compression, known also as entropy coding compression, is increased by manipulating the indices at the intermediate stage. Manipulation of the intermediate representation improves lossy compression performance by 1 to 10%. 21 figs.

Compression embedding

DOEpatents

Sandford, II, Maxwell T.; Handel, Theodore G.; Bradley, Jonathan N.

1998-01-01

A method and apparatus for embedding auxiliary information into the digital representation of host data created by a lossy compression technique and a method and apparatus for constructing auxiliary data from the correspondence between values in a digital key-pair table with integer index values existing in a representation of host data created by a lossy compression technique. The methods apply to data compressed with algorithms based on series expansion, quantization to a finite number of symbols, and entropy coding. Lossy compression methods represent the original data as ordered sequences of blocks containing integer indices having redundancy and uncertainty of value by one unit, allowing indices which are adjacent in value to be manipulated to encode auxiliary data. Also included is a method to improve the efficiency of lossy compression algorithms by embedding white noise into the integer indices. Lossy compression methods use loss-less compression to reduce to the final size the intermediate representation as indices. The efficiency of the loss-less compression, known also as entropy coding compression, is increased by manipulating the indices at the intermediate stage. Manipulation of the intermediate representation improves lossy compression performance by 1 to 10%.

Comparative data compression techniques and multi-compression results

NASA Astrophysics Data System (ADS)

Hasan, M. R.; Ibrahimy, M. I.; Motakabber, S. M. A.; Ferdaus, M. M.; Khan, M. N. H.

2013-12-01

Data compression is very necessary in business data processing, because of the cost savings that it offers and the large volume of data manipulated in many business applications. It is a method or system for transmitting a digital image (i.e., an array of pixels) from a digital data source to a digital data receiver. More the size of the data be smaller, it provides better transmission speed and saves time. In this communication, we always want to transmit data efficiently and noise freely. This paper will provide some compression techniques for lossless text type data compression and comparative result of multiple and single compression, that will help to find out better compression output and to develop compression algorithms.

"Passing loop" technique: a new modification of the piggyback technique tailored to voluminous liver grafts--case report.

PubMed

Eldeen, F Z; Lee, C-F; Lee, C-S; Chan, K-M; Lee, W-C

2013-03-01

The modified piggyback technique with side-to-side cavocavostomy decreases the risk of outflow obstruction compared with the standard piggyback method. However, this modification is not ideal for recipients who receive a graft that is voluminous or bears an enlarged caudate lobe. We modified the inferior vena cava (IVC) preservation technique against deleterious complications of compression by using a passing loop. A 49-year-old woman, who underwent orthotopic liver transplantation for hepatic failure, was allocated a large-size liver. In anticipation of serious caval compression due to the voluminous grafts, we kept the suprahepatic or infrahepatic donor caval cuffs open for an anastomosis. The first anastomosis was performed between suprahepatic donor IVC cuff and recipient middle-left hepatic vein common channel; the second anastomosis was a terminolateral cavocavostomy between infrahepatic donor IVC cuff and the anterior wall of the recipient's IVC. When the liver circulation was restored, the donor retrohepatic vena cava served as a passing loop for both hepatic venous outflow and infra-diaphragmatic venous return to bypass possible IVC compression. Our technique may solve a dilemna for patients receiving voluminous liver grafts. Copyright © 2013 Elsevier Inc. All rights reserved.

Compression of electromyographic signals using image compression techniques.

PubMed

Costa, Marcus Vinícius Chaffim; Berger, Pedro de Azevedo; da Rocha, Adson Ferreira; de Carvalho, João Luiz Azevedo; Nascimento, Francisco Assis de Oliveira

2008-01-01

Despite the growing interest in the transmission and storage of electromyographic signals for long periods of time, few studies have addressed the compression of such signals. In this article we present an algorithm for compression of electromyographic signals based on the JPEG2000 coding system. Although the JPEG2000 codec was originally designed for compression of still images, we show that it can also be used to compress EMG signals for both isotonic and isometric contractions. For EMG signals acquired during isometric contractions, the proposed algorithm provided compression factors ranging from 75 to 90%, with an average PRD ranging from 3.75% to 13.7%. For isotonic EMG signals, the algorithm provided compression factors ranging from 75 to 90%, with an average PRD ranging from 3.4% to 7%. The compression results using the JPEG2000 algorithm were compared to those using other algorithms based on the wavelet transform.

[Feasibility and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis in surgical treatment of gastric cancer].

PubMed

Du, Guangsheng; Jiang, Enlai; Qiu, Yuan; Wang, Wensheng; Wang, Shuai; Li, Yunbo; Peng, Ke; Li, Xiang; Yang, Hua; Xiao, Weidong

2018-05-25

To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer. Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed. A 2.5-3.0 cm incision around the umbilicus was made for placing the gloveport as the passage for the lens, and the instruments of the surgeon and the assistant. Another operative port was placed in the left upper quadrant with a 12-mm Trocar for the passage of the energy device, the endoscopic cutting closure, as well as the postoperative drainage tube. A D2 lymph node (LNs) dissection was regularly conducted. After the abdominal esophagus was routinely mobilized, a side-to-side esophagus-jejunum anastomosis was made through a gastric pre-pulling esophagojejunal π-shaped anastomosis. The transection was then performed with a ligation on the cardia (or esophagus above the upper margin of the tumor) using a sterilized hemp rope in order to better expose the abdominal esophagus. Throughout the course of reconstruction, the ligature rope was held by the assistant to hold down the esophagus to allow easier esophagojejunal anastomosis. A hole was then made on the posterior wall of the esophagus, between 2 cm and 3 cm above the ligature rope, and another hole was made at the anti-mesenteric border of the jejunum 40 cm distal to the Treitz ligament. A side-to-side esophagojejunal π-shaped anastomosis was performed through two holes. An entry hole was formed after the anastomosis. After checking the anastomosis, this entry hole was closed through an intestinal mesenteric hole pre-made on its opposite side. The resected esophagus and stomach, together with the afferent loop jejunum, were simultaneously

A semi-analytic model of magnetized liner inertial fusion

DOE PAGES

McBride, Ryan D.; Slutz, Stephen A.

2015-05-21

Presented is a semi-analytic model of magnetized liner inertial fusion (MagLIF). This model accounts for several key aspects of MagLIF, including: (1) preheat of the fuel (optionally via laser absorption); (2) pulsed-power-driven liner implosion; (3) liner compressibility with an analytic equation of state, artificial viscosity, internal magnetic pressure, and ohmic heating; (4) adiabatic compression and heating of the fuel; (5) radiative losses and fuel opacity; (6) magnetic flux compression with Nernst thermoelectric losses; (7) magnetized electron and ion thermal conduction losses; (8) end losses; (9) enhanced losses due to prescribed dopant concentrations and contaminant mix; (10) deuterium-deuterium and deuterium-tritium primarymore » fusion reactions for arbitrary deuterium to tritium fuel ratios; and (11) magnetized α-particle fuel heating. We show that this simplified model, with its transparent and accessible physics, can be used to reproduce the general 1D behavior presented throughout the original MagLIF paper [S. A. Slutz et al., Phys. Plasmas 17, 056303 (2010)]. We also discuss some important physics insights gained as a result of developing this model, such as the dependence of radiative loss rates on the radial fraction of the fuel that is preheated.« less

A semi-analytic model of magnetized liner inertial fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

McBride, Ryan D.; Slutz, Stephen A.

Presented is a semi-analytic model of magnetized liner inertial fusion (MagLIF). This model accounts for several key aspects of MagLIF, including: (1) preheat of the fuel (optionally via laser absorption); (2) pulsed-power-driven liner implosion; (3) liner compressibility with an analytic equation of state, artificial viscosity, internal magnetic pressure, and ohmic heating; (4) adiabatic compression and heating of the fuel; (5) radiative losses and fuel opacity; (6) magnetic flux compression with Nernst thermoelectric losses; (7) magnetized electron and ion thermal conduction losses; (8) end losses; (9) enhanced losses due to prescribed dopant concentrations and contaminant mix; (10) deuterium-deuterium and deuterium-tritium primarymore » fusion reactions for arbitrary deuterium to tritium fuel ratios; and (11) magnetized α-particle fuel heating. We show that this simplified model, with its transparent and accessible physics, can be used to reproduce the general 1D behavior presented throughout the original MagLIF paper [S. A. Slutz et al., Phys. Plasmas 17, 056303 (2010)]. We also discuss some important physics insights gained as a result of developing this model, such as the dependence of radiative loss rates on the radial fraction of the fuel that is preheated.« less

Detection of compression vessels in trigeminal neuralgia by surface-rendering three-dimensional reconstruction of 1.5- and 3.0-T magnetic resonance imaging.

PubMed

Shimizu, Masahiro; Imai, Hideaki; Kagoshima, Kaiei; Umezawa, Eriko; Shimizu, Tsuneo; Yoshimoto, Yuhei

2013-01-01

Surface-rendered three-dimensional (3D) 1.5-T magnetic resonance (MR) imaging is useful for presurgical simulation of microvascular decompression. This study compared the sensitivity and specificity of 1.5- and 3.0-T surface-rendered 3D MR imaging for preoperative identification of the compression vessels of trigeminal neuralgia. One hundred consecutive patients underwent microvascular decompression for trigeminal neuralgia. Forty and 60 patients were evaluated by 1.5- and 3.0-T MR imaging, respectively. Three-dimensional MR images were constructed on the basis of MR imaging, angiography, and venography data and evaluated to determine the compression vessel before surgery. MR imaging findings were compared with the microsurgical findings to compare the sensitivity and specificity of 1.5- and 3.0-T MR imaging. The agreement between MR imaging and surgical findings depended on the compression vessels. For superior cerebellar artery, 1.5- and 3.0-T MR imaging had 84.4% and 82.7% sensitivity and 100% and 100% specificity, respectively. For anterior inferior cerebellar artery, 1.5- and 3.0-T MR imaging had 33.3% and 50% sensitivity and 92.9% and 95% specificity, respectively. For the petrosal vein, 1.5- and 3.0-T MR imaging had 75% and 64.3% sensitivity and 79.2% and 78.1% specificity, respectively. Complete pain relief was obtained in 36 of 40 and 55 of 60 patients undergoing 1.5- and 3.0-T MR imaging, respectively. The present study showed that both 1.5- and 3.0-T MR imaging provided high sensitivity and specificity for preoperative assessment of the compression vessels of trigeminal neuralgia. Preoperative 3D imaging provided very high quality presurgical simulation, resulting in excellent clinical outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience.

PubMed

Surve, Amit; Cottam, Daniel; Sanchez-Pernaute, Andres; Torres, Antonio; Roller, Joshua; Kwon, Yong; Mourot, Joshua; Schniederjan, Bleu; Neichoy, Bo; Enochs, Paul; Tyner, Michael; Bruce, Jon; Bovard, Scott; Roslin, Mitchell; Jawad, Muhammad; Teixeira, Andre; Srikanth, Myur; Free, Jason; Zaveri, Hinali; Pilati, David; Bull, Jamie; Belnap, LeGrand; Richards, Christina; Medlin, Walter; Moon, Rena; Cottam, Austin; Sabrudin, Sarah; Cottam, Samuel; Dhorepatil, Aneesh

2018-02-02

The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction. The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures. Mixed of private and teaching facilities. The medical records of 1328 patients who underwent primary SADS procedure (single-anastomosis duodeno-ileal bypass with sleeve gastrectomy or stomach intestinal pylorus-sparing surgery) by 17 surgeons from 3 countries (United States, Spain, and Australia) at 9 centers over a 6-year period were retrospectively reviewed, and their results were compared with articles in the literature. Mean preoperative body mass index was 51.6 kg/m 2 . Of 1328 patients, 123 patients received a linear stapled duodeno-ileostomy (DI) and 1205 patients a hand-sewn DI. In the overall series, the anastomotic leak, ulcer, and bile reflux occurred in .6% (9/1328), .1% (2/1328), and .1% (2/1328), respectively. None of our patients experienced volvulus at the DI or an internal hernia. Overall, 5 patients (.3%) (3/123 [2.4%] with linear stapled DI versus 2/1205 [.1%] with hand-sewn DI [P<.05]) experienced stricture at the DI in this series. The overall incidence of complications associated with loop DI was lower than the reported incidence of anastomotic complications after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. SADS procedures may cause much fewer anastomotic complications compared with Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The C-seal trial: colorectal anastomosis protected by a biodegradable drain fixed to the anastomosis by a circular stapler, a multi-center randomized controlled trial

PubMed Central

2012-01-01

Background Anastomotic leakage is a major complication in colorectal surgery and with an incidence of 11% the most common cause of morbidity and mortality. In order to reduce the incidence of anastomotic leakage the C-seal is developed. This intraluminal biodegradable drain is stapled to the anastomosis with a circular stapler and prevents extravasation of intracolonic content in case of an anastomotic dehiscence. The aim of this study is to evaluate the efficacy of the C-seal in reducing anastomotic leakage in stapled colorectal anastomoses, as assessed by anastomotic leakage leading to invasive treatment within 30 days postoperative. Methods The C-seal trial is a prospective multi-center randomized controlled trial with primary endpoint, anastomotic leakage leading to re-intervention within 30 days after operation. In this trial 616 patients will be randomized to the C-seal or control group (1:1), stratified by center, anastomotic height (proximal or distal of peritoneal reflection) and the intention to create a temporary deviating ostomy. Interim analyses are planned after 50% and 75% of patient inclusion. Eligible patients are at least 18 years of age, have any colorectal disease requiring a colorectal anastomosis to be made with a circular stapler in an elective setting, with an ASA-classification < 4. Oral mechanical bowel preparation is mandatory and patients with signs of peritonitis are excluded. The C-seal student team will perform the randomization procedure, supports the operating surgeon during the C-seal application and achieves the monitoring of the trial. Patients are followed for one year after randomization en will be analyzed on an intention to treat basis. Discussion This Randomized Clinical trial is designed to evaluate the effectiveness of the C-seal in preventing clinical anastomotic leakage. Trial registration NTR3080 PMID:23153188

FAST TRACK COMMUNICATION: Finite-temperature magnetism in bcc Fe under compression

NASA Astrophysics Data System (ADS)

Sha, Xianwei; Cohen, R. E.

2010-09-01

We investigate the contributions of finite-temperature magnetic fluctuations to the thermodynamic properties of bcc Fe as functions of pressure. First, we apply a tight-binding total-energy model parameterized to first-principles linearized augmented plane-wave computations to examine various ferromagnetic, anti-ferromagnetic, and noncollinear spin spiral states at zero temperature. The tight-binding data are fit to a generalized Heisenberg Hamiltonian to describe the magnetic energy functional based on local moments. We then use Monte Carlo simulations to compute the magnetic susceptibility, the Curie temperature, heat capacity, and magnetic free energy. Including the finite-temperature magnetism improves the agreement with experiment for the calculated thermal expansion coefficients.

Compression of an Accelerated Taylor State in SSX

NASA Astrophysics Data System (ADS)

Shrock, J. E.; Suen-Lewis, E. M.; Barbano, L. J.; Kaur, M.; Schaffner, D. A.; Brown, M. R.

2017-10-01

In the Swarthmore Spheromak Experiment (SSX), compact toroidal plasmas are launched from a plasma gun and evolve into minimum energy twisted Taylor states. The plumes initially have a velocity 40 km/s, density 0.4 ×1016 cm-3 , and proton temperature 20 eV . After formation, the plumes are accelerated by pulsed pinch coils with rise times τ1 / 4 = (π / 2) √{ LC } less than 1 μ s and currents Ipeak =V0 / Z =V0 /√{ L / C } on the order of 104 A. The accelerated Taylor States are abruptly stagnated in a copper flux conserver, and over the course of t < 10 μ s, adiabatic compression is observed. The magnetothermodynamics of this compression do not appear to be dictated by the MHD equation of state d / dt (P /nγ) = 0 . Rather, the compression appears to evolve according to the Chew-Goldberger-Low (CGL) double adiabatic model. CGL theory presents two equations of state, one corresponding with particle motion perpendicular to magnetic field in a plasma, the other to particle motion parallel to the field. We observe Taylor state compression most in agreement with the parallel equation of state: d / dt (P∥B2 /n3) = 0 . DOE ARPA-E ALPHA Program.

Comparative Study of Hand-Sutured versus Circular Stapled Anastomosis for Gastrojejunostomy in Laparoscopy Assisted Distal Gastrectomy.

PubMed

Seo, Su Hyun; Kim, Ki Han; Kim, Min Chan; Choi, Hong Jo; Jung, Ghap Joong

2012-06-01

Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups. Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001). Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.

[Computer-assisted image processing for quantifying histopathologic variables in the healing of colonic anastomosis in dogs].

PubMed

Novelli, M D; Barreto, E; Matos, D; Saad, S S; Borra, R C

1997-01-01

The authors present the experimental results of the computerized quantifying of tissular structures involved in the reparative process of colonic anastomosis performed by manual suture and biofragmentable ring. The quantified variables in this study were: oedema fluid, myofiber tissue, blood vessel and cellular nuclei. An image processing software developed at Laboratório de Informática Dedicado à Odontologia (LIDO) was utilized to quantifying the pathognomonic alterations in the inflammatory process in colonic anastomosis performed in 14 dogs. The results were compared to those obtained through traditional way diagnosis by two pathologists in view of counterproof measures. The criteria for these diagnoses were defined in levels represented by absent, light, moderate and intensive which were compared to analysis performed by the computer. There was significant statistical difference between two techniques: the biofragmentable ring technique exhibited low oedema fluid, organized myofiber tissue and higher number of alongated cellular nuclei in relation to manual suture technique. The analysis of histometric variables through computational image processing was considered efficient and powerful to quantify the main tissular inflammatory and reparative changing.

The Utility of Magnetic Resonance Imaging in Assessing Patients With Pituitary Tumors Compressing the Anterior Visual Pathway.