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Sample records for partial surgery experimental

  1. Importance and Limits of Ischemia in Renal Partial Surgery: Experimental and Clinical Research

    PubMed Central

    Secin, Fernando P.

    2008-01-01

    Introduction. The objective is to determine the clinical and experimental evidences of the renal responses to warm and cold ischemia, kidney tolerability, and available practical techniques of protecting the kidney during nephron-sparing surgery. Materials and methods. Review of the English and non-English literature using MEDLINE, MD Consult, and urology textbooks. Results and discussion. There are three main mechanisms of ischemic renal injury, including persistent vasoconstriction with an abnormal endothelial cell compensatory response, tubular obstruction with backflow of urine, and reperfusion injury. Controversy persists on the maximal kidney tolerability to warm ischemia (WI), which can be influenced by surgical technique, patient age, presence of collateral vascularization, indemnity of the arterial bed, and so forth. Conclusions. When WI time is expected to exceed from 20 to 30 minutes, especially in patients whose baseline medical characteristics put them at potentially higher, though unproven, risks of ischemic damage, local renal hypothermia should be used. PMID:18645616

  2. Effect of Timing of Surgery in Partially Injured ACLs.

    PubMed

    Li, Bin; Bai, Lunhao; Fu, Yonghui; Wang, Guangbin; He, Ming; Wang, Jiashi

    2012-05-01

    The purpose of this study was to explore the optimal timing for surgical intervention of partially injured anterior cruciate ligaments (ACL). Thirty-eight patients were divided into early (n=17) or delayed (n=21) surgery groups based on the interval between injury and surgery. Minimum follow-up was 2 years. The outcome measures used were the International Knee Documentation Committee score, Lysholm knee score, Tegner activity rating, range of motion, and arthrometer measurements. The findings of this study indicate that early surgical reconstruction of partially ruptured ACLs did not result in arthrofibrosis but may prevent secondary loosening of the intact bundles and further meniscal and chondral injury.

  3. Cellular proliferation after experimental glaucoma filtration surgery

    SciTech Connect

    Jampel, H.D.; McGuigan, L.J.; Dunkelberger, G.R.; L'Hernault, N.L.; Quigley, H.A.

    1988-01-01

    We used light microscopic autoradiography to determine the time course of cellular incorporation of tritiated thymidine (a correlate of cell division) following glaucoma filtration surgery in seven eyes of four cynomolgus monkeys with experimental glaucoma. Incorporation of tritiated thymidine was detected as early as 24 hours postoperatively. Peak incorporation occurred five days postoperatively and had returned to baseline levels by day 11. Cells incorporating tritiated thymidine included keratocytes, episcleral cells, corneal and capillary endothelial cells, and conjunctival and corneal epithelial cells. Transmission electron microscopy was correlated with the autoradiographic results to demonstrate that fibroblasts were dividing on the corneoscleral margin. These findings have potential clinical implications for the use of antiproliferative agents after filtration surgery.

  4. Achieving zero ischemia in minimally invasive partial nephrectomy surgery.

    PubMed

    Hou, Weibin; Ji, Zhigang

    2015-06-01

    Widespread application of the minimally invasive partial nephrectomy (MIPN) techniques like laparoscopic and robotic partial nephrectomy, has been limited by concerns about prolonged warm ischemia. So techniques aiming at performing have been actively explored. A systemic review of literatures on the MIPN without hilar clamping was performed and related methods were summarized. There are mainly seven methods including selective/segmental renal artery clamping technique, selective renal parenchymal clamping technique, targeted renal blood flow interruption technique, laser supported MIPN, radio frequency assisted MIPN, hydro-jet assisted MIPN, and sequential preplaced suture renorrhaphy technique that have been undergoing enthusiastic investigation for achieving MINP without hilar clamping. All of these emerging techniques represent the exploring work to achieve a zero ischemia MIPN for small renal tumors of different characteristics. Though not perfect for any of the technique, they deserve a further assessment during their future experimental and clinical applications.

  5. Diode laser supported partial nephrectomy in laparoscopic surgery: preliminary results

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Hennig, Georg; Zillinberg, Katja; Khoder, Wael Y.

    2011-07-01

    Introduction: Warm ischemia and bleeding during laparoscopic partial nephrectomy place technical constraints on surgeons. Therefore it was the aim to develop a safe and effective laser assisted partial nephrectomy technique without need for ischemia. Patients and methods: A diode laser emitting light at 1318nm in cw mode was coupled into a bare fibre (core diameter 600 μm) thus able to transfer up to 100W to the tissue. After dry lab experience, a total of 8 patients suffering from kidney malformations underwent laparoscopic/retroperitoneoscopic partial nephrectomy. Clinically, postoperative renal function and serum c-reactive protein (CRP) were monitored. Laser induced coagulation depth and effects on resection margins were evaluated. Demographic, clinical and follow-up data are presented. Results: Overall interventions, the mean operative time was 116,5 minutes (range 60-175min) with mean blood loss of 238ml (range 50-600ml) while laser assisted resection of the kidney tissue took max 15min. After extirpation of the tumours all patients showed clinical favourable outcome during follow up period. The tumour size was measured to be 1.8 to 5cm. With respect to clinical safety and due to blood loos, two warm ischemia (19 and 24min) must be performed. Immediate postoperative serum creatinine and CRP were elevated within 0.1 to 0.6 mg/dl (mean 0.18 mg/dl) and 2.1-10 mg/dl (mean 6.24 mg/dl), respectively. The depth of the coagulation on the removed tissue ranged between <1 to 2mm without effect on histopathological evaluation of tumours or resection margin. As the surface of the remaining kidney surface was laser assisted coagulated after removal. The sealing of the surface was induced by a slightly larger coagulation margin, but could not measured so far. Conclusion: This prospective in-vivo feasibility study shows that 1318nm-diode laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery

  6. Partial discharge in a high voltage experimental test assembly

    SciTech Connect

    Koss, R.J.; Brainard, J.P.

    1998-07-01

    This study was initiated when a new type of breakdown occurred in a high voltage experimental test assembly. An anomalous current pulse was observed, which indicated partial discharges, some leading to total breakdowns. High voltage insulator defects are shown along with their effect on the electrostatic fields in the breakdown region. OPERA electromagnetic field modeling software is used to calculate the fields and present a cause for the discharge. Several design modifications are investigated and one of the simplest resulted in a 25% decrease in the field at the discharge surface.

  7. [Submucosal Partial-turbinectomy (SPT) Preceding an Endoscopic Sinus Surgery (ESS) Procedure].

    PubMed

    Hirai, Tomohisa; Fukushima, Noriyuki; Miyahara, Nobuyuki; Miyoshi, Ayako; Ariki, Masahiko

    2015-07-01

    Preceding a endoscopic sinus surgery (ESS), we have proposed performing a submucosal partial-turbinectomy (SPT) which removes a part of the inferior nasal concha bone attached to maxillary sinus with an antrostomy. By this method, we could not only make a large antrostomy but also obtain good maneuverability by opening the middle nasal meatus in ESS. We performed SPT preceding ESS in 140 cases (261 sides) between January 2012 and June 2014. The stenosis rates of the middle nasal meatus were 14.2% (37 sides from 261 sides) in one month, 7.4% (18 sides from 243 sides) in three months and 3.7% (6 sides from 163 sides) in 6 months after surgery. The closing rates of the antrostomy were 1.5% (4 sides from 261 sides) in one month, 2.9% (7 sides from 243 sides) in three months and 6.7% (11 sides from 163 sides) in 6 months after surgery. We considered that the SPT method would contribute to secure sufficient ventilation routes for wound healing of sinusitis following surgery on the mucous membrane. In addition, the SPT method has merit from the point of deceasing risks of atrophic rhinitis and empty nose syndrome by preserving most of the inferior nasal concha.

  8. Partial sternotomy coronary surgery with triple-vessel disease in dextrocardia and situs inversus totalis.

    PubMed

    Su, Pi Xiong; Gu, Song; Liu, Yan; Gao, Jie

    2013-07-01

    Dextrocardia associated with situs inversus totalis is a rare congenital condition. A small number of cases with these conditions have been reported who underwent myocardial revascularization via the on-pump or off-pump techniques. Among them, only 1 patient with dextrocardia and situs inversus totalis was reported to have the procedure performed with minimally invasive coronary surgery via a right anterior small thoracotomy. However, the case was a single-vessel disease and only one graft was achieved. We describe the case of a 65-year old female patient with triple-vessel obstructive coronary diseases who was successfully revascularized with three grafts using a minimally invasive technique. This was achieved via partial sternotomy and employing off-pump coronary artery bypass grafting.

  9. Digital approach to planning computer-guided surgery and immediate provisionalization in a partially edentulous patient.

    PubMed

    Arunyanak, Sirikarn P; Harris, Bryan T; Grant, Gerald T; Morton, Dean; Lin, Wei-Shao

    2016-07-01

    This report describes a digital approach for computer-guided surgery and immediate provisionalization in a partially edentulous patient. With diagnostic data obtained from cone-beam computed tomography and intraoral digital diagnostic scans, a digital pathway of virtual diagnostic waxing, a virtual prosthetically driven surgical plan, a computer-aided design and computer-aided manufacturing (CAD/CAM) surgical template, and implant-supported screw-retained interim restorations were realized with various open-architecture CAD/CAM systems. The optional CAD/CAM diagnostic casts with planned implant placement were also additively manufactured to facilitate preoperative inspection of the surgical template and customization of the CAD/CAM-fabricated interim restorations. PMID:26868961

  10. Does Warden's procedure reduce sinus node dysfunction after surgery for partial anomalous pulmonary venous connection?

    PubMed

    Okonta, Kelechi E; Agarwal, Vijay

    2012-06-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Does Warden's procedure reduce sinus node dysfunction (SND) after surgery for partial anomalous pulmonary venous connection?' Altogether 101 papers were found using the reported search; of which 10 papers provided the best evidence to answer the question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes, length of follow-up and results of these studies were tabulated. There was a particular reference to Warden's procedure, avoidance of incision across the cavoatrial junction and the postoperative sinus node status. There was a direct reference to the adoption of Warden's procedure in nine studies while one study emphasized the careful use of incision across the cavoatrial junction as a way of averting postoperative SND. The evidence supports the notion that preservation of the sinus node and its blood supply through the adoption of Warden's technique results in near-absent SND during long-term follow-up. The incidence of SND ranged from 0 to 6.5% when Warden's procedure was used, increasing to 18.1% when the atrial incision was extended across the cavoatrial junction into the superior vena cava and reaching as high as 55% in double-patch repair. The study limitations include the lack of randomized controlled trial, absence of 24 h Holter monitoring in most of the patients and shorter periods of follow-up.

  11. Experimental evidence supports mantle partial melting in the asthenosphere.

    PubMed

    Chantel, Julien; Manthilake, Geeth; Andrault, Denis; Novella, Davide; Yu, Tony; Wang, Yanbin

    2016-05-01

    The low-velocity zone (LVZ) is a persistent seismic feature in a broad range of geological contexts. It coincides in depth with the asthenosphere, a mantle region of lowered viscosity that may be essential to enabling plate motions. The LVZ has been proposed to originate from either partial melting or a change in the rheological properties of solid mantle minerals. The two scenarios imply drastically distinct physical and geochemical states, leading to fundamentally different conclusions on the dynamics of plate tectonics. We report in situ ultrasonic velocity measurements on a series of partially molten samples, composed of mixtures of olivine plus 0.1 to 4.0 volume % of basalt, under conditions relevant to the LVZ. Our measurements provide direct compressional (V P) and shear (V S) wave velocities and constrain attenuation as a function of melt fraction. Mantle partial melting appears to be a viable origin for the LVZ, for melt fractions as low as ~0.2%. In contrast, the presence of volatile elements appears necessary to explaining the extremely high V P/V S values observed in some local areas. The presence of melt in LVZ could play a major role in the dynamics of plate tectonics, favoring the decoupling of the plate relative to the asthenosphere. PMID:27386548

  12. Experimental evidence supports mantle partial melting in the asthenosphere.

    PubMed

    Chantel, Julien; Manthilake, Geeth; Andrault, Denis; Novella, Davide; Yu, Tony; Wang, Yanbin

    2016-05-01

    The low-velocity zone (LVZ) is a persistent seismic feature in a broad range of geological contexts. It coincides in depth with the asthenosphere, a mantle region of lowered viscosity that may be essential to enabling plate motions. The LVZ has been proposed to originate from either partial melting or a change in the rheological properties of solid mantle minerals. The two scenarios imply drastically distinct physical and geochemical states, leading to fundamentally different conclusions on the dynamics of plate tectonics. We report in situ ultrasonic velocity measurements on a series of partially molten samples, composed of mixtures of olivine plus 0.1 to 4.0 volume % of basalt, under conditions relevant to the LVZ. Our measurements provide direct compressional (V P) and shear (V S) wave velocities and constrain attenuation as a function of melt fraction. Mantle partial melting appears to be a viable origin for the LVZ, for melt fractions as low as ~0.2%. In contrast, the presence of volatile elements appears necessary to explaining the extremely high V P/V S values observed in some local areas. The presence of melt in LVZ could play a major role in the dynamics of plate tectonics, favoring the decoupling of the plate relative to the asthenosphere.

  13. Experimental evidence supports mantle partial melting in the asthenosphere

    PubMed Central

    Chantel, Julien; Manthilake, Geeth; Andrault, Denis; Novella, Davide; Yu, Tony; Wang, Yanbin

    2016-01-01

    The low-velocity zone (LVZ) is a persistent seismic feature in a broad range of geological contexts. It coincides in depth with the asthenosphere, a mantle region of lowered viscosity that may be essential to enabling plate motions. The LVZ has been proposed to originate from either partial melting or a change in the rheological properties of solid mantle minerals. The two scenarios imply drastically distinct physical and geochemical states, leading to fundamentally different conclusions on the dynamics of plate tectonics. We report in situ ultrasonic velocity measurements on a series of partially molten samples, composed of mixtures of olivine plus 0.1 to 4.0 volume % of basalt, under conditions relevant to the LVZ. Our measurements provide direct compressional (VP) and shear (VS) wave velocities and constrain attenuation as a function of melt fraction. Mantle partial melting appears to be a viable origin for the LVZ, for melt fractions as low as ~0.2%. In contrast, the presence of volatile elements appears necessary to explaining the extremely high VP/VS values observed in some local areas. The presence of melt in LVZ could play a major role in the dynamics of plate tectonics, favoring the decoupling of the plate relative to the asthenosphere. PMID:27386548

  14. Comparison of Theory with Experimental Data For a Partially Covered Double-Sandwich Cantilever Beam

    NASA Technical Reports Server (NTRS)

    Chen, Qinghua; Levy, Cesar

    1998-01-01

    In this paper, vibration characteristics of a partially covered, double-sandwich cantilever beam are evaluated experimentally and compared to the theoretical results of Levy and Chen for partially covered beams with and without end mass. The results obtained indicate that the theoretical models serve very well in providing the frequency factors and loss factors for the system being investigated.

  15. Partial reanimation of experimental complex ANI at Mt. Aragats (proposal)

    NASA Astrophysics Data System (ADS)

    Shaulov, S.B.; Martirosov, R.M.; Mamidjanian, E.A.; Jones, L.W.; Saavedra, O.; Tamada, M.

    We present the proposal for reanimation of the half-built experimental complex ANI at Mt. Aragats (Armenia, 3200 m a.s.l.). It is proposed as a first stage to complete the functioning GAMMA installation by big X-ray emulsion chamber for detailed study of EAS cores at energies 1-100 PeV. Preliminary data obtained in this fieled by the Tien Shan “Hadron” installation are presented. This proposal is an EFT and requests creation of an international cooperation.

  16. Partial reanimation of experimental complex ANI at Mt. Aragats (proposal)

    NASA Astrophysics Data System (ADS)

    Shaulov, S. B.; Martirosov, R. M.; Mamidjanian, E. A.; Jones, L. W.; Saavedra, O.; Tamada, M.

    2009-12-01

    The proposal is presented for reanimation of the half-built experimental complex ANI at Mt. Aragats (Armenia, 3200 m a.s.l.). It is proposed as a first stage to complete the functioning GAMMA installation by big X-ray emulsion chamber for detailed study of extensive air shower cores at energies 1-100 PeV. Preliminary data obtained in this field by the Tien-Shan HADRON installation are presented. This proposal is an EFT and requests creation of an international cooperation.

  17. Computer-assisted virtual treatment planning combined with flapless surgery and immediate loading in the rehabilitation of partial edentulies.

    PubMed

    DE Vico, G; Spinelli, D; Bonino, M; Schiavetti, R; Pozzi, A; Ottria, L

    2012-01-01

    It has been suggested that for success with immediate loaded dental implants it is necessary that, prior to their placement, bone quality and quantity as well as the biomechanical environment in which the implants are to function be evaluated.However, conventional techniques currently used for immediate implant placement lack sufficient precision and are usually accomplished by opening flap procedures. Nowadays computer-guided flapless surgery for implant placement using stereolithographic templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical disconfort and reduced time required for definitive rehabilitation. The introduction of digital planning programs has made it possible to place dental implants in preplanned positions and being immediately functionally loaded by using prefabricated prostheses. The surgical guide is used, infact, to develop a master model and fabricate the provisional bridge that will be secured to the implants immediately after their placement using the guided surgery template. In this way patients are able to achieve, in the same day of the surgery, a comfortable fixed rehabilitation needing only minor occlusal adjustments. Job S. et al during the three-month period, have demonstrated that the average reduction of crestal bone height around the implants placed with flapless surgery (0.06 mm) is not statistically significant, while the average reduction of crestal bone height around the implants placed using flap surgery (0.4 mm) is statistically significant, concluding that the use of stereolithographic appliances in accordance with flapless surgery makes immediate placement of the implants more predictable. However, the documentation of this technique in partial rehabilitations is limited. PURPOSE of this paper is to report the benefit of sophisticated pre-operative diagnostic implant planning

  18. Computer-assisted virtual treatment planning combined with flapless surgery and immediate loading in the rehabilitation of partial edentulies

    PubMed Central

    DE VICO, G.; SPINELLI, D.; BONINO, M.; SCHIAVETTI, R.; POZZI, A.; OTTRIA, L.

    2012-01-01

    SUMMARY It has been suggested that for success with immediate loaded dental implants it is necessary that, prior to their placement, bone quality and quantity as well as the biomechanical environment in which the implants are to function be evaluated. However, conventional techniques currently used for immediate implant placement lack sufficient precision and are usually accomplished by opening flap procedures. Nowadays computer-guided flapless surgery for implant placement using stereolithographic templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical disconfort and reduced time required for definitive rehabilitation. The introduction of digital planning programs has made it possible to place dental implants in preplanned positions and being immediately functionally loaded by using prefabricated prostheses. The surgical guide is used, infact, to develop a master model and fabricate the provisional bridge that will be secured to the implants immediately after their placement using the guided surgery template. In this way patients are able to achieve, in the same day of the surgery, a comfortable fixed rehabilitation needing only minor occlusal adjustments. Job S. et al during the three-month period, have demonstrated that the average reduction of crestal bone height around the implants placed with flapless surgery (0.06 mm) is not statistically significant, while the average reduction of crestal bone height around the implants placed using flap surgery (0.4 mm) is statistically significant, concluding that the use of stereolithographic appliances in accordance with flapless surgery makes immediate placement of the implants more predictable. However, the documentation of this technique in partial rehabilitations is limited. PURPOSE of this paper is to report the benefit of sophisticated pre-operative diagnostic implant

  19. The Relationship Between Oxygen Reserve Index and Arterial Partial Pressure of Oxygen During Surgery

    PubMed Central

    Dorotta, Ihab L.; Wells, Briana; Juma, David; Applegate, Patricia M.

    2016-01-01

    BACKGROUND: The use of intraoperative pulse oximetry (Spo2) enhances hypoxia detection and is associated with fewer perioperative hypoxic events. However, Spo2 may be reported as 98% when arterial partial pressure of oxygen (Pao2) is as low as 70 mm Hg. Therefore, Spo2 may not provide advance warning of falling arterial oxygenation until Pao2 approaches this level. Multiwave pulse co-oximetry can provide a calculated oxygen reserve index (ORI) that may add to information from pulse oximetry when Spo2 is >98%. This study evaluates the ORI to Pao2 relationship during surgery. METHODS: We studied patients undergoing scheduled surgery in which arterial catheterization and intraoperative arterial blood gas analysis were planned. Data from multiple pulse co-oximetry sensors on each patient were continuously collected and stored on a research computer. Regression analysis was used to compare ORI with Pao2 obtained from each arterial blood gas measurement and changes in ORI with changes in Pao2 from sequential measurements. Linear mixed-effects regression models for repeated measures were then used to account for within-subject correlation across the repeatedly measured Pao2 and ORI and for the unequal time intervals of Pao2 determination over elapsed surgical time. Regression plots were inspected for ORI values corresponding to Pao2 of 100 and 150 mm Hg. ORI and Pao2 were compared using mixed-effects models with a subject-specific random intercept. RESULTS: ORI values and Pao2 measurements were obtained from intraoperative data collected from 106 patients. Regression analysis showed that the ORI to Pao2 relationship was stronger for Pao2 to 240 mm Hg (r2 = 0.536) than for Pao2 over 240 mm Hg (r2 = 0.0016). Measured Pao2 was ≥100 mm Hg for all ORI over 0.24. Measured Pao2 was ≥150 mm Hg in 96.6% of samples when ORI was over 0.55. A random intercept variance component linear mixed-effects model for repeated measures indicated that Pao2 was significantly related to ORI

  20. Experimental demonstration of nonlocal effects in the partial-collapse measurement and reversal process

    SciTech Connect

    Xu Xiaoye; Xu Jinshi; Li Chuanfeng; Zou Yang; Guo Guangcan

    2011-01-15

    We demonstrate experimentally the nonlocal reversal of a partial-collapse quantum measurement of a two-photon entangled state. Both the partial-collapse measurement and the reversal operation are implemented in linear optics with two displaced Sagnac interferometers, characterized by single-qubit quantum-process tomography. The recovered state is measured by quantum-state tomography, and its nonlocality is characterized by testing the Bell inequality. Our result will be helpful in quantum communication and quantum error correction.

  1. Experimental realization of optimal asymmetric cloning and telecloning via partial teleportation.

    PubMed

    Zhao, Zhi; Zhang, An-Ning; Zhou, Xiao-Qi; Chen, Yu-Ao; Lu, Chao-Yang; Karlsson, Anders; Pan, Jian-Wei

    2005-07-15

    We report an experimental realization of both optimal asymmetric cloning and telecloning of single photons by making use of partial teleportation of an unknown state. In the experiment, we demonstrate that, conditioned on the success of partial teleportation of single photons, not only the optimal asymmetric cloning can be accomplished, but also one of two outputs can be transferred to a distant location, realizing the telecloning. The experimental results represent a novel way to achieve quantum cloning and may have potential applications in the context of quantum communication.

  2. The experimental validation of free fat grafts in thoracic surgery.

    PubMed

    Murakami, Junichi; Ueda, Kazuhiro; Hayashi, Masataro; Kondo, Tomoko; Hamano, Kimikazu

    2016-10-01

    We evaluated the viability of free fat grafts in the thoracic cavity using 3-month old male swine (n = 2). After left caudal lobectomy, 1-3 g of subcutaneous fat tissue harvested via the thoracotomy site was implanted in the chest cavity. At re-thoracotomy 6 weeks after implantation, all of the implanted fat grafts (n = 15) were found to have closely adhered to the parietal pleura and visceral pleura. There was a significant decrease by ∼30% in the weight of the fat grafts after implantation. Regardless of the weight loss, the implanted fat graft showed normal structuring without scar formation in the central area. Our results may suggest that free fat pads, which weighed up to 3 g, were successfully cultured in the thoracic cavity until the implanted tissues integrated into the surrounding tissues. Therefore, the free fat pad can be used as a biomaterial for some purposes in thoracic surgery.

  3. Wound healing after laser surgery: an experimental study.

    PubMed

    Cochrane, J P; Beacon, J P; Creasey, G H; Russell, R C

    1980-10-01

    Healing after carbon dioxide laser incisions has been assessed in three animal experiments. Nine incisions in pig skin were found to be significantly weaker after 7 days than similar incisions made with a scalpel, but stronger than those made with a cutting diathermy. Laser excision of skin discs in pigs provided a satisfactory base to take split-skin grafts, but graft take around the edges was less complete than after scalpel excisions. Division and anasto mosis of the colon of 75 rats showed that the laser produced anastomoses that were as strong after 7 days as those produced by scalpel or diathermy division, but the laser did not produce the narrowing of the lumen that occurred with diathermy. It is concluded that if epithelial surfaces are particularly thick and slow to cut with the laser than thermal damage will impair healing, but that in general epithelial surfaces need not be avoided in laser surgery.

  4. [The experimental surgery and your relation with the university: an experience report].

    PubMed

    Yamaki, Vitor Nagai; Teixeira, Renan Kleber Costa; Feijo, Daniel Haber; Silva, José Antonio Cordero da; Botelho, Nara Macedo; Henriques, Marcus Vinicius

    2014-01-01

    The laboratory of experimental surgery represents one of the key points for the university, especially in the biomedical area. This focuses on the university's tripod of primary structure that are teaching, research and extension, which are essential for formation of humanistic and practice of a good doctor that is based, first of all, on scientific evidence and critical knowledge. The importance of a laboratory of experimental surgery centers for medical education was regulated from the new curriculum guidelines of the Ministério da Educação e Cultura, establishing a mandatory laboratory within college centers. Therefore, it is of great importance to the contribution of the laboratories of experimental surgery in the curriculum, both in the discipline of surgical technics and experimental surgery, and an incentive for basic research. Thus, the study presents the experience of 15 years of the Laboratory of Experimental Surgery from Universidade do Estado do Pará, with the goal show the importance of this to medical graduation and the university.

  5. Experimental study of flow due to an isolated suction hole and a partially plugged suction slot

    NASA Technical Reports Server (NTRS)

    Goglia, G. L.; Wilkinson, S. P.

    1980-01-01

    Details for construction of a model of a partially plugged, laminar flow control, suction slot and an isolated hole are presented. The experimental wind tunnel facility and instrumentation is described. Preliminary boundary layer velocity profiles (without suction model) are presented and shown to be in good agreement with the Blasius laminar profile. Recommendations for the completion of the study are made. An experimental program for study of transition on a rotating disk is described along with preliminary disturbance amplification rate data.

  6. Thyroid surgery with a harmonic scalpel: an experimental study

    PubMed Central

    Dequanter, Didier; Lammens, Martin; Nagy, Nathalie; Shahla, Mohammad; Deniz, Yasmine; Aubert, Christine; Vanhemelrijck, Youri; Lothaire, Philippe

    2016-01-01

    Background The goal of the study was to determinate the safety of the harmonic scalpel, widely used in thyroidectomy, near the recurrent laryngeal nerve (RLN). Methods The study involved ten pigs of either sex. Twenty RLNs at risk were dissected using the new harmonic scalpel FOCUS. The distances between the nerve and the activated instrument were checked with a millimeter ruler. After dissection, the pigs were euthanized, and both RLNs were fixed in formol and examined by histology after staining with hematoxylin–eosin. Due to technical reasons, only 18 RLNs from the ten pigs could be examined. Results In the experiment that investigated the extent of heat injury, ultrasonic dissection did not cause any immediate damage of the nerve even close to the RLN (1 mm away from the RLN). Conclusion The use of harmonic scalpel FOCUS for thyroid surgery is safe for the surrounding structures (nerves). Careful tissue applications of the device near the RLN (1 mm) did not cause any lesion histologically. PMID:27354833

  7. Vascular grafts in microvascular surgery. An experimental study

    SciTech Connect

    Marrangoni, A.G.; Marcelli, G.; Culig, M.; Simone, S.T.

    1988-02-01

    The patency of microvascular grafts depends on the luminal diameter, which is determined by the amount of fibrin and platelets deposited on the intraluminal surface and the anastomotic site, and the extent of pseudointimal formation. An experimental microvascular model in rats has been developed in our laboratory using Indium-111-labeled platelets to measure the amount of deposition on grafts inserted into the infrarenal aorta. This study was designed to assess the patency rates in these grafts and the pathologic maturation as determined by light and electron microscopy. Our study suggests that substantial patency rates can be achieved in aspirin-treated rats, although there was little influence on the pathologic maturation. Indium-111 oxine-labeled platelets can be used to document platelet aggregation, and the technique can be a valuable adjunct in the study of microvascular grafts.

  8. [Is experimental surgery necessary or essential in the training program of a pediatric surgeon?].

    PubMed

    García González, M; Caramés Bouzán, J; Gómez Veiras, J R; García Palacios, M; Molina Vázquez, E; Somoza Argibay, I; Dargallo Carbonell, T; Pais Piñeiro, E; Gómez Tellado, M; Vela Nieto, D

    2011-10-01

    Many surgical procedures performed in pediatric surgery have a slow learning curve, the volume of patients and the existence of complex diseases that require extensive training and surgical skill, have taken our service to create a global training program of experimental surgery. This program based on the simulation and training invasive procedures in real anatomical models, aims to educate our residents in a global and efficiently way in order to obtain an improvement of technical training, and increased patient safety result of experience and expertise wined in the experimental animal. This paper presents the main features, objectives and results obtained with this training program and seeks to promote the incorporation of simulation programs in live animal as an essential part of the training of pediatric surgery resident.

  9. An experimental investigation on the ultimate strength of epoxy repaired braced partial infilled RC frames

    NASA Astrophysics Data System (ADS)

    Dubey, Shailendra Kumar Damodar; Kute, Sunil

    2014-09-01

    Due to earthquake, buildings are damaged partially or completely. Particularly structures with soft storey are mostly affected. In general, such damaged structures are repaired and reused. In this regard, an experimental investigation was planned and conducted on models of single-bay, single-storey of partial concrete infilled reinforced concrete (RC) frames up to collapse with corner, central and diagonal steel bracings. Such collapsed frames were repaired with epoxy resin and retested. The initiative was to identify the behaviour, extent of restored ultimate strength and deflection of epoxy-retrofitted frames in comparison to the braced RC frames. The performance of such frames has been considered only for lateral loads. In comparison to bare RC frames, epoxy repaired partial infilled frames have significant increase in the lateral load capacity. Central bracing is more effective than corner and diagonal bracing. For the same load, epoxy repaired frames have comparable deflection than similar braced frames.

  10. Surgery

    MedlinePlus

    ... there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery. Agency for Healthcare Research and Quality

  11. Ancillary procedures necessary for translational research in experimental craniomaxillofacial surgery

    PubMed Central

    Al Rakan, Mohammed; Shores, Jaimie T.; Bonawitz, Steve; Santiago, Gabriel; Christensen, Joani M.; Grant, Gerald; Murphy, Ryan J.; Basafa, Ehsan; Armand, Mehran; Otovic, Pete; Eller, Sue; Brandacher, Gerald; Gordon, Chad R.

    2014-01-01

    Introduction Swine are often regarded as having analogous facial skeletons to humans and therefore serve as an ideal animal model for translational investigation. However, there's a dearth of literature describing the pertinent ancillary procedures required for craniomaxillofacial research. With this in mind, our objective was to evaluate all necessary procedures required for peri-operative management and animal safety related to experimental craniomaxillofacial surgical procedures such as orthotopic, maxillofacial transplantation. Methods Miniature swine (n=9) were used to investigate peri-operative airway management, methods for providing nutrition, and long-dwelling intravenous access. Flap perfusion using near-infrared laser angiography and facial nerve assessment with EMG were explored. Results Bivona(R) tracheostomy was deemed appropriate versus Shiley since soft, wire-reinforced tubing reduced the incidence of tracheal necrosis. PEG tube, as opposed to esophagostomy, provided a reliable route for post-operative feeding. Femoral venous access with dorsal tunneling proved to be an ideal option being far from pertinent neck vessels. Laser angiography was beneficial for real-time evaluation of graft perfusion. Facial EMG techniques for tracing capture were found most optimal using percutaneous leads near the oral commissure. Experience shows that ancillary procedures are critical and malpositioning of devices may lead to irreversible sequelae with premature animal death. Conclusion Face-jaw-teeth transplantation in swine is a complicated procedure which demands special attention to airway, feeding, and intravascular access. It is critical that each ancillary procedure be performed by a dedicated team familiar with relevant anatomy and protocol. Emphasis should be placed on secure skin-level fixation for all tube/lines to minimize risk of dislodgement. A reliable veterinarian team is invaluable and critical for long-term success. PMID:25377964

  12. Observation and partial targeted surgery in the management of tympano-jugular paraganglioma: a contribution to the multioptional treatment.

    PubMed

    Mazzoni, Antonio; Zanoletti, Elisabetta

    2016-03-01

    The objective of this study was to assess the value of a limited tumor excision in tympano-jugular paragangliomas treated with observation with the goal of preventing, or repairing, a neural (VII cranial nerve) or brain damage and continue an otherwise correct observation. This is a retrospective case review. Each patient was submitted to a complete neuro-radiological work-up for diagnosis including CT, MRI, and angiography if needed of tympano-jugular paraganglioma class C. All the cases were submitted to observation and in 16 cases partial targeted surgery was performed. In 10 cases, the procedure involved a targeted removal of the tumor growing in contact with, or invading, the Fallopius. In four cases, the procedure was a petro-occipital trans-sigmoid approach to remove the intradural portion of tumor producing the picture of brain stem compression. In two cases, there was the excision of the bleeding tumor surfaces in the outer ear canal. Follow-up ranged from 4 to 20 years. Success was considered the maintenance of observation without the change of class of tumor extension. In 13 over 16 cases, the observation could be continued, as it still was the more favorable option between natural and surgical morbidity. In the other three cases, a newly installed paralysis of the 9-10 cranial nerves due to tumor growth involved a correction of the strategy to a radical procedure. Partial targeted surgery was directed to cases submitted to observation. It allowed to prevent, or repair, an impending, or actual damage to the facial nerve or the brain stem and to continue the abstentional treatment by keeping the balance between natural and therapy morbidity in favor of observation.

  13. Observation and partial targeted surgery in the management of tympano-jugular paraganglioma: a contribution to the multioptional treatment.

    PubMed

    Mazzoni, Antonio; Zanoletti, Elisabetta

    2016-03-01

    The objective of this study was to assess the value of a limited tumor excision in tympano-jugular paragangliomas treated with observation with the goal of preventing, or repairing, a neural (VII cranial nerve) or brain damage and continue an otherwise correct observation. This is a retrospective case review. Each patient was submitted to a complete neuro-radiological work-up for diagnosis including CT, MRI, and angiography if needed of tympano-jugular paraganglioma class C. All the cases were submitted to observation and in 16 cases partial targeted surgery was performed. In 10 cases, the procedure involved a targeted removal of the tumor growing in contact with, or invading, the Fallopius. In four cases, the procedure was a petro-occipital trans-sigmoid approach to remove the intradural portion of tumor producing the picture of brain stem compression. In two cases, there was the excision of the bleeding tumor surfaces in the outer ear canal. Follow-up ranged from 4 to 20 years. Success was considered the maintenance of observation without the change of class of tumor extension. In 13 over 16 cases, the observation could be continued, as it still was the more favorable option between natural and surgical morbidity. In the other three cases, a newly installed paralysis of the 9-10 cranial nerves due to tumor growth involved a correction of the strategy to a radical procedure. Partial targeted surgery was directed to cases submitted to observation. It allowed to prevent, or repair, an impending, or actual damage to the facial nerve or the brain stem and to continue the abstentional treatment by keeping the balance between natural and therapy morbidity in favor of observation. PMID:25822289

  14. Inhibitory simple partial (non-convulsive) status epilepticus after intracranial surgery

    PubMed Central

    Armon, C.; Radtke, R.; Friedman, A.

    2000-01-01

    OBJECTIVES—To report on five patients who developed, 2 to 4 days after an intracranial neurosurgical procedure, new, persistent, focal neurological deficits which were due to inhibitory simple partial (non-convulsive) status epilepticus, and resolved with anticonvulsant treatment.
METHODS—The age range of the five patients was 15-74 years. The operations were: aneurysm clipping (three patients) and resections of an oligodendroglioma and a cavernous haemangioma (one patient each). The new focal deficits were: right hemiparesis and aphasia (two patients), aphasia alone (two patients), and left hemiparesis (one patient). The deficits were not explained by CT (obtained in all patients) or cerebral angiography (performed in two).
RESULTS—Electroencephalography showed, in all patients, continuous or intermittent focal seizures arising from cortex regionally relevant to the clinical dysfunction. Subtle positive epileptic phenomena (jerking) occurred intermittently in three patients as a late concommitant. Administration of anticonvulsant drugs resulted in significant improvement within 24 hours in four patients, with parallel resolution of ictal EEG activity. The fifth patient improved more slowly. Two patients relapsed when anticonvulsant concentrations fell, and improved again when they were raised.
CONCLUSIONS—It is suggested that inhibitory simple partial (non-convulsive) status epilepticus be considered in the differential diagnosis when a new unexplained neurological deficit develops after an intracranial neurosurgical procedure. An EEG may help to diagnose this condition, leading to definitive treatment.

 PMID:10864598

  15. Production of ferroan andesites by the experimental partial melting of an LL chondrite

    NASA Technical Reports Server (NTRS)

    Mcguire, J. C.; Jurewicz, A. J. G.; Jones, J. H.

    1994-01-01

    A partial melting experiment on the St. Severin (LL) chondrite produced a melt that was andesitic, having 54-60 wt% silica, at 1200 C and an oxygen fugacity of IW+2, two log units above the iron-wustite (IW) buffer. Under these same conditions, CV, CM, and L chondrites produced low-silica melts resembling angrites. This experimental study attempts to reproduce and explain this unusual result.

  16. Secure endoscopic sinus surgery with partial middle turbinate modification: a 16-year long-term outcome report and literature review.

    PubMed

    Toffel, Paul H

    2003-02-01

    The efficacy of functional endoscopic sinus surgery for the treatment of chronic sinusitis is well established. Two contrasting European techniques were introduced to North America in the 1980s: that espoused by Wigand, which included endoscopic isthmus modification of all sinus ostia and cavities with modification of the middle turbinates, and that developed by Messerklinger, who practiced only minimal opening of the narrow osteomeatal tract at the anterior ethmoid sinus to achieve physiologic reversal of sinus disease. These techniques were additionally modified recently by the introduction of power resection techniques by Setliff and Christmas and stereotactic computer navigation by Anon and Fried. In 1986, after exposure to both original techniques, I developed a middle-ground approach that lies between the extremes of the two European schools. The benefits of this middle-ground multimodal secure technique include a high success rate, maximal safety, and the ability to be performed as an adjunct to any other indicated functional nasal surgery. Since its inception, a key feature of this technique has included partial modification of the bulky inferior portion of the middle turbinates. This has contributed markedly to successful long-term outcome and safety rates.

  17. [Some notes on the history of the experimental surgery laboratory. Reflections on its relevance in education and surgical research].

    PubMed

    de la Garza-Rodea, Anabel Sofía; Padilla-Sánchez, Luis; de la Garza-Aguilar, Javier; Neri-Vela, Rolando

    2007-01-01

    The progress of medicine has largely been due to research, and for surgery, in particular, the experimental surgical laboratory has been considered fundamental to the surgeon's education. In this study, a general view of experimental surgery is given in animal models based on bioethical norms as well as to design, create and apply different surgical procedures before performing in humans. Experimental surgery also facilitates surgical teaching and promotes the surgeon's scientific reasoning. Methods. This is a retrospective and descriptive study. Data were collected from direct and indirect sources of available publications on the historical, bioethical and educational aspects of medicine, focusing on surgery. The important facts corresponding to the field of experimental surgery and applicable in Mexico were selected. Concepts of experimental surgical models and of the experimental surgery laboratory were described. Bioethical considerations are emphasized for care of experimental animals. Finally, this work focuses on the importance of surgical experimentation in current and future development of the surgical researcher. Conclusions. Experimentation with animal models in a surgical laboratory is essential for surgical teaching and promotes development of the scientific thought in the surgeon. It is necessary for surgical research and is fundamental for making progress in surgery, treatment and medicine as science. PMID:18177574

  18. [Some notes on the history of the experimental surgery laboratory. Reflections on its relevance in education and surgical research].

    PubMed

    de la Garza-Rodea, Anabel Sofía; Padilla-Sánchez, Luis; de la Garza-Aguilar, Javier; Neri-Vela, Rolando

    2007-01-01

    The progress of medicine has largely been due to research, and for surgery, in particular, the experimental surgical laboratory has been considered fundamental to the surgeon's education. In this study, a general view of experimental surgery is given in animal models based on bioethical norms as well as to design, create and apply different surgical procedures before performing in humans. Experimental surgery also facilitates surgical teaching and promotes the surgeon's scientific reasoning. Methods. This is a retrospective and descriptive study. Data were collected from direct and indirect sources of available publications on the historical, bioethical and educational aspects of medicine, focusing on surgery. The important facts corresponding to the field of experimental surgery and applicable in Mexico were selected. Concepts of experimental surgical models and of the experimental surgery laboratory were described. Bioethical considerations are emphasized for care of experimental animals. Finally, this work focuses on the importance of surgical experimentation in current and future development of the surgical researcher. Conclusions. Experimentation with animal models in a surgical laboratory is essential for surgical teaching and promotes development of the scientific thought in the surgeon. It is necessary for surgical research and is fundamental for making progress in surgery, treatment and medicine as science.

  19. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Compliance to the Dosimetry Requirements of RTOG-0413

    SciTech Connect

    Wen Bixiu; Hsu, Howard; Formenti-Ujlaki, George F.; Lymberis, Stella; Magnolfi, Chiara; Zhao Xuan; Chang Jenghwa; DeWyngaert, J. Keith; Jozsef, Gabor; Formenti, Silvia C.

    2012-11-15

    Purpose: The dosimetric results from our institution's trials of prone accelerated partial breast irradiation are compared with the dosimetric requirements of RTOG-0413. Methods and Materials: Trial 1 and Trial 2 are 2 consecutive trials of prone-accelerated partial breast irradiation. Eligible for both trials were stage I breast cancer patients with negative margins after breast-conserving surgery. The planning target tumor volume (PTV) was created by extending the surgical cavity 2.0 cm for Trial 1 and 1.5 cm for Trial 2, respectively. Contralateral breast, heart, lungs, and thyroid were contoured. Thirty Gray was delivered in five daily fractions of 6 Gy by a three-dimensional conformal radiation therapy technique in Trial 1 and were by image-guided radiation therapy/intensity-modulated radiation therapy in Trial 2. Dosimetric results from the trials are reported and compared with RTOG 0413 requirements. Results: One hundred forty-six consecutive plans were analyzed: 67 left and 79 right breast cancers. The plans from the trials complied with the required >90% of prescribed dose covering 90% of PTV{sub E}VAL (=generated from the PTV by cropping 0.5 cm from the skin edge and excluding the chest wall): V90% was 98.1 {+-} 3.0% (with V100% and V95%, 89.4 {+-} 12.8%, 96.4 {+-} 5.1%, respectively). No significant difference between laterality was found (Student's t test). The dose constraints criteria of the RTOG-0413 protocol for ipsilateral and contralateral lung (V30 <15% and Dmax <3%), heart (V5 <40%), and thyroid (Dmax <3%) were satisfied because the plans showed an average V5% of 0.6% (range, 0-13.4) for heart, an average V30% of 0.6% (range, 0-9.1%) for ipsilateral lung, and <2% maximum dose to the thyroid. However, our partial breast irradiation plans demonstrated a higher dose to contralateral breast than that defined by RTOG constraints, with a median value of maximum doses of 4.1% (1.2 Gy), possibly as a result of contouring differences. Conclusions: Our

  20. TRANEXAMIC ACID ACTION ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY: EXPERIMENTAL MODEL IN RATS

    PubMed Central

    SOBRAL, Felipe Antonio; DAGA, Henrique; RASERA, Henrique Nogueira; PINHEIRO, Matheus da Rocha; CELLA, Igor Furlan; MORAIS, Igor Henrique; MARQUES, Luciana de Oliveira; COLLAÇO, Luiz Martins

    2016-01-01

    ABSTRACT Background: Different lesions may affect the liver resulting in harmful stimuli. Some therapeutic procedures to treat those injuries depend on liver regeneration to increase functional capacity of this organ. Aim: Evaluate the effects of tranexamic acid on liver regeneration after partial hepatectomy in rats. Method: 40 rats (Rattus norvegicus albinus, Rodentia mammalia) of Wistar-UP lineage were randomly divided into two groups named control (CT) and tranexamic acid (ATX), with 20 rats in each. Both groups were subdivided, according to liver regeneration time of 32 h or seven days after the rats had been operated. The organ regeneration was evaluated through weight and histology, stained with HE and PCNA. Results: The average animal weight of ATX and CT 7 days groups before surgery were 411.2 g and 432.7 g, and 371.3 g and 392.9 g after the regeneration time, respectively. The average number of mitotic cells stained with HE for the ATX and CT 7 days groups were 33.7 and 32.6 mitosis, and 14.5 and 14.9 for the ATX and CT 32 h groups, respectively. When stained with proliferating cell nuclear antigen, the numbers of mitotic cells counted were 849.7 for the ATX 7 days, 301.8 for the CT 7 days groups, 814.2 for the ATX 32 hand 848.1 for the CT 32 h groups. Conclusion: Tranexamic acid was effective in liver regeneration, but in longer period after partial hepatectomy. PMID:27438036

  1. Catalytic partial oxidation of iso-octane over rhodium catalysts: An experimental, modeling, and simulation study

    SciTech Connect

    Hartmann, M.; Minh, H.D.; Maier, L.; Deutschmann, O.

    2010-09-15

    Catalytic partial oxidation of iso-octane over a rhodium/alumina coated honeycomb monolith is experimentally and numerically studied at short-contact times for varying fuel-to-oxygen ratios. A new experimental set-up with well-defined inlet and boundary conditions is presented. The conversion on the catalyst and in the gas-phase is modeled by detailed reaction mechanisms including 857 gas-phase and 17 adsorbed species. Elementary-step based heterogeneous and homogeneous reaction mechanisms are implemented into two-dimensional flow field description of a single monolith channel. Experiment and simulation provide new insights into the complex reaction network leading to varying product distribution as function of fuel-to-oxygen ratio. At fuel rich conditions, the formation of by-products that can serve as coke precursors is observed and interpreted. (author)

  2. Experimental Measurement of Frozen and Partially Melted Water Droplet Impact Dynamics

    NASA Technical Reports Server (NTRS)

    Palacios, Jose; Yan, Sihong; Tan, Jason; Kreeger, Richard E.

    2014-01-01

    High-speed video of single frozen water droplets impacting a surface was acquired. The droplets diameter ranged from 0.4 mm to 0.9 mm and impacted at velocities ranging from 140 m/sec to 309 m/sec. The techniques used to freeze the droplets and launch the particles against the surfaces is described in this paper. High-speed video was used to quantify the ice accretion area to the surface for varying impact angles (30 deg, 45 deg, 60 deg), impacting velocities, and break-up angles. An oxygen /acetylene cross-flow flame used to ensure partial melting of the traveling frozen droplets is also discussed. A linear relationship between impact angle and ice accretion is identified for fully frozen particles. The slope of the relationship is affected by impact speed. Perpendicular impacts, i.e. 30 deg, exhibited small differences in ice accretion for varying velocities, while an increase of 60% in velocity from 161 m/sec to 259 m/sec, provided an increase on ice accretion area of 96% at an impact angle of 60 deg. The increase accretion area highlights the importance of impact angle and velocity on the ice accretion process of ice crystals. It was experimentally observed that partial melting was not required for ice accretion at the tested velocities when high impact angles were used (45 and 60 deg). Partially melted droplets doubled the ice accretion areas on the impacting surface when 0.0023 Joules were applied to the particle. The partially melted state of the droplets and a method to quantify the percentage increase in ice accretion area is also described in the paper.

  3. Effects of Honghua preserved amniotic membrane on scar healing in experimental glaucoma surgery

    PubMed Central

    Shao, Yi; Yu, Yao; Liu, Qiu-Ping; Li, Jing-Ming; Dong, Fei; Huang, Xin; Pei, Chong-Gang; Tu, Ping; Li, Hen-Hui; Gao, Gui-Ping

    2014-01-01

    AIM To investigate the efficacy and safety of Honghua preserved amniotic membrane (AM) for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery. METHODS Totally 36 rabbits (36 eyes) were randomly divided into 3 groups: the experimental group (ocular trabeculectomy in combination with Honghua preserved AM transplantation), the control group (ocular trabeculectomy surgery in combination with AM implantation), and the blank group (single trabeculectomy). Clinical observations [including intraocular pressure (IOP), filtering blebs and complications], Masson-Trichrome staining, real-time quantitative reverse transcription-polymerase chain reaction (real-time PCR), Western blot were performed on different time points (D1, D7, D14, D21 and D56) after the surgery. RESULTS After operated for 14d, there were statistically significant differences in the filtering blebs compared to the situation before operation (P<0.05), whereas no statistically difference on that among three groups (P>0.05). After 21d, the IOP of experimental group was lowest (P<0.05). There was significant difference between control group and blank group (P<0.05). On postoperative D14, the mean number of fibroblasts in the experimental group was significantly lower (40.6±10.2) compared to those in the control group (54.4±10.8) and blank group (68.2±11.6) (P<0.05, respectively). The mean numbers of the macrophage in the experimental and control groups were respcitively significantly lower versus the blank group (P<0.05, P<0.05, respectively). Compared to that in blank group, the level of transforming growth factor-β (TGF-β1) expression in sclera and conjunctival areas was reduced in the experimental and control groups on protein and mRNA level (P<0.05), but not significant difference between these two groups (P>0.05). CONCLUSION The trabeculectory surgery with Honghua preserved AM can control IOP, sustain the functional filtration bleb, inhibit the

  4. Experimental deformation of partially molten granite and implications for strain localization

    NASA Astrophysics Data System (ADS)

    Goncalves, L.; Hirth, G.; Alkmim, F.; Pedrosa-Soares, A.; Goncalves, C.

    2011-12-01

    To improve our understanding of partially molten systems we conducted a set of hydrostatic, general shear and axial compression experiments on sintered aggregates composed of equal amounts by weight of quartz, albite and microcline (grain size of 37-53μm). All experiments were conducted using a Griggs solid medium apparatus at T=900°C, P=1.5GPa and strain rates from 10-4/s to 10-6/s. Previous hydrostatic and axial compression experiments conducted on partial molten granitic rocks have shown that the initial grain size, amount of melt and strain rate are important parameters for the development of distinct microstructures, LPO, and melt distribution. In addition, some of these studies demonstrated that the strength of granite and aplite decrease significantly for melt contents up to 15%, when compared to similar melt-free rocks. The rock's strength deep within the Earth decreases owing to partial melting which brings up some questions: would strain localization take place when partial melt affects rheology? Would brittle and/or ductile shear zones act as potential regions for concentration of partial melt? Is there a critical fraction of melt responsible for strain localization? How is melt distribution influenced by deformation? How does the kinematics of deformation (i.e., axial compression versus general shear) affect melt distribution? The purpose of our experiments is to investigate the role of melting on the rheological properties of crustal rocks. In addition, we seek to provide new constraints on the grain scale processes that control the properties of partially molten rocks and the importance of these processes in understanding shear localization in the lithosphere. Samples were made from crushed Amelia albite (Ab97Or2An1), Hugo Microcline (Or90) and Black Hills quartzite, which have all been used in previous experimental deformation studies. The albite is essentially pure; the microcline contains ~ 1% of muscovite. The Black Hills quartzite contains < 1

  5. Experimental identification and study of hydraulic resonance test rig with Francis turbine operating at partial load

    NASA Astrophysics Data System (ADS)

    Favrel, A.; Landry, C.; Müller, A.; Avellan, F.

    2012-11-01

    Resonance in hydraulic systems is characterized by pressure fluctuations of high amplitude which can lead to undesirable and dangerous effects, such as noise, vibration and structural failure. For a Francis turbine operating at partial load, the cavitating vortex rope developing at the outlet of the runner induces pressure fluctuations which can excite the hydraulic system resonance, leading to undesirable large torque and power fluctuations. At resonant operating points, the prediction of amplitude pressure fluctuations by hydro-acoustic models breaks down and gives unreliable results. A more detailed knowledge of the eigenmodes and a better understanding of phenomenon occurring at resonance could allow improving the hydro-acoustic models prediction.This paper presents an experimental identification of a resonance observed in a close-looped hydraulic system with a Francis turbine reduced scale model operating at partial load. The resonance is excited matching one of the test rig eigenfrequencies with the vortex rope precession frequency. At this point, the hydro-acoustic response of the test rig is studied more precisely and used finally to reproduce the shape of the excited eigenmode.

  6. Experimental test of the viscous anisotropy hypothesis for partially molten rocks.

    PubMed

    Qi, Chao; Kohlstedt, David L; Katz, Richard F; Takei, Yasuko

    2015-10-13

    Chemical differentiation of rocky planets occurs by melt segregation away from the region of melting. The mechanics of this process, however, are complex and incompletely understood. In partially molten rocks undergoing shear deformation, melt pockets between grains align coherently in the stress field; it has been hypothesized that this anisotropy in microstructure creates an anisotropy in the viscosity of the aggregate. With the inclusion of anisotropic viscosity, continuum, two-phase-flow models reproduce the emergence and angle of melt-enriched bands that form in laboratory experiments. In the same theoretical context, these models also predict sample-scale melt migration due to a gradient in shear stress. Under torsional deformation, melt is expected to segregate radially inward. Here we present torsional deformation experiments on partially molten rocks that test this prediction. Microstructural analyses of the distribution of melt and solid reveal a radial gradient in melt fraction, with more melt toward the center of the cylinder. The extent of this radial melt segregation grows with progressive strain, consistent with theory. The agreement between theoretical prediction and experimental observation provides a validation of this theory. PMID:26417107

  7. Experimental test of the viscous anisotropy hypothesis for partially molten rocks

    PubMed Central

    Qi, Chao; Kohlstedt, David L.; Katz, Richard F.; Takei, Yasuko

    2015-01-01

    Chemical differentiation of rocky planets occurs by melt segregation away from the region of melting. The mechanics of this process, however, are complex and incompletely understood. In partially molten rocks undergoing shear deformation, melt pockets between grains align coherently in the stress field; it has been hypothesized that this anisotropy in microstructure creates an anisotropy in the viscosity of the aggregate. With the inclusion of anisotropic viscosity, continuum, two-phase-flow models reproduce the emergence and angle of melt-enriched bands that form in laboratory experiments. In the same theoretical context, these models also predict sample-scale melt migration due to a gradient in shear stress. Under torsional deformation, melt is expected to segregate radially inward. Here we present torsional deformation experiments on partially molten rocks that test this prediction. Microstructural analyses of the distribution of melt and solid reveal a radial gradient in melt fraction, with more melt toward the center of the cylinder. The extent of this radial melt segregation grows with progressive strain, consistent with theory. The agreement between theoretical prediction and experimental observation provides a validation of this theory. PMID:26417107

  8. Design and Experimental Performance of a Two Stage Partial Admission Turbine, Task B.1/B.4

    NASA Technical Reports Server (NTRS)

    Sutton, R. F.; Boynton, J. L.; Akian, R. A.; Shea, Dan; Roschak, Edmund; Rojas, Lou; Orr, Linsey; Davis, Linda; King, Brad; Bubel, Bill

    1992-01-01

    A three-inch mean diameter, two-stage turbine with partial admission in each stage was experimentally investigated over a range of admissions and angular orientations of admission arcs. Three configurations were tested in which first stage admission varied from 37.4 percent (10 of 29 passages open, 5 per side) to 6.9 percent (2 open, 1 per side). Corresponding second stage admissions were 45.2 percent (14 of 31 passages open, 7 per side) and 12.9 percent (4 open, 2 per side). Angular positions of the second stage admission arcs with respect to the first stage varied over a range of 70 degrees. Design and off-design efficiency and flow characteristics for the three configurations are presented. The results indicated that peak efficiency and the corresponding isentropic velocity ratio decreased as the arcs of admission were decreased. Both efficiency and flow characteristics were sensitive to the second stage nozzle orientation angles.

  9. Computer-guided implant surgery and immediate loading with a modifiable radiographic template in a patient with partial edentulism: A clinical report.

    PubMed

    Lanis, Alejandro; Padial-Molina, Miguel; Gamil, Rami; Alvarez del Canto, Orlando

    2015-09-01

    Computer-guided implant surgery in fresh extraction sites is an underdeveloped procedure. The presence of teeth that will be extracted makes the creation of an appropriate radiographic template for virtual simulation of the rehabilitation impossible. A modified radiographic template is presented to define a digital restorative simulation for the maxillary rehabilitation of a patient with partial edentulism. This modification enables 3-dimensional prosthetic virtual information in regions where teeth will be extracted.

  10. Experimental Spinel Standards for Ferric Iron (Fe3+) Determination During Peridotite Partial Melting

    NASA Astrophysics Data System (ADS)

    Wenz, M. D.; Sorbadere, F.; Rosenthal, A.; Frost, D. J.; McCammon, C. A.

    2014-12-01

    The presence of ferric iron (Fe3+) in the mantle plays a significant role in the oxygen fugacity (fO2) of the Earth's interior. This has a wide range of implications for Earth related processes ranging from the composition of the atmosphere to magmatic phase relations during melting and crystallization processes [1]. A major source of Earth's mantle magmas is spinel peridotite. Despite its low abundance, spinel (Fe3+/ƩFe = 15-34%, [2]) is the main contributor of Fe3+to the melt upon partial melting. Analyses of Fe3+ on small areas of spinel and melt are required to study the Fe3+ behavior during partial melting of spinel peridotite. Fe K-edge X-ray Absorption Near Edge Structure (XANES) combines both high precision and small beam size, but requires standards with a wide range of Fe3+ content to obtain good calibration. Glasses with varying Fe3+ content are easily synthesized [3, 4]. Spinel, however, presents a challenge for experimental standards due to the low diffusion of Cr and Al preventing compositional homogeneity. Natural spinel standards are often used, but only cover a narrow Fe3+ range. Thus, there is a need for better experimental spinel standards over a wider range of fO2. Our study involves making experimental mantle spinels with variable Fe3+ content. We used a sol-gel auto-combustion method to synthesize our starting material [5]. FMQ-2, FMQ+0, and air fO2 conditions were established using a gas mixing furnace. Piston cylinder experiments were performed at 1.5GPa, and 1310 -1370°C to obtain solid material for XANES. To maintain distinct oxidizing conditions, three capsules were used: graphite for reduced, Re for intermediate and AuPd for oxidized conditions. The spinels were analyzed by Mössbauer spectroscopy. Fe3+/ƩFe ranged from 0.3 to 0.6. These values are consistent with the Fe edge position obtained using XANES analyses, between 7130 and 7132 eV, respectively. Our spinels are thus suitable standards for Fe3+ measurements in peridotite

  11. Experimental investigation of virus and clay particles cotransport in partially saturated columns packed with glass beads.

    PubMed

    Syngouna, Vasiliki I; Chrysikopoulos, Constantinos V

    2015-02-15

    Suspended clay particles in groundwater can play a significant role as carriers of viruses, because, depending on the physicochemical conditions, clay particles may facilitate or hinder the mobility of viruses. This experimental study examines the effects of clay colloids on the transport of viruses in variably saturated porous media. All cotransport experiments were conducted in both saturated and partially saturated columns packed with glass beads, using bacteriophages MS2 and ΦX174 as model viruses, and kaolinite (KGa-1b) and montmorillonite (STx-1b) as model clay colloids. The various experimental collision efficiencies were determined using the classical colloid filtration theory. The experimental data indicated that the mass recovery of viruses and clay colloids decreased as the water saturation decreased. Temporal moments of the various breakthrough concentrations collected, suggested that the presence of clays significantly influenced virus transport and irreversible deposition onto glass beads. The mass recovery of both viruses, based on total effluent virus concentrations, was shown to reduce in the presence of suspended clay particles. Furthermore, the transport of suspended virus and clay-virus particles was retarded, compared to the conservative tracer. Under unsaturated conditions both clay particles facilitated the transport of ΦX174, while hindered the transport of MS2. Moreover, the surface properties of viruses, clays and glass beads were employed for the construction of classical DLVO and capillary potential energy profiles, and the results suggested that capillary forces play a significant role on colloid retention. It was estimated that the capillary potential energy of MS2 is lower than that of ΦX174, and the capillary potential energy of KGa-1b is lower than that of STx-1b, assuming that the protrusion distance through the water film is the same for each pair of particles. Moreover, the capillary potential energy is several orders of

  12. Impact of textural anisotropy on syn-kinematic partial melting of natural gneisses: an experimental approach.

    NASA Astrophysics Data System (ADS)

    Ganzhorn, Anne-Céline; Trap, Pierre; Arbaret, Laurent; Champallier, Rémi; Fauconnier, Julien; Labrousse, Loic; Prouteau, Gaëlle

    2015-04-01

    Partial melting of continental crust is a strong weakening process controlling its rheological behavior and ductile flow of orogens. This strength weakening due to partial melting is commonly constrained experimentally on synthetic starting material with derived rheological law. Such analog starting materials are preferentially used because of their well-constrained composition to test the impact of melt fraction, melt viscosity and melt distribution upon rheology. In nature, incipient melting appears in particular locations where mineral and water contents are favorable, leading to stromatic migmatites with foliation-parallel leucosomes. In addition, leucosomes are commonly located in dilatants structural sites like boudin-necks, in pressure shadows, or in fractures within more competent layers of migmatites. The compositional layering is an important parameter controlling melt flow and rheological behavior of migmatite but has not been tackled experimentally for natural starting material. In this contribution we performed in-situ deformation experiments on natural rock samples in order to test the effect of initial gneissic layering on melt distribution, melt flow and rheological response. In-situ deformation experiments using a Paterson apparatus were performed on two partially melted natural gneissic rocks, named NOP1 & PX28. NOP1, sampled in the Western Gneiss Region (Norway), is biotite-muscovite bearing gneiss with a week foliation and no gneissic layering. PX28, sampled from the Sioule Valley series (French Massif Central), is a paragneiss with a very well pronounced layering with quartz-feldspar-rich and biotite-muscovite-rich layers. Experiments were conducted under pure shear condition at axial strain rate varying from 5*10-6 to 10-3 s-1. The main stress component was maintained perpendicular to the main plane of anisotropy. Confining pressure was 3 kbar and temperature ranges were 750°C and 850-900°C for NOP1 and PX28, respectively. For the 750

  13. Theoretical and experimental investigation of thermohydrologic processes in a partially saturated, fractured porous medium

    SciTech Connect

    Green, R.T.; Manteufel, R.D.; Dodge, F.T.; Svedeman, S.J.

    1993-07-01

    The performance of a geologic repository for high-level nuclear waste will be influenced to a large degree by thermohydrologic phenomena created by the emplacement of heat-generating radioactive waste. The importance of these phenomena is manifest in that they can greatly affect the movement of moisture and the resulting transport of radionuclides from the repository. Thus, these phenomena must be well understood prior to a definitive assessment of a potential repository site. An investigation has been undertaken along three separate avenues of analysis: (i) laboratory experiments, (ii) mathematical models, and (iii) similitude analysis. A summary of accomplishments to date is as follows. (1) A review of the literature on the theory of heat and mass transfer in partially saturated porous medium. (2) A development of the governing conservation and constitutive equations. (3) A development of a dimensionless form of the governing equations. (4) A numerical study of the importance and sensitivity of flow to a set of dimensionless groups. (5) A survey and evaluation of experimental measurement techniques. (6) Execution of laboratory experiments of nonisothermal flow in a porous medium with a simulated fracture.

  14. Erythropoietin administration partially prevents adipose tissue loss in experimental cancer cachexia models

    PubMed Central

    Penna, Fabio; Busquets, Silvia; Toledo, Miriam; Pin, Fabrizio; Massa, David; López-Soriano, Francisco J.; Costelli, Paola; Argilés, Josep M.

    2013-01-01

    Cancer-associated cachexia is characterized, among other symptoms, by a dramatic loss of both muscle and fat. In addition, the cachectic syndrome is often associated with anemia. The object of the present investigation was to assess the effects of erythropoietin (EPO) treatment on experimental cancer cachexia models. The results clearly show that, in addition to the improvement of the hematocrit, EPO treatment promoted a partial preservation of adipose tissue while exerting negligible effects on muscle loss. Administration of EPO to tumor-bearing animals resulted in a significant increase of lipoprotein lipase (LPL) activity in adipose tissue, suggesting that the treatment favored triacylglycerol (TAG) accumulation in the adipose tissue. In vitro experiments using both adipose tissue slices and 3T3-L1 adipocytes suggests that EPO is able to increase the lipogenic rate through the activation of its specific receptor (EPOR). This metabolic pathway, in addition to TAG uptake by LPL, may contribute to the beneficial effects of EPO on fat preservation in cancer cachexia. PMID:23966665

  15. Ocular explosion during cataract surgery: a clinical, histopathological, experimental, and biophysical study.

    PubMed Central

    Bullock, J D; Warwar, R E; Green, W R

    1998-01-01

    INTRODUCTION: An increasing number of cases are being recognized in which a peribulbar anesthetic for cataract surgery has been inadvertently injected directly into the globe under high pressure until the globe ruptures or explodes. We reviewed the records of 6 such cases (one of which was reported previously by us), and one additional case has been reported in the literature. Surprisingly, 2 of these 7 cases went unrecognized at the time, and the surgeons proceeded with the cataract operation; all of the patients ultimately developed severe visual loss and/or loss of the eye. OBJECTIVES: To reproduce this eye explosion in a live anesthetized rabbit model and to perform a clinical, histopathological, experimental, biophysical, and mathematical analysis of this injury. METHODS: Eyes of live anesthetized rabbits were ruptured by means of the injection of saline directly into the globe under high pressure. The clinical and pathological findings of the ruptured human and animal eyes were documented photographically and/or histopathologically. An experimental, biophysical, and mathematical analysis of the pressures and forces required to rupture the globe via direct injection using human cadavers, human eye-bank eyes, and classic physics and ophthalmic formulas was performed. The laws of Bernoulli, LaPlace, Friedenwald, and Pascal were applied to the theoretical and experimental models of this phenomenon. RESULTS: The clinical and pathological findings of scleral rupture, retinal detachment, vitreous hemorrhage, and lens extrusion were observed. In the exploded human and rabbit eyes, the scleral ruptures appeared at the equator, the limbal area, or the posterior pole. In 2 of the 7 human eyes, the anterior segments appeared entirely normal despite the rupture, and cataract surgery was completed; surgery was canceled in the other 4 cases. In 4 of the 5 injected and ruptured rabbit eyes, the anterior segments appeared essentially normal. The experiments with human eye

  16. Topical infliximab for the suppression of wound healing following experimental glaucoma filtration surgery

    PubMed Central

    Turgut, Burak; Eren, Kenan; Akın, Mehmet Mustafa; Demir, Tamer; Kobat, Sabiha

    2014-01-01

    Background The purpose of this work was to look into the effects of infliximab on wound healing in experimental glaucoma filtration surgery and to compare the antifibrotic effects of this agent to that of mitomycin-C (MMC). Methods Twenty-eight male New Zealand White rabbits were randomly assigned to four groups, each including seven rabbits: control group, sham group, MMC group, and infliximab group. The rabbits in the control group were not operated on and did not receive any treatment. The rabbits in the sham group underwent trabeculectomy and had one drop of saline instilled four times a day for 14 days. The rabbits in the MMC treatment group underwent trabeculectomy, and a sponge soaked in 0.4 mg/mL MMC was applied intraoperatively to the scleral surgical site for three minutes. The rabbits in the infliximab treatment group underwent trabeculectomy and one drop of 10 mg/mL infliximab was instilled four times a day for 14 days after surgery. On day 14 of the experiment, the operated and control eyes were enucleated and histologically and immunohistochemically analyzed. Results The mean fibroblast and mononuclear cell (MNC) numbers and the mean immunostaining intensities of transforming growth factor-β (TGF-β), fibroblast growth factor-β (FGF-β), and platelet-derived growth factor (PDGF) in the sham group were higher than those of the control group (P<0.01). The mean fibroblast and MNC numbers and the mean immunostaining intensities of TGF-β, FGF-β, and PDGF in the MMC and infliximab groups were statistically significantly lower than those of the sham group (P<0.01). The mean fibroblast and MNC numbers and the mean TGF-β, FGF-β, and PDGF immunostaining intensities of the MMC and infliximab groups were similar (P>0.05). Conclusion Our study suggests that topical infliximab effectively suppresses the subconjunctival wound healing response after experimental glaucoma filtration surgery, reducing the MNC and fibroblast numbers and immunostaining intensities

  17. Experimental investigation on ignition schemes of partially covered cavities in a supersonic flow

    NASA Astrophysics Data System (ADS)

    Cai, Zun; Sun, Mingbo; Wang, Hongbo; Wang, Zhenguo

    2016-04-01

    In this study, ignition schemes of the partially covered cavity in a scramjet combustor were investigated under inflow conditions of Ma=2.1 with stagnation pressure P0=0.7 Mpa and stagnation temperature T0=947 K. It reveals that the ignition scheme of the partially covered cavity has a great impact on the ignition and flame stabilization process. There always exists an optimized global equivalence ratio of a fixed ignition scheme, and the optimized global equivalence ratio of ignition in the partially covered cavity is lower than that of the uncovered cavity. For tandem dual-cavities, ignition in the partially covered cavity could be enhanced with the optimization of global equivalence ratio. However, ignition in the partially covered cavity would be exacerbated with further increasing the global equivalence ratio. The global equivalence ratio and the jet penetration height have a strong coupling with the combustion flow-field. For multi-cavities, it is assured that fuel injection on the opposite side could hardly be ignited after ignition in the partially covered cavity even with the optimized global equivalence ratio. It is possible to realize ignition enhancement in the partially covered cavity with the optimization of global equivalence ratio, but it is not beneficial for thrust increment during the steady combustion process.

  18. Experimental Hydrous Partial Melting of Natural Pristine and Altered MORB Beneath Subduction Zones

    NASA Astrophysics Data System (ADS)

    Carter, L. B.; Skora, S. E.; Blundy, J.

    2012-12-01

    Experimental determination of the hydrous phase relations and trace element partitioning behaviour of Mid-Ocean Ridge Basalt (MORB) constrains the conditions for melting of subducted oceanic crust. This study utilises natural pristine MORB (from the Kolbeinsey ridge, north of Iceland) and altered MORB from the altered oceanic crust (AOC, from the DSDP leg 46, Mid Atlantic, ~20°N), hydrated with about 15wt% water, in experiments using piston-cylinder apparatus to simulate pressures and temperatures equivalent to about 100 km depth (3.0 GPa, 800-1000°C). Our motivation of (re-)studying the melting behaviour of undoped subducted basalt is two-fold. First, previous studies that focused on the trace element behaviour 'doped' their starting materials with trace elements to facilitate analysis and positive identification of accessory phases. Only by applying the 'doping' method has it been found that allanite may exert a key control on the light rare earth element (approx. La-Sm) budget in subducted basalt. However, it is still a matter of debate whether the ubiquitous presence of allanite in these experimental studies is solely due to doping of La-Sm. In addition, bulk fluid-solid partition coefficients so obtained may not be uncritically applied to model the trace element transfer in nature because of the enhanced proportions of accessory phases in the experimental solid residue. Second, there appears to be a clear difference in the melting behaviour of K-free and K-bearing MORB (and sediment), even if K2O only appears in minor concentrations. These differences are difficult to quantify, as the various studies were carried out at differing P-T-XH2O conditions. In agreement with earlier studies, we find that the vapour-saturated solidus is shifted toward higher temperatures at 3 GPa in pristine MORB (800°C < Tsolidus < 850°C), because it is virtually K-free (approx. 0.03 wt% K2O), in contrast to altered MORB where melting starts at T < 800°C (approx. 0.26 wt% K2O

  19. Bevacizumab-Loaded Polyurethane Subconjunctival Implants: Effects on Experimental Glaucoma Filtration Surgery

    PubMed Central

    Ribeiro, Vanessa Raquel Coimbra; Chahud, Fernando; Cannellini, Roberta; Monteiro, Tassia Cristina; de Lima Gomes, Elionai Cassiana; Reinach, Peter Sol; Veronese Rodrigues, Maria de Lourdes; Silva-Cunha, Armando

    2013-01-01

    Abstract Purpose Vascular endothelial growth factor (VEGF) may contribute to the scarring process resulting from glaucoma filtration surgery, since this cytokine may stimulate fibroblast proliferation. The aim of this study was to describe a new bevacizumab-loaded polyurethane implant (BPUI) and to evaluate its effectiveness as a new drug delivery system of anti-VEGF antibody in a rabbit model of glaucoma filtration surgery. Methods An aqueous dispersion of polyurethane was obtained via the conventional process. Bevacizumab (1.5 mg) was then incorporated into the dispersion and was subsequently dried to form the polymeric films. Films with dimensions of 3×3×1 mm that either did (group BPUI, n=10) or did not contain bevacizumab (group PUI, n=10) were implanted in the subconjunctival space, at the surgical site in 1 eye of each rabbit. The in vitro bevacizumab release was evaluated using size-exclusion high-performance liquid chromatography (HPLC), and the in vivo effects of the drug were investigated in a rabbit experimental trabeculectomy model by examining the bleb characteristics and collagen accumulation, and by performing immunohistological analyses of VEGF expression. Results HPLC showed that only 10% of the bevacizumab in the implants had been released by postoperative day 5. In vivo studies demonstrated that the drug had no adverse effects; however, no significant differences in either the bleb area score or the collagen deposit intensity between the group PUI and the group that BPUI were observed. Moreover, the group BPUI presented a significantly lower proportion of VEGF-expressing fibroblasts than group PUI (0.17±0.03 vs. 0.35±0.05 cells/field, P=0.005). Conclusions This study demonstrated that bevacizumab release from the BPUIs only occurred for a short time probably from the surface of the films. Nevertheless, they were well tolerated in rabbit eyes and reduced the number of VEGF-expressing fibroblasts. PMID:23391327

  20. Stannern-Trend Eucrite Petrogenesis: An Assessment of Partial Melt Contamination Models via Experimental Petrology

    NASA Astrophysics Data System (ADS)

    Crossley, S. D.; Mayne, R. G.; Lunning, N. G.; McCoy, T. J.; Greenwood, R. C.; Franchi, I. A.

    2016-08-01

    Melting experiments were performed on the eucrite, NWA 8562, in order to test the partial melt assimilation model of Stannern-trend petrogenesis. Major and trace element data will be applied to the model, and preliminary results appear to fit.

  1. A correlational and experimental examination of reality television viewing and interest in cosmetic surgery.

    PubMed

    Markey, Charlotte N; Markey, Patrick M

    2010-03-01

    Two studies are presented that examine the influence of media messages about cosmetic surgery on youths' interest in altering their own physical appearance. In Study 1, 170 participants (59% female; M age=19.77 years) completed surveys assessing their impression of reality television shows featuring cosmetic surgery, appearance satisfaction, self-esteem, and their interest in cosmetic surgery. Results indicated that participants who reported favorable impressions of reality television shows featuring cosmetic surgery were more likely to indicate interest in pursuing surgery. One hundred and eighty-nine participants (51% female; M age=19.84 years) completed Study 2. Approximately half of the participants were exposed to a television message featuring a surgical make-over; the other half was exposed to a neutral message. Results indicated that participants who watched a television program about cosmetic surgery wanted to alter their own appearance using cosmetic surgery more than did participants who were not exposed to this program. PMID:20089464

  2. A correlational and experimental examination of reality television viewing and interest in cosmetic surgery.

    PubMed

    Markey, Charlotte N; Markey, Patrick M

    2010-03-01

    Two studies are presented that examine the influence of media messages about cosmetic surgery on youths' interest in altering their own physical appearance. In Study 1, 170 participants (59% female; M age=19.77 years) completed surveys assessing their impression of reality television shows featuring cosmetic surgery, appearance satisfaction, self-esteem, and their interest in cosmetic surgery. Results indicated that participants who reported favorable impressions of reality television shows featuring cosmetic surgery were more likely to indicate interest in pursuing surgery. One hundred and eighty-nine participants (51% female; M age=19.84 years) completed Study 2. Approximately half of the participants were exposed to a television message featuring a surgical make-over; the other half was exposed to a neutral message. Results indicated that participants who watched a television program about cosmetic surgery wanted to alter their own appearance using cosmetic surgery more than did participants who were not exposed to this program.

  3. Experimental studies on wave interactions of partially perforated wall under obliquely incident waves.

    PubMed

    Lee, Jong-In; Kim, Young-Taek; Shin, Sungwon

    2014-01-01

    This study presents wave height distribution in terms of stem wave evolution phenomena on partially perforated wall structures through three-dimensional laboratory experiments. The plain and partially perforated walls were tested to understand their effects on the stem wave evolution under the monochromatic and random wave cases with the various wave conditions, incident angle (from 10 to 40 degrees), and configurations of front and side walls. The partially perforated wall reduced the relative wave heights more effectively compared to the plain wall structure. Partially perforated walls with side walls showed a better performance in terms of wave height reduction compared to the structure without the side wall. Moreover, the relative wave heights along the wall were relatively small when the relative chamber width is large, within the range of the chamber width in this study. The wave spectra showed a frequency dependency of the wave energy dissipation. In most cases, the existence of side wall is a more important factor than the porosity of the front wall in terms of the wave height reduction even if the partially perforated wall was still effective compared to the plain wall.

  4. Large animal models in experimental knee sports surgery: focus on clinical translation.

    PubMed

    Madry, Henning; Ochi, Mitsuo; Cucchiarini, Magali; Pape, Dietrich; Seil, Romain

    2015-12-01

    Large animal models play a crucial role in sports surgery of the knee, as they are critical for the exploration of new experimental strategies and the clinical translation of novel techniques. The purpose of this contribution is to provide critical aspects of relevant animal models in this field, with a focus on paediatric anterior cruciate ligament (ACL) reconstruction, high tibial osteotomy, and articular cartilage repair. Although there is no single large animal model strictly replicating the human knee joint, the sheep stifle joint shares strong similarities. Studies in large animal models of paediatric ACL reconstruction identified specific risk factors associated with the different surgical techniques. The sheep model of high tibial osteotomy is a powerful new tool to advance the understanding of the effect of axial alignment on the lower extremity on specific issues of the knee joint. Large animal models of both focal chondral and osteochondral defects and of osteoarthritis have brought new findings about the mechanisms of cartilage repair and treatment options. The clinical application of a magnetic device for targeted cell delivery serves as a suitable example of how data from such animal models are directly translated into in clinical cartilage repair. As novel insights from studies in these translational models will advance the basic science, close cooperation in this important field of clinical translation will improve current reconstructive surgical options and open novel avenues for regenerative therapies of musculoskeletal disorders. PMID:26914877

  5. Effect of pre-experimental maintenance care duration on the development of gingivitis in a partial mouth experimental gingivitis model.

    PubMed

    Van der Weijden, G A; Timmerman, M F; Danser, M M; Nijboer, A; Saxton, C A; Van der Velden, U

    1994-05-01

    The present study was designed to evaluate if different periods of supervised oral hygiene prior to the experimental gingivitis trial have an effect on the amount of inflammation which develops in the 'toothshield' model. Two groups were compared. One group (Group A) was supervised over a 5-month period before experimental gingivitis. Six months later Group A participated in a second trial, this time receiving only a 1-month pretrial. A second group (Group B) which served as a control was supervised over a pre-trial period of 1-month prior to the start of the experimental gingivitis phase. During the pre-trial period all subjects undertook a regime of vigorous oral hygiene which included polishing of the test quadrant in the upper jaw and supervised subgingival brushing, interdental taping or the use of toothpicks. The presence of plaque and bleeding were assessed. Following the pre-trial period all plaque control measures in the experimental area were prevented during oral hygiene periods by the temporary placement of soft, loosely fitting vinyl toothshield guard. During this period they accumulated plaque rapidly and developed a generalized gingivitis. The results of this study indicate that, irrespective of the length of the pretrial period, subjects by group develop a comparable mean level of plaque and gingival bleeding. However, the extent to which gingivitis develops differs among individuals and was for a number of subjects not consistent. Therefore, in designing an experimental gingivitis trial care should be taken to include a sufficient number of subjects to account for individual variation.

  6. Experimental Bariatric Surgery in Rats Generates a Cytotoxic Chemical Environment in the Gut Contents

    PubMed Central

    Li, Jia V.; Reshat, Reshat; Wu, Qianxin; Ashrafian, Hutan; Bueter, Marco; le Roux, Carel W.; Darzi, Ara; Athanasiou, Thanos; Marchesi, Julian R.; Nicholson, Jeremy K.; Holmes, Elaine; Gooderham, Nigel J.

    2011-01-01

    Bariatric surgery, also known as metabolic surgery, is an effective treatment for morbid obesity, which also offers pronounced metabolic effects including the resolution of type 2 diabetes and a decrease in cardiovascular disease and long-term cancer risk. However, the mechanisms of surgical weight loss and the long-term consequences of bariatric surgery remain unclear. Bariatric surgery has been demonstrated to alter the composition of both the microbiome and the metabolic phenotype. We observed a marked shift toward Gammaproteobacteria, particularly Enterobacter hormaechei, following Roux-en-Y gastric bypass (RYGB) surgery in a rat model compared with sham-operated controls. Fecal water from RYGB surgery rats was highly cytotoxic to rodent cells (mouse lymphoma cell line). In contrast, fecal water from sham-operated animals showed no/very low cytotoxicity. This shift in the gross structure of the microbiome correlated with greatly increased cytotoxicity. Urinary phenylacetylglycine and indoxyl sulfate and fecal gamma-aminobutyric acid, putrescine, tyramine, and uracil were found to be inversely correlated with cell survival rate. This profound co-dependent response of mammalian and microbial metabolism to RYGB surgery and the impact on the cytotoxicity of the gut luminal environment suggests that RYGB exerts local and global metabolic effects which may have an influence on long-term cancer risk and cytotoxic load. PMID:21949514

  7. Experimental investigation of gas hydrate formation, plugging and transportability in partially dispersed and water continuous systems

    NASA Astrophysics Data System (ADS)

    Vijayamohan, Prithvi

    As oil/gas subsea fields mature, the amount of water produced increases significantly due to the production methods employed to enhance the recovery of oil. This is true especially in the case of oil reservoirs. This increase in the water hold up increases the risk of hydrate plug formation in the pipelines, thereby resulting in higher inhibition cost strategies. A major industry concern is to reduce the severe safety risks associated with hydrate plug formation, and significantly extending subsea tieback distances by providing a cost effective flow assurance management/safety tool for mature fields. Developing fundamental understanding of the key mechanistic steps towards hydrate plug formation for different multiphase flow conditions is a key challenge to the flow assurance community. Such understanding can ultimately provide new insight and hydrate management guidelines to diminish the safety risks due to hydrate formation and accumulation in deepwater flowlines and facilities. The transportability of hydrates in pipelines is a function of the operating parameters, such as temperature, pressure, fluid mixture velocity, liquid loading, and fluid system characteristics. Specifically, the hydrate formation rate and plugging onset characteristics can be significantly different for water continuous, oil continuous, and partially dispersed systems. The latter is defined as a system containing oil/gas/water, where the water is present both as a free phase and partially dispersed in the oil phase (i.e., entrained water in the oil). Since hydrate formation from oil dispersed in water systems and partially dispersed water systems is an area which is poorly understood, this thesis aims to address some key questions in these systems. Selected experiments have been performed at the University of Tulsa flowloop to study the hydrate formation and plugging characteristics for the partially dispersed water/oil/gas systems as well as systems where the oil is completely dispersed

  8. [Treatment of hepatocellular carcinoma--partial hepatic resection under hand-assisted laparoscopic surgery and local ablation therapy with ethanol and radio frequency].

    PubMed

    Doi, Koichi; Beppu, Toru; Ishiko, Takatoshi; Ishimoto, Takatsugu; Hayashi, Hiromitsu; Hirota, Masahiko; Ogawa, Michio

    2002-11-01

    A 76-year old female patient with chronic B type hepatitis had HCC expanding into the extra-hepatic space. In July 2001, we safely performed partial hepatic resection under hand-assisted laparoscopic surgery (HALS). Three months after the treatment, computed tomography of the liver revealed HCC close to the first branch of right portal vein and bile duct. Although we performed transcatheter arterial chemoembolization (TACE) for the tumor, this treatment was not effective. So we treated percutaneous ethanol injection therapy (PEIT) for the tumor area neighboring Glisson's capsule and radiofrequency ablation therapy (RFA) for the tumor. After this treatment the tumor showed no viability on dynamic CT, and there was no liver infarction or damage to the bile duct. Four months after the final treatment, enhanced CT revealed no viable lesion, and serum alpha-fetoprotein level was declining toward the normal range. We conclude that selection of an applicable treatment and approach is of importance for safe and effective therapy.

  9. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

    SciTech Connect

    Formenti, Silvia C.; Hsu, Howard; Fenton-Kerimian, Maria; Roses, Daniel; Guth, Amber; Jozsef, Gabor; Goldberg, Judith D.; DeWyngaert, J. Keith

    2012-11-01

    Purpose: To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position. Methods and Materials: Postmenopausal patients with Stage I breast cancer with nonpalpable tumors <2 cm, negative margins and negative nodes, positive hormone receptors, and no extensive intraductal component were eligible. The trial was offered only after eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone setup. 3D-CRT was delivered at a dose of 30 Gy in five 6-Gy/day fractions over 10 days with port film verification at each treatment. Rates of ipsilateral breast failure, ipsilateral nodal failure, contralateral breast failure, and distant failure were estimated using the cumulative incidence method. Rates of disease-free, overall, and cancer-specific survival were recorded. Results: One hundred patients were enrolled in this institutional review board-approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation, and another patient elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients were evaluable for toxicity, and, in 1 case, both breasts were treated with partial breast irradiation. Median patient age was 68 years (range, 53-88 years); in 55% of patients the tumor size was <1 cm. All patients had hormone receptor-positive cancers: 87% of patients underwent adjuvant antihormone therapy. At a median follow-up of 64 months (range, 2-125 months), there was one local recurrence (1% ipsilateral breast failure) and one contralateral breast cancer (1% contralateral breast failure). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (one breast edema, one transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36

  10. Cost comparison of open approach, transoral laser microsurgery and transoral robotic surgery for partial and total laryngectomies.

    PubMed

    Dombrée, Manon; Crott, Ralph; Lawson, Georges; Janne, Pascal; Castiaux, Annick; Krug, Bruno

    2014-10-01

    Activity-based costing is used to give a better insight into the actual cost structure of open, transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) supraglottic and total laryngectomies. Cost data were obtained from hospital administration, personnel and vendor structured interviews. A process map identified 17 activities, to which the detailed cost data are related. One-way sensitivity analyses on the patient throughput, the cost of the equipment or operative times were performed. The total cost for supraglottic open (135-203 min), TLM (110-210 min) and TORS (35-130 min) approaches were 3,349 euro (3,193-3,499 euro), 3,461 euro (3,207-3,664 euro) and 5,650 euro (4,297-5,974 euro), respectively. For total laryngectomy, the overall cost were 3,581 euro (3,215-3,846 euro) for open and 6,767 euro (6,418-7,389 euro) for TORS. TORS cost is mostly influenced by equipment (54%) where the other procedures are predominantly determined by personnel cost (about 45%). Even when we doubled the yearly case-load, used the shortest operative times or a calculation without robot equipment costs we did not reach cost equivalence. TORS is more expensive than standard approaches and mainly influenced by purchase and maintenance costs and the use of proprietary instruments. Further trials on long-term outcomes and costs following TORS are needed to evaluate its cost-effectiveness. PMID:24906840

  11. Experimental investigation of gas hydrate formation, plugging and transportability in partially dispersed and water continuous systems

    NASA Astrophysics Data System (ADS)

    Vijayamohan, Prithvi

    As oil/gas subsea fields mature, the amount of water produced increases significantly due to the production methods employed to enhance the recovery of oil. This is true especially in the case of oil reservoirs. This increase in the water hold up increases the risk of hydrate plug formation in the pipelines, thereby resulting in higher inhibition cost strategies. A major industry concern is to reduce the severe safety risks associated with hydrate plug formation, and significantly extending subsea tieback distances by providing a cost effective flow assurance management/safety tool for mature fields. Developing fundamental understanding of the key mechanistic steps towards hydrate plug formation for different multiphase flow conditions is a key challenge to the flow assurance community. Such understanding can ultimately provide new insight and hydrate management guidelines to diminish the safety risks due to hydrate formation and accumulation in deepwater flowlines and facilities. The transportability of hydrates in pipelines is a function of the operating parameters, such as temperature, pressure, fluid mixture velocity, liquid loading, and fluid system characteristics. Specifically, the hydrate formation rate and plugging onset characteristics can be significantly different for water continuous, oil continuous, and partially dispersed systems. The latter is defined as a system containing oil/gas/water, where the water is present both as a free phase and partially dispersed in the oil phase (i.e., entrained water in the oil). Since hydrate formation from oil dispersed in water systems and partially dispersed water systems is an area which is poorly understood, this thesis aims to address some key questions in these systems. Selected experiments have been performed at the University of Tulsa flowloop to study the hydrate formation and plugging characteristics for the partially dispersed water/oil/gas systems as well as systems where the oil is completely dispersed

  12. Experimental derivation of nepheline syenite and phonolite liquids by partial melting of upper mantle peridotites

    NASA Astrophysics Data System (ADS)

    Laporte, Didier; Lambart, Sarah; Schiano, Pierre; Ottolini, Luisa

    2014-10-01

    Piston-cylinder experiments were performed to characterize the composition of liquids formed at very low degrees of melting of two fertile lherzolite compositions with 430 ppm and 910 ppm K2O at 1 and 1.3 GPa. We used the microdike technique (Laporte et al., 2004) to extract the liquid phase from the partially molten peridotite, allowing us to analyze liquid compositions at degrees of melting F down to 0.9%. At 1.3 GPa, the liquid is in equilibrium with olivine + orthopyroxene + clinopyroxene + spinel in all the experiments; at 1 GPa, plagioclase is present in addition to these four mineral phases up to about 5% of melting (T≈1240 °C). Important variations of liquid compositions are observed with decreasing temperature, including strong increases in SiO2, Na2O, K2O, and Al2O3 concentrations, and decreases in MgO, FeO, and CaO concentrations. The most extreme liquid compositions are phonolites with 57% SiO2, 20-22% Al2O3, Na2O + K2O up to 14%, and concentrations of MgO, FeO, and CaO as low as 2-3%. Reversal experiments confirm that low-degree melts of a fertile lherzolite have phonolitic compositions, and pMELTS calculations show that the amount of phonolite liquid generated at 1.2 GPa increases from 0.3% in a source with 100 ppm K2O to 3% in a source with 2000 ppm K2O. The enrichment in silica and alkalis with decreasing melt fraction is coupled with an increase of the degree of melt polymerization, which has important consequences for the partitioning of minor and trace elements. Thus Ti4+ in our experiments and, by analogy with Ti4+, other highly charged cations, and rare earth elements become less incompatible near the peridotite solidus. Our study brings a strong support to the hypothesis that phonolitic lavas or their plutonic equivalents (nepheline syenites) may be produced directly by partial melting of upper mantle rock-types at moderate pressures (1-1.5 GPa), especially where large domains of the subcontinental lithospheric mantle has been enriched in

  13. Experimental Verification of the Kruskal-Shafranov Stability Limit in Line-Tied Partial Toroidal Plasmas

    SciTech Connect

    Oz, E.; Myers, C. E.; Yamada, M.; Ji, H.; Kulsrud, R. M.; Xie, J.

    2011-07-19

    The stability properties of partial toroidal flux ropes are studied in detail in the laboratory, motivated by ubiquitous arched magnetic structures found on the solar surface. The flux ropes studied here are magnetized arc discharges formed between two electrodes in the Magnetic Reconnection Experiment (MRX) [Yamada et al., Phys. Plasmas, 4, 1936 (1997)]. The three dimensional evolution of these flux ropes is monitored by a fast visible light framing camera, while their magnetic structure is measured by a variety of internal magnetic probes. The flux ropes are consistently observed to undergo large-scale oscillations as a result of an external kink instability. Using detailed scans of the plasma current, the guide field strength, and the length of the flux rope, we show that the threshold for kink stability is governed by the Kruskal-Shafranov limit for a flux rope that is held fixed at both ends (i.e., qa = 1).

  14. An experimental study on the ergonomics indices of partial pressure suits.

    PubMed

    Li, Xianxue; Ding, Li; Hedge, Alan; Hu, Huimin; Qin, Zhifeng; Zhou, Qianxiang

    2013-05-01

    Partial pressure suits (PPSs) are used under high altitude, low-pressure conditions to protect the pilots. However, the suit often limits pilot's mobility and work efficiency. The lack of ergonomic data on the effects of PPSs on mobility and performance creates difficulties for human factor engineers and cockpit layout specialists. This study investigated the effects of PPSs on different ergonomic mobility and performance indices in order to evaluate the suit's impact on pilot's body mobility and work efficiency. Three types of ergonomics indices were studied: the manipulative mission, operational reach and operational strength. Research results indicated that a PPS significantly affects the mobility and operational performance of the wearers. The results may provide mission planners and human factors engineers with better insight into the understanding of pilots' operational function, mobility and strength capabilities when wearing PPS. PMID:23102522

  15. Experimental demonstration of optimal universal asymmetric quantum cloning of polarization states of single photons by partial symmetrization

    SciTech Connect

    Cernoch, Antonin; Soubusta, Jan; Celechovska, Lucie; Dusek, Miloslav; Fiurasek, Jaromir

    2009-12-15

    We report on experimental implementation of the optimal universal asymmetric 1->2 quantum cloning machine for qubits encoded into polarization states of single photons. Our linear-optical machine performs asymmetric cloning by partially symmetrizing the input polarization state of signal photon and a blank copy idler photon prepared in a maximally mixed state. We show that the employed method of measurement of mean clone fidelities exhibits strong resilience to imperfect calibration of the relative efficiencies of single-photon detectors used in the experiment. Reliable characterization of the quantum cloner is thus possible even when precise detector calibration is difficult to achieve.

  16. From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients.

    PubMed

    Dolcini, Giorgio Andrea; Colombo, Marco; Mangano, Carlo

    2016-01-01

    Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT), the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA) temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy) and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results. PMID:27493665

  17. From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients

    PubMed Central

    2016-01-01

    Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT), the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA) temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy) and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results. PMID:27493665

  18. Experimental and theoretical results on electron emission in collisions between partially dressed ions with He targets

    NASA Astrophysics Data System (ADS)

    Monti, J. M.; Fiol, J.; Fregenal, D.; Fainstein, P. D.; Rivarola, R. D.; Wolff, W.; Horsdal, E.; Bernardi, G.; Suárez, S.

    2013-09-01

    Experimental and theoretical results for electron emission in 440 keV u-1 Li+ with He targets are presented. Theoretical cross-sections are obtained using extensions of the continuum distorted wave and the continuum distorted wave-eikonal initial state models to the case of dressed projectiles and a four-body classical trajectory Monte-Carlo. The contributions of electron emission from the different aggregates of the collision system are investigated.

  19. Experimental determination of carbonation rate in Portland cement at 25°C and relatively high CO2 partial pressure

    NASA Astrophysics Data System (ADS)

    Hernández-Rodríguez, Ana; Montegrossi, Giordano; Huet, Bruno; Virgili, Giorgio; Orlando, Andrea; Vaselli, Orlando; Marini, Luigi

    2016-04-01

    The aim of this work is to study the alteration of Portland class G Cement at ambient temperature under a relatively high CO2 partial pressure through suitably designed laboratory experiments, in which cement hydration and carbonation are taken into account separately. First, the hydration process was carried out for 28 days to identify and quantify the hydrated solid phases formed. After the completion of hydration, accompanied by partial carbonation under atmospheric conditions, the carbonation process was investigated in a stirred micro-reactor (Parr instrument) with crushed cement samples under 10 bar or more of pure CO2(g) and MilliQ water adopting different reaction times. The reaction time was varied to constrain the reaction kinetics of the carbonation process and to investigate the evolution of secondary solid phases. Chemical and mineralogical analyses (calcimetry, chemical composition, SEM and X-ray Powder Diffraction) were carried out to characterize the secondary minerals formed during cement hydration and carbonation. Water analyses were also performed at the end of each experimental run to measure the concentrations of relevant solutes. The specific surface area of hydrated cement was measured by means of the BET method to obtain the rates of cement carbonation. Experimental outcomes were simulated by means of the PhreeqC software package. The obtained results are of interest to understand the comparatively fast cement alteration in CO2 production wells with damaged casing.

  20. Blocking Sympathetic Nervous System Reverses Partially Stroke-Induced Immunosuppression but does not Aggravate Functional Outcome After Experimental Stroke in Rats.

    PubMed

    Deng, Qi-Wen; Yang, Heng; Yan, Fu-Ling; Wang, Huan; Xing, Fang-Lan; Zuo, Lei; Zhang, Han-Qing

    2016-08-01

    Stoke results in activation of the sympathetic nervous system (SNS), inducing systemic immunosuppression. However, the potential mechanisms underlying stroke-induced immunosuppression remain unclear. Here, we determined the SNS effects on functional outcome and explored the interactions among SNS, β-arrestin2 and nuclear factor-κB (NF-κB) after experimental stroke in rats. In the current study, stroke was induced by a transient middle cerebral artery occlusion (MCAO) in rats, and SNS activity was inhibited by intraperitoneal injection of 6-hydroxydopamine HBr (6-OHDA). 7.0 T Micro-MRI and Longa score were employed to assess the functional outcome after stroke. Flow cytometry and ELISA assay were used to measure the expression of MHC class II, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ). Western blot was conducted to analyze β-arrestin2 and NF-κB protein expression levels after experimental stroke. We found significantly increased infarct volumes and functional impairment after MCAO at different post-surgery time points, which were not aggravated by 6-OHDA treatment. SNS blockade partially reversed the expression of MHC class II after stroke over time, as well as TNF-α and IFN-γ levels in lipopolysaccharide-stimulated macrophages in vitro. Treatment of MCAO rats with SNS-inhibitor significantly diminished NF-κB activation and enhanced β-arrestin2 expression after stroke. This study suggests that pharmacological SNS inhibition dose not aggravate functional outcome after stroke. Stroke-induced immunosuppression may be involved in the SNS-β-arrestin2-NF-κB pathway. PMID:27059792

  1. Parents influence asymmetric sibling competition: experimental evidence with partially dependent young.

    PubMed

    Smiseth, Per T; Ward, Richard J S; Moore, Allen J

    2007-12-01

    Asymmetric sibling competition, which occurs when some siblings hatch as stronger competitors than others, is an important component of avian reproductive strategies. Here, we report two experiments on the burying beetle Nicrophorus vespilloides investigating how parents might influence the outcome of asymmetric sibling competition. In this species, as in altricial birds, different-aged offspring compete for resources provided by the parents. However, unlike altricial birds, offspring depend only partially on their parents for resources, and parents adjust the brood size directly through filial cannibalism. In the first experiment, we compared the growth and survivorship of different-aged offspring when parents could and could not influence asymmetric sibling competition. In the second experiment, we recorded behavioral interactions between different-aged offspring and parents. We found that senior offspring (early-hatched) grew faster than juniors (late-hatched) when parents were present and could influence the outcome of sibling competition, whereas seniors and juniors grew at similar rates when parents were removed. Thus, seniors benefited more than did juniors when the offspring could obtain resources by begging from the female parent. There was no difference in the survivorship of seniors and juniors. We also found that seniors and juniors spent a similar amount of time feeding from female parents, but juniors spent more time begging and were less effective at begging than seniors. Interestingly, juniors spent more time begging only as long as seniors also begged, suggesting that juniors adjusted their begging effort in response to direct competition against seniors for resources provided by parents. Our study provides novel insights into the ecological significance of asymmetric sibling competition by showing that asymmetric sibling competition took place when parents were present and offspring could obtain resources by begging. In contrast, we found no

  2. Experimental evidence for melt partitioning between olivine and orthopyroxene in partially molten harzburgite

    NASA Astrophysics Data System (ADS)

    Miller, Kevin J.; Zhu, Wen-lu; Montési, Laurent G. J.; Gaetani, Glenn A.; Le Roux, Véronique; Xiao, Xianghui

    2016-08-01

    Observations of dunite channels in ophiolites and uranium series disequilibria in mid-ocean ridge basalt suggest that melt transport in the upper mantle beneath mid-ocean ridges is strongly channelized. We present experimental evidence that spatial variations in mineralogy can also focus melt on the grain scale. This lithologic melt partitioning, which results from differences in the interfacial energies associated with olivine-melt and orthopyroxene-melt boundaries, may complement other melt focusing mechanisms in the upper mantle such as mechanical shear and pyroxene dissolution. We document here lithologic melt partitioning in olivine-/orthopyroxene-basaltic melt samples containing nominal olivine to orthopyroxene ratio of 3 to 2 and melt fractions of 0.02 to 0.20. Experimental samples were imaged using synchrotron-based X-ray microcomputed tomography at a resolution of 700 nm per voxel. By analyzing the local melt fraction distributions associated with olivine and orthopyroxene grains in each sample, we found that the melt partitioning coefficient, i.e., the ratio of melt fraction around olivine to that around orthopyroxene grains, varies between 1.1 and 1.6. The permeability and electrical conductivity of our digital samples were estimated using numerical models and compared to those of samples containing only olivine and basaltic melt. Our results suggest that lithologic melt partitioning and preferential localization of melt around olivine grains might play a role in melt focusing, potentially enhancing average melt ascent velocities.

  3. Experimental test of theory for the stability of partially saturated vertical cut slopes

    USGS Publications Warehouse

    Morse, Michael M.; Lu, N.; Wayllace, Alexandra; Godt, Jonathan W.; Take, W.A.

    2014-01-01

    This paper extends Culmann's vertical-cut analysis to unsaturated soils. To test the extended theory, unsaturated sand was compacted to a uniform porosity and moisture content in a laboratory apparatus. A sliding door that extended the height of the free face of the slope was lowered until the vertical cut failed. Digital images of the slope cross section and upper surface were acquired concurrently. A recently developed particle image velocimetry (PIV) tool was used to quantify soil displacement. The PIV analysis showed strain localization at varying distances from the sliding door prior to failure. The areas of localized strain were coincident with the location of the slope crest after failure. Shear-strength and soil-water-characteristic parameters of the sand were independently tested for use in extended analyses of the vertical-cut stability and of the failure plane angle. Experimental failure heights were within 22.3% of the heights predicted using the extended theory.

  4. Development of a finite element human head model partially validated with thirty five experimental cases.

    PubMed

    Mao, Haojie; Zhang, Liying; Jiang, Binhui; Genthikatti, Vinay V; Jin, Xin; Zhu, Feng; Makwana, Rahul; Gill, Amandeep; Jandir, Gurdeep; Singh, Amrinder; Yang, King H

    2013-11-01

    This study is aimed to develop a high quality, extensively validated finite element (FE) human head model for enhanced head injury prediction and prevention. The geometry of the model was based on computed tomography (CT) and magnetic resonance imaging scans of an adult male who has the average height and weight of an American. A feature-based multiblock technique was adopted to develop hexahedral brain meshes including the cerebrum, cerebellum, brainstem, corpus callosum, ventricles, and thalamus. Conventional meshing methods were used to create the bridging veins, cerebrospinal fluid, skull, facial bones, flesh, skin, and membranes-including falx, tentorium, pia, arachnoid, and dura. The head model has 270,552 elements in total. Thirty five loading cases were selected from a range of experimental head impacts to check the robustness of the model predictions based on responses including the brain pressure, relative skull-brain motion, skull response, and facial response. The brain pressure was validated against intracranial pressure data reported by Nahum et al. (1977, "Intracranial Pressure Dynamics During Head Impact," Proc. 21st Stapp Car Crash Conference, SAE Technical Paper No. 770922) and Trosseille et al. (1992, "Development of a F.E.M. of the Human Head According to a Specific Test Protocol," Proc. 36th Stapp Car Crash Conference, SAE Technical Paper No. 922527). The brain motion was validated against brain displacements under sagittal, coronal, and horizontal blunt impacts performed by Hardy et al. (2001, "Investigation of Head Injury Mechanisms Using Neutral Density Technology and High-Speed Biplanar X-Ray," Stapp Car Crash Journal, 45, pp. 337-368; and 2007, "A Study of the Response of the Human Cadaver Head to Impact," Stapp Car Crash Journal, 51, pp. 17-80). The facial bone responses were validated under nasal impact (Nyquist et al. 1986, "Facial Impact Tolerance and Response," Proc. 30th Stapp Car Crash Conference, SAE Technical Paper No. 861896

  5. Recurrence after Neoadjuvant Chemoradiation and Surgery for Esophageal Cancer: Does the Pattern of Recurrence Differ for Complete Responders and Those with Partial or No response?

    PubMed Central

    Meguid, Robert A.; Hooker, Craig M.; Taylor, Joshua T.; Kleinberg, Laurence R.; Cattaneo, Stephen M.; Sussman, Marc S.; Yang, Stephen C.; Heitmiller, Richard F.; Forastiere, Arlene A.; Brock, Malcolm V.

    2013-01-01

    Objective We hypothesized that most relapses in esophageal patients undergoing neoadjuvant chemoradiation therapy would occur outside of the surgical and radiation fields. Methods Recurrence patterns, time to recurrence, and median survival were examined in 267 patients who underwent esophagectomy after neoadjuvant chemoradiation therapy at Johns Hopkins over 19 years. Results Of 267 patients, 82 (30.7%) were complete responders (CR) to neoadjuvant therapy, with 108 (40.4%) and 77 (28.8%) being partial responders (PR) and non-responders (NR), respectively. Recurrence developed in 84 patients, (CR 18 /82 (21.4%), PR 39/108 (36.1%), NR 27/77 (35.1%) ,p=0.055, respectively.) Most patients recurred at distant sites (65/84;77.4) regardless of pathological response and subsequent survival was brief (median 8.37 months). Median disease-free survival was short (10 months) and did not differ based on recurrence site for partial and non-responding patients, but was longer for CR patients with distant recurrence whose median disease-free survival was 27.3 months (p=0.008).By multivariate analysis, no other factor except for pathological response to neoadjuvant therapy was associated with disease recurrence or death. PR and NR patients were 1.97 and 2.23 times more likely to recur than CR patients (p=0.024 and p=0.012, respectively). Conclusions Most esophageal cancer recurrences after neoadjuvant therapy and surgery are distant, and survival time after recurrence is short regardless of pathological response. Fewer patients achieving CR recur, and distant recurrences in these patients manifest later than in patients with PR and NR. Only pathological response is significantly associated with disease recurrence suggesting that tumor biology and chemosensitivity are critical in long-term patient outcome. PMID:19931663

  6. Experimental test of MR fluid based tactile device for minimally invasive surgery

    NASA Astrophysics Data System (ADS)

    Oh, Jong-Seok; Kim, Jin-Kyu; Choi, Seung-Bok

    2013-04-01

    Recently, it is very popular in modern medical industry to adopt robotic technology such as robotic minimally invasive surgery (RMIS). Compared with open surgery, the RMIS needs the robot to perform surgery through the usage of long surgical instruments that are inserted through incision points. This causes the surgeon not to feel viscosity and stiffness of the tissue or organ. So, for the tactile recognition of human organ in RMIS, this work proposes a novel tactile device that incorporates with magnetorheological (MR) fluid. The MR fluid is fully contained by diaphragm and several pins. By applying different magnetic field, the operator can feel different force from the proposed tactile device. In order to generate required force from the device, the repulsive force of human body is firstly measured as reference data and an appropriate size of tactile device is designed. Pins attached with the diaphragm are controlled by shape-memory-alloy (SMA). Thus, the proposed tactile device can realize repulsive force and shape of organ. It has been demonstrated via experiment whether the measured force can be achieved by applying proper control input current. In addition, psychophysical experiments are conducted to evaluate performance on the tactile rendering of the proposed tactile device. From these results, the practical feasibility of the tactile device is verified.

  7. Nitric oxide and asymmetric dimethyl arginine (ADMA) levels in an experimental hydronephrotic kidney caused by unilateral partial ureteral obstruction

    PubMed Central

    Alan, Cabir; Kurt, Hasan Anil; Topaloğlu, Naci; Ersay, Ahmet Reşit; Çakir, Dilek Ülker; Baştürk, Gökhan

    2016-01-01

    ABSTRACT Aim Our aim is to measure asymmetric dimethyl arginine and nitric oxide levels in rats with induced unilateral acute ureteral obstruction to research the effects on the kidney. Material and Methods The study included 21 adolescent (average age 6 weeks) Sprague-Dawley male rats weighing between 240-290g divided at random into 3 groups. Group-1: Control group (n=6): underwent no procedures. Group-2: Sham group (n=6): underwent the same procedures as the experimental group without ureter and psoas muscle dissection. Group-3: Group with induced partial unilateral ureteral obstruction (n=9). All rats were sacrificed after 12 weeks. Superoxide dismutase enzyme activity and nitrite and nitrate salt levels were measured in renal tissue. Plasma nitrite-nitrate and ADMA levels were examined. Results In the experimental group histopathological changes observed included renal pelvis dilatation, flattened papillae, sclerotic glomerulus and fibrosis. In the experimental group tissue SOD and blood ADMA levels were higher than the control and sham groups (p<0.05) while tissue NO and plasma NO values were lower than in the sham and control groups (p<0.05). Conclusion Oxidative stress and disruption of NO synthesis play an important role in renal function and histopathological changes after obstructive renal disease. To prevent renal complications developing after obstructive nephropathy we believe that a new strategy may be research on reducing ADMA. PMID:27286129

  8. The risk of biomaterial-associated infection after revision surgery due to an experimental primary implant infection.

    PubMed

    Engelsman, Anton F; Saldarriaga-Fernandez, Isabel C; Nejadnik, M Reza; van Dam, Gooitzen M; Francis, Kevin P; Ploeg, Rutger J; Busscher, Henk J; van der Mei, Henny C

    2010-10-01

    The fate of secondary biomaterial implants was determined by bio-optical imaging and plate counting, after antibiotic treatment of biomaterials-associated-infection (BAI) and surgical removal of an experimentally infected, primary implant. All primary implants and tissue samples from control mice showed bioluminescence and were culture-positive. In an antibiotic treated group, no bioluminescence was detected and only 20% of all primary implants and no tissue samples were culture-positive. After revision surgery, bioluminescence was detected in all control mice. All the implants and 80% of all tissue samples were culture-positive. In contrast, in the antibiotic treated group, 17% of all secondary implants and 33% of all tissue samples were culture-positive, despite antibiotic treatment. The study illustrates that due to the BAI of a primary implant, the infection risk of biomaterial implants is higher in revision surgery than in primary surgery, emphasizing the need for full clearance of the infection, as well as from surrounding tissues prior to implantation of a secondary implant.

  9. A joint experimental and numerical study of mechanisms associated to instability of partial cavitation on two-dimensional hydrofoil

    NASA Astrophysics Data System (ADS)

    Leroux, Jean-Baptiste; Coutier-Delgosha, Olivier; Astolfi, Jacques André

    2005-05-01

    The present work was carried out in the scope of a numerical-experimental collaborative research program, whose main objective is to understand the mechanisms of instabilities in partial cavitating flow. Experiments were conducted in the configuration of a rectangular foil located in a cavitation tunnel. Partial cavitation was investigated by multipoint wall-pressure measurements together with lift and drag measurements and numerical videos. The computations were conducted on two-dimensional hydrofoil section and are based on a single fluid model of cavitation: the liquid/vapor mixture is considered as a homogeneous fluid whose composition is regulated by a barotropic state law. The algorithm of resolution is derived from the SIMPLE approach, modified to take into account the high compressibility of the medium. Several physical features were pointed out by this joint approach. Particularly two distinct cavity self-oscillation dynamics characterized by two different frequencies (dynamics 1 and dynamics 2) were obtained experimentally and numerically at the angles of incidence of 6° and 8°. In both cases, the reentrant jet was found to be mainly responsible for the cavity breakdown. Dynamics 2 corresponds to the "classical" cavity breakdown and resulting cloud cavitation. A more complex flow pattern was evidenced for dynamics 1. In this case the growth/breakdown cycle of the cavity was observed at a lower Strouhal number (˜0.07/0.09) than dynamics 2 (˜0.3). Moreover, the mechanism is composed of two successive steps: (i) an interaction between the reentrant jet and the cavity interface in the closure region leading to the periodic shedding of secondary cavitation clouds before the main cloud detachment occurs, and (ii) a shock wave induced by the collapse of the main cloud, which influences the growth of the residual cavity.

  10. A petrologic, thermodynamic and experimental study of brachinites: Partial melt residues of an R chondrite-like precursor

    NASA Astrophysics Data System (ADS)

    Gardner-Vandy, Kathryn G.; Lauretta, Dante S.; McCoy, Timothy J.

    2013-12-01

    The primitive achondrites provide a window into the initial melting of asteroids in the early solar system. The brachinites are olivine-dominated meteorites with a recrystallized texture that we and others interpret as evidence of partial melting and melt removal on the brachinite parent body. We present a petrologic, thermodynamic and experimental study of the brachinites to evaluate the conditions under which they formed and test our hypothesis that the precursor material to the brachinites was FeO-rich compared to the precursors of other primitive achondrites. Petrologic analysis of six brachinites (Brachina, Allan Hills (ALH) 84025, Hughes 026, Elephant Moraine (EET) 99402, Northwest Africa (NWA) 3151, and NWA 4969) and one brachinite-like achondrite (NWA 5400) shows that they are meteorites with recrystallized texture that are enriched in olivine (⩾80 vol.%) and depleted in other minerals with respect to a chondritic mineralogy. Silicates in the brachinites are FeO-rich (Fa32-36). Brachinite-like achondrite Northwest Africa 5400 is similar in mineralogy and texture to the brachinites but with a slightly lower FeO-content (Fa30). Thermodynamic calculations yield equilibration temperatures above the Fe,Ni-FeS cotectic temperature (∼950 °C) for all meteorites studied here and temperatures above the silicate eutectic (∼1050 °C) for all but two. Brachina formed at an fO2 of ∼IW, and the other brachinites and NWA 5400 formed at ∼IW - 1. All the meteorites show great evidence of formation by partial melting having approximately chondritic to depleted chondritic mineralogies, equilibrated mineral compositions, and recrystallized textures, and having reached temperatures above that required for melt generation. In an attempt to simulate the formation of the brachinite meteorites, we performed one-atmosphere, gas-mixing partial melting experiments of R4 chondrite LaPaz Ice Field 03639. Experiments at 1250 °C and an oxygen fugacity of IW - 1 produce residual

  11. Partial reverse of the TCA cycle is enhanced in Taenia crassiceps experimental neurocysticercosis after in vivo treatment with anthelminthic drugs.

    PubMed

    de Almeida Leandro, Leticia; Fraga, Carolina Miguel; de Souza Lino, Ruy; Vinaud, Marina Clare

    2014-04-01

    Neurocysticercosis (NCC) is the most common helminthic infection and neglected disease of the central nervous system. It is the leading cause of acquired epilepsy and seizures worldwide. Therefore, to study this important neglected disease, it is important to use experimental models. There is no report in the literature on how the parasite's metabolism reacts to antihelminthic treatment when it is still within the central nervous system of the host. Therefore, the aim of this study was to investigate the energetic metabolism of cysticerci experimentally inoculated in the encephala of BALB/c mice after treatment with low dosages (not sufficient to kill the parasite) of albendazole (ABDZ) and praziquantel (PZQ). BALB/c mice were intracranially inoculated with Taenia crassiceps cysticerci and, after 30 days, received treatment with low dosages of ABDZ and PZQ. After 24 h of treatment, the mice were euthanized, and the cysticerci were removed and analyzed through high-performance liquid chromatography (HPLC) to quantify the organic acids related to the energetic metabolism of the parasite. The partial reverse of the TCA cycle was enhanced by the ABDZ and PZQ treatments both with the higher dosage, as the organic acids of this pathway were significantly increased when compared to the control group and to the other dosages. In conclusion, it was possible to detect the increase of this pathway in the parasites that were exposed to low dosages of ABDZ and PZQ, as it is a mechanism that would amplify the energy production in a hostile environment.

  12. [Accelerated partial breast irradiation with image-guided intensity-modulated radiotherapy following breast-conserving surgery - preliminary results of a phase II clinical study].

    PubMed

    Mészáros, Norbert; Major, Tibor; Stelczer, Gábor; Zaka, Zoltán; Mózsa, Emõke; Fodor, János; Polgár, Csaba

    2015-06-01

    The purpose of the study was to implement accelerated partial breast irradiation (APBI) by means of image-guided intensity-modulated radiotherapy (IG-IMRT) following breast-conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive (St I-II) breast cancer who underwent BCS were enrolled in our phase II prospective study. Postoperative APBI was given by means of step and shoot IG-IMRT using 4 to 5 fields to a total dose of 36.9 Gy (9×4.1 Gy) using a twice-a-day fractionation. Before each fraction, series of CT images were taken from the region of the target volume using a kV CT on-rail mounted in the treatment room. An image fusion software was used for automatic image registration of the planning and verification CT images. Patient set-up errors were detected in three directions (LAT, LONG, VERT), and inaccuracies were adjusted by automatic movements of the treatment table. Breast cancer related events, acute and late toxicities, and cosmetic results were registered and analysed. At a median follow-up of 24 months (range 12-44) neither locoregional nor distant failure was observed. Grade 1 (G1), G2 erythema, G1 oedema, and G1 and G2 pain occurred in 21 (35%), 2 (3.3%), 23 (38.3%), 6 (10%) and 2 (3.3%) patients, respectively. No G3-4 acute side effects were detected. Among late radiation side effects G1 pigmentation, G1 fibrosis, and G1 fat necrosis occurred in 5 (8.3%), 7 (11.7%), and 2 (3.3%) patients, respectively. No ≥G2 late toxicity was detected. Excellent and good cosmetic outcome was detected in 45 (75%) and 15 (25%) patients. IG-IMRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. Preliminary results are promising, early radiation side effects are minimal, and cosmetic results are excellent. PMID:26035158

  13. [Plastic surgery of the anterior cruciate ligament: experimental study of intra-articular aramid fibers in dogs].

    PubMed

    Passuti, N; Daculsi, G; Gouin, F; Martin, S; Vigneron, M

    1989-01-01

    The authors explored the possibility of replacing an anterior cruciate ligament with an aramid fiber (Kevlar) implant. This study was performed in intra-articular site in 9 dogs and the average implantation period was 5 months. Studies were carried out by macroscopic, photon microscopy, and electron microscopy examination of the samples obtained at the time the animals were sacrificed. Clinical and radiographic studies of the knees were performed in order to assess functional consequences. Overall, the results showed a partial or complete rupture of 10 neoligaments out of the 17 studied ligaments; on the other hand, osseous anchorage and reintegration in the intra-articular zone appeared satisfactory. Kevlar fiber only partially meets the performance specifications for an artificial ligament intended to serve as an anterior cruciate ligament substitute. Some positive results have encouraged the authors to carry on further this experimental study.

  14. Fetal reconstructive surgery: experimental use of the latissimus dorsi flap to correct myelomeningocele in utero.

    PubMed

    Meuli-Simmen, C; Meuli, M; Hutchins, G M; Harrison, M R; Buncke, H J; Sullivan, K M; Adzick, N S

    1995-10-01

    A recent study in human fetuses with myelomeningocele produced evidence that nonclosure of the spine leads to progressive damage of the exposed spinal cord during pregnancy. Thus in utero coverage might spare function. We tested the use of the latissimus dorsi flap for fetal myelomeningocele repair. In seven sheep fetuses, a lumbar myelomeningocele type of lesion was created at 75 days' gestation and was covered with a "reversed" latissimus dorsi flap at 100 days. At term, the three survivors had healed cutaneous wounds and normal hindlimb function. The vascular pedicle of the latissimus dorsi flap was patent, the viable flap covered the entire lesion, and the underlying spinal cord was grossly intact. We conclude that the latissimus dorsi flap repair is suitable for fetal surgery and provides efficient coverage of the lesion. These results have clinical implications, since fetal myelomeningocele repair may be a compelling way to reduce the severe neurologic deficit in humans. PMID:7568473

  15. Effects of octreotide acetate and amniotic membrane on wound healing in experimental glaucoma surgery.

    PubMed

    Demir, Tamer; Turgut, Burak; Celiker, Ulku; Ozercan, Ibrahim; Ulas, Fatih; Akyol, Nuray

    2003-09-01

    Wound healing affects the success of glaucoma filtering surgery. Antimetabolites and antifibrotic agents are used in the modulation of surgical trauma. This study is performed to evaluate the effects of amniotic membrane and octreotide acetate on wound healing. Thirty pigmented rabbits were divided into three groups each including 10 animals. Trabeculectomy and topical postoperative prednisolone sodium phosphate four times daily for 7 days were applied to one eye of all the rabbits. After trabeculectomy, octreotide 10 microg three times daily applied topically to the octreotide group for 14 days and amniotic membrane transplantation was performed by suturing amniotic membrane between scleral flap and sclera to the amniotic membrane group. The operated eyes of the rabbits were enucleated on the 14th day of the operation and histopathological specimens were obtained from the bleb sites and they were evaluated by light microscope. Fibroblast and macrophage number per cm2 were counted and the average values were calculated. Compared with the control group, the fibroblasts and macrophages significantly decreased in the other two groups (p < 0.0001, p < 0.0001, respectively). The mean number of fibroblasts was lower than those of the control and amniotic membrane groups (p < 0.0001, p < 0.0001, respectively). Similarly the mean macrophage number was significantly lower in the octreotide group versus the control and amniotic membrane groups (p < 0.0001, p < 0.01, respectively). Octreotide administration and amniotic membrane transplantation might be alternative treatments in modulating the wound healing after trabeculectomy.

  16. Experimental investigation of transport of discrete solids with surge flows in a 10.0 cm diameter partially filled pipe

    NASA Astrophysics Data System (ADS)

    Mahajan, B. M.

    1982-01-01

    The transport of discrete solids with surge flows in a partially filled slightly pitched horizontal pipe was investigated. The experimental apparatus, instrumentation, and procedures are described. The experiments were conducted using a cylindrical solid in a 10.0 cm (4 in) diameter pipe. The water surge flows were obtained by discharging different volumes of water into the pipe from a falling head open container which simulated a water closet. Flow induced solid velocities and stream depth histories at various locations along the length of the pipe were measured. The effects of water volume used, pipe slope, and size of the solid on the solid velocities were examined. Solid velocities were compared with the maximum water velocities estimated from the stream depth histories. Also, the distance traversed by the solids in the pipe were measured for those cases in which the solids did not clear the pipe. The solid velocity increased with an increase in water volume used, a decrease in the size of the solid, and an increase in the pipe slope. The solid velocity in the initial reach of the pipe was less than the maximum water velocity; and the solid velocity approaches the maximum water velocity as the solid traveled downstream, except for some experiments with small water volumes.

  17. YAG laser in experimental and clinical surgery of the head and neck

    NASA Astrophysics Data System (ADS)

    Tulibacki, Marek P.; Kukwa, Andrzej; Zajac, Andrzej; Zendzian, Waldemar

    1996-03-01

    The authors present their basic and clinical experience aiming at the evaluation of the possibilities of different types of YAG-laser. The aim of the present study was the assessment of the degree of tissue destruction for the most adequate clinical application of laser; the work was carried out using experimental animals and cadavers.

  18. Experimental assessment of energy requirements and tool tip visibility for photoacoustic-guided endonasal surgery

    NASA Astrophysics Data System (ADS)

    Lediju Bell, Muyinatu A.; Dagle, Alicia B.; Kazanzides, Peter; Boctor, Emad M.

    2016-03-01

    Endonasal transsphenoidal surgery is an effective approach for pituitary adenoma resection, yet it poses the serious risk of internal carotid artery injury. We propose to visualize these carotid arteries, which are hidden by bone, with an optical fiber attached to a surgical tool and a transcranial ultrasound probe placed on the patient's temple (i.e. intraoperative photoacoustic imaging). To investigate energy requirements for vessel visualization, experiments were conducted with a phantom containing ex vivo sheep brain, ex vivo bovine blood, and 0.5-2.5 mm thick human cadaveric skull specimens. Photoacoustic images were acquired with 1.2-9.3 mJ laser energy, and the resulting vessel contrast was measured at each energy level. The distal vessel boundary was difficult to distinguish at the chosen contrast threshold for visibility (4.5 dB), which was used to determine the minimum energies for vessel visualization. The blood vessel was successfully visualized in the presence of the 0-2.0 mm thick sphenoid and temporal bones with up to 19.2 dB contrast. The minimum energy required ranged from 1.2-5.0 mJ, 4.2-5.9 mJ, and 4.6-5.2 mJ for the 1.0 temporal and 0-1.5 mm sphenoid bones, 1.5 mm temporal and 0-0.5 mm sphenoid bones, and 2.0 mm temporal and 0-0.5 mm sphenoid bones, respectively, which corresponds to a fluence range of 4-21 mJ/cm2. These results hold promise for vessel visualization within safety limits. In a separate experiment, a mock tool tip was placed, providing satisfactory preliminary evidence that surgical tool tips can be visualized simultaneously with blood vessels.

  19. Epilepsy (partial)

    PubMed Central

    2011-01-01

    Introduction About 3% of people will be diagnosed with epilepsy during their lifetime, but about 70% of people with epilepsy eventually go into remission. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of starting antiepileptic drug treatment following a single seizure? What are the effects of drug monotherapy in people with partial epilepsy? What are the effects of additional drug treatments in people with drug-resistant partial epilepsy? What is the risk of relapse in people in remission when withdrawing antiepileptic drugs? What are the effects of behavioural and psychological treatments for people with epilepsy? What are the effects of surgery in people with drug-resistant temporal lobe epilepsy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 83 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiepileptic drugs after a single seizure; monotherapy for partial epilepsy using carbamazepine, gabapentin, lamotrigine, levetiracetam, phenobarbital, phenytoin, sodium valproate, or topiramate; addition of second-line drugs for drug-resistant partial epilepsy (allopurinol, eslicarbazepine, gabapentin, lacosamide, lamotrigine, levetiracetam, losigamone, oxcarbazepine, retigabine, tiagabine, topiramate, vigabatrin, or zonisamide); antiepileptic drug withdrawal for people with partial or

  20. Comparison of false-negative/positive results of intraoperative evoked potential monitoring between no and partial neuromuscular blockade in patients receiving propofol/remifentanil-based anesthesia during cerebral aneurysm clipping surgery: A retrospective analysis of 685 patients.

    PubMed

    Kim, Sung-Hoon; Jin, Seok-Joon; Karm, Myong-Hwan; Moon, Young-Jin; Jeong, Hye-Won; Kim, Jae-Won; Ha, Seung-Il; Kim, Joung-Uk

    2016-08-01

    Although the elicited responses of motor evoked potential (MEP) monitoring are very sensitive to suppression by anesthetic agents and muscle relaxants, the use of neuromuscular blockade (NMB) during MEP monitoring is still controversial because of serious safety concerns and diagnostic accuracy. Here, we evaluated the incidence of unacceptable movement and compared false-negative MEP results between no and partial NMB during cerebral aneurysm clipping surgery. We reviewed patient medical records for demographic data, anesthesia regimen, neurophysiology event logs, MEP results, and clinical outcomes. Patients were divided into 2 groups according to the intraoperative use of NMB: no NMB group (n = 276) and partial NMB group (n = 409). We compared the diagnostic accuracy of MEP results to predict postoperative outcomes between both groups. Additionally, we evaluated unwanted patient movement during MEP monitoring in both groups. Of the 685 patients, 622 (90.8%) manifested no intraoperative changes in MEP and no postoperative motor deficits. Twenty patients showed postoperative neurologic deficits despite preserved intraoperative MEP. False-positive MEP results were 3.6% in the no NMB group and 3.9% in the partial NMB group (P = 1.00). False-negative MEP results were 1.1% in the no NMB group and 4.2% in the partial NMB group (P = 0.02). No spontaneous movement or spontaneous respiration was observed in either group. Propofol/remifentanil-based anesthesia without NMB decreases the stimulation intensity of MEPs, which may reduce the false-negative ratio of MEP monitoring during cerebral aneurysm surgery. Our anesthetic protocol enabled reliable intraoperative MEP recording and patient immobilization during cerebral aneurysm clipping surgery. PMID:27559984

  1. Comparison of false-negative/positive results of intraoperative evoked potential monitoring between no and partial neuromuscular blockade in patients receiving propofol/remifentanil-based anesthesia during cerebral aneurysm clipping surgery: A retrospective analysis of 685 patients.

    PubMed

    Kim, Sung-Hoon; Jin, Seok-Joon; Karm, Myong-Hwan; Moon, Young-Jin; Jeong, Hye-Won; Kim, Jae-Won; Ha, Seung-Il; Kim, Joung-Uk

    2016-08-01

    Although the elicited responses of motor evoked potential (MEP) monitoring are very sensitive to suppression by anesthetic agents and muscle relaxants, the use of neuromuscular blockade (NMB) during MEP monitoring is still controversial because of serious safety concerns and diagnostic accuracy. Here, we evaluated the incidence of unacceptable movement and compared false-negative MEP results between no and partial NMB during cerebral aneurysm clipping surgery. We reviewed patient medical records for demographic data, anesthesia regimen, neurophysiology event logs, MEP results, and clinical outcomes. Patients were divided into 2 groups according to the intraoperative use of NMB: no NMB group (n = 276) and partial NMB group (n = 409). We compared the diagnostic accuracy of MEP results to predict postoperative outcomes between both groups. Additionally, we evaluated unwanted patient movement during MEP monitoring in both groups. Of the 685 patients, 622 (90.8%) manifested no intraoperative changes in MEP and no postoperative motor deficits. Twenty patients showed postoperative neurologic deficits despite preserved intraoperative MEP. False-positive MEP results were 3.6% in the no NMB group and 3.9% in the partial NMB group (P = 1.00). False-negative MEP results were 1.1% in the no NMB group and 4.2% in the partial NMB group (P = 0.02). No spontaneous movement or spontaneous respiration was observed in either group. Propofol/remifentanil-based anesthesia without NMB decreases the stimulation intensity of MEPs, which may reduce the false-negative ratio of MEP monitoring during cerebral aneurysm surgery. Our anesthetic protocol enabled reliable intraoperative MEP recording and patient immobilization during cerebral aneurysm clipping surgery.

  2. Experimental partial melting of the Allende (CV) and Murchison (CM) chondrites and the origin of asteroidal basalt

    NASA Technical Reports Server (NTRS)

    Jurewicz, A. J. G.; Mittlefehldt, D. W.; Jones, J. H.

    1993-01-01

    Following the investigation of Jurewicz et al. (1991) on the composition of partial melts of eucrites and angrites, this study investigates partial melts of the Allende and Murchison chondrites and details the anhydrous phase relations of both chondrites at 1 atm, under temperatures and oxygen fugacities plausigle for the formation of basaltic meteorites. It was found that, in general, ambient oxygen fugacity exerts a strong influence on the compositions of partial melts of chondrites by controlling the amount of FeO available to the silicate system. At high f(O2), angritic magmas are produced, whereas eucritic melts are produced at low levels of f(O2).

  3. An experimental study on laser-induced suturing of venous grafts in cerebral revascularization surgery

    NASA Astrophysics Data System (ADS)

    Puca, Alfredo; Albanese, Alessio; Esposito, Giuseppe; Maira, Giulio; Rossi, Giacomo; Pini, Roberto

    2005-04-01

    To test laser-assisted high flow bypass in cerebral revascularization procedures, we set up an experimental model on rabbits which included harvesting a jugular vein graft and its implantation on the common carotid artery through a double end-to-side anastomosis. The study was carried out on 25 New Zealand rabbits by performing on each animal the proximal anastomosis using conventional suturing, while the distal one was obtained by means of low-power diode laser welding in association with the topical application of Indocyanine Green (ICG) solution to enhance local absorption of the laser light. After the procedure, the animals were subjected to a follow-up from 2 to 9 days. Bypass patency was evaluated by means of Doppler study. The vascular segments were excised and evaluated by histological and immunohistochemical examinations. Utilization of the diode laser was associated with a substantial shortening of the operative time, as well as with a more active endothelial regeneration process at the anastomotic site.

  4. The effect of a forced-air warming blanket on patients' end-tidal and transcutaneous carbon dioxide partial pressures during eye surgery under local anaesthesia: a single-blind, randomised controlled trial.

    PubMed

    Sukcharanjit, S; Tan, A S B; Loo, A V P; Chan, X L; Wang, C Y

    2015-12-01

    Surgical drapes used during eye surgery are impermeable to air and hence risk trapping air underneath them. We investigated the effect of a forced-air warming blanket on carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia without sedation. Forty patients of ASA physical status 1 and 2 were randomly assigned to either the forced-air warmer (n = 20) or a control heated overblanket (n = 20). All patients were given 1 l.min(-1) oxygen. We measured transcutaneous and end-tidal carbon dioxide partial pressures, heart rate, arterial pressure, respiratory rate, temperature and oxygen saturation before and after draping, then every 5 min thereafter for 30 min. The mean (SD) transcutaneous carbon dioxide partial pressure in the forced-air warming group stayed constant after draping at 5.7 (0.2) kPa but rose to a maximum of 6.4 (0.4) kPa in the heated overblanket group (p = 0.0001 for the difference at time points 15 min and later). We conclude that forced-air warming reduces carbon dioxide accumulation under the drapes in patients undergoing eye surgery under local anaesthesia.

  5. Experimental and theoretical study of the heating dynamics of carbon-containing optothermal fibre converters for laser surgery

    NASA Astrophysics Data System (ADS)

    Belikov, A. V.; Skrypnik, A. V.; Kurnyshev, V. Yu; Shatilova, K. V.

    2016-06-01

    We have studied carbon-containing optothermal fibre converters (COTFCs) that are located on the distal end of a quartz – quartz optical fibre for delivering laser radiation in medical laser surgery systems and differ in the thickness and structure of the layer of a material converting laser radiation into heat. The heating dynamics of 'thin-film' and '3D' converters have been investigated at average incident 980-nm semiconductor laser beam powers of 0.3, 1.0 and 4.0 W, with the converters placed freely in air. The results demonstrate that, before the instant of disintegration, the efficiency of laser heating of the converter surface can reach 3000 °C W-1 for thin-film converters, 1000 °C W-1 for spherical 3D converters and 55 °C W-1 for planar 3D converters. The thin-film converter breaks down at an average laser beam power as low as 0.30 +/- 0.05 W, which is accompanied by a considerable reduction in heating efficiency and is caused by the disintegration of the carbon film on its surface. The spherical 3D converter breaks down at an average power of 4.0 +/- 0.1 W, as a result of the disintegration of the carbon film on its surface and partial melting of a modified layer containing microbubbles. The carbon film on the surface of the planar 3D converter also disintegrates at an average power of 4.0 +/- 0.1 W, but the structure of the modified layer remains unchanged. We have constructed structural and optophysical models of the converters by simulating light absorption in carbon films on the surface of the COTFC and inside the microbubbles present in the modified layer of the converters. The proposed models of the COTFCs have been shown to adequately describe real converters.

  6. Experimental and theoretical study of the heating dynamics of carbon-containing optothermal fibre converters for laser surgery

    NASA Astrophysics Data System (ADS)

    Belikov, A. V.; Skrypnik, A. V.; Kurnyshev, V. Yu; Shatilova, K. V.

    2016-06-01

    We have studied carbon-containing optothermal fibre converters (COTFCs) that are located on the distal end of a quartz - quartz optical fibre for delivering laser radiation in medical laser surgery systems and differ in the thickness and structure of the layer of a material converting laser radiation into heat. The heating dynamics of 'thin-film' and '3D' converters have been investigated at average incident 980-nm semiconductor laser beam powers of 0.3, 1.0 and 4.0 W, with the converters placed freely in air. The results demonstrate that, before the instant of disintegration, the efficiency of laser heating of the converter surface can reach 3000 °C W-1 for thin-film converters, 1000 °C W-1 for spherical 3D converters and 55 °C W-1 for planar 3D converters. The thin-film converter breaks down at an average laser beam power as low as 0.30 +/- 0.05 W, which is accompanied by a considerable reduction in heating efficiency and is caused by the disintegration of the carbon film on its surface. The spherical 3D converter breaks down at an average power of 4.0 +/- 0.1 W, as a result of the disintegration of the carbon film on its surface and partial melting of a modified layer containing microbubbles. The carbon film on the surface of the planar 3D converter also disintegrates at an average power of 4.0 +/- 0.1 W, but the structure of the modified layer remains unchanged. We have constructed structural and optophysical models of the converters by simulating light absorption in carbon films on the surface of the COTFC and inside the microbubbles present in the modified layer of the converters. The proposed models of the COTFCs have been shown to adequately describe real converters.

  7. Spherical mechanism analysis of a surgical robot for minimally invasive surgery -- analytical and experimental approaches.

    PubMed

    Rosen, Jacob; Lum, Mitch; Trimble, Denny; Hannaford, Blake; Sinanan, Mika

    2005-01-01

    Recent advances in technology have led to the fusion of MIS techniques and robot devices. However, current systems are large and cumbersome. Optimizing the surgical robot mechanism will eventually lead to its integration into the operating room (OR) of the future becoming the extended presence of the surgeon and nurses in a room occupied by the patient alone. By optimizing a spherical mechanism using data collected in-vivo during MIS procedures, this study is focused on a bottom-up approach to developing a new class of surgical robotic arms while maximizing their performance and minimizing their size. The spherical mechanism is a rotational manipulator with all axes intersecting at the center of the sphere. Locating the rotation center of the mechanism at the MIS port makes this class of mechanism a suitable candidate for the first two links of a surgical robot for MIS. The required dexterous workspace (DWS) is defined as the region in which 95% of the tool motions are contained based on in-vivo measurements. The extended dexterous workspace (EDWS) is defined as the entire abdominal cavity reachable by a MIS instruments. The DWS is defined by a right circular cone with a vertex angle of 60 degrees and the EDWS is defined by a cone with an elliptical cross section created by two orthogonal vertex angles of 60 degrees and 90 degrees. A compound function based on the mechanism's isotropy and the mechanism stiffness was considered as the performance metric cost function. Optimization across both the DWS and the EDWS lead to a serial mechanism configuration with link length angles of 74 degrees and 60 degrees for a serial configuration. This mechanism configuration maximized the kinematic performance in the DWS while keeping the EDWS as its reachable workspace. Surgeons, using a mockup of two mechanisms in a MIS setup, validated these results experimentally. From these experiments the serial configuration was deemed most applicable for MIS robotic applications compared

  8. Experimental study of a fiber optically guided CO2 laser probe for intraocular surgery: measurement of the immediate retinal adhesion force

    NASA Astrophysics Data System (ADS)

    DeRowe, Ari; Bartov, Elisha; Triester, G.; Belkin, Michael; Katzir, Abraham

    1992-08-01

    Using an experimental fiberoptically guided CO2 laser system, we performed lesions on fresh bovine retinas. These lesions were shown to achieve measurable immediate chorioretinal adhesion. This model implies the feasibility of utilizing a fiberoptic CO2 laser probe in intraocular surgery for retinal detachment. The advantages of using CO2 laser energy are minimal damage surrounding the desired lesion and its versatility as a coagulator and cutter. With further research we believe that the technical problem of delivery can be solved. The CO2 endolaser holds promise for intraocular surgery.

  9. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  10. Experimental and geochemical evidence for derivation of the El Capitan Granite, California, by partial melting of hydrous gabbroic lower crust

    USGS Publications Warehouse

    Ratajeski, K.; Sisson, T.W.; Glazner, A.F.

    2005-01-01

    Partial melting of mafic intrusions recently emplaced into the lower crust can produce voluminous silicic magmas with isotopic ratios similar to their mafic sources. Low-temperature (825 and 850??C) partial melts synthesized at 700 MPa in biotite-hornblende gabbros from the central Sierra Nevada batholith (Sisson et al. in Contrib Mineral Petrol 148:635-661, 2005) have major-element and modeled trace-element (REE, Rb, Ba, Sr, Th, U) compositions matching those of the Cretaceous El Capitan Granite, a prominent granite and silicic granodiorite pluton in the central part of the Sierra Nevada batholith (Yosemite, CA, USA) locally mingled with coeval, isotopically similar quartz diorite through gabbro intrusions (Ratajeski et al. in Geol Soc Am Bull 113:1486-1502, 2001). These results are evidence that the El Capitan Granite, and perhaps similar intrusions in the Sierra Nevada batholith with lithospheric-mantle-like isotopic values, were extracted from LILE-enriched, hydrous (hornblende-bearing) gabbroic rocks in the Sierran lower crust. Granitic partial melts derived by this process may also be silicic end members for mixing events leading to large-volume intermediate composition Sierran plutons such as the Cretaceous Lamarck Granodiorite. Voluminous gabbroic residues of partial melting may be lost to the mantle by their conversion to garnet-pyroxene assemblages during batholithic magmatic crustal thickening. ?? Springer-Verlag 2005.

  11. A comparison of the clinical and experimental characteristics of four acute surgical pain models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery.

    PubMed

    Singla, Neil K; Desjardins, Paul J; Chang, Phoebe D

    2014-03-01

    When a clinical trial of an analgesic produces a negative finding, it is important to consider the influence (if any) of experimental error on the validity of that result. Although efforts to identify and minimize experimental error in chronic pain investigations have begun in earnest, less work has been performed on the optimization of acute pain methodology. Of the acute surgical pain methodology articles that have been published over the last decade, almost all focus on either the dental or bunion model. Analgesics are typically evaluated in a variety of surgical models that eventually include hospital-based models (eg, joint replacement and soft tissue surgery). Every surgical procedure has unique clinical characteristics that must be considered to optimize study design and conduct. Much of the methodological knowledge garnered from bunion and dental studies is applicable to other surgical models, but some extrapolations are hazardous. The purposes of this review were (1) to qualitatively describe the clinical and experimental characteristics of the 4 classic surgical models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery; and (2) to quantitatively compare the models by analyzing 3 factors: effect size, enrollment rate, and demographics. We found that the dental extraction and bunionectomy models had higher assay sensitivity than the joint replacement and soft tissue surgery models. It is probable that this finding is secondary to the superior experimental conditions under which the dental and bunion models are executed (utilization of few centers that have the ability to reduce surgical, anesthetic, and postoperative confounders).

  12. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO.

    PubMed

    Kim, Dong-Ae; Abo-Mosallam, Hany; Lee, Hye-Young; Lee, Jung-Hwan; Kim, Hae-Won; Lee, Hae-Hyoung

    2015-01-01

    Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved.Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements.Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol%) of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitrorat dental pulp stem cells (rDPSCs) viability were examined for the prepared GICs and compared to a commercial GIC.Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min) specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05) and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs.Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials. PMID:26398508

  13. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO.

    PubMed

    Kim, Dong-Ae; Abo-Mosallam, Hany; Lee, Hye-Young; Lee, Jung-Hwan; Kim, Hae-Won; Lee, Hae-Hyoung

    2015-01-01

    Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved.Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements.Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol%) of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitrorat dental pulp stem cells (rDPSCs) viability were examined for the prepared GICs and compared to a commercial GIC.Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min) specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05) and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs.Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials.

  14. Experimental investigation of gabbro partial melting in the presence of NaCl-rich fluid - implications for the genesis of oceanic plagiogranites

    NASA Astrophysics Data System (ADS)

    Almeev, R. R.; Koepke, J.; Silantyev, S. A.; Portnyagin, M.; Garbe-Schoenberg, C.; Botcharnikov, R. E.

    2013-12-01

    We present results of the experimental study designed to assess the role of NaCl-rich hydrous fluids (modeled seawater-derived fluid) on partial melting of gabbroic rocks. Three contrasting compositions, i.e., olivine-bearing gabbro, gabbro-norite and Fe-Ti-gabbro, were investigated experimentally in the presence of the hydrous fluids with and without an excess of NaCl. The experiments were conducted in the range of pressures (100-200 MPa), temperatures (800-1040°C) and redox conditions (FMQ - FMQ+3). Partial melting in the presence of single aqueous fluid of low salinity (< 20 wt %NaCl) does not show any significant differences from the partial melting in the presence of salt-free aqueous fluid. In contrast, the presence of large amounts of NaCl (20-50 wt % in the fluid) and formation of saline-rich liquid (brine) causes the dramatic decrease in silica concentration of the partial melts and thus is not a premise to produce natural plagiogranites at investigated conditions. However the presence of NaCl may have played an important role at lower temperatures above the hydrous (only H2O-bearing fluid) solidus of the system in the presence of more complex fluids (saline and with low aH2O). Recently, J.Brophy proposed to use SiO2-REE diagrams for natural systems to decode the consequences of ideal fractionation of the basaltic melt and batch melting of the gabbro in application to the genesis of plagiogranites in mid-ocean ridge environments (e.g. Brophy, 2009). He argued that, for liquids with SiO2 greater than ~62 wt. %, hydrous melting of gabbroic cumulate should yield a negative correlation between REE abundances and increasing SiO2, while fractional crystallization of mid-ocean ridge basalt should produce a positive correlation. Our new experiments and trace element determinations in runs with large melt pools can be used to test this model. We observed the depletion of HREE (Yb) with increasing SiO2 (> 62 wt%) well predicted by the model of Brophy. In contrast

  15. Noncontrast and contrast enhanced MR imaging in the evaluation of partial ureteral obstruction: An experimental study in the micropig

    SciTech Connect

    Thurnher, S.; Tzika, A.A.; Hricak, H.; Mattei, P.; Aboseif, S.; Engelstad, B.; Price, D.C. )

    1989-07-01

    Twelve Yucatan micropigs (3 controls; 3 sham-operated; 6 with unilateral obstruction) were studied to assess the value of noncontrast and contrast-enhanced (Gadolinium-DTPA) magnetic resonance (MR) imaging in the evaluation of partial ureteral obstruction. MR findings were correlated with findings of quantitative (Tc-99m-DMSA) scintigraphy, and histology. On noncontrast T1-weighted images, the normal porcine kidney demonstrated good corticomedullary contrast (CMC = 16.8% +/- 5.0). Five minutes after administration of Gd-DTPA, there was enhancement of the renal cortex (+24.4%) and medulla (+46.2%), and CMC was no longer discernible. Enhancement of the urine within the collecting system (+119.1%) was also observed. The obstructed kidneys demonstrated marked thinning of the renal parenchyma and decreased signal intensity on noncontrast T1- and T2-weighted images (P less than 0.01). Urine in the dilated collecting system did not differ significantly from urine in controls except in the three animals with urinary tract infection (P less than 0.05). Five minutes following injection of Gd-DTPA, there was enhancement of the renal parenchyma in all kidneys. Excretion was seen in three pigs and no excretion in two. Thus, useful information can be obtained in partial ureteral obstruction from both pre-contrast and Gd-DTPA-enhanced MR images of the kidney.

  16. Experimental wavelengths for intrashell transitions in tungsten ions with partially filled 3p and 3d subshells

    NASA Astrophysics Data System (ADS)

    Lennartsson, Thomas; Clementson, Joel; Beiersdorfer, Peter

    2013-06-01

    Spectra and measured wavelengths of intrashell n=3 transitions in highly charged tungsten ions with partially filled 3p and 3d valence shells, Al-like W61+ through Fe-like W48+, are presented. The ions were created and excited at the electron-beam ion-trap facility at the Lawrence Livermore National Laboratory and measured with a high-resolution grazing-incidence spectrometer. The spectral lines were studied in the 27-41 Å range and were analyzed by a comparison with synthetic spectra based on a collisional-radiative model. We determined that the emission includes not only electric-dipole-allowed transitions, but also several electric-quadrupole and magnetic-dipole transitions. Line-position uncertainties as low as 25 ppm were achieved. Thus, our measurements provide much-needed benchmarks for calculations of the atomic structure of highly charged ions with a partially filled subshell, since these ions are difficult to calculate due to electron-correlation effects.

  17. Cosmetic Surgery

    MedlinePlus

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face ...

  18. Comparison of Brånemark fixture integration and short-term survival using one-stage or two-stage surgery in completely and partially edentulous mandibles.

    PubMed

    Collaert, B; De Bruyn, H

    1998-04-01

    The aim of this prospective study was to compare the clinical integration and survival of Brånemark fixtures when using the conventional 2-stage surgical procedure to 1-stage surgical approach in completely and partially edentulous mandibles. A total of 85 patients were consecutively treated for partial (n = 35) or complete (n = 50) mandibular edentulousness. Fixtures removed because of mobility, pain or infection were counted as failures. The first 10 patients of each group were selected for radiographical analysis of crestal bone changes 1 year after prosthesis insertion. In 33 patients with edentulous mandibles, 170 fixtures were placed in a 1-stage approach. In this group, 4 fixtures (2.4%) were lost prior to prosthetic restoration. Seventeen edentulous patients received a total of 70 fixtures in a 2-stage procedure. Out of these, 5 fixtures (7.1%) were lost at abutment connection. In 17 partially edentulous patients, 41 fixtures were inserted in a 1-stage approach. Two fixtures (5%) were lost in this group. Finally, 18 partially edentulous patients received a total of 49 fixtures in a 2-stage procedure. Out of these, 6 fixtures (12%) were lost at abutment connection. In total 313 of the 330 installed mandibular implants were loaded between 6 and 12 months (94.8% success). No further losses occurred in the implants functioning at least 1 year (267 implants) or at least 2 years (59 implants). Statistical analysis (Chi square test) revealed no difference in fixture survival between the treatment modalities. Radiographical analysis after 1 year of functional loading showed the typical bone resorption changes up to the most coronal implant thread in both modalities. Although this study pertains to relatively early loading of 2 years, the results seem to indicate that in the mandible a 1-stage surgical approach with Brånemark fixtures may be as predictable as the conventional 2-stage procedure.

  19. Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

    PubMed

    Shiroki, Ryoichi; Fukami, Naohiko; Fukaya, Kosuke; Kusaka, Mamoru; Natsume, Takahiro; Ichihara, Takashi; Toyama, Hiroshi

    2016-02-01

    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy

  20. An Experimental Investigation of Mechanical Properties in Clay Brick Masonry by Partial Replacement of Fine Aggregate with Clay Brick Waste

    NASA Astrophysics Data System (ADS)

    Kumavat, Hemraj Ramdas

    2016-09-01

    The compressive stress-strain behavior and mechanical properties of clay brick masonry and its constituents clay bricks and mortar, have been studied by several laboratory tests. Using linear regression analysis, a analytical model has been proposed for obtaining the stress-strain curves for masonry that can be used in the analysis and design procedures. The model requires only the compressive strengths of bricks and mortar as input data, which can be easily obtained experimentally. Development of analytical model from the obtained experimental results of Young's modulus and compressive strength. Simple relationships have been identified for obtaining the modulus of elasticity of bricks, mortar, and masonry from their corresponding compressive strengths. It was observed that the proposed analytical model clearly demonstrates a reasonably good prediction of the stress-strain curves when compared with the experimental curves.

  1. Experimental verification of the Kruskal-Shafranov stability limit in line-tied partial-toroidal plasmas

    NASA Astrophysics Data System (ADS)

    Oz, E.; Myers, C. E.; Yamada, M.; Ji, H.; Kulsrud, R. M.; Xie, J.

    2011-10-01

    The stability properties of partial-toroidal flux ropes are studied in detail in the laboratory, motivated by ubiquitous arched magnetic structures found on the solar surface. The flux ropes studied here are magnetized arc discharges formed between two electrodes in the Magnetic Reconnection Experiment (MRX) [Yamada et al., Phys. Plasmas 4, 1936 (1997)]. The three dimensional evolution of these flux ropes is monitored by a fast visible light framing camera, while their magnetic structure is measured by a variety of internal magnetic probes. The flux ropes are consistently observed to undergo large-scale oscillations as a result of an external kink instability. Using detailed scans of the plasma current, the guide field strength, and the length of the flux rope, we show that the threshold for kink stability is governed by the Kruskal-Shafranov limit for a flux rope that is held fixed at both ends (i.e., qa = 1).

  2. Fetal Surgery

    PubMed Central

    Laberge, Jean-Martin

    1986-01-01

    Fetal surgery has come of age. For decades experimental fetal surgery proved essential in studying normal fetal physiology and development, and pathophysiology of congenital defects. Clinical fetal surgery started in the 1960s with intrauterine transfusions. In the 1970s, the advent of ultrasonography revolutionized fetal diagnosis and created a therapeutic vacuum. Fetal treatment, medical and surgical, is slowly trying to fill the gap. Most defects detected are best treated after birth, some requiring a modification in the time, mode and place of delivery for optimal obstetrical and neonatal care. Surgical intervention in utero should be considered for malformations that cause progressive damage to the fetus, leading to death or severe morbidity; that can be corrected or palliated in utero with a reasonable expectation of normal postnatal development; that cannot wait to be corrected after birth, even considering pre-term delivery; that are not accompanied by chromosomal or other major anomalies. At present, congenital hydronephrosis is the most common indication for fetal surgery, followed by obstructive hydrocephalus. Congenital diaphragmatic hernia also fulfills the criteria, but its correction poses more problems, and no clinical attempts have been reported so far. In the future many other malformations or diseases may become best treated in utero. The ethical and moral issues are complex and need to be discussed as clinical and experimental progress is made. PMID:21267309

  3. Partial knee replacement

    MedlinePlus

    ... You will need to understand what surgery and recovery will be like. Partial knee arthroplasty may be a good choice if you have arthritis in only one side or part of the knee and: You are older, thin, and not very active. You do not ...

  4. High Pressure Experimental Investigation of the Interaction between Partial Melts of Eclogite and Mantle Peridotite during Upwelling

    NASA Astrophysics Data System (ADS)

    Pinter, Z.; Rosenthal, A.; Frost, D. J.; McCammon, C. A.; Höfer, H. E.; Yaxley, G. M.; Berry, A.; Woodland, A. B.; Vasilyev, P.; Pearson, G. D.

    2015-12-01

    Many mantle-derived magmas may originate through partial melting of complex, mixed mantle rocks including not only peridotite, but also oceanic crust recycled into the mantle [1,2]. There is, however, little detailed knowledge concerning how such material is produced, how it melts, the types of liquids produced and how they are extracted from the mantle. We have conducted a series of peridotite/basalt layered experiments using an average altered mid-ocean ridge basalt GA2 [3] and fertile peridotite HZ1 [4] doped with Ir to act as a redox sensor [5,6]. Experiments were performed at 3-10 GPa, 1235-1660°C, using a multi anvil apparatus. The compositions of minerals and melts were analysed using an electron microprobe. Fourier-transform infrared and Mössbauer spectroscopy were also employed to determine the concentrations of small amounts of volatiles and the Fe3+/ΣFe ratio, respectively. Experiments yielded well-crystallised heterogeneous mantle assemblages. Similar to previous studies [3,7], 'dry' eclogite starts to melt at higher depths than ambient 'dry' mantle along adiabatic paths. Highly siliceous melts produced through near-adiabatic ascent freeze into ambient peridotite, forming distinct orthopyroxene-rich reaction zones [8]. We demonstrate that impregnating partial melts of eclogite in an upwelling mantle differ in their metasomatic effects depending on the particular adiabatic path, as suggested previously [7]. Thus, melt compositions formed by subsequent re-melting of such metasomatic assemblages strongly depend on potential temperature of the adiabat [7]. [1] Hofmann et al. Treatise Geochem 2, 2.03, 61-101 (2003) [2] Sobolev et al. Science 316, 412-417 (2007) [3] Spandler et al. J Petrol 49, 771-795 (2008) [4] Green et al. Nature 467, 448-451 (2010) [5] Stagno et al. Nature 493, 84-88 (2013) [6] Stagno et al. Contrib Mineral Petrol 169:16 (2015) [7] Rosenthal et al. Sci Rep 4, 6099 (2014) [8] Yaxley & Green Schweiz Mineral Petrogr Mitt 78, 243-255 (1998)

  5. Size-dependent selectivity and activity of silver nanoclusters in the partial oxidation of propylene to propylene oxide and acrolein : A joint experimental and theoretical study.

    SciTech Connect

    Molina, L M.; Lee, S.; Sell, K.; Barcaro, G.; Fortunelli, A.; Lee, B.; Seifert, S.; Winans, R. E.; Elam, J. W.; Pellin, M. J.; Barke, I.; von Oeynhausen, V.; Lei, Y.; Meyer, R. J.; Alonso, J. A.; Fraile-Rodriguez, A.; Kleibert, A.; Giorgio, S.; Henry, C. R.; Heinz Meiwes-Broer, K.; Vadja, S.; Univ. de Valladolid; Univ. Rostock; IPCF-CNR; Univ. of Illinois at Chicago; Swiss Light Source; CINaM-CNRS and Aix-Marseille Univ.; Yale Univ.

    2011-02-02

    Model silver nanocatalysts between 9 and 23 nm in size were prepared by size-selected cluster deposition from a free cluster beam on amorphous alumina films and their size-dependent catalytic performance studied in the partial oxidation of propylene under realistic reaction conditions. Smaller clusters preferentially produced acrolein, while the 23 nm particles were considerably more selective towards the formation of propylene oxide, at reaction rates far exceeding those previously reported for larger silver particles. The activity of clusters dropped significantly with increasing particle size. First-principle calculations, of the activation energies for oxygen adsorption and its dissociation, at variable surface coverage yielded surface energies which resulted in particle shapes resembling the experimentally observed shapes of partially oxidized silver clusters. The calculated activation barriers for propylene oxide and acrolein formation on various facets and on the edges of the nanoparticles provided detailed information about the energetics of the competing reaction pathways. The size- and corresponding morphology dependent theoretical activity and selectivity are in good accord with experimental observations.

  6. Experimental approach to the anion problem in DFT calculation of the partial charge transfer during adsorption at electrochemical interfaces

    NASA Astrophysics Data System (ADS)

    Marichev, V. A.

    2005-08-01

    In DFT calculation of the charge transfer (Δ N), anions pose a special problem since their electron affinities are unknown. There is no method for calculating reasonable values of the absolute electronegativity ( χA) and chemical hardness ( ηA) for ions from data of species themselves. We propose a new approach to the experimental measurement of χA at the condition: Δ N = 0 at which η values may be neglected and χA = χMe. Electrochemical parameters corresponding to this condition may be obtained by the contact electric resistance method during in situ investigation of anion adsorption in the particular system anion-metal.

  7. Experimental study of vorticity-strain rate interaction in turbulent partially-premixed jet flames using tomographic particle image velocimetry

    DOE PAGES

    Coriton, Bruno; Frank, Jonathan H.

    2016-02-16

    In turbulent flows, the interaction between vorticity, ω, and strain rate, s, is considered a primary mechanism for the transfer of energy from large to small scales through vortex stretching. The ω-s coupling in turbulent jet flames is investigated using tomographic particle image velocimetry (TPIV). TPIV provides a direct measurement of the three-dimensional velocity field from which ω and s are determined. The effects of combustion and mean shear on the ω-s interaction are investigated in turbulent partially premixed methane/air jet flames with high and low probabilities of localized extinction as well as in a non-reacting isothermal air jet withmore » Reynolds number of approximately 13,000. Results show that combustion causes structures of high vorticity and strain rate to agglomerate in highly correlated, elongated layers that span the height of the probe volume. In the non-reacting jet, these structures have a more varied morphology, greater fragmentation, and are not as well correlated. The enhanced spatiotemporal correlation of vorticity and strain rate in the stable flame results in stronger ω-s interaction characterized by increased enstrophy and strain-rate production rates via vortex stretching and straining, respectively. The probability of preferential local alignment between ω and the eigenvector of the intermediate principal strain rate, s2, which is intrinsic to the ω-s coupling in turbulent flows, is larger in the flames and increases with the flame stability. The larger mean shear in the flame imposes a preferential orientation of ω and s2 tangential to the shear layer. The extensive and compressive principal strain rates, s1 and s3, respectively, are preferentially oriented at approximately 45° with respect to the jet axis. As a result, the production rates of strain and vorticity tend to be dominated by instances in which ω is parallel to the s1¯-s2¯ plane and orthogonal to s3¯.« less

  8. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    SciTech Connect

    Strnad, Vratislav; Hildebrandt, Guido; Poetter, Richard; Hammer, Josef; Hindemith, Marion; Resch, Alexandra; Spiegl, Kurt; Lotter, Michael; Uter, Wolfgang; Bani, Mayada; Kortmann, Rolf-Dieter; Beckmann, Matthias W.; Fietkau, Rainer; Ott, Oliver J.

    2011-05-01

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was < 3 cm, resection margins were clear by at least 2 mm, no lymph node metastases existed, age was >35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (D{sub ref} = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (D{sub ref} = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects {>=}Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  9. LES and experimental studies of cold and reacting flow in a swirled partially premixed burner with and without fuel modulation

    SciTech Connect

    Sengissen, A.X.; Van Kampen, J.F.; Huls, R.A.; Stoffels, G.G.M.; Kok, J.B.W.; Poinsot, T.J.

    2007-07-15

    In devices where air and fuel are injected separately, combustion processes are influenced by oscillations of the air flow rate but may also be sensitive to fluctuations of the fuel flow rate entering the chamber. This paper describes a joint experimental and numerical study of the mechanisms controlling the response of a swirled complex-geometry combustor burning natural gas and air. The flow is first characterized without combustion and LDV results are compared to large eddy simulation (LES) data. The nonpulsated reacting regime is then studied and characterized in terms of the heat release field. Finally the fuel flow rate is pulsated at several amplitudes and the response of the chamber is analyzed using phase-locked averaging and acoustic analysis. Results show that LES and acoustic analysis predict the flame dynamics in this complex configuration with accuracy when heat losses (radiation and convection) are accounted for. (author)

  10. Experimental Characterization of Combustion Instabilities and Flow-Flame Dynamics in a Partially-Premixed Gas Turbine Model Combustor

    NASA Astrophysics Data System (ADS)

    Allison, Patton Manuel

    Partially-premixed, swirl combustion is applied in gas turbine combustors to achieve flame stabilization and reduced emission production. However, this method is also inherently sensitive to combustion instabilities which can cause large pressure, velocity, and heat release fluctuations. This thesis investigates thermoacoustic coupling created by flow-flame dynamics in a gas turbine model combustor (GTMC) for a variety of fuels and operating flow rates. Several naturally occurring instability modes were identified to control the acoustic response of the system, including Helmholtz resonances from the plenum and convective-acoustic effects which cause equivalence ratio oscillations. Laser Doppler velocimetry was used to measure radial flow in the GTMC, which can set up flow-fields which create loudly resonating flat-shaped flames, in comparison to quiet V-shaped flames. Flame location and shape altered convective time delays which determine the relative phases of pressure and heat release oscillations. Simultaneous pressure and chemiluminescence imaging showed that the heat release, pressure fluctuations, and flame motion are all coupled at the same instability frequency. Videos of the flame motion also revealed that the precessing vortex core (PVC), created by the swirling flow, influences the rocking behavior of the flame. Acetone was added to the fuel to act as a tracer in fluorescence measurements which indicated the localization of unburned fuel. It was discovered that fuel was distributed in lobes which corresponded to locations surrounding the shear layer outside of the central recirculation zone, and that the relative distribution of the lobes adjusted to forcing by the flow. Finally, high-speed formaldehyde planar laser-induced fluorescence was applied to study the motion of preheat zone surfaces in response to the oscillations of the instability. The flame surface density and wrinkling fluctuated at the acoustic frequency and displayed dampened motions

  11. Cataract Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  12. Purple Pitcher Plant (Sarracenia rosea) Dieback and Partial Community Disassembly following Experimental Storm Surge in a Coastal Pitcher Plant Bog

    PubMed Central

    Abbott, Matthew J.; Battaglia, Loretta L.

    2015-01-01

    Sea-level rise and frequent intense hurricanes associated with climate change will result in recurrent flooding of inland systems such as Gulf Coastal pitcher plant bogs by storm surges. These surges can transport salt water and sediment to freshwater bogs, greatly affecting their biological integrity. Purple pitcher plants (Sarracenia rosea) are Gulf Coast pitcher plant bog inhabitants that could be at a disadvantage under this scenario because their pitcher morphology may leave them prone to collection of saline water and sediment after a surge. We investigated the effects of storm surge water salinity and sediment type on S. rosea vitality, plant community structure, and bog soil-water conductivity. Plots (containing ≥1 ramet of S. rosea) were experimentally flooded with fresh or saline water crossed with one of three sediment types (local, foreign, or no sediment). There were no treatment effects on soil-water conductivity; nevertheless, direct exposure to saline water resulted in significantly lower S. rosea cover until the following season when a prescribed fire and regional drought contributed to the decline of all the S. rosea to near zero percent cover. There were also significant differences in plant community structure between treatments over time, reflecting how numerous species increased in abundance and a few species decreased in abundance. However, in contrast to S. rosea, most of the other species in the community appeared resilient to the effects of storm surge. Thus, although the community may be somewhat affected by storm surge, those few species that are particularly sensitive to the storm surge disturbance will likely drop out of the community and be replaced by more resilient species. Depending on the longevity of these biological legacies, Gulf Coastal pitcher plant bogs may be incapable of fully recovering if they become exposed to storm surge more frequently due to climate change. PMID:25874369

  13. Purple pitcher plant (Sarracenia rosea) Dieback and partial community disassembly following experimental storm surge in a coastal pitcher plant bog.

    PubMed

    Abbott, Matthew J; Battaglia, Loretta L

    2015-01-01

    Sea-level rise and frequent intense hurricanes associated with climate change will result in recurrent flooding of inland systems such as Gulf Coastal pitcher plant bogs by storm surges. These surges can transport salt water and sediment to freshwater bogs, greatly affecting their biological integrity. Purple pitcher plants (Sarracenia rosea) are Gulf Coast pitcher plant bog inhabitants that could be at a disadvantage under this scenario because their pitcher morphology may leave them prone to collection of saline water and sediment after a surge. We investigated the effects of storm surge water salinity and sediment type on S. rosea vitality, plant community structure, and bog soil-water conductivity. Plots (containing ≥1 ramet of S. rosea) were experimentally flooded with fresh or saline water crossed with one of three sediment types (local, foreign, or no sediment). There were no treatment effects on soil-water conductivity; nevertheless, direct exposure to saline water resulted in significantly lower S. rosea cover until the following season when a prescribed fire and regional drought contributed to the decline of all the S. rosea to near zero percent cover. There were also significant differences in plant community structure between treatments over time, reflecting how numerous species increased in abundance and a few species decreased in abundance. However, in contrast to S. rosea, most of the other species in the community appeared resilient to the effects of storm surge. Thus, although the community may be somewhat affected by storm surge, those few species that are particularly sensitive to the storm surge disturbance will likely drop out of the community and be replaced by more resilient species. Depending on the longevity of these biological legacies, Gulf Coastal pitcher plant bogs may be incapable of fully recovering if they become exposed to storm surge more frequently due to climate change. PMID:25874369

  14. Purple pitcher plant (Sarracenia rosea) Dieback and partial community disassembly following experimental storm surge in a coastal pitcher plant bog.

    PubMed

    Abbott, Matthew J; Battaglia, Loretta L

    2015-01-01

    Sea-level rise and frequent intense hurricanes associated with climate change will result in recurrent flooding of inland systems such as Gulf Coastal pitcher plant bogs by storm surges. These surges can transport salt water and sediment to freshwater bogs, greatly affecting their biological integrity. Purple pitcher plants (Sarracenia rosea) are Gulf Coast pitcher plant bog inhabitants that could be at a disadvantage under this scenario because their pitcher morphology may leave them prone to collection of saline water and sediment after a surge. We investigated the effects of storm surge water salinity and sediment type on S. rosea vitality, plant community structure, and bog soil-water conductivity. Plots (containing ≥1 ramet of S. rosea) were experimentally flooded with fresh or saline water crossed with one of three sediment types (local, foreign, or no sediment). There were no treatment effects on soil-water conductivity; nevertheless, direct exposure to saline water resulted in significantly lower S. rosea cover until the following season when a prescribed fire and regional drought contributed to the decline of all the S. rosea to near zero percent cover. There were also significant differences in plant community structure between treatments over time, reflecting how numerous species increased in abundance and a few species decreased in abundance. However, in contrast to S. rosea, most of the other species in the community appeared resilient to the effects of storm surge. Thus, although the community may be somewhat affected by storm surge, those few species that are particularly sensitive to the storm surge disturbance will likely drop out of the community and be replaced by more resilient species. Depending on the longevity of these biological legacies, Gulf Coastal pitcher plant bogs may be incapable of fully recovering if they become exposed to storm surge more frequently due to climate change.

  15. Generation of Chimeric “ABS Nanohemostat” Complex and Comparing Its Histomorphological In Vivo Effects to the Traditional Ankaferd Hemostat in Controlled Experimental Partial Nephrectomy Model

    PubMed Central

    Huri, Emre; Beyazit, Yavuz; Mammadov, Rashad; Toksoz, Sila; Tekinay, Ayse B.; Guler, Mustafa O.; Ustun, Huseyin; Kekilli, Murat; Dadali, Mumtaz; Celik, Tugrul; Astarci, Müzeyyen; Haznedaroglu, Ibrahim C.

    2013-01-01

    Purpose. Using the classical Ankaferd Blood Stopper (ABS) solution to create active hemostasis during partial nephrectomy (PN) may not be so effective due to insufficient contact surface between the ABS hemostatic liquid agent and the bleeding area. In order to broaden the contact surface, we generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. Materials and Methods. In order to generate ABS nanohemostat, a positively charged Peptide Amphiphile (PA) molecule was synthesized by using solid phase peptide synthesis. For animal experiments, 24 Wistar rats were divided into the following 4 groups: Group 1: control; Group 2: conventional PN with only 0.5 ml Ankaferd hemostat; Group 3: conventional PN with ABS + peptide gel; Group 4: conventional PN with only 0.5 ml peptide solution. Results. Mean warm ischemia times (WITs) were 232.8  ±  56.3, 65.6 ± 11.4, 75.5 ± 17.2, and 58.1 ± 17.6 seconds in Group 1 to Group 4, respectively. Fibrosis was not different among the groups, while inflammation was detected to be significantly different in G3 and G4. Conclusions. ABS nanohemostat has comparable hemostatic efficacy to the traditional Ankaferd hemostat in the partial nephrectomy experimental model. Elucidation of the cellular and tissue effects of this chimeric compound may establish a catalytic spark and open new avenues for novel experimental and clinical studies in the battlefield of hemostasis. PMID:23509463

  16. Generation of Chimeric "ABS Nanohemostat" Complex and Comparing Its Histomorphological In Vivo Effects to the Traditional Ankaferd Hemostat in Controlled Experimental Partial Nephrectomy Model.

    PubMed

    Huri, Emre; Beyazit, Yavuz; Mammadov, Rashad; Toksoz, Sila; Tekinay, Ayse B; Guler, Mustafa O; Ustun, Huseyin; Kekilli, Murat; Dadali, Mumtaz; Celik, Tugrul; Astarci, Müzeyyen; Haznedaroglu, Ibrahim C

    2013-01-01

    Purpose. Using the classical Ankaferd Blood Stopper (ABS) solution to create active hemostasis during partial nephrectomy (PN) may not be so effective due to insufficient contact surface between the ABS hemostatic liquid agent and the bleeding area. In order to broaden the contact surface, we generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. Materials and Methods. In order to generate ABS nanohemostat, a positively charged Peptide Amphiphile (PA) molecule was synthesized by using solid phase peptide synthesis. For animal experiments, 24 Wistar rats were divided into the following 4 groups: Group 1: control; Group 2: conventional PN with only 0.5 ml Ankaferd hemostat; Group 3: conventional PN with ABS + peptide gel; Group 4: conventional PN with only 0.5 ml peptide solution. Results. Mean warm ischemia times (WITs) were 232.8  ±  56.3, 65.6 ± 11.4, 75.5 ± 17.2, and 58.1 ± 17.6 seconds in Group 1 to Group 4, respectively. Fibrosis was not different among the groups, while inflammation was detected to be significantly different in G3 and G4. Conclusions. ABS nanohemostat has comparable hemostatic efficacy to the traditional Ankaferd hemostat in the partial nephrectomy experimental model. Elucidation of the cellular and tissue effects of this chimeric compound may establish a catalytic spark and open new avenues for novel experimental and clinical studies in the battlefield of hemostasis. PMID:23509463

  17. Finnish Degenerative Meniscal Lesion Study (FIDELITY): a protocol for a randomised, placebo surgery controlled trial on the efficacy of arthroscopic partial meniscectomy for patients with degenerative meniscus injury with a novel ‘RCT within-a-cohort’ study design

    PubMed Central

    Sihvonen, Raine; Paavola, Mika; Malmivaara, Antti; Järvinen, Teppo L N

    2013-01-01

    Introduction Arthroscopic partial meniscectomy (APM) to treat degenerative meniscus injury is the most common orthopaedic procedure. However, valid evidence of the efficacy of APM is lacking. Controlling for the placebo effect of any medical intervention is important, but seems particularly pertinent for the assessment of APM, as the symptoms commonly attributed to a degenerative meniscal injury (medial joint line symptoms and perceived disability) are subjective and display considerable fluctuation, and accordingly difficult to gauge objectively. Methods and analysis A multicentre, parallel randomised, placebo surgery controlled trial is being carried out to assess the efficacy of APM for patients from 35 to 65 years of age with a degenerative meniscus injury. Patients with degenerative medial meniscus tear and medial joint line symptoms, without clinical or radiographic osteoarthritis of the index knee, were enrolled and then randomly assigned (1 : 1) to either APM or diagnostic arthroscopy (placebo surgery). Patients are followed up for 12 months. According to the prior power calculation, 140 patients were randomised. The two randomised patient groups will be compared at 12 months with intention-to-treat analysis. To safeguard against bias, patients, healthcare providers, data collectors, data analysts, outcome adjudicators and the researchers interpreting the findings will be blind to the patients’ interventions (APM/placebo). Primary outcomes are Lysholm knee score (a generic knee instrument), knee pain (using a numerical rating scale), and WOMET score (a disease-specific, health-related quality of life index). The secondary outcome is 15D (a generic quality of life instrument). Further, in one of the five centres recruiting patients for the randomised controlled trial (RCT), all patients scheduled for knee arthroscopy due to a degenerative meniscus injury are prospectively followed up using the same protocol as in the RCT to provide an external

  18. Effect of three different bariatric obesity surgery procedures on nutrient and energy digestibility using a swine experimental model

    PubMed Central

    Hodgkinson, Suzanne Marie; Riveros, José Luis; Bas, Fernando

    2015-01-01

    Morbid obesity is a worldwide health concern that compromises life quality and health status of obese human subjects. Bariatric surgery for treating morbid obesity remains as one of the best alternatives to promote excess weight loss and to reduce co-morbidities. We have not found studies reporting nutrients and energy balance considering digestibility trials in humans following surgery. The purpose of this study was to determine protein, lipid, fiber, energy, calcium, and phosphorous digestibility in a swine model that underwent ileal transposition (IT), sleeve gastrectomy with ileal transposition (SGIT), Roux-en-Y gastric bypass (RYGBP), and with sham operated animals (SHAM). Thirty-two pigs were randomly assigned to four laparoscopic procedures: IT (n = 8), RYGBP (n = 8), SGIT (n = 8), and Sham-operated pigs (n = 8). From day 0 postsurgery to 130, pigs were weighed monthly to determine live weight and weight gain was calculated for each month postsurgery until day 130. Food intake in a metabolic weight basis was calculated by measuring ad libitum food intake at day 130. Swine were fitted into metabolic crates to determine digestibility coefficients of dry matter, protein, fat, fiber, ash, energy, calcium, and phosphorous from day 130. A one-way ANOVA and Student–Newman–Keuls were used to detect differences in weight, food intake, and digestibility coefficients. Digestibility values for dry matter, fiber, phosphorus, and energy showed no differences among groups (P > 0.05). However, significant differences (P ≤ 0.05) were encountered among groups for fat, protein, ash, and calcium digestibilities. The RYGBP procedure, when applied to the pig model, significantly reduced calcium, fat, and ash digestibility, which did not occur with SGIT or IT procedure, when compared with Sham-operated animals. PMID:25711878

  19. Effect of three different bariatric obesity surgery procedures on nutrient and energy digestibility using a swine experimental model.

    PubMed

    Gandarillas, Mónica; Hodgkinson, Suzanne Marie; Riveros, José Luis; Bas, Fernando

    2015-09-01

    Morbid obesity is a worldwide health concern that compromises life quality and health status of obese human subjects. Bariatric surgery for treating morbid obesity remains as one of the best alternatives to promote excess weight loss and to reduce co-morbidities. We have not found studies reporting nutrients and energy balance considering digestibility trials in humans following surgery. The purpose of this study was to determine protein, lipid, fiber, energy, calcium, and phosphorous digestibility in a swine model that underwent ileal transposition (IT), sleeve gastrectomy with ileal transposition (SGIT), Roux-en-Y gastric bypass (RYGBP), and with sham operated animals (SHAM). Thirty-two pigs were randomly assigned to four laparoscopic procedures: IT (n = 8), RYGBP (n = 8), SGIT (n = 8), and Sham-operated pigs (n = 8). From day 0 postsurgery to 130, pigs were weighed monthly to determine live weight and weight gain was calculated for each month postsurgery until day 130. Food intake in a metabolic weight basis was calculated by measuring ad libitum food intake at day 130. Swine were fitted into metabolic crates to determine digestibility coefficients of dry matter, protein, fat, fiber, ash, energy, calcium, and phosphorous from day 130. A one-way ANOVA and Student-Newman-Keuls were used to detect differences in weight, food intake, and digestibility coefficients. Digestibility values for dry matter, fiber, phosphorus, and energy showed no differences among groups (P > 0.05). However, significant differences (P ≤ 0.05) were encountered among groups for fat, protein, ash, and calcium digestibilities. The RYGBP procedure, when applied to the pig model, significantly reduced calcium, fat, and ash digestibility, which did not occur with SGIT or IT procedure, when compared with Sham-operated animals.

  20. Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study

    PubMed Central

    Martín-Cancho, María F.; Crisóstomo, Verónica; Soria, Federico; Calles, Carmen; Sánchez-Margallo, Francisco M.; Díaz-Güemes, Idoia; Usón-Gargallo, Jesús

    2008-01-01

    The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy, n = 6) and II (laparoscopy, n = 6). Group III (laparoscopy, n = 6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group). Ventilatory and hemodynamic parameters and renal function were serially determined in all groups. A significant decrease in pH and significant increase in PaCO2 were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II. Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery. PMID:21197458

  1. [Bariatric surgery and multidisciplinary treatment for obesity].

    PubMed

    Yu, Jian-chun

    2011-06-01

    Bariatric surgery is one of the most effective treatment options for obesity. Compared with laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery has demonstrated more benefits and surgical risks. Bariatric surgery can result in the decreases in multiple gastrointestinal hormone levels, which can partially explain the mechanisms behind weight loss and resolution of diabetes after bariatric surgery. The management after bariatric surgery should be multidisciplinary and comprehensive, including dietary adjustment, physical exercise, behavioral intervention, and drug therapy.

  2. Plastic Surgery

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  3. Lung surgery

    MedlinePlus

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  4. Foot Surgery

    MedlinePlus

    ... About Feet » Foot Health Information Surgery When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat ...

  5. Experimental Cancer Cachexia Changes Neuron Numbers and Peptide Levels in the Intestine: Partial Protective Effects after Dietary Supplementation with L-Glutamine.

    PubMed

    Vicentini, Geraldo E; Fracaro, Luciane; de Souza, Sara R G; Martins, Heber A; Guarnier, Flávia A; Zanoni, Jacqueline N

    2016-01-01

    Gastrointestinal dysmotility frequently occurs in cancer cachexia and may result from damage to enteric innervation caused by oxidative stress, especially due to glutathione depletion. We assessed the effect of dietary supplementation with 20 g/kg l-glutamine (a glutathione precursor) on the intrinsic innervation of the enteric nervous system in healthy and Walker 256 tumor-bearing Wistar rats during the development of experimental cachexia (14 days), in comparison with non-supplemented rats, by using immunohistochemical methods and Western blotting. The total neural population and cholinergic subpopulation densities in the myenteric plexus, as well as the total population and VIPergic subpopulation in the submucosal plexus of the jejunum and ileum, were reduced in cachectic rats, resulting in adaptive morphometric alterations and an increase in vasoactive intestinal peptide (VIP) and calcitonin gene-related peptide (CGRP) expression, suggesting a neuroplastic response. l-glutamine supplementation prevented decrease in myenteric neuronal density in the ileum, morphometric alterations in the neurons and nerve fibers (in both the plexuses of the jejunum and ileum), and the overexpression of VIP and CGRP. Cancer cachexia severely affected the intrinsic innervation of the jejunum and ileum to various degrees and this injury seems to be associated with adaptive neural plasticity. l-glutamine supplementation presented partial protective effects on the enteric innervation against cancer cachexia, possibly by attenuating oxidative stress. PMID:27635657

  6. Analysis of ORFs 2b, 3, 4, and partial ORF5 of sequential isolates of equine arteritis virus shows genetic variation following experimental infection of horses.

    PubMed

    Liu, Lihong; Castillo-Olivares, Javier; Davis-Poynter, Nick J; Baule, Claudia; Xia, Hongyan; Belák, Sándor

    2008-06-22

    Samples from horses experimentally infected with the "large plaque variant (LP3A+)" of equine arteritis virus were analysed. These included 182 nasal swabs collected from day 1 to 14 post-infection (p.i.), and 21 virus isolates obtained from white blood cells of animals that showed a prolonged viraemia between days 30 to 72 p.i. In order to determine the genetic stability of the virus and particularly to characterise the genetic variants found during the prolonged viraemia, partial sequences of open reading frame 5 (ORF5) encoding glycoprotein 5 (GP5) were generated. Viruses with amino acid substitutions in GP5 were used for further amplification and sequencing of a fragment encompassing ORFs 2b, 3, and 4. The ORF5 nucleotide sequences of the virus present in 65 out of 66 nasal swabs were identical to that of the inoculated virus, suggesting that the ORF5 gene of LP3A+ was genetically stable during the first 2 weeks p.i. Contrary to this, a number of mutations were found in the ORF5 of virus isolates obtained from day 30 p.i. The mutations mainly clustered in antigenic neutralization site C within variable region 1 of the GP5 ectodomain. Sequence variability was also identified in ORFs 2b, 3 and 4, with ORF 4 having the highest proportion of non-synonymous changes (4/6).

  7. Experimental Cancer Cachexia Changes Neuron Numbers and Peptide Levels in the Intestine: Partial Protective Effects after Dietary Supplementation with L-Glutamine

    PubMed Central

    Vicentini, Geraldo E.; Fracaro, Luciane; de Souza, Sara R. G.; Martins, Heber A.; Guarnier, Flávia A.; Zanoni, Jacqueline N.

    2016-01-01

    Gastrointestinal dysmotility frequently occurs in cancer cachexia and may result from damage to enteric innervation caused by oxidative stress, especially due to glutathione depletion. We assessed the effect of dietary supplementation with 20 g/kg l-glutamine (a glutathione precursor) on the intrinsic innervation of the enteric nervous system in healthy and Walker 256 tumor-bearing Wistar rats during the development of experimental cachexia (14 days), in comparison with non-supplemented rats, by using immunohistochemical methods and Western blotting. The total neural population and cholinergic subpopulation densities in the myenteric plexus, as well as the total population and VIPergic subpopulation in the submucosal plexus of the jejunum and ileum, were reduced in cachectic rats, resulting in adaptive morphometric alterations and an increase in vasoactive intestinal peptide (VIP) and calcitonin gene-related peptide (CGRP) expression, suggesting a neuroplastic response. l-glutamine supplementation prevented decrease in myenteric neuronal density in the ileum, morphometric alterations in the neurons and nerve fibers (in both the plexuses of the jejunum and ileum), and the overexpression of VIP and CGRP. Cancer cachexia severely affected the intrinsic innervation of the jejunum and ileum to various degrees and this injury seems to be associated with adaptive neural plasticity. l-glutamine supplementation presented partial protective effects on the enteric innervation against cancer cachexia, possibly by attenuating oxidative stress. PMID:27635657

  8. Experimental Cancer Cachexia Changes Neuron Numbers and Peptide Levels in the Intestine: Partial Protective Effects after Dietary Supplementation with L-Glutamine.

    PubMed

    Vicentini, Geraldo E; Fracaro, Luciane; de Souza, Sara R G; Martins, Heber A; Guarnier, Flávia A; Zanoni, Jacqueline N

    2016-01-01

    Gastrointestinal dysmotility frequently occurs in cancer cachexia and may result from damage to enteric innervation caused by oxidative stress, especially due to glutathione depletion. We assessed the effect of dietary supplementation with 20 g/kg l-glutamine (a glutathione precursor) on the intrinsic innervation of the enteric nervous system in healthy and Walker 256 tumor-bearing Wistar rats during the development of experimental cachexia (14 days), in comparison with non-supplemented rats, by using immunohistochemical methods and Western blotting. The total neural population and cholinergic subpopulation densities in the myenteric plexus, as well as the total population and VIPergic subpopulation in the submucosal plexus of the jejunum and ileum, were reduced in cachectic rats, resulting in adaptive morphometric alterations and an increase in vasoactive intestinal peptide (VIP) and calcitonin gene-related peptide (CGRP) expression, suggesting a neuroplastic response. l-glutamine supplementation prevented decrease in myenteric neuronal density in the ileum, morphometric alterations in the neurons and nerve fibers (in both the plexuses of the jejunum and ileum), and the overexpression of VIP and CGRP. Cancer cachexia severely affected the intrinsic innervation of the jejunum and ileum to various degrees and this injury seems to be associated with adaptive neural plasticity. l-glutamine supplementation presented partial protective effects on the enteric innervation against cancer cachexia, possibly by attenuating oxidative stress.

  9. Does Laser Surgery Interfere with Optical Nerve Identification in Maxillofacial Hard and Soft Tissue?--An Experimental Ex Vivo Study.

    PubMed

    Bergauer, Bastian; Knipfer, Christian; Amann, Andreas; Rohde, Maximilian; Tangermann-Gerk, Katja; Adler, Werner; Schmidt, Michael; Nkenke, Emeka; Stelzle, Florian

    2015-01-01

    The protection of sensitive structures (e.g., nerves) from iatrogenic damage is of major importance when performing laser surgical procedures. Especially in the head and neck area both function and esthetics can be affected to a great extent. Despite its many benefits, the surgical utilization of a laser is therefore still limited to superficial tissue ablation. A remote feedback system which guides the laser in a tissue-specific way would provide a remedy. In this context, it has been shown that nerval structures can be specifically recognized by their optical diffuse reflectance spectra both before and after laser ablation. However, for a translation of these findings to the actual laser ablation process, a nerve protection within the laser pulse is of utmost significance. Thus, it was the aim of the study to evaluate, if the process of Er:YAG laser surgery--which comes with spray water cooling, angulation of the probe (60°) and optical process emissions--interferes with optical tissue differentiation. For the first time, no stable conditions but the ongoing process of laser tissue ablation was examined. Therefore, six different tissue types (nerve, skin, muscle, fat, cortical and cancellous bone) were acquired from 15 pig heads. Measurements were performed during Er:YAG laser ablation. Diffuse reflectance spectra (4500, wavelength range: 350-650 nm) where acquired. Principal component analysis (PCA) and quadratic discriminant analysis (QDA) were calculated for classification purposes. The clinical highly relevant differentiation between nerve and bone was performed correctly with an AUC of 95.3% (cortial bone) respectively 92.4% (cancellous bone). The identification of nerve tissue against the biological very similar fat tissue yielded good results with an AUC value of 83.4% (sensitivity: 72.3%, specificity: of 82.3%). This clearly demonstrates that nerve identification by diffuse reflectance spectroscopy works reliably in the ongoing process of laser ablation

  10. [What Must the (Abdominal) Surgeon Know about Experimental Medicine (?) - Translational Research in General (Abdominal) Surgery(Viszeral-)Chirurg & experimentelle Medizin].

    PubMed

    Wex, T; Kuester, D; Meyer, F

    2015-08-01

    Experimental medicine has evolved tremendously in the last few years. In particular, the introduction of novel techniques, in-vitro models, knock-out/transgenic animals and high-through put analytical methodologies have resulted in a deeper understanding of cellular pathophysiology and diseases. The daily clinical management has benefited by the introduction of biomarkers and targeted therapies. This development has been accompanied by increasing specialisation across all fields of research and medicine. Therefore, clinical-translational research requires a team of competent partners nowadays. The visceral surgeon can contribute significantly to these projects. The present review highlights several aspects of translational research and put chances and potential pitfalls into perspective in context with the work of the visceral surgeon.

  11. THE INFLUENCE OF MONTELUKAST ON THE ACTIVITY OF THE AUTONOMIC NERVOUS SYSTEM ESTIMATED BY HEART RATE VARIABILITY IN EXPERIMENTAL PARTIAL BLADDER OUTLET OBSTRUCTION IN RATS.

    PubMed

    Dobrek, Łukasz; Skowron, Beata; Baranowska, Agnieszka; Zurowski, Daniel; Thor, Piotr Jan

    2016-01-01

    Due to their paracrine action, leukotrienes released from the urothelium are involved in control of the bladder function. Anti-leukotriene agents appear to exert an ameliorating effect in bladder overactivity. It is unknown, whether their possible, modulatory impact on the autonomic nervous system (ANS) activity may also contribute to the potentially beneficial effect of those compounds. Therefore, our aim was to indirectly estimate the ANS function using the heart rate variability (HRV) study in rats with experimental partial bladder outlet obstruction (PBOO), reflecting human benign prostatic hyperplasia (BPH), treated with leukotriene receptor antagonist - montelukast (MLKT). Twenty rats with surgically induced PBOO lasting for 14 days, divided into two groups: group 1 (10 control subjects) and group 2 (10 MLKT-treated rats; 2 mg/rat/day) were subjected to HRV recordings, preceded by daily urine collection and a subsequent cystectomy with histopathological evaluation of collected bladders. Standard HRV time and spectral parameters were calculated. MLKT-treated animals demonstrated an increase in power of non-normalized LF (low frequency) and HF (high frequency) components with no change of the total HRV power. Moreover, an increase and decrease in normalized nLF and nHF, respectively, were assessed in those animals compared to the control. Additionally, a decrease in daily diuresis measurement was demonstrated in MLKT-treated animals. Montelukast treatment resulted in the functional ANS status re-arrangement, with sympathetic overdrive and parasympathetic withdrawal. Those changes may contribute to alleviation of bladder overactivity symptoms, independently on leukotriene receptors blockade. PMID:27476297

  12. Development and trial manufacturing of 1/2-scale partial mock-up of blanket box structure for fusion experimental reactor

    NASA Astrophysics Data System (ADS)

    Hashimoto, Toshiyuki; Takatsu, Hideyuki; Sato, Satoshi

    1994-07-01

    Conceptual design of breeding blanket has been discussed during the CDA (Conceptual Design Activities) of ITER (International Thermonuclear Experimental Reactor). Structural concept of breeding blanket is based on box structure integrated with first wall and shield, which consists of three coolant manifolds for first wall, breeding and shield regions. The first wall must have cooling channels to remove surface heat flux and nuclear heating. The box structure includes plates to form the manifolds and stiffening ribs to withstand enormous electromagnetic load, coolant pressure and blanket internal (purge gas) pressure. A 1/2-scale partial model of the blanket box structure for the outboard side module near midplane is manufactured to estimate the fabrication technology, i.e. diffusion bonding by HIP (Hot Isostatic Pressing) and EBW (Electron Beam Welding) procedure. Fabrication accuracy is a key issue to manufacture first wall panel because bending deformation during HIP may not be small for a large size structure. Data on bending deformation during HIP was obtained by preliminary manufacturing of HIP elements. For the shield structure, it is necessary to reduce the welding strain and residual stress of the weldment to establish the fabrication procedure. Optimal shape of the parts forming the manifolds, welding locations and welding sequence have been investigated. In addition, preliminary EBW tests have been performed in order to select the EBW conditions, and fundamental data on built-up shield have been obtained. Especially, welding deformation by joining the first wall panel to the shield has been measured, and total deformation to build-up shield by EBW has been found to be smaller than 2 mm. Consequently, the feasibility of fabrication technologies has been successfully demonstrated for a 1m-scaled box structure including the first wall with cooling channels by means of HIP, EBW and TIG (Tungsten Inert Gas arc)-welding.

  13. Evidence that 1 per cent Meshushit ointment prevents progressive dermal ischaemia of experimental deep partial skin thickness burns: a preliminary, quantitative controlled study.

    PubMed

    Kaufman, T; Ullman, Y

    1989-02-01

    This study quantitatively assessed the topical effects of Meshushit, a new herbal compound, on the healing process of experimental deep partial skin thickness burns over 27 days. To symmetrical circular burns were inflicted on the back of 15 animals by aluminium templates. The Meshushit and its control vehicle containing 0.1 per cent gentamycin or the control vehicle plus antibiotic alone, were applied topically to randomly selected burns at equal time intervals. Epithelialization and contraction were assessed on postburn days 6, 10, 15, 18, 22 and 27 using a computerized planimeter. The newly formed granulation tissue was assessed histologically on postburn day 27, while the hair follicles were counted in the same sections. Student's t test was used to differentiate the rates of contraction and epithelialization; hair follicle counts and the thickness of the newly formed granulation tissue. None of the animals died during the experiment. The epithelialization and contraction rates did not differ significantly between the test groups. The Meshushit-treated wounds showed a significantly thicker granulation tissue layer as compared to its control (828.72 +/- 46.39 microns vs. 540.78 +/- 37.81 microns, P less than 0.01). The count of hair follicles was significantly higher in the Meshushit-treated burns (23.38 +/- 1.84 vs. 3.76 +/- 0.35, P less than 0.001). It is concluded that the herbal Meshushit ointment enhanced the newly formed granulation tissue and preserved better the hair follicles in the present burn wound model. It is suggested that these findings are due to the preservation of the dermal microcirculation.

  14. Kinetic-Hydrodynamic Models of the Solar Wind Interaction with the Partially Ionized Supersonic Flow of the Local Interstellar Gas: Predictions and Interpretations of the Experimental Data

    NASA Astrophysics Data System (ADS)

    Baranov, Vladimir B.

    2009-02-01

    At present there is no doubt that the local interstellar medium (LISM) is mainly partially ionized hydrogen gas moving with a supersonic flow relative to the solar system. The bulk velocity of this flow is approximately equal ˜26 km/s. Although the interaction of the solar wind with the charged component (below plasma component) of the LISM can be described in the framework of hydrodynamic approach, the interaction of H atoms with the plasma component can be correctly described only in the framework of kinetic theory because the mean free path of H atoms in the main process of the resonance charge exchange is comparable with a characteristic length of the problem considered. Results of self-consistent, kinetic-hydrodynamic models are considered in this review paper. First, such the model was constructed by Baranov and Malama (J. Geophys. Res. 98(A9):15,157-15,163, 1993). Up to now it is mainly developed by Moscow group taking into account new experimental data obtained onboard spacecraft studying outer regions of the solar system (Voyager 1 and 2, Pioneer 10 and 11, Hubble Space Telescope, Ulysses, SOHO and so on). Predictions and interpretations of experimental data obtained on the basis of these models are presented. Kinetic models for describing H atom motion were later suggested by Fahr et al. (Astron. Astrophys 298:587-600, 1995) and Lipatov et al. (J. Geophys. Res. 103(A9):20,631-20,642, 1998). However they were not self-consistent and did not incorporate sources to the plasma component. A self-consistent kinetic-hydrodynamic model suggested by Heerikhuisen et al. (J. Geophys. Res. 111:A06110, 2006, Astrophys. J. 655:L53-L56, 2007) was not tested on the results by Baranov and Malama (J. Geophys. Res. 111:A06110, 1993) although it was suggested much later. Besides authors did not describe in details their Monte Carlo method for a solution of the H atom Boltzmann equation and did not inform about an accuracy of this method. Therefore the results of

  15. A review of prospective Clinical Trials for neurogenic bladder: The place of surgery, experimental techniques and devices

    PubMed Central

    Braschi, Emmanuel; Lavelle, John

    2014-01-01

    Introduction The neurogenic urinary bladder has been known for at least 30 years now and the concepts behind it are continuously evolving, but there is actually not much work that has been done to accumulate solid clinical evidence in this field. We review the surgical and experimental techniques used in the management of this condition. Material and methods To achieve our goal, we performed Internet searches using the same search string: Urinary bladder, neurogenic. In each case, the search was limited to clinical trial, subjects were human and the language was English. After duplicate removal, we obtained a final number of 580 papers. Data was extracted from each paper into a database file and was analyzed separately for adult and pediatric populations. Results A total of 70 full text papers were reviewed and analyzed according to the previously mentioned algorithm. The first prospective, randomized surgical trials were published less than 20 years ago, starting with 1994, and the number of papers published each year since then has remained in the range of 1–3. The oldest prospective clinical trial for this indication dates back to 1975. The total number of patients included in surgical trials is 3453, out of which 59% are males. The papers include a total of 369 children (21.2%), essentially looking at all the techniques that are also used in adults. Conclusions There is still a lot of work to be done in order to obtain a significant level of evidence in the field of surgical procedures used in neurogenic bladder patients. PMID:25247086

  16. [AN EXPERIMENTAL STUDY OF THE HISTOLOGICAL FIBRO GENESIS ABILITIES IN THE AREA OF IMPLANTATION OF ALOTRANSPLANTATES APPLYING INTRAABDOMINAL AND PREPERITONEAL PLASTIC SURGERY].

    PubMed

    Ioffe, Y; Shvets, I; Tarasiuk, T; Furmanov, A; Stetsenko, A; Tsura, Y

    2014-12-01

    The histological fibro genesis abilities in the area of implantation of allotransplantates applying intraabdominal and preperitoneal plastic surgery were examined during experimental research. The experiment involved 12 Russian chinchilla rabbits. The animals were spitted into two groups: I group--operated using IPOM methodology (intraperitonealonlaymesh, n = 6) with the installation "Proceed" mesh made by "Ethicon", group II--modeling preperitoneal plastics with the installation of "Ethicon's Ultrapro" mesh (n = 6). After removing the animals from the experiment, the implants with adhering musculo-aponeurotic tissue layer were excised and sent for histological examination. At the same time the severity of the inflammatory process were rated, the composition of the inflammatory infiltrate, germination of the connective tissue through the pores of the prosthesis and neovascularization. Analyzing the research data of histological connective abilities complexes formed in the area of the allotransplants implantation using intra-abdominal and pre-peritoneal plastic during the experiment, we can conclude that intra-abdominal installation of mesh prostheses reduces the severity of inflammatory changes surrounding tissues and reduces the probability of seroma formation in comparison with the placement of the pre-peritoneal implant. PMID:26638474

  17. [AN EXPERIMENTAL STUDY OF THE HISTOLOGICAL FIBRO GENESIS ABILITIES IN THE AREA OF IMPLANTATION OF ALOTRANSPLANTATES APPLYING INTRAABDOMINAL AND PREPERITONEAL PLASTIC SURGERY].

    PubMed

    Ioffe, Y; Shvets, I; Tarasiuk, T; Furmanov, A; Stetsenko, A; Tsura, Y

    2014-12-01

    The histological fibro genesis abilities in the area of implantation of allotransplantates applying intraabdominal and preperitoneal plastic surgery were examined during experimental research. The experiment involved 12 Russian chinchilla rabbits. The animals were spitted into two groups: I group--operated using IPOM methodology (intraperitonealonlaymesh, n = 6) with the installation "Proceed" mesh made by "Ethicon", group II--modeling preperitoneal plastics with the installation of "Ethicon's Ultrapro" mesh (n = 6). After removing the animals from the experiment, the implants with adhering musculo-aponeurotic tissue layer were excised and sent for histological examination. At the same time the severity of the inflammatory process were rated, the composition of the inflammatory infiltrate, germination of the connective tissue through the pores of the prosthesis and neovascularization. Analyzing the research data of histological connective abilities complexes formed in the area of the allotransplants implantation using intra-abdominal and pre-peritoneal plastic during the experiment, we can conclude that intra-abdominal installation of mesh prostheses reduces the severity of inflammatory changes surrounding tissues and reduces the probability of seroma formation in comparison with the placement of the pre-peritoneal implant.

  18. After Surgery

    MedlinePlus

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  19. Turbinate surgery

    MedlinePlus

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  20. Laparoscopic partial splenic resection.

    PubMed

    Uranüs, S; Pfeifer, J; Schauer, C; Kronberger, L; Rabl, H; Ranftl, G; Hauser, H; Bahadori, K

    1995-04-01

    Twenty domestic pigs with an average weight of 30 kg were subjected to laparoscopic partial splenic resection with the aim of determining the feasibility, reliability, and safety of this procedure. Unlike the human spleen, the pig spleen is perpendicular to the body's long axis, and it is long and slender. The parenchyma was severed through the middle third, where the organ is thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the resection. The tissue was removed with a 33-mm trocar. The operation was successfully concluded in all animals. No capsule tears occurred as a result of applying the stapler. Optimal hemostasis was achieved on the resected edges in all animals. Although these findings cannot be extended to human surgery without reservations, we suggest that diagnostic partial resection and minor cyst resections are ideal initial indications for this minimally invasive approach.

  1. Effect of Catechol-O-methyltransferase-gene (COMT) Variants on Experimental and Acute Postoperative Pain in 1,000 Women undergoing Surgery for Breast Cancer

    PubMed Central

    Kambur, Oleg; Kaunisto, Mari A.; Tikkanen, Emmi; Leal, Suzanne M.; Ripatti, Samuli; Kalso, Eija A.

    2016-01-01

    Background Catechol-O-methyltransferase (COMT) metabolizes catecholamines in different tissues. Polymorphisms in COMT gene can attenuate COMT activity and increase sensitivity to pain. Human studies exploring the effect of COMT polymorphisms on pain sensitivity have mostly included small, heterogeneous samples and have ignored several important single nucleotide polymorphisms (SNPs). This study examines the effect of COMT polymorphisms on experimental and postoperative pain phenotypes in a large ethnically homogeneous female patient cohort. Methods Intensity of cold (+2–4°C) and heat (+48°C) pain and tolerance to cold pain were assessed in 1,000 patients scheduled for breast cancer surgery. Acute postoperative pain and oxycodone requirements were recorded. Twenty-two COMT SNPs were genotyped and their association with six pain phenotypes analyzed with linear regression. Results There was no association between any of the tested pain phenotypes and SNP rs4680. The strongest association signals were seen between rs165774 and heat pain intensity as well as rs887200 and cold pain intensity. In both cases, minor allele carriers reported less pain. Neither of these results remained significant after strict multiple testing corrections. When analyzed further, the effect of rs887200 was, however, shown to be significant and consistent throughout the cold pressure test. No evidence of association between the SNPs and postoperative oxycodone consumption was found. Conclusions SNPs rs887200 and rs165774 located in the untranslated regions of the gene had the strongest effects on pain sensitivity. Their effect on pain is described here for the first time. These results should be confirmed in further studies and the potential functional mechanisms of the variants studied. PMID:24343288

  2. Coupler for surgery on small animals

    NASA Technical Reports Server (NTRS)

    Johnson, J. E., Jr.; Swartz, P. F.

    1979-01-01

    Minicoupler simplifies exchange of fluids with organs of laboratory animals enabling one person to perform surgery on experimental animals such as rats and mice. Innovation eliminates obstructing hands and instruments from areas of surgery.

  3. Strabismus Surgery

    MedlinePlus

    ... used. Some surgeons prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery. More technical ... Screening Recommendations Loading... Most Common Searches Adult ...

  4. Rhabdomyosarcoma: Surgery

    MedlinePlus

    ... is and what type of operation is done. Physical changes after surgery can range from little more than a scar to changes in appearance or in how some parts of the body function, which may require physical rehabilitation. For more on surgery as a treatment ...

  5. Unnecessary surgery.

    PubMed Central

    Leape, L L

    1989-01-01

    The extent of unnecessary surgery has been the object of considerable speculation and occasional wild accusation in recent years. Most evidence of the existence of unnecessary surgery, such as information from studies of geographic variations and the results of second surgical opinion programs, is circumstantial. However, results from the few studies that have measured unnecessary surgery directly indicate that for some highly controversial operations the fraction that are unwarranted could be as high as 30 percent. Most unnecessary surgery results from physician uncertainty about the effectiveness of an operation. Elimination of this uncertainty requires more efficient production and dissemination of scientific information about clinical effectiveness. In the absence of adequate data from scientific studies, the use of a consensus of expert opinion, disseminated by means of comprehensive practice guidelines, offers the best opportunity to identify and eliminate unnecessary surgery. PMID:2668237

  6. Delivery of antifibroblast agents as adjuncts to filtration surgery. Part I--Periocular clearance of cobalt-57 bleomycin in experimental drug delivery: pilot study in the rabbit

    SciTech Connect

    Kay, J.S.; Litin, B.S.; Woolfenden, J.M.; Chvapil, M.; Herschler, J.

    1986-10-01

    Antitumor and antifibroblast agents show promise as adjuncts after glaucoma filtration surgery in reducing postoperative scarring and failure. We used nuclear imaging in rabbits to investigate periocular clearance of one such agent (/sup 57/Co-bleomycin). Sub-Tenon injection was compared to other delivery techniques. Our results showed that a collagen sponge and a silastic disc implant with a microhole prolonged drug delivery when compared to sub-Tenon injection alone or injection with a viscosity enhancing agent (0.5% sodium hyaluronate). We theorize that if an antifibroblast agent can be delivered in small and sustained amounts after filtration surgery, this may prolong bleb longevity and avoid unnecessary drug toxicity.

  7. Virtual reality in laparoscopic surgery.

    PubMed

    Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

    2004-01-01

    Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery. PMID:15747974

  8. Virtual reality in laparoscopic surgery.

    PubMed

    Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

    2004-01-01

    Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery.

  9. Experimental study of optimal self compacting concrete with spent foundry sand as partial replacement for M-sand using Taguchi approach

    NASA Astrophysics Data System (ADS)

    Nirmala, D. B.; Raviraj, S.

    2016-06-01

    This paper presents the application of Taguchi approach to obtain optimal mix proportion for Self Compacting Concrete (SCC) containing spent foundry sand and M-sand. Spent foundry sand is used as a partial replacement for M-sand. The SCC mix has seven control factors namely, Coarse aggregate, M-sand with Spent Foundry sand, Cement, Fly ash, Water, Super plasticizer and Viscosity modifying agent. Modified Nan Su method is used to proportion the initial SCC mix. L18 (21×37) Orthogonal Arrays (OA) with the seven control factors having 3 levels is used in Taguchi approach which resulted in 18 SCC mix proportions. All mixtures are extensively tested both in fresh and hardened states to verify whether they meet the practical and technical requirements of SCC. The quality characteristics considering "Nominal the better" situation is applied to the test results to arrive at the optimal SCC mix proportion. Test results indicate that the optimal mix satisfies the requirements of fresh and hardened properties of SCC. The study reveals the feasibility of using spent foundry sand as a partial replacement of M-sand in SCC and also that Taguchi method is a reliable tool to arrive at optimal mix proportion of SCC.

  10. Encenicline, an α7 Nicotinic Acetylcholine Receptor Partial Agonist, Reduces Immune Cell Infiltration in the Colon and Improves Experimental Colitis in Mice.

    PubMed

    Salaga, M; Blomster, L V; Piechota-Polańczyk, A; Zielińska, M; Jacenik, D; Cygankiewicz, A I; Krajewska, W M; Mikkelsen, J D; Fichna, Jakub

    2016-01-01

    The α7 pentamer nicotinic acetylcholine receptors (nAChRs) are a target in transduction of anti-inflammatory signals from the central nervous system to the gastrointestinal (GI) tract. The aim of this study was to investigate the anti-inflammatory action of the novel α7 nAChR partial agonist encenicline and to determine the mechanism underlying its activity. Anti-inflammatory activity of encenicline was evaluated using trinitrobenzenesulfonic acid (TNBS)- and dextran sulfate sodium (DSS)-induced models of colitis. Macroscopic score, ulcer score, colon length and thickness, as well as myeloperoxidase (MPO) activity were recorded. Immunohistochemistry (IHC) was used to measure the infiltration of immune cells in the colon. Furthermore, we employed flow cytometry to determine the effect of encenicline on frequencies of FoxP3(+) and interleukin (IL)-17A(+) T cells in the mouse colon. Encenicline attenuated TNBS- and DSS-induced colitis in mice via α7 nAChRs, as indicated by significantly reduced macroscopic parameters and MPO activity. Treatment with encenicline significantly reduced the infiltration of macrophages, neutrophils, and B cells in the colon of TNBS-treated animals, as indicated by IHC. In the TNBS model encenicline reduced the frequency of FoxP3(+) IL-17A(+) T cells in the colon. In the DSS-model treatment encenicline increased the frequency of FoxP3(+) T cells and reduced IL-17A(+) T cells. Stimulation of α7 nAChR with partial agonist encenicline alleviates colitis via alteration of the number and/or activation status of the immune cells in the gut, emphasizing a potential role of α7 nAChRs as a target for anticolitic drugs. PMID:26462538

  11. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  12. Thyroid Surgery

    MedlinePlus

    ... thyroid surgery, requiring treatment with thyroid hormone (see Hypothyroidism brochure ). This is especially true if you had ... Nodules Goiter Graves’ Disease Hashimoto’s Thyroiditis Hyperthyroidism (Overactive) Hypothyroidism (Underactive) Iodine Deficiency Low Iodine Diet Radioactive Iodine ...

  13. Cosmetic Surgery

    MedlinePlus

    ... defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic ... can create both physical changes and changes in self-esteem. But if you are seeking surgery with the ...

  14. Rodding Surgery

    MedlinePlus

    ... Rods can be made of stainless steel or titanium. Regular rods do not expand. They have many ... v regular), the rod materials (stainless steel v titanium) and the age for a first rodding surgery. ...

  15. Experts' understanding of partial derivatives using the partial derivative machine

    NASA Astrophysics Data System (ADS)

    Roundy, David; Weber, Eric; Dray, Tevian; Bajracharya, Rabindra R.; Dorko, Allison; Smith, Emily M.; Manogue, Corinne A.

    2015-12-01

    [This paper is part of the Focused Collection on Upper Division Physics Courses.] Partial derivatives are used in a variety of different ways within physics. Thermodynamics, in particular, uses partial derivatives in ways that students often find especially confusing. We are at the beginning of a study of the teaching of partial derivatives, with a goal of better aligning the teaching of multivariable calculus with the needs of students in STEM disciplines. In this paper, we report on an initial study of expert understanding of partial derivatives across three disciplines: physics, engineering, and mathematics. We report on the central research question of how disciplinary experts understand partial derivatives, and how their concept images of partial derivatives differ, with a focus on experimentally measured quantities. Using the partial derivative machine (PDM), we probed expert understanding of partial derivatives in an experimental context without a known functional form. In particular, we investigated which representations were cued by the experts' interactions with the PDM. Whereas the physicists and engineers were quick to use measurements to find a numeric approximation for a derivative, the mathematicians repeatedly returned to speculation as to the functional form; although they were comfortable drawing qualitative conclusions about the system from measurements, they were reluctant to approximate the derivative through measurement. On a theoretical front, we found ways in which existing frameworks for the concept of derivative could be expanded to include numerical approximation.

  16. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  17. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era. PMID:25643879

  18. Corrective Jaw Surgery

    MedlinePlus

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  19. Partial protection against experimental vaginal candidiasis after mucosal vaccination with heat-killed Candida albicans and the mucosal adjuvant LT(R192G).

    PubMed

    Cárdenas-Freytag, L; Steele, C; Wormley, F L; Cheng, E; Clements, J D; Fidel, P L

    2002-06-01

    The effectiveness of a mucosal vaccine composed of heat-killed Candida albicans (HK-CA) or C. albicans culture filtrate (CaCF) in conjunction with the mucosal adjuvant LT(R192G) against vulvovaginal candidiasis was examined in an estrogen-dependent murine model. Mice vaccinated intranasally with HK-CA + LT(R192G) exhibited a significant but short-lived protection accompanied by a vigorous delayed-type hypersensitivity response as well as high titers of circulating C. albicans-specific antibodies. Surprisingly, the levels of antigen-specific antibodies in the vaginal secretions of protected mice were negligible and no correlates of vaginal-associated Type 1 or Type 2 cytokines were observed. Vaginal priming with C. albicans before vaccination did not alter the protective outcome. Immunization with CaCF + LT(R192G) induced a discrete level of protection when administered intrarectally but not intranasally. These results suggest that mucosal vaccination can afford partial protection against vulvovaginal candidiasis, but the precise immune mechanisms responsible for protection are complex and as yet, not well understood.

  20. Study of hemorheological parameters following partial hepatectomy in rats with chronic aluminium intoxication.

    PubMed

    Contini, María del Carmen; Mahieu, Stella; Bazzoni, Graciela; Bernal, Claudio A; Carnovale, Cristina E

    2006-01-01

    The aim of our work was to analyze the hemorheological parameters following partial hepatectomy in rats with chronic Al-intoxication (Al). Male Wistar rats were randomly assigned into four experimental groups (n=6 each one): Sham (rats subjected to simulated surgery); Al+Sham; Partial Hepatectomy (animals subjected to 65% liver resection) and Al+Partial Hepatectomy. Our results show that both Partial Hepatectomy and Al treatment produce a decrease of plasma cholesterol level, which showed a negative association with Rigidity Index increase (r(s)=-0.6475, p<0.05). The increase of Rigidity Index observed in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy could be related to the increase of the proportion of non-discocytic erythrocytes, particularly stomatocytes, which determines a diminution of the Morphological Index. In the Altreated groups, greater changes in Rigidity Index and Morphological Index were observed. The relative viscosity of blood at a standard haematocrit of 40% was increased in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy as compared to Sham, due to erythrocyte rigidity. On the other hand, we observed that the increase of plasma fibrinogen concentration correlates with augmentation of plasma viscosity (r(s)=0.689, p=0.004) for all the experimental groups studied. The results indicate that both administration of Al and Partial Hepatectomy induce microcytic hypocromic anaemia in the rats reflected by a significant decrease of haematocrit, mean corpuscular volume and mean corpuscular haemoglobin concentration. From these results, we conclude that in partially hepatectomized, Al-overloaded rats the decrease in erythrocyte deformability may be an important factor leading to the installation of anaemia. PMID:17148841

  1. Study of hemorheological parameters following partial hepatectomy in rats with chronic aluminium intoxication.

    PubMed

    Contini, María del Carmen; Mahieu, Stella; Bazzoni, Graciela; Bernal, Claudio A; Carnovale, Cristina E

    2006-01-01

    The aim of our work was to analyze the hemorheological parameters following partial hepatectomy in rats with chronic Al-intoxication (Al). Male Wistar rats were randomly assigned into four experimental groups (n=6 each one): Sham (rats subjected to simulated surgery); Al+Sham; Partial Hepatectomy (animals subjected to 65% liver resection) and Al+Partial Hepatectomy. Our results show that both Partial Hepatectomy and Al treatment produce a decrease of plasma cholesterol level, which showed a negative association with Rigidity Index increase (r(s)=-0.6475, p<0.05). The increase of Rigidity Index observed in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy could be related to the increase of the proportion of non-discocytic erythrocytes, particularly stomatocytes, which determines a diminution of the Morphological Index. In the Altreated groups, greater changes in Rigidity Index and Morphological Index were observed. The relative viscosity of blood at a standard haematocrit of 40% was increased in Partial Hepatectomy, Al+Sham and Al+Partial Hepatectomy as compared to Sham, due to erythrocyte rigidity. On the other hand, we observed that the increase of plasma fibrinogen concentration correlates with augmentation of plasma viscosity (r(s)=0.689, p=0.004) for all the experimental groups studied. The results indicate that both administration of Al and Partial Hepatectomy induce microcytic hypocromic anaemia in the rats reflected by a significant decrease of haematocrit, mean corpuscular volume and mean corpuscular haemoglobin concentration. From these results, we conclude that in partially hepatectomized, Al-overloaded rats the decrease in erythrocyte deformability may be an important factor leading to the installation of anaemia.

  2. Partially coherent ultrafast spectrography

    PubMed Central

    Bourassin-Bouchet, C.; Couprie, M.-E.

    2015-01-01

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter. PMID:25744080

  3. Partially coherent ultrafast spectrography

    NASA Astrophysics Data System (ADS)

    Bourassin-Bouchet, C.; Couprie, M.-E.

    2015-03-01

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter.

  4. A new type mixture refrigeration auto-cascade cycle with partial condensation and separation reflux exchanger and its preliminary experimental test

    NASA Astrophysics Data System (ADS)

    Wu, J. F.; Gong, M. Q.; Liu, J. L.; Luo, E. C.; Qi, Y. F.; Hu, Q. G.

    2002-05-01

    A new type of mixture refrigeration cycle with reflux exchanger is presented in this paper. In this cycle, a new type of L-V separator with inner heat and mass transfer is employed to replace the combination of conventional L-V separator or complicated rectifier and succeeding heat exchanger used in traditional auto-cascade cycle or Kleemenko cycle. A prototype is developed based on this refrigeration cycle. The thermodynamic performance is discussed as well as some other specifications such as cost, reliability, etc. The experimental results show that this prototype can reach 74 W at 135 K and 265 W at 171 K with a nominal input power of 1.5 HP.

  5. Experimental test of postfire management in pine forests: impact of salvage logging versus partial cutting and nonintervention on bird-species assemblages.

    PubMed

    Castro, Jorge; Moreno-Rueda, Gregorio; Hódar, José A

    2010-06-01

    There is an intense debate about the effects of postfire salvage logging versus nonintervention policies on regeneration of forest communities, but scant information from experimental studies is available. We manipulated a burned forest area on a Mediterranean mountain to experimentally analyze the effect of salvage logging on bird-species abundance, diversity, and assemblage composition. We used a randomized block design with three plots of approximately 25 ha each, established along an elevational gradient in a recently burned area in Sierra Nevada Natural and National Park (southeastern Spain). Three replicates of three treatments differing in postfire burned wood management were established per plot: salvage logging, nonintervention, and an intermediate degree of intervention (felling and lopping most of the trees but leaving all the biomass). Starting 1 year after the fire, we used point sampling to monitor bird abundance in each treatment for 2 consecutive years during the breeding and winter seasons (720 censuses total). Postfire burned-wood management altered species assemblages. Salvage logged areas had species typical of open- and early-successional habitats. Bird species that inhabit forests were still present in the unsalvaged treatments even though trees were burned, but were almost absent in salvage-logged areas. Indeed, the main dispersers of mid- and late-successional shrubs and trees, such as thrushes (Turdus spp.) and the European Jay (Garrulus glandarius) were almost restricted to unsalvaged treatments. Salvage logging might thus hamper the natural regeneration of the forest through its impact on assemblages of bird species. Moreover, salvage logging reduced species abundance by 50% and richness by 40%, approximately. The highest diversity at the landscape level (gamma diversity) resulted from a combination of all treatments. Salvage logging may be positive for bird conservation if combined in a mosaic with other, less-aggressive postfire

  6. Nose Surgery

    MedlinePlus

    ... and expand the nasal passages. Treatments include injection, freezing, and partial removal. Allergies, too, can cause internal ... evaluating your injury as the swelling recedes. (Apply ice while waiting to see the doctor.) What's most ...

  7. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  8. Cosmetic surgery.

    PubMed Central

    Harris, D. L.

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks. PMID:2589786

  9. Robotic surgery.

    PubMed

    Oleynikov, Dmitry

    2008-10-01

    This article discusses the developments that led up to robotic surgical systems as well as what is on the horizon for new robotic technology. Topics include how robotics is enabling new types of procedures, including natural orifice endoscopic translumenal surgery in which one cannot reach by hand under any circumstances, and how these developments will drive the next generation of robots. PMID:18790158

  10. Cardiac Surgery

    PubMed Central

    Weisse, Allen B.

    2011-01-01

    Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121

  11. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

  12. [Laparoscopic surgery in day surgery].

    PubMed

    Micali, S; Bitelli, M; Torelli, F; Valitutti, M; Micali, F

    1998-06-01

    Since ten years laparoscopic techniques have been employed as alternatives of many established open procedures in gynecologic, abdominal and finally urologic surgery. Laparoscopic techniques show significant advantages compared to open surgery, such as less hospitalization, reduced need of analgesic drugs, quick return to daily activities and far a better cosmetic results. Laparoscopic surgery has been advocated for urologic, uro-gynecologic and andrologic diseases. Since 1983 one-day surgery was proposed for only a few gynecologic and abdominal procedures and only recently for laparoscopic renal biopsy and abdominal testis evaluation. In these preliminary experiences the conditions for a correct management of laparoscopic one-day surgery have been clearly pointed out: 1. correct surgical indication; 2. through knowledge of surgical technique; 3. duration of the procedure less than 90 minutes; 4. correct anesthesia. Technique of anesthesia must be adapted to the surgical procedure required, its duration and the physical features of the patient. General anesthesia is usually preferred for either longer and more complex procedures or when a higher abdominal insufflation pressure is needed. Spinal or local anesthesia are preferred for simpler procedures or when only one trocar is required. At date only few urologic procedures seem to be suitable to one-day laparoscopic surgery. 1) Varicocele: although laparoscopic varicocelectomy in one-day surgery has never been reported previously, it can be performed in a short time, only 3 trocars are needed and insufflation pressure can be maintained within 15 mm Hg. 2) Renal biopsy and marsupialization of renal cysts. These are usually managed percutaneously but in some particular indications procedures under direct vision should be preferable. Both are short-lasting and only superficial general anesthesia is required; as surgical access is retroperitoneal only two trocars are sufficient; at date only renal biopsies have

  13. Experimental determination of dissolved CO2 content in nominally anhydrous andesitic melts at graphite/diamond saturation - Remobilization of deeply subducted reduced carbon via partial melts of MORB-like eclogite

    NASA Astrophysics Data System (ADS)

    Eguchi, J.; Dasgupta, R.

    2015-12-01

    Experimental phase relations of carbonated lithologies [1] and geochemistry of deep diamonds [2] suggest that deep recycling of carbon has likely been efficient for a significant portion of Earth's history. Both carbonates and organic carbon subduct into the mantle, but with gradual decrease of fO2 with depth [3] most carbon in deep mantle rocks including eclogite could be diamond/graphite [4]. Previous studies investigated the transfer of CO2 from subducted eclogite to the ambient mantle by partial melting in the presence of carbonates, i.e., by generation of carbonate-rich melts [5]. However, the transfer of carbon from subducted eclogite to the mantle can also happen, perhaps more commonly, by extraction of silicate partial melt in the presence of reduced carbon; yet, CO2 solubility in eclogite-derived andesitic melt at graphite/diamond saturation remains unconstrained. CO2content of eclogite melts is also critical as geochemistry of many ocean island basalts suggest the presence of C and eclogite in their source regions [6]. In the present study we determine CO2 concentration in a model andesitic melt [7] at graphite/diamond saturation at conditions relevant for partial melting of eclogite in the convecting upper mantle. Piston cylinder and multi anvil experiments were conducted at 1-6 GPa and 1375-1550 °C using Pt/Gr double capsules. Oxygen fugacity was monitored with Pt-Fe sensors in the starting mix. Completed experiments at 1-3 GPa show that CO2 concentration increases with increasing P, T, and fO2 up to ~0.3 wt%. Results were used to develop empirical and thermodynamic models to predict CO2 concentration in partial melts of graphite saturated eclogite. This allowed us to quantify the extent to which CO2 can mobilize from eclogitic heterogeneities at graphite/diamond saturated conditions. With estimates of eclogite contribution to erupted basaltic lavas, the models developed here allow us to put constraints on the flux of CO2 to mantle source regions

  14. [Tumor surgery].

    PubMed

    Hausamen, J E

    2000-05-01

    Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DOSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or

  15. Surgery for Breast Cancer

    MedlinePlus

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  16. Heart bypass surgery

    MedlinePlus

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  17. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... for lung carcinoid tumor symptoms Surgery to treat lung carcinoid tumors Surgery is the main treatment for ... often be cured by surgery alone. Types of lung surgery Different operations can be used to treat ( ...

  18. Tennis elbow surgery - discharge

    MedlinePlus

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

  19. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  20. Comprehensive review on endonasal endoscopic sinus surgery

    PubMed Central

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  1. [Glaucoma and retinal surgery].

    PubMed

    Müller, M; Geerling, G; Zierhut, M; Klink, T

    2010-05-01

    In the therapeutic approach to complex glaucomas different initial situations were considered: pre-existing glaucoma, induction of glaucoma after vitreoretinal surgery and antiglaucomatous procedures. In pre-existing glaucoma and after filtering surgery maintenance of the filtering bleb requires a vitreoretinal approach for conjunctiva preservation with techniques such as pneumatic retinopexy or small gauge vitrectomy. After vitreoretinal surgery an increase in intraocular pressure (IOP) is common. Secondary glaucoma may occur after scleral buckling and after vitrectomy with or without gas or silicone oil tamponade as well as after application of steroids. Angle closure glaucoma after scleral buckling develops because of congestion and anterior rotation of the ciliary body. Vitreous tamponades with expansive or saturated gases may cause angle-closure glaucoma with or without pupillary blockage and may critically shorten ocular perfusion. Postoperative checks, immediate action and a ban on boarding aircraft over the period of intraocular gas tamponade prevent permanent damage to the eye. The majority of secondary glaucomas can effectively be controlled by topical medication and adequate postoperative posture of the patient. Besides the temporary use of systemic antiglaucomatous medication or laser therapy, very rarely in cases of massive swelling or overfill, a direct intervention, such as partial gas or silicone oil removal is required. A prophylactic inferior peripheral iridectomy prevents pupillary blockage in aphakic eyes with intraocular tamponade. In cases of heavy silicone oil use, the peripheral iridectomy is placed in the superior position. Nd:YAG laser application will regulate IOP in cases of occlusion. Secondary glaucoma due to silicone oil emulsification overload is treated by trabecular meshwork aspiration and lavage. In refractory glaucoma repetitive cyclophotocoagulation and drainage implants represent an approved method for long-term IOP regulation

  2. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures. PMID:24144815

  3. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures.

  4. The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study

    PubMed Central

    2012-01-01

    Background Optical diffuse reflectance can remotely differentiate various bio tissues. To implement this technique in an optical feedback system to guide laser surgery in a tissue-specific way, the alteration of optical tissue properties by laser ablation has to be taken into account. It was the aim of this study to evaluate the general feasibility of optical soft tissue differentiation by diffuse reflectance spectroscopy under the influence of laser ablation, comparing the tissue differentiation results before and after laser intervention. Methods A total of 70 ex vivo tissue samples (5 tissue types) were taken from 14 bisected pig heads. Diffuse reflectance spectra were recorded before and after Er:YAG-laser ablation. The spectra were analyzed and differentiated using principal component analysis (PCA), followed by linear discriminant analysis (LDA). To assess the potential of tissue differentiation, area under the curve (AUC), sensitivity and specificity was computed for each pair of tissue types before and after laser ablation, and compared to each other. Results Optical tissue differentiation showed good results before laser exposure (total classification error 13.51%). However, the tissue pair nerve and fat yielded lower AUC results of only 0.75. After laser ablation slightly reduced differentiation results were found with a total classification error of 16.83%. The tissue pair nerve and fat showed enhanced differentiation (AUC: 0.85). Laser ablation reduced the sensitivity in 50% and specificity in 80% of the cases of tissue pair comparison. The sensitivity of nerve–fat differentiation was enhanced by 35%. Conclusions The observed results show the general feasibility of tissue differentiation by diffuse reflectance spectroscopy even under conditions of tissue alteration by laser ablation. The contrast enhancement for the differentiation between nerve and fat tissue after ablation is assumed to be due to laser removal of the surrounding lipid-rich nerve

  5. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their

  6. [Role of surgery in treatment of hyperthyroidism].

    PubMed

    Martin, F; Caporal, R; Tran Ba Huy, P

    1999-09-01

    Hyperthyroidism is treated with antithyroid drugs, radioactive iodine or surgery. The aim of surgery is to obtain long-lasting euthyroidism with a minimal risk of recurrence, secondary hypothyroidism, and complications involving the recurrent nerve or the parathyroids. Depending on the etiology, total or partial resection is indicated in light of these objectives. According to the literature, surgery is not used as first intention treatment for Grave's disease, its role and indications remaining a question of debate. However, surgery is the treatment of choice for toxic nodules, current consensus favoring extracapsular total lobectomy. For multinodular toxic goiter, three are several surgical indications: failure of medical treatment, relapse after drug withdrawal, specific clinical or socioeconomic situations requiring rapid efficacy. Total lobectomy associated with subtotal contralateral hemithyroidectomy appears to be the most appropriate procedure. Surgery may also be indicated for treatment of pregnancy-, diabetes-, or amiodarone-induced hyperthyroidism. PMID:10519008

  7. Robotic Surgery

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

  8. Open heart surgery

    MedlinePlus

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  9. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  10. Gastric bypass surgery

    MedlinePlus

    ... Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... Weight-loss surgery may be an option if you are very obese and have not been able to ...

  11. Coronary Artery Bypass Surgery

    MedlinePlus

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  12. Laser surgery - skin

    MedlinePlus

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  13. Carotid artery surgery - discharge

    MedlinePlus

    ... Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol . 2011 Feb 22;57( ... 21288680 . Kinlay S, Bhatt DL. Treatment of noncoronary obstructive ... Textbook of Surgery . 19th ed. Elsevier Saunders; 2012:chap 63.

  14. [Microsurgery in reanimation, lymphoedema and hand surgery].

    PubMed

    Bonde, Christian T; Jensen, Lisa Toft; Tos, Tina; Kiil, Birgitte Jul; Toft, Gete Ester; Larsen, Søren Erik; Birkeland, Peter; Sørensen, Jens Ahm

    2016-06-01

    Microsurgery is defined as surgery performed with the aid of ocular magnification. In Denmark, this is undertaken by four units. This review describes the history of microsurgery which evolved during the 1960s. Microsurgery in hand surgery is primarily replantation and revascularisation but also peripheral nerve surgery as well as brachial plexus surgery. Lymphoedema is being treated with super microsurgery on an experimental basis. Dynamic reconstruction of facial palsy is performed in a two-stage operation with cross-over nerve graft and a free microvascular muscle flap, typically gracilis. PMID:27292577

  15. Statistics and Ethics in Surgery and Anesthesia

    ERIC Educational Resources Information Center

    Gilbert, John P.; And Others

    1977-01-01

    Analyzes 46 medical research papers on the effects of innovative versus standard surgical procedures on the health of patients. Results reveal that innovations generally reduce complications. The ethics of experimental surgery are also discussed. (CP)

  16. Cosmetic Plastic Surgery Statistics

    MedlinePlus

    2014 Cosmetic Plastic Surgery Statistics Cosmetic Procedure Trends 2014 Plastic Surgery Statistics Report Please credit the AMERICAN SOCIETY OF PLASTIC SURGEONS when citing statistical data or using ...

  17. [Rene Leriche, pioneer of modern surgery].

    PubMed

    Germain, Michel A

    2008-01-01

    René Leriche (1879-1955) is not unknowned, but he has an important place in surgery. He is one of the glory of the contemporary surgery. He has dominated the French surgery during more than thirty years. The life of Leriche is specified: Lyon, medical career, marriage, military service, first world war, Strasbourg, Collage de France, second world war, Académie des Sciences; he was president of the Académie de Chirurgie, chief of the surgical department of the American Hospital; retirement, and death. His scientific work is eminent: surgery of pain, of the sympathic system, vascular surgery, experimental surgery, medical teaching in France, and the Ordre des Mêdecins. Leriche was a fervent patriot and served France to the best of his ability in peace, in war and during occupation by the enemy.

  18. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their

  19. Partial (focal) seizure

    MedlinePlus

    ... Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure; Epilepsy - partial seizures ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  20. Partial tooth gear bearings

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  1. [Endoscopic surgery for benign esophageal diseases].

    PubMed

    Ozawa, Soji

    2006-07-01

    Gastroesophageal reflux disease (GERD) and esophageal achalasia are common benign esophageal diseases. Today minimally invasive surgery is recommended to treat these diseases. Surgical indications for GERD are failure of medical management, medical complications attributable to a large hiatal hernia, 'atypical' symptoms (asthma, hoarseness, cough, chest pain, aspiration), etc. according to the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) guidelines. Laparoscopic Nissen fundoplication has emerged as the most widely accepted procedure for GERD patients with normal esophageal motility. Partial fundoplication (e.g., Toupet fundoplication) is also considered to decrease the possibility of postoperative dysphagia. Although pneumatic dilatation has been the first line treatment for esophageal achalasia, laparoscopic Heller myotomy and partial fundoplication (e.g., Dor fundoplication) to prevent reflux is preferred by most gastroenterologists and surgeons as the primary treatment modality. Laparoscopic surgery for GERD and esophageal achalasia are effective in most patients and safe in all patients. Finally, laparoscopic surgery should be performed only by skilled surgeons.

  2. From bariatric to metabolic surgery: Looking for a "disease modifier" surgery for type 2 diabetes.

    PubMed

    Cordera, Renzo; Adami, Gian Franco

    2016-01-25

    In this review the recent evolution of the comprehension of clinical and metabolic consequences of bariatric surgery is depicted. At the beginning bariatric surgery aim was a significant and durable weight loss. Later on, it became evident that bariatric surgery was associated with metabolic changes, activated by unknown pathways, partially or totally independent of weight loss. Paradigm of this "metabolic" surgery is its effects on type 2 diabetes mellitus (T2DM). In morbid obese subjects it was observed a dramatic metabolic response leading to decrease blood glucose, till diabetes remission, before the achievement of clinically significant weight loss, opening the avenue to search for putative anti-diabetic "intestinal" factors. Both proximal duodenal (still unknown) and distal (GLP1) signals have been suggested as hormonal effectors of surgery on blood glucose decrease. Despite these findings T2DM remission was never considered a primary indication for bariatric surgery but only a secondary one. Recently T2DM remission in obese subjects with body mass index (BMI) greater than 35 has become a primary aim for surgery. This change supports the idea that "metabolic surgery" definition could more appropriate than bariatric, allowing to explore the possibility that metabolic surgery could represent a "disease modifier" for T2DM. Therefore, several patients have undergone surgery with a primary aim of a definitive cure of T2DM and today this surgery can be proposed as an alternative therapy. How much surgery can be considered truly metabolic is still unknown. To be truly "metabolic" it should be demonstrated that surgery could cause T2DM remission not only in subjects with BMI > 35 but also with BMI < 35 or even < 30. Available evidence on this topic is discussed in this mini-review.

  3. Robotic partial nephrectomy: current technique and outcomes.

    PubMed

    Wang, Liang; Lee, Benjamin R

    2013-09-01

    Over the past decade, management of the T1 renal mass has focused on nephron-sparing surgery. Robotic partial nephrectomy has played an increasing role in the technique of preserving renal function by decreasing warm ischemia time, as well as optimizing outcomes of hemorrhage and fistula. Robot-assisted partial nephrectomy is designed to provide a minimally-invasive nephron-sparing surgical option utilizing reconstructive capability, decreasing intracorporeal suturing time, technical feasibility and safety. Ultimately, its benefits are resulting in its dissemination across institutions. Articulated instrumentation and three-dimensional vision facilitate resection, collecting system reconstruction and renorrhaphy, leading to decreased warm ischemia time while preserving oncological outcomes. The aim of the present review was to present our surgical sequence and technique, as well as review the current status of robot-assisted partial nephrectomy.

  4. Tissue holder for experimental and Demonstration Surgery

    NASA Technical Reports Server (NTRS)

    Kuchta, F. J.; Pavlik, J. B.; Vargo, D. J.; Winters, G. R.

    1972-01-01

    Development of device for holding anatomical tissues during operations is discussed. Device consists of plastic dish with hemispherical recess in center to hold excised eyes. Low vacuum applied to underside of recess insures holding of part.

  5. Partial splenic resection using the TA-stapler.

    PubMed

    Uranüs, S; Kronberger, L; Kraft-Kine, J

    1994-07-01

    Since 1987, we have used the TA-stapler for 15 partial resections of the spleen. The cases included 5 second- to third-degree traumatic ruptures, 4 splenic cysts, 3 injuries resulting from accidents during upper-abdominal surgery, 2 diagnostic resections, and 1 intralienal pancreatic cyst. The TA-55 stapler was used 14 times and the TA-90 once. No patient developed postoperative bleeding or required further surgery. Postoperative laboratory chemistry and scintigraphy findings were within the limits indicative of normal function in all cases. The TA-stapler expands the technical possibilities for organ-conserving splenic surgery.

  6. Experimental study of local dehydration and partial melting of biotite-amphibole gneiss with participation of the H2O-CO2-(K, Na)Cl fluids at the middle-crustal conditions

    NASA Astrophysics Data System (ADS)

    Safonov, O.; Kozhukhantseva, S.

    2012-04-01

    Activity of aqueous chloride-rich brines coexisting with CO2-rich fluids is identified in many amphibolite and granulite terrains suggesting that this type of fluid is an important agent of high-grade metamorphism in the lower to middle crust (see reviews in Touret, 2009; Newton, Manning, 2010). Although thermodynamic and transport properties of these fluids is well constrained both theoretically and experimentally, their affect on complex natural assemblages is poorly understood and demands systematic experimental study. We report here results of the experiments on interaction of the biotite-amphibole gneiss from the Sand River formation (Limpopo Complex, South Africa) with the fluids H2O-CO2-(K, Na)Cl at 5.5 kbar, 750 and 800 C, the chloride/(H2O+CO2) varying from 0 0.1, and molar CO2/(CO2+H2O) = 0.5. No any reaction textures were identified in the sample interacted with the chloride-free CO2-H2O fluid at 750 C. At this temperature, addition of KCl into the fluid resulted in formation of spectacular reaction textures around biotite (Bt), amphibole (Amp), plagioclase (Pl) and quartz (Qtz) in the starting gneiss. These textures are intergrowths of low-Al clinopyroxene (Cpx) and K-feldspar (Kfs) (sporadically accompanied by ilmenite, sphene and Ti-bearing low-Al mica) corresponding to a progress of the following reactions: Phl + 3An + 18Qtz + 3(K2O in fluid) = 3Di + 7Kfs + (H2O in fluid) and Prg + Ed + 7(K2O in fluid) + 37Qtz + 5An = 9Di + 14Kfs + (2H2O + Na2O in fluid). Local partial melting of the gneiss interacted with KCl-bearing fluids at 750OC was observed only in the run at KCl/(CO2+H2O) = 1/30 and could be caused by local variation of water activity in the sample. Nevertheless, at 800 OC, granitic (>70 wt. % of SiO2) K2O-rich and Cl-bearing melt appears along the grain boundaries in all run samples. This melt produces K-feldspar and clinopyroxene, which are found as euhedral crystals in the glass. Melt films are usually accompanied by K-feldspar microveins

  7. Applications of Computational Modeling in Cardiac Surgery

    PubMed Central

    Lee, Lik Chuan; Genet, Martin; Dang, Alan B.; Ge, Liang; Guccione, Julius M.; Ratcliffe, Mark B.

    2014-01-01

    Although computational modeling is common in many areas of science and engineering, only recently have advances in experimental techniques and medical imaging allowed this tool to be applied in cardiac surgery. Despite its infancy in cardiac surgery, computational modeling has been useful in calculating the effects of clinical devices and surgical procedures. In this review, we present several examples that demonstrate the capabilities of computational cardiac modeling in cardiac surgery. Specifically, we demonstrate its ability to simulate surgery, predict myofiber stress and pump function, and quantify changes to regional myocardial material properties. In addition, issues that would need to be resolved in order for computational modeling to play a greater role in cardiac surgery are discussed. PMID:24708036

  8. [Prophylactic pancreas surgery].

    PubMed

    Langer, P; Rothmund, M; Bartsch, D K

    2006-01-01

    The goal of prophylactic surgery is to prevent malignant growth in patients with hereditary tumor predisposition. The pancreas presents as particularly challenging, due to the difficulty of operation and comparatively high risk of morbidity and even mortality. In addition, partial operative procedures and, more significantly, total resection lead to exocrine pancreas insufficiency and secondary diabetes, with grave consequences for the patient. Hereditary tumor predisposition syndromes that can result in pancreaticoduodenal endocrine tumors (PET) include multiple endocrine neoplasia type 1 syndrome and von Hippel-Lindau syndrome. As penetrance is maximally 70-80% and the 10-year survival rate over 80%, prophylactic pancreatic resection without evidence of a tumor is not indicated. However, prophylactic extension of a resection would be advised, should a PET be diagnosed. Patients predisposed to developing ductal pancreatic carcinoma (PC) are at risk of familial pancreatic cancer syndrome (FPC), hereditary pancreatitis, and other hereditary tumor predisposition syndromes such as Peutz-Jeghers syndrome and familial atypical multiple mole-melanoma syndrome. As the gene defect responsible for FPC has yet to be identified and the penetrance of PC in the other tumor predisposition syndromes is low or unknown, a prophylactic pancreatectomy based on today's knowledge is not indicated. Prophylactic extension of the resection is advisable should PC or high-grade PanIN lesions be diagnosed, as these patients often present with multifocal dysplasia and even carcinoma.

  9. Periodontal Plastic Surgery

    MedlinePlus

    ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ...

  10. Plastic Surgery for Teenagers

    MedlinePlus

    ... or severe acne and scarring. Teens frequently gain self-esteem and confidence when their physical problems are corrected. ... art as a helpful index of anxiety and self-esteem with plastic surgery. Plastic and Reconstructive Surgery 2002. ...

  11. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  12. Weight Loss Surgery

    MedlinePlus

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  13. Ear Plastic Surgery

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  14. Refractive corneal surgery - discharge

    MedlinePlus

    ... after surgery, it should be okay to use artificial tears. Check with your doctor. Do NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. Do NOT use any makeup, creams, or lotions ...

  15. Complications of Sinus Surgery

    MedlinePlus

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  16. Technology needs for corneal transplant surgery

    NASA Astrophysics Data System (ADS)

    Vaddavalli, Pravin K.; Yoo, Sonia H.

    2011-03-01

    Corneal transplant surgery has undergone numerous modifications over the years with improvements in technique, instrumentation and eye banking. The main goals of corneal transplantation are achieving excellent optical clarity with long-term graft survival. Penetrating, anterior and posterior lamellar surgery along with femtosecond laser technology have partially met these goals, but outcomes are often unpredictable and surgeon dependent. Technology to predictably separate stroma from Descemet's membrane, techniques to minimize endothelial cell loss, improvements in imaging technology and emerging techniques like laser welding that might replace suturing, eventually making corneal transplantation a refractively predictable procedure are on the wish list of the cornea surgeon.

  17. Xanthogranulomatous cholecystitis in laparoscopic surgery.

    PubMed

    Guzmán-Valdivia, Gilberto

    2005-04-01

    Xanthogranulomatous cholecystitis (XGC) is one presentation of cholecystitis and can be a cause of difficulty in cholecystectomy. We reviewed the clinical files of 12,426 patients who had undergone cholecystectomy. In this group, there were 182 cases of XGC, and 41 of these patients had undergone laparoscopic surgery. Patients with XGC represented 1.46% of the cholecystectomies that were performed. Of the 41 patients who underwent laparoscopic surgery, 27 were men (66%) and 14 were women (34%) (average age, 52 years). A total of 36 patients (88%) presented with a chronic condition. XGC was found to be associated with lithiasis in 85%, with jaundice in 22%, and with cancer in 2.4% (one patient). A total of 33 patients (80%) required conversion to open surgery, because of technical difficulties; of these patients, 64% underwent partial cholecystectomy. We conclude that XGC creates difficulty at laparoscopy and therefore any preoperative suspicion of XGC should cause the clinician to consider open cholecystectomy. PMID:15797229

  18. Robotic liver surgery

    PubMed Central

    Leung, Universe

    2014-01-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  19. Robotic liver surgery.

    PubMed

    Leung, Universe; Fong, Yuman

    2014-10-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  20. Infection after hand surgery.

    PubMed

    Eberlin, Kyle R; Ring, David

    2015-05-01

    Postoperative infections are uncommon after hand surgery. Infection can delay recovery and contribute to scarring and stiffness. Measures intended to reduce the risk of infection after hand surgery include hand washing, skin preparation, sterile technique, and prophylactic antibiotics. The role of prophylactic antibiotics for small, clean, elective hand surgery procedures lasting less than 2 hours is debated.

  1. Infection after hand surgery.

    PubMed

    Eberlin, Kyle R; Ring, David

    2015-05-01

    Postoperative infections are uncommon after hand surgery. Infection can delay recovery and contribute to scarring and stiffness. Measures intended to reduce the risk of infection after hand surgery include hand washing, skin preparation, sterile technique, and prophylactic antibiotics. The role of prophylactic antibiotics for small, clean, elective hand surgery procedures lasting less than 2 hours is debated. PMID:25934209

  2. Cavus Foot Surgery

    MedlinePlus

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  3. Partial coalescence of soap bubbles

    NASA Astrophysics Data System (ADS)

    Harris, Daniel M.; Pucci, Giuseppe; Bush, John W. M.

    2015-11-01

    We present the results of an experimental investigation of the merger of a soap bubble with a planar soap film. When gently deposited onto a horizontal film, a bubble may interact with the underlying film in such a way as to decrease in size, leaving behind a smaller daughter bubble with approximately half the radius of its progenitor. The process repeats up to three times, with each partial coalescence event occurring over a time scale comparable to the inertial-capillary time. Our results are compared to the recent numerical simulations of Martin and Blanchette and to the coalescence cascade of droplets on a fluid bath.

  4. [Functional surgery for head and neck squamous cell carcinoma].

    PubMed

    Janot, François; Julieron, Morbize

    2002-12-01

    Surgery for head and neck squamous cell carcinoma can alter speech, swallowing, and cosmoses. Recent tendency is to avoid mutilating surgery unless the tumour is aggressive or resistant to chemotherapy and or radiotherapy. Functional surgery is being widely employed, and for example it may vary between conventional partial surgery and endoscopic laser surgery for small sized vocal cord cancers. Various new reconstructive procedures have been developed to help early functional restoration. Loco-regional flaps can be used to replace gums and avoid dental extractions. Free flaps with micro-vascular anastomosis can be employed for immediate reconstruction of extensive surgical defects involving pharyngeal wall, tongue, mandible and mid-face to restore better function and cosmoses. Few recently developed techniques can be also employed in selected cases of laryngo-pharyngeal cancers to avoid permanent laryngeal mutilation. Another goal of functional surgery is to decrease the postoperative radiotherapy or chemo-radiotherapy sequelae, and obtain successful postoperative functional rehabilitation.

  5. White adipose tissue re-growth after partial lipectomy in high fat diet induced obese wistar rats.

    PubMed

    Bueno, Allain Amador; Habitante, Carlos Alexandre; Oyama, Lila Missae; Estadella, Débora; Ribeiro, Eliane Beraldi; Oller do Nascimento, Cláudia Maria

    2011-01-01

    The effects of partial removal of epididymal (EPI) and retroperitoneal (RET) adipose tissues (partial lipectomy) on the triacylglycerol deposition of high fat diet induced obese rats were analyzed, aiming to challenge the hypothesized body fat regulatory system. Male 28-day-old wistar rats received a diet enriched with peanuts, milk chocolate and sweet biscuits during the experimental period. At the 90th day of life, rats were submitted to either lipectomy (L) or sham surgery. After 7 or 30 days, RET, EPI, liver, brown adipose tissue (BAT), blood and carcass were obtained and analyzed. Seven days following surgery, liver lipogenesis rate and EPI relative weight were increased in L. After 30 days, L, RET and EPI presented increased lipogenesis, lipolysis and percentage of small area adipocytes. L rats also presented increased liver malic enzyme activity, BAT lipogenesis, and triacylglycerol and corticosterone serum levels. The partial removal of visceral fat pads affected the metabolism of high fat diet obese rats, which leads to excised tissue re-growth and possibly compensatory growth of non-excised depots at a later time.

  6. [The insula in partial epilepsy].

    PubMed

    Isnard, J; Mauguière, F

    2005-01-01

    The role of the insular lobe in temporal lobe epilepsy (TLE) has often been suggested but never directly demonstrated. In this article, we review data from recent literature and from our stereo-electroencephalographic (SEEG) recordings in patients referred for temporal lobe epilepsy surgery (TLE). Our description of the clinical features of insular lobe seizures is based on data from video and SEEG ictal recordings and direct electric cortical stimulation in a population of 50 consecutive patients whose seizures, on the basis of scalp video EEG recordings, were suspected to originate from, or to rapidly propagate to, the peri-sylvian cortex. A total of 144 intra-insular electrodes have been implanted in this series of patients. In six patients a stereotyped sequence of ictal symptoms could be identified on the basis of electro-clinical correlations. The clinical presentation of insular lobe seizures was that of simple partial seizures occurring in full consciousness, beginning with a sensation of laryngeal constriction followed by paresthesiae that were often unpleasant affecting large cutaneous territories. These initial symptoms were eventually followed by dysarthric speech and/or elementary auditory hallucinations, and seizures often ended with focal dystonic postures. The insular origin of these symptoms was supported by the data from functional cortical mapping of the insula using direct cortical stimulations. We were able to reproduce several of the spontaneous ictal symptoms in the six patients with insular seizures. Moreover, from the whole set of insular stimulations that we performed it could be concluded that the insular cortex is involved in somatic, vegetative and visceral functions to which spontaneous ictal insular symptoms are related. The observation of the insular symptoms sequence at the onset of seizures in patients who are candidates for TLE surgery strongly suggests that the epileptic focus is located in the insular lobe. It entails the risk

  7. Current status of robotic surgery in Japan

    PubMed Central

    2015-01-01

    The da Vinci S surgical system (Intuitive Surgical) was approved as a medical device in 2009 by the Japanese Ministry of Health, Labour and Welfare. Robotic surgery has since been used in gastrointestinal, thoracic, gynecological, and urological surgeries. In April 2012, robotic-assisted laparoscopic radical prostatectomy (RALP) was first approved for insurance coverage. Since then, RALP has been increasingly used, with more than 3,000 RALP procedures performed by March 2013. By July 2014, 183 institutions in Japan had installed the da Vinci surgical system. Other types of robotic surgeries are not widespread because they are not covered by public health insurance. Clinical trials using robotic partial nephrectomy and robotic gastrectomy for renal and gastric cancers, respectively, have recently begun as advanced medical treatments to evaluate health insurance coverage. These procedures must be evaluated for efficacy and safety before being covered by public health insurance. Other types of robotic surgery are being evaluated in clinical studies. There are several challenges in robotic surgery, including accreditation, training, efficacy, and cost. The largest issue is the cost-benefit balance. In this review, the current situation and a prospective view of robotic surgery in Japan are discussed. PMID:25763120

  8. Twisted partially pure spinors

    NASA Astrophysics Data System (ADS)

    Herrera, Rafael; Tellez, Ivan

    2016-08-01

    Motivated by the relationship between orthogonal complex structures and pure spinors, we define twisted partially pure spinors in order to characterize spinorially subspaces of Euclidean space endowed with a complex structure.

  9. The future of robotics in hand surgery.

    PubMed

    Liverneaux, P; Nectoux, E; Taleb, C

    2009-10-01

    Robotics has spread over many surgical fields over the last decade: orthopaedic, cardiovascular, urologic, gynaecologic surgery and various other types of surgery. There are five different types of robots: passive, semiactive and active robots, telemanipulators and simulators. Hand surgery is at a crossroad between orthopaedic surgery, plastic surgery and microsurgery; it has to deal with fixing all sorts of tissues from bone to soft tissues. To our knowledge, there is not any paper focusing on potential clinical applications in this realm, even though robotics could be helpful for hand surgery. One must point out the numerous works on bone tissue with regard to passive robots (such as fluoroscopic navigation as an ancillary for percutaneous screwing in the scaphoid bone). Telemanipulators, especially in microsurgery, can improve surgical motion by suppressing physiological tremor thanks to movement demultiplication (experimental vascular and nervous sutures previously published). To date, the robotic technology has not yet become simple-to-use, cheap and flawless but in the future, it will probably be of great technical help, and even allow remote-controlled surgery overseas. PMID:19766036

  10. Metabolic surgery: quo vadis?

    PubMed

    Ramos-Leví, Ana M; Rubio Herrera, Miguel A

    2014-01-01

    The impact of bariatric surgery beyond its effect on weight loss has entailed a change in the way of regarding it. The term metabolic surgery has become more popular to designate those interventions that aim at resolving diseases that have been traditionally considered as of exclusive medical management, such as type 2 diabetes mellitus (T2D). Recommendations for metabolic surgery have been largely addressed and discussed in worldwide meetings, but no definitive consensus has been reached yet. Rates of diabetes remission after metabolic surgery have been one of the most debated hot topics, with heterogeneity being a current concern. This review aims to identify and clarify controversies regarding metabolic surgery, by focusing on a critical analysis of T2D remission rates achieved with different bariatric procedures, and using different criteria for its definition. Indications for metabolic surgery for patients with T2D who are not morbidly obese are also discussed.

  11. Variance Components: Partialled vs. Common.

    ERIC Educational Resources Information Center

    Curtis, Ervin W.

    1985-01-01

    A new approach to partialling components is used. Like conventional partialling, this approach orthogonalizes variables by partitioning the scores or observations. Unlike conventional partialling, it yields a common component and two unique components. (Author/GDC)

  12. Fundamentals of bipolar high-frequency surgery.

    PubMed

    Reidenbach, H D

    1993-04-01

    In endoscopic surgery a very precise surgical dissection technique and an efficient hemostasis are of decisive importance. The bipolar technique may be regarded as a method which satisfies both requirements, especially regarding a high safety standard in application. In this context the biophysical and technical fundamentals of this method, which have been known in principle for a long time, are described with regard to the special demands of a newly developed field of modern surgery. After classification of this method into a general and a quasi-bipolar mode, various technological solutions of specific bipolar probes, in a strict and in a generalized sense, are characterized in terms of indication. Experimental results obtained with different bipolar instruments and probes are given. The application of modern microprocessor-controlled high-frequency surgery equipment and, wherever necessary, the integration of additional ancillary technology into the specialized bipolar instruments may result in most useful and efficient tools of a key technology in endoscopic surgery.

  13. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-17

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  14. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  15. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    2001-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  16. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-24

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  17. Oxygen partial pressure sensor

    DOEpatents

    Dees, D.W.

    1994-09-06

    A method for detecting oxygen partial pressure and an oxygen partial pressure sensor are provided. The method for measuring oxygen partial pressure includes contacting oxygen to a solid oxide electrolyte and measuring the subsequent change in electrical conductivity of the solid oxide electrolyte. A solid oxide electrolyte is utilized that contacts both a porous electrode and a nonporous electrode. The electrical conductivity of the solid oxide electrolyte is affected when oxygen from an exhaust stream permeates through the porous electrode to establish an equilibrium of oxygen anions in the electrolyte, thereby displacing electrons throughout the electrolyte to form an electron gradient. By adapting the two electrodes to sense a voltage potential between them, the change in electrolyte conductivity due to oxygen presence can be measured. 1 fig.

  18. Oxygen partial pressure sensor

    DOEpatents

    Dees, Dennis W.

    1994-01-01

    A method for detecting oxygen partial pressure and an oxygen partial pressure sensor are provided. The method for measuring oxygen partial pressure includes contacting oxygen to a solid oxide electrolyte and measuring the subsequent change in electrical conductivity of the solid oxide electrolyte. A solid oxide electrolyte is utilized that contacts both a porous electrode and a nonporous electrode. The electrical conductivity of the solid oxide electrolyte is affected when oxygen from an exhaust stream permeates through the porous electrode to establish an equilibrium of oxygen anions in the electrolyte, thereby displacing electrons throughout the electrolyte to form an electron gradient. By adapting the two electrodes to sense a voltage potential between them, the change in electrolyte conductivity due to oxygen presence can be measured.

  19. Dynamics of partial control.

    PubMed

    Sabuco, Juan; Sanjuán, Miguel A F; Yorke, James A

    2012-12-01

    Safe sets are a basic ingredient in the strategy of partial control of chaotic systems. Recently we have found an algorithm, the sculpting algorithm, which allows us to construct them, when they exist. Here we define another type of set, an asymptotic safe set, to which trajectories are attracted asymptotically when the partial control strategy is applied. We apply all these ideas to a specific example of a Duffing oscillator showing the geometry of these sets in phase space. The software for creating all the figures appearing in this paper is available as supplementary material. PMID:23278093

  20. Hyperoxaluria and Bariatric Surgery

    NASA Astrophysics Data System (ADS)

    Asplin, John R.

    2007-04-01

    Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.

  1. Pediatric heart surgery - discharge

    MedlinePlus

    Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - discharge; Tetralogy of Fallot repair - discharge; Coarctation of the aorta repair - discharge; ...

  2. Lung surgery - discharge

    MedlinePlus

    Thoracotomy - discharge; Lung tissue removal - discharge; Pneumonectomy - discharge; Lobectomy - discharge; Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - ...

  3. Surgery center joint ventures.

    PubMed

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  4. [Clamping procedures in hepatic surgery].

    PubMed

    Frangov, T; Dimitrova, V; Kasten, D; Bismiut, A

    2005-01-01

    The advance of liver surgery and transplantation offers a new procedures--vascular clamping. Results of hepatic resections depends essentially on proper control of intraoperative hemorrhage. We present here the different procedures for vascular clamping and discussing their indications. Four parametres can be used to define the type of clamping: 1) place of application--control of arterial or glisson pedicles and portal veins (pedicles, selective hilar, suprahilar and intrahepatic clamps), suprahepatic veins or vena cava; 2) selectivity--partial or total clamp of hepatic blood supply; 3) duration--continuous or intermittent; 4) association measures to favor tolerence to ischemia (cooling, preservation fluids) or to limit downstream consequences (extracorporal circulaton, derivation). The clamping procedures depends on the localisation of the lesion and its relationships with the great vessels, presence of liver desease and the patients general and cardiovascular status. The aim is to use clamp moderate, favoring selective clamps to avoid ischemia. PMID:18693516

  5. [Laparascopic surgery and robotic-guided surgery].

    PubMed

    Shemer, Joshua

    2009-03-01

    Surgical procedures are constantly developing in intricacy due to both technological innovation and professional medical competency. Over the past decades new trends reveal interest in minimally invasive procedures, a decline in invasive techniques and developments in imaging technology and telemedicine. Since 1985, laparoscopic surgery has facilitated new horizons in a wide range of clinical fields: gynecology, urology, chest and abdominal surgery, orthopedics, cardiology and more. Recently, robotic surgery has emerged, using these techniques and improving outcomes through better imaging and treatment, decreasing the side effects of the classic operation. These sophisticated instruments are technical tools in the hands of the skilled professional and deserve the attention of the medical community and decision-makers. Preliminary understanding of the adoption and implementation of new medical technologies may improve the rate of their utilization enabling appropriate preparedness within the health system.

  6. Secondary surgery in paediatric facial paralysis reanimation.

    PubMed

    Terzis, Julia K; Olivares, Fatima S

    2010-11-01

    Ninety-two children, the entire series of paediatric facial reanimation by a single surgeon over thirty years, are presented. The objective is to analyse the incidence and value of secondary revisions for functional and aesthetic refinements following the two main stages of reanimation. The reconstructive strategy varied according to the denervation time, the aetiology, and whether the paralysis was uni- or bilateral, complete or partial. Irrespective of these variables, 89% of the patients required secondary surgery. Post-operative videos were available in seventy-two cases. Four independent observers graded patients' videos using a scale from poor to excellent. The effect of diverse secondary procedures was measured computing a mean-percent-gain score. Statistical differences between treatment groups means were tested by the t-test and one-way ANOVA. Two-thirds of the corrective and ancillary techniques utilized granted significantly higher mean-scores post-secondary surgery. A comparison of pre- and post-operative data found valuable improvements in all three facial zones after secondary surgery. In conclusion, inherent to dynamic procedures is the need for secondary revisions. Secondary surgery builds in the potential of reanimation surgery, effectively augmenting functional faculties and aesthesis.

  7. Laparoscopic partial nephrectomy and wedge resection.

    PubMed

    Kozlowski, P M; Winfield, H N

    2000-12-01

    Partial nephrectomy is a more challenging operation than radical or simple nephrectomy, primarily because of the risk of complications such as bleeding. This problem is even more troublesome with minimally invasive approaches because of the dearth of effective hemostatic instruments and supplies. The location of the lesion determines whether a transperitoneal or a retroperitoneal route will be employed. Centrally located or anterior renal lesions generally are approached transperitoneally whereas peripheral lateral or posterior lesions are accessed by retroperitoneoscopy. The Harmonic Scalpel with slow cutting and high coagulation settings is useful for incising the renal capsule and parenchyma. The argon beam coagulator is helpful to stop any persistent bleeding. The few reported series of laparoscopic partial nephrectomy indicate considerably longer operative times than are needed for open surgery and hospitalization of upwards of 5 days, largely to monitor drainage and urine leakage. It is hoped that this advanced laparoscopic technique will become more user friendly with further developments in techniques and instrumentation to provide patients with the expected benefits of minimally invasive surgery.

  8. An Ultrasonic Clamp for Bloodless Partial Nephrectomy

    NASA Astrophysics Data System (ADS)

    Lafon, Cyril; Bouchoux, Guillaume; Murat, François Joseph; Birer, Alain; Theillère, Yves; Chapelon, Jean Yves; Cathignol, Dominique

    2007-05-01

    Maximum conservation of the kidney is preferable through partial nephrectomy for patients at risk of disease recurrence of renal cancers. Haemostatic tools are needed in order to achieve bloodless surgery and reduce post surgery morbidity. Two piezo-ceramic transducers operating at a frequency of 4 MHz were mounted on each arm of a clamp. When used for coagulation purposes, two transducers situated on opposite arms of the clamp were driven simultaneously. Heat delivery was optimized as each transducers mirrored back to targeted tissues the wave generated by the opposite transducer. Real-time treatment monitoring with an echo-based technique was also envisaged with this clamp. Therapy was periodically interrupted so one transducer could generate a pulse. The echo returning from the opposite transducer was treated. Coagulation necroses were obtained in vitro on substantial thicknesses (23-38mm) of pig liver over exposure durations ranging from 30s to 130s, and with acoustic intensities of less than 15W/cm2 per transducer. Both kidneys of two pigs were treated in vivo with the clamp (14.5W/cm2 for 90s), and the partial nephrectomies performed proved to be bloodless. In vitro and in vivo, wide transfixing lesions corresponded to an echo energy decrease superior to -10dB and parabolic form of the time of flight versus treatment time. In conclusion, this ultrasound clamp has proven to be an excellent mean for achieving monitored haemostasis in kidney.

  9. Partial facetectomy for lumbar foraminal stenosis.

    PubMed

    Kang, Kevin; Rodriguez-Olaverri, Juan Carlos; Schwab, Frank; Hashem, Jenifer; Razi, Afshin; Farcy, Jean Pierre

    2014-01-01

    Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms. Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes. Results. 27 of 47 patients (57%) reported no back pain and no functional limitations. Eight of 47 patients (17%) reported moderate pain, but had no limitations. Six of 47 patients (13%) continued to experience degenerative symptoms. Five of 47 patients (11%) required additional surgery. Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.

  10. Partial hue-matching.

    PubMed

    Logvinenko, Alexander D; Beattie, Lesley L

    2011-01-01

    It is widely believed that color can be decomposed into a small number of component colors. Particularly, each hue can be described as a combination of a restricted set of component hues. Methods, such as color naming and hue scaling, aim at describing color in terms of the relative amount of the component hues. However, there is no consensus on the nomenclature of component hues. Moreover, the very notion of hue (not to mention component hue) is usually defined verbally rather than perceptually. In this paper, we make an attempt to operationalize such a fundamental attribute of color as hue without the use of verbal terms. Specifically, we put forth a new method--partial hue-matching--that is based on judgments of whether two colors have some hue in common. It allows a set of component hues to be established objectively, without resorting to verbal definitions. Specifically, the largest sets of color stimuli, all of which partially match each other (referred to as chromaticity classes), can be derived from the observer's partial hue-matches. A chromaticity class proves to consist of all color stimuli that contain a particular component hue. Thus, the chromaticity classes fully define the set of component hues. Using samples of Munsell papers, a few experiments on partial hue-matching were carried out with twelve inexperienced normal trichromatic observers. The results reinforce the classical notion of four component hues (yellow, blue, red, and green). Black and white (but not gray) were also found to be component colors. PMID:21742961

  11. Minimally invasive aortic valve surgery

    PubMed Central

    Castrovinci, Sebastiano; Emmanuel, Sam; Moscarelli, Marco; Murana, Giacomo; Caccamo, Giuseppa; Bertolino, Emanuela Clara; Nasso, Giuseppe; Speziale, Giuseppe; Fattouch, Khalil

    2016-01-01

    Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has demonstrably proven to be both safe and effective. Over the last few decades, in an attempt to reduce surgical trauma, different minimally invasive approaches for aortic valve replacement have been developed and are now being increasingly utilized. A narrative review of the literature was carried out to describe the surgical techniques for minimally invasive aortic valve surgery and report the results from different experienced centers. Minimally invasive aortic valve replacement is associated with low perioperative morbidity, mortality and a low conversion rate to full sternotomy. Long-term survival appears to be at least comparable to that reported for conventional full sternotomy. Minimally invasive aortic valve surgery, either with a partial upper sternotomy or a right anterior minithoracotomy provides early- and long-term benefits. Given these benefits, it may be considered the standard of care for isolated aortic valve disease. PMID:27582764

  12. Minimally invasive aortic valve surgery.

    PubMed

    Castrovinci, Sebastiano; Emmanuel, Sam; Moscarelli, Marco; Murana, Giacomo; Caccamo, Giuseppa; Bertolino, Emanuela Clara; Nasso, Giuseppe; Speziale, Giuseppe; Fattouch, Khalil

    2016-09-01

    Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has demonstrably proven to be both safe and effective. Over the last few decades, in an attempt to reduce surgical trauma, different minimally invasive approaches for aortic valve replacement have been developed and are now being increasingly utilized. A narrative review of the literature was carried out to describe the surgical techniques for minimally invasive aortic valve surgery and report the results from different experienced centers. Minimally invasive aortic valve replacement is associated with low perioperative morbidity, mortality and a low conversion rate to full sternotomy. Long-term survival appears to be at least comparable to that reported for conventional full sternotomy. Minimally invasive aortic valve surgery, either with a partial upper sternotomy or a right anterior minithoracotomy provides early- and long-term benefits. Given these benefits, it may be considered the standard of care for isolated aortic valve disease. PMID:27582764

  13. Bilateral pneumothorax after orthognatic surgery

    PubMed Central

    Bertossi, Dario; Malchiodi, Luciano; Turra, Matteo; Bondi, Vincenzo; Albanese, Massimo; Lucchese, Alessandra; Carinci, Francesco; Nocini, Pierfrancesco

    2012-01-01

    Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28-year-old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post-surgical dispnea associated to sub-cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post-surgical orthognatic treatment can be extremely difficult requiring a multi-disciplinary approach. PMID:23814593

  14. Hemostasis in Laryngeal Surgery.

    PubMed

    Athanasiadis, Theodore; Allen, Jacqui

    2016-06-01

    The larynx is a highly vascularized organ supplied by the superior and inferior laryngeal arteries. Both microphonosurgery and external laryngeal surgery require excellent hemostasis. Topical agents including adrenalin and fibrin-based products as well as surgical instrumentation, such as coagulation devices or in some cases embolization, are in the surgeon's armamentarium and facilitate efficient and successful surgery. PMID:27267020

  15. Preparing for Surgery

    MedlinePlus

    ... ray, and an electrocardiogram. An electrocardiogram is a test of heart function with an instrument that prints out the results as a graph. What preparation may be necessary before surgery? Depending on the type of surgery, your health care provider may want you to use a laxative ...

  16. Advances in fetal surgery

    PubMed Central

    Pedreira, Denise Araujo Lapa

    2016-01-01

    ABSTRACT This paper discusses the main advances in fetal surgical therapy aiming to inform health care professionals about the state-of-the-art techniques and future challenges in this field. We discuss the necessary steps of technical evolution from the initial open fetal surgery approach until the development of minimally invasive techniques of fetal endoscopic surgery (fetoscopy). PMID:27074241

  17. Robotic heart surgery.

    PubMed

    Zenati, M A

    2001-01-01

    Advances in computer and robotic technology are transforming cardiac surgery, overcoming the limitations of conventional endoscopic tools. Using minimal access through 5 millimeter ports, computer-enhanced instruments provide superhuman dexterity through tremor filtration and motion scaling, and are capable of precise manipulation in confined body cavities. Using these technologies, endoscopic beating heart coronary bypass surgery as well as complex mitral valve repairs have been performed in the last few years. However, the current world experience with robotic heart surgery is mostly anecdotal, retrospective, and noncontrolled. Results of rigorous prospective randomized studies in the United States under Food and Drug Administration approved protocols, are awaited. The use of robotic telemanipulation technology for heart surgery is restricted in the United States to patients enrolled in clinical studies in a few elite centers. Further refinement in robotic and image-guided technology for cardiac surgery may further expand the use of computer enhanced instrumentation in the near future.

  18. Partial coalescence of soap bubbles

    NASA Astrophysics Data System (ADS)

    Pucci, G.; Harris, D. M.; Bush, J. W. M.

    2015-06-01

    We present the results of an experimental investigation of the merger of a soap bubble with a planar soap film. When gently deposited onto a horizontal film, a bubble may interact with the underlying film in such a way as to decrease in size, leaving behind a smaller daughter bubble with approximately half the radius of its progenitor. The process repeats up to three times, with each partial coalescence event occurring over a time scale comparable to the inertial-capillary time. Our results are compared to the recent numerical simulations of Martin and Blanchette ["Simulations of surfactant effects on the dynamics of coalescing drops and bubbles," Phys. Fluids 27, 012103 (2015)] and to the coalescence cascade of droplets on a fluid bath.

  19. Partial Return Yoke for MICE

    SciTech Connect

    Witte H.; Plate, S

    2013-05-03

    The international Muon Ionization Cooling Experiment (MICE) is a large scale experiment which is presently assembled at the Rutherford Appleton Laboratory in Didcot, UK. The purpose of MICE is to demonstrate the concept of ionization cooling experimentally. Ionization cooling is an important accelerator concept which will be essential for future HEP experiments such as a potential Muon Collider or a Neutrino Factory. The MICE experiment will house up to 18 superconducting solenoids, all of which produce a substantial amount of magnetic flux. Recently it was realized that this magnetic flux leads to a considerable stray magnetic field in the MICE hall. This is a concern as technical equipment in the MICE hall may may be compromised by this. In July 2012 a concept called partial return yoke was presented to the MICE community, which reduces the stray field in the MICE hall to a safe level. This report summarizes the general concept, engineering considerations and the expected shielding performance.

  20. Accuracy Of Stereometry In Assessing Orthognathic Surgery

    NASA Astrophysics Data System (ADS)

    King, Geoffrey E.; Bays, R. A.

    1983-07-01

    An X-ray stereometric technique has been developed for the determination of 3-dimensional coordinates of spherical metallic markers previously implanted in monkey skulls. The accuracy of the technique is better than 0.5mm. and uses readily available demountable X-ray equipment. The technique is used to study the effects and stability of experimental orthognathic surgery.

  1. Preparing for Breast Reconstruction Surgery

    MedlinePlus

    ... after breast reconstruction surgery Preparing for breast reconstruction surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  2. Limited-Access Heart Surgery

    MedlinePlus

    ... not have to be split open. What is robotic-assisted heart surgery? In yet another kind of ... perform videoscopic surgery with even greater precision. In robotic-assisted surgery, surgeons make several small incisions in ...

  3. Plastic Surgery for Ethnic Patients

    MedlinePlus

    ... Briefing Papers > Plastic Surgery for Ethnic Patients Briefing Paper: Plastic Surgery for Ethnic Patients More than 3. ... 2067-2071. Share Related Links Plastic Surgery Briefing Papers Menu Cosmetic Reconstructive Patient Safety Before & After Find ...

  4. Tests and visits before surgery

    MedlinePlus

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  5. Cleft Lip and Palate Surgery

    MedlinePlus

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery ... to correct a physical defect caused by a cleft lip or cleft palate, which occur once in every ...

  6. Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

    MedlinePlus

    ... 2013 August 2013 (historical) Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients Many ... arthroscopic partial meniscectomy that involves surgically removing the torn part of the meniscus and stabilizing it, or ...

  7. Partially integrated exhaust manifold

    SciTech Connect

    Hayman, Alan W; Baker, Rodney E

    2015-01-20

    A partially integrated manifold assembly is disclosed which improves performance, reduces cost and provides efficient packaging of engine components. The partially integrated manifold assembly includes a first leg extending from a first port and terminating at a mounting flange for an exhaust gas control valve. Multiple additional legs (depending on the total number of cylinders) are integrally formed with the cylinder head assembly and extend from the ports of the associated cylinder and terminate at an exit port flange. These additional legs are longer than the first leg such that the exit port flange is spaced apart from the mounting flange. This configuration provides increased packaging space adjacent the first leg for any valving that may be required to control the direction and destination of exhaust flow in recirculation to an EGR valve or downstream to a catalytic converter.

  8. Digital generation of partially coherent vortex beams.

    PubMed

    Perez-Garcia, Benjamin; Yepiz, Adad; Hernandez-Aranda, Raul I; Forbes, Andrew; Swartzlander, Grover A

    2016-08-01

    We present an experimental technique to generate partially coherent vortex beams with an arbitrary azimuthal index using only a spatial light modulator. Our approach is based on digitally simulating the intrinsic randomness of broadband light passing through a spiral phase plate. We illustrate the versatility of the technique by generating partially coherent beams with different coherence lengths and orbital angular momentum content, without any moving optical device. Consequently, we study its cross-correlation function in a wavefront folding interferometer. The comparison with theoretical predictions yields excellent agreement. PMID:27472596

  9. [Surgery for thoracic tuberculosis].

    PubMed

    Kilani, T; Boudaya, M S; Zribi, H; Ouerghi, S; Marghli, A; Mestiri, T; Mezni, F

    2015-01-01

    Tuberculosis is mainly a medical disease. Surgery has been the unique therapeutic tool for a long time before the advent of specific antituberculous drugs, and the role of surgery was then confined to the treatment of the sequelae of tuberculosis and their complications. The resurgence of tuberculosis and the emergence of multidrug-resistant TB combined to immunosuppressed patients represent a new challenge for tuberculosis surgery. Surgery may be indicated for a diagnostic purpose in patients with pulmonary, pleural, mediastinal or thoracic wall involvement, or with a therapeutic purpose (drainage, resection, residual cavity obliteration). Modern imaging techniques and the advent of video-assisted thoracic surgery allowed a new approach of this pathology; the majority of diagnostic interventions and selected cases requiring lung resection can be performed through a mini-invasive approach. Patients proposed for aggressive surgery may be treated with the best results thanks to a good evaluation of the thoracic lesions, of the patients' nutritional, infectious and general status combined with a good coordination between the specialized medical team for an optimal preparation to surgery.

  10. Craniofacial Surgery Fellowship Websites.

    PubMed

    Silvestre, Jason; Agarwal, Divyansh; Taylor, Jesse A

    2016-06-01

    Applicants for craniofacial surgery fellowships utilize Internet-based resources like the San Francisco (SF) Match to manage applications. The purpose of this study was to evaluate the accessibility and content of craniofacial surgery fellowship websites (CSFWs). A list of available craniofacial surgery fellowships was compiled from directories of the American Society of Craniofacial Surgery (ACSFS) and SF Match. Accessibility of CSFWs was assessed via links from these directories and a Google search. Craniofacial surgery fellowship websites were evaluated on education and recruitment content and compared via program characteristics. Twenty-four of the 28 US-based craniofacial surgery fellowship programs had a CSFW (86%). The ACSFS and SF Match databases had limited CSFW accessibility, but a Google search revealed most CSFWs had the top search result (76%). In total, CSFWs provided an average of 39% of education and recruitment variables. While most programs provided fellowship program descriptions (96%), application links (96%), and faculty listings (83%), relatively few provided rotation schedules (13%), fellow selection process information (13%), or interview dates (8%). CSFW content did not vary by program location, faculty size, accreditation status, or institutional affiliations (P > 0.05). Craniofacial surgery fellowships often lack readily accessible websites from national program lists and have limited information for interested applicants. The consistent lack of online information across programs suggests future opportunities exist to improve these educational resources. PMID:27285892

  11. Emergency ulcer surgery.

    PubMed

    Lee, Constance W; Sarosi, George A

    2011-10-01

    The rate of elective surgery for peptic ulcer disease has been declining steadily over the past 3 decades. During this same period, the rate of emergency ulcer surgery rose by 44%. This means that the gastrointestinal surgeon is likely to be called on to manage the emergent complications of peptic ulcer disease without substantial experience in elective peptic ulcer disease surgery. The goal of this review is to familiarize surgeons with our evolving understanding of the pathogenesis, epidemiology, presentation, and management of peptic ulcer disease in the emergency setting, with a focus on peptic ulcer disease-associated bleeding and perforation.

  12. Diffraction imaging: The limits of partial coherence

    NASA Astrophysics Data System (ADS)

    Chen, Bo; Abbey, Brian; Dilanian, Ruben; Balaur, Eugeniu; van Riessen, Grant; Junker, Mark; Tran, Chanh Q.; Jones, Michael W. M.; Peele, Andrew G.; McNulty, Ian; Vine, David J.; Putkunz, Corey T.; Quiney, Harry M.; Nugent, Keith A.

    2012-12-01

    Coherent diffraction imaging (CDI) typically requires that the source should be highly coherent both laterally and longitudinally. In this paper, we demonstrate that lateral and longitudinal partial coherence can be successfully included in a CDI reconstruction algorithm simultaneously using experimental x-ray data. We study the interplay between lateral partial coherence and longitudinal partial coherence and their relative influence on CDI. We compare our results against the coherence criteria published by Spence [Spence , UltramicroscopyULTRD60304-399110.1016/j.ultramic.2004.05.005 101, 149 (2004)] and show that for iterative ab initio phase-recovery algorithms based on those typically used in CDI and in cases where the coherence properties are known, we are able to relax the minimal coherence requirements by a factor of 2 both laterally and longitudinally, potentially yielding significant reduction in exposure time.

  13. Melancholia and partial insanity.

    PubMed

    Jackson, S W

    1983-04-01

    In the medical literature of the eighteenth century melancholia came to be defined as partial insanity. Seventeenth-century English law introduced the term and influenced later forensic concerns about the concept. But the history of melancholia reveals a gradual development of such a concept of limited derangement associated with the delusions usually cited in accounts of this disease. In the early nineteenth century the relationship of melancholia and this concept weakened and was gradually abandoned, the content of the syndrome of melancholia was reduced, and out of this complex process emerged the notion of monomania.

  14. Esthetic removable partial dentures.

    PubMed

    Ancowitz, Stephen

    2004-01-01

    This article provides information regarding the many ways that removable partial dentures (RPDs) may be used to solve restorative problems in the esthetic zone without displaying metal components or conspicuous acrylic resin flanges. The esthetic zone is defined and described, as are methods for recording it. Six dental categories are presented that assist the dentist in choosing a variety of RPD design concepts that may be used to avoid metal display while still satisfying basic principles of RPDs. New materials that may be utilized for optimal esthetics are presented and techniques for contouring acrylic resin bases and tinting denture bases are described.

  15. Expectations of Sinus Surgery

    MedlinePlus

    ... after surgery, it can be treated with antibiotics. Steroids - One of the underlying causes of some forms ... forms of swelling, your doctor may prescribe oral steroids or topical (spray, irrigation) steroids or both. Packing – ...

  16. Brain Tumor Surgery

    MedlinePlus

    ... The surgical removal of a portion of the skull. Doing so allows the neurosurgeon to find the ... much of it as possible. The piece of skull that was removed is replaced following surgery. Craniectomy: ...

  17. Retrosternal thyroid surgery

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007558.htm Retrosternal thyroid surgery To use the sharing features on this page, please enable JavaScript. The thyroid gland is normally located at the front of ...

  18. Breast augmentation surgery

    MedlinePlus

    ... a change in the shape of your breast, hardening of breast tissue, or some pain. Emotional risks ... starting 5 days after surgery. Massaging helps reduce hardening of the capsule that surrounds the implant. Ask ...

  19. Heart bypass surgery

    MedlinePlus

    Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, ... of this great vein will be used to bypass the blocked arteries in the heart. The venous ...

  20. Transanal Minimally Invasive Surgery

    PubMed Central

    deBeche-Adams, Teresa; Nassif, George

    2015-01-01

    Transanal minimally invasive surgery (TAMIS) was first described in 2010 as a crossover between single-incision laparoscopic surgery and transanal endoscopic microsurgery (TEM) to allow access to the proximal and mid-rectum for resection of benign and early-stage malignant rectal lesions. The TAMIS technique can also be used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical surgery. Proper workup and staging should be done before surgical decision-making. In addition to the TAMIS port, instrumentation and set up include readily available equipment found in most operating suites. TAMIS has proven its usefulness in a wide range of applications outside of local excision, including repair of rectourethral fistula, removal of rectal foreign body, control of rectal hemorrhage, and as an adjunct in total mesorectal excision for rectal cancer. TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM. PMID:26491410

  1. American Board of Surgery

    MedlinePlus

    ... Training & Certification Toggle navigation arrow Becoming Certified Dates & Fees Taking a Computer Exam International Training & Visas For ... Year Reporting) MOC Exams - Recertification Exam Information Dates & Fees Taking a Computer Exam General Surgery About the ...

  2. Endoscopy after bariatric surgery

    PubMed Central

    Malli, Chrysoula P.; Sioulas, Athanasios D.; Emmanouil, Theodoros; Dimitriadis, George D.; Triantafyllou, Konstantinos

    2016-01-01

    Obesity is a global epidemic with significant morbidity and mortality. Weight loss results in reduction of health risks and improvement in quality of life, thus representing a goal of paramount importance. Bariatric surgery is the most efficacious choice compared to conservative alternatives including diet, exercise, drugs and behavioral modification to treat obese patients. Following bariatric operations, patients may present with upper gastrointestinal tract complaints that warrant endoscopic evaluation and the various bariatric surgery types are often linked to complications. A subset of these complications necessitates endoscopic interventions for accurate diagnosis and effective, minimal invasive treatment. This review aims to highlight the role of upper gastrointestinal endoscopy in patients who have undergone bariatric surgery to evaluate and potentially treat surgery-related complications and upper gastrointestinal symptoms. PMID:27366025

  3. Weight Loss Surgery

    MedlinePlus

    ... loss surgery (especially gastric bypass). Doctors call this "dumping syndrome." It can cause nausea, weakness, sweating, cramping, ... high-sugar or high-fat foods can make dumping worse. Patients need to be careful about what ...

  4. [Ulcer surgery - what remains?].

    PubMed

    Hölscher, A H; Bollschweiler, E; Mönig, S P

    2006-06-01

    Ulcer surgery today concentrates on the complications of chronic ulcer disease, especially ulcer perforation and endoscopically uncontrollable ulcer bleeding. In this case the laparoscopic or open closure of the gastroduodenal defect or local hemostasis of the bleeding ulcer by laparotomy are the main aims of surgery. Elective operations due to recurrent gastric or duodenal ulcers have become rare. An indication for gastric ulcer resistant to conservative therapy could be persisting suspicion of malignancy whereas in duodenal ulcer gastric outlet obstruction represents a reason for surgery. If these indications are confirmed the classic procedures of gastric resection like Billroth I and Billroth II are performed whereas vagotomy is no longer used. Altogether ulcer surgery has become very safe although it is practiced quite rarely.

  5. Endoscopic Sinus Surgery

    MedlinePlus

    ... The nasal endoscope is a small, lighted metal telescope placed into the nostril. The endoscope allows the ... sinus surgery involves the use of a small telescope (nasal endoscope) that is inserted through the nostril ...

  6. Robotics in Colorectal Surgery

    PubMed Central

    Weaver, Allison; Steele, Scott

    2016-01-01

    Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients. PMID:27746895

  7. Brain surgery - discharge

    MedlinePlus

    Gasco J, Mohanty A, Hanbali F, Patterson JT. Neurosurgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012: ...

  8. Deep breathing after surgery

    MedlinePlus

    do Nascimento Junior P, Módolo NS, Andrade S, Guimarães MM, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Sys ...

  9. Scoliosis surgery - child

    MedlinePlus

    ... taken from a bone bank, much like a blood bank. This is called an allograft. These grafts are not always as successful as autografts. Manmade (synthetic) bone substitute may also be used. Different surgeries use different ...

  10. Ear surgery - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100016.htm Ear surgery - series—Normal anatomy To use the sharing ... Overview This image demonstrates normal appearance of the ears in relation to the face. Update Date 10/ ...

  11. [Surgery education in Europe].

    PubMed

    Witte, J

    1999-01-01

    Due to European law all examinations taken by officially recognized national boards have to be accepted in every member state. In 1958 the UEMS was founded on behalf of the European Council. Several Divisions in the "Section of Surgery" and the "European Board of Surgery" have to define the content and duration of their knowledge within the common trunk as well for the division's specialty itself. European Examinations today are offered in Surgery and Vascular Surgery. Continuing Medical Education is not yet organised officially in all member-states. East European countries start to harmonize their structure due to the demands of the UEMS. The charter on continuing Medical Education was established by the UEMS in 1998. This concept was also accepted by the national authorities in Germany and will be officially structured in our country very soon.

  12. Surgery for pancreatic cancer

    MedlinePlus

    ... 81. Update Date 5/20/2015 Updated by: John A. Daller, MD, PhD., Department of Surgery, University ... commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ...

  13. Gastric bypass surgery - discharge

    MedlinePlus

    ... bypass - discharge; Gastric bypass - Roux-en-Y - discharge; Obesity gastric bypass discharge; Weight loss - gastric bypass discharge ... al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised ...

  14. Surgery for Testicular Cancer

    MedlinePlus

    ... have sex. But if both testicles are removed, sperm cells cannot be produced and a man becomes ... sparing surgery with their doctors, as well as sperm banking (freezing and storing sperm cells obtained before ...

  15. Experts' Understanding of Partial Derivatives Using the Partial Derivative Machine

    ERIC Educational Resources Information Center

    Roundy, David; Weber, Eric; Dray, Tevian; Bajracharya, Rabindra R.; Dorko, Allison; Smith, Emily M.; Manogue, Corinne A.

    2015-01-01

    Partial derivatives are used in a variety of different ways within physics. Thermodynamics, in particular, uses partial derivatives in ways that students often find especially confusing. We are at the beginning of a study of the teaching of partial derivatives, with a goal of better aligning the teaching of multivariable calculus with the needs of…

  16. Neuroprotection during cardiac surgery.

    PubMed

    Grocott, Hilary P; Yoshitani, Kenji

    2007-01-01

    Cerebral injury following cardiac surgery continues to be a significant source of morbidity and mortality after cardiac surgery. A spectrum of injuries ranging from subtle neurocognitive dysfunction to fatal strokes are caused by a complex series of multifactorial mechanisms. Protecting the brain from these injuries has focused on intervening on each of the various etiologic factors. Although numerous studies have focused on a pharmacologic solution, more success has been found with nonpharmacologic strategies, including optimal temperature management and reducing emboli generation. PMID:17680190

  17. Future of cosmetic surgery.

    PubMed

    Goldberg, Robert Alan

    2014-04-01

    Changes in cosmetic surgery will be driven by several key forces. The patient's self-image, and perceived place in society, will continue to drive patients to the cosmetic surgeon as well as to demand newer and better treatments. Technological advances, especially those based on an enhanced understanding of cellular and tissue physiology, promise enhanced tools other than the scalpel for the surgeon. Conceptual advances in our understanding of beauty and patient psychology will lead to a more integrative approach to cosmetic surgery.

  18. Neuroprotection during aortic surgery.

    PubMed

    Lindsay, Helen; Srinivas, Coimbatore; Djaiani, George

    2016-09-01

    Neurological injury is a major limitation of aortic surgery, whether it involves spinal cord injury following intervention to the thoracoabdominal aorta, or stroke following surgery on the arch and ascending aorta. Despite an extensive body of literature and various proposals, a completely effective strategy to prevent or treat neurological injury remains elusive. In this article, we summarise the evidence for established and emerging strategies, and review current concepts in pathophysiology and risk assessment as they relate to neurological injury. PMID:27650340

  19. Aortic valve replacement through J-shaped partial upper sternotomy

    PubMed Central

    Benedetto, Umberto; Amrani, Mohamed

    2013-01-01

    The introduction of minimally invasive techniques in general surgery, in the late 1980s, influenced cardiac surgery as well. This led to the emergence of several minimal access approaches for aortic valve replacement (AVR). Currently, the upper partial sternotomy with unilateral J-shaped extension to the right through the fourth intercostal space is the most popular minimal access approach. This approach offers the comfort factor of sternotomy, improved cosmetic result, preserved respiratory mechanics, and last but not the least cost saving as no new equipment is required. On the other hand, inability to visualize the whole heart, adequately de-air the left heart, and failure to apply epicardial pacing wires are some of the perceived disadvantages of this approach. This article provides a comprehensive review of the indications, contraindications, technical aspects, outcomes, advantages and disadvantages of AVR through J-shaped partial upper sternotomy. PMID:24251025

  20. Emergency laparoscopic partial splenectomy for ruptured spleen: A case report

    PubMed Central

    Cai, Yun-Qiang; Li, Chun-Lin; Zhang, Hua; Wang, Xin; Peng, Bing

    2014-01-01

    Splenic rupture is a common consequence of blunt abdominal trauma. Emergency splenectomy is indicated when conservative management is not effective. With better understanding of the immunologic function of the spleen, surgeons have begun to perform the splenic-preserving surgery. However, it is technical challenge to perform emergency laparoscopic partial splenectomy for patient with spleen rupture. A 15-year-old male patient suffered from grade III spleen injury basing on the American association for the surgery of trauma splenic injury scale. Conservative treatment failed to success basing on the dramatically decreased hemoglobin level. During the laparoscopic exploration, we found that two individual ruptures were associated with the upper pole of spleen. An emergency laparoscopic partial splenectomy was successfully carried out. The operative time was approximate 150 min and the estimated blood loss was 200 mL. The post-operative course was uneventful and the patient was discharged on the 7th post-operative day. PMID:25516684

  1. Transoral robotic supracricoid partial laryngectomy with cartilaginous framework preservation.

    PubMed

    Vural, Emre; Tulunay-Ugur, Ozlem E; Suen, James Y

    2012-12-01

    To report the technical feasibility of performing transoral robotic supracricoid partial laryngectomy with preservation of the thyroid cartilage. This is a case report from a tertiary-care academic institution. A patient with recurrent T2 glottic squamous cell carcinoma of the larynx underwent supracricoid partial laryngectomy with negative margins and preservation of the laryngeal framework using transoral robotic surgery, where an adequate exposure to the endolarynx was obtained by using a Feyh-Kastenbauer retractor. The patient was successfully decannulated in postoperative week 4, and his gastrostomy tube was removed in postoperative week 6. Transoral robotic surgery may be feasible in select glottic/subglottic laryngeal lesions, if adequate exposure is obtained. PMID:27628480

  2. Robotic surgery in gynecology

    PubMed Central

    Sinha, Rooma; Sanjay, Madhumati; Rupa, B.; Kumari, Samita

    2015-01-01

    FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over. PMID:25598600

  3. Robotic surgery in gynecology.

    PubMed

    Sinha, Rooma; Sanjay, Madhumati; Rupa, B; Kumari, Samita

    2015-01-01

    FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over. PMID:25598600

  4. A new dimension in endo surgery: Micro endo surgery

    PubMed Central

    Pecora, Gabriele Edoardo; Pecora, Camilla Nicole

    2015-01-01

    There is an immense difference between tradizional Endodontic Surgery and Micro-Endo Surgery. Microsurgical techniques made possible and accessible results,that were unimaginable before. Under microscopic control,the operative techniques reached continous changes,allowing a better precision and quality standards. The dramatic evolution from Endo Surgery to Micro-Endo Surgery has enlarged the horizon of therapeutic options. Illumination and magnification through the Microscope has fundamentally and radically changed the way endo surgery can be performed. PMID:25657519

  5. Is Titan Partially Differentiated?

    NASA Astrophysics Data System (ADS)

    Mitri, G.; Pappalardo, R. T.; Stevenson, D. J.

    2009-12-01

    The recent measurement of the gravity coefficients from the Radio Doppler data of the Cassini spacecraft has improved our knowledge of the interior structure of Titan (Rappaport et al. 2008 AGU, P21A-1343). The measured gravity field of Titan is dominated by near hydrostatic quadrupole components. We have used the measured gravitational coefficients, thermal models and the hydrostatic equilibrium theory to derive Titan's interior structure. The axial moment of inertia gives us an indication of the degree of the interior differentiation. The inferred axial moment of inertia, calculated using the quadrupole gravitational coefficients and the Radau-Darwin approximation, indicates that Titan is partially differentiated. If Titan is partially differentiated then the interior must avoid melting of the ice during its evolution. This suggests a relatively late formation of Titan to avoid the presence of short-lived radioisotopes (Al-26). This also suggests the onset of convection after accretion to efficiently remove the heat from the interior. The outer layer is likely composed mainly of water in solid phase. Thermal modeling indicates that water could be present also in liquid phase forming a subsurface ocean between an outer ice I shell and a high pressure ice layer. Acknowledgments: This work was conducted at the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.

  6. Partial Triceps Disruption

    PubMed Central

    Foulk, David M.; Galloway, Marc T.

    2011-01-01

    Partial triceps tendon disruptions are a rare injury that can lead to debilitating outcomes if misdiagnosed or managed inappropriately. The clinician should have a high index of suspicion when the mechanism involves a fall onto an outstretched arm and there is resultant elbow extension weakness along with pain and swelling. The most common location of rupture is at the tendon-osseous junction. This case report illustrates a partial triceps tendon disruption with involvement of, primarily, the medial head and the superficial expansion. Physical examination displayed weakness with resisted elbow extension in a flexed position over 90°. Radiographs revealed a tiny fleck of bone proximal to the olecranon, but this drastically underestimated the extent of injury upon surgical exploration. Magnetic resonance imaging is essential to ascertain the percentage involvement of the tendon; it can be used for patient education and subsequently to determine treatment recommendations. Although excellent at finding associated pathology, it may misjudge the size of the tear. As such, physicians must consider associated comorbidities and patient characteristics when formulating treatment plans. PMID:23016005

  7. Harmonic scalpel for a bloodless partial glossectomy: a case report.

    PubMed

    Irfan, M; Aliyu, Y A; Baharudin, A; Shahid, H

    2011-06-01

    Tongue surgery is almost always complicated by intraoperative bleeding. Its rich blood supply especially from the lingual vessels makes the operative field bloody. Electrocautery has been widely used to replace cold scissors in order to achieve better hemostasis. The use of ultrasonic harmonic scalpel for glossectomy is still new in this country. We report a case of partial glossectomy using the harmonic scalpel in a patient who had a squamous cell carcinoma of the lateral border of the tongue.

  8. Energy sources for laparoscopic partial nephrectomy--critical appraisal.

    PubMed

    Rubinstein, Mauricio; Moinzadeh, Alireza; Colombo, Jose R; Favorito, Luciano A; Sampaio, Francisco J; Gill, Inderbir S

    2007-01-01

    Laparoscopic partial nephrectomy (LPN) has emerged as a viable alternative for the conventional open nephron-sparing surgery (NSS). So far, an adequate renal parenchymal cutting and hemostasis, as well as caliceal repair remains technically challenging. Numerous investigators have developed techniques using different energy sources to simplify the technically demanding LPN. Herein we review these energy sources, discussing perceived advantages and disadvantages of each technique.

  9. Partial return yoke for MICE step IV and final step

    SciTech Connect

    Witte, H.; Plate, S.; Berg, J. S.; Tarrant, J.; Bross, A.

    2015-05-03

    This paper reports on the progress of the design and construction of a retro-fitted return yoke for the international Muon Ionization Cooling Experiment (MICE). MICE is a proof-of-principle experiment aiming to demonstrate ionization cooling experimentally. In earlier studies we outlined how a partial return yoke can be used to mitigate stray magnetic field in the experimental hall; we report on the progress of the construction of the partial return yoke for MICE Step IV. We also discuss an extension of the Partial Return Yoke for the final step of MICE; we show simulation results of the expected performance.

  10. Partial Return Yoke for MICE Step IV and Final Step

    SciTech Connect

    Witte, Holger; Plate, Stephen; Berg, J.Scott; Tarrant, Jason; Bross, Alan

    2015-06-01

    This paper reports on the progress of the design and construction of a retro-fitted return yoke for the international Muon Ionization Cooling Experiment (MICE). MICE is a proof-of-principle experiment aiming to demonstrate ionization cooling experimentally. In earlier studies we outlined how a partial return yoke can be used to mitigate stray magnetic field in the experimental hall; we report on the progress of the construction of the partial return yoke for MICE Step IV. We also discuss an extension of the Partial Return Yoke for the final step of MICE; we show simulation results of the expected performance.

  11. Partially segmented deformable mirror

    DOEpatents

    Bliss, E.S.; Smith, J.R.; Salmon, J.T.; Monjes, J.A.

    1991-05-21

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp. 5 figures.

  12. Partially segmented deformable mirror

    DOEpatents

    Bliss, Erlan S.; Smith, James R.; Salmon, J. Thaddeus; Monjes, Julio A.

    1991-01-01

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp.

  13. Partial oxidation catalyst

    DOEpatents

    Krumpelt, Michael; Ahmed, Shabbir; Kumar, Romesh; Doshi, Rajiv

    2000-01-01

    A two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion. The dehydrogenation portion is a group VIII metal and the oxide-ion conducting portion is selected from a ceramic oxide crystallizing in the fluorite or perovskite structure. There is also disclosed a method of forming a hydrogen rich gas from a source of hydrocarbon fuel in which the hydrocarbon fuel contacts a two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion at a temperature not less than about 400.degree. C. for a time sufficient to generate the hydrogen rich gas while maintaining CO content less than about 5 volume percent. There is also disclosed a method of forming partially oxidized hydrocarbons from ethanes in which ethane gas contacts a two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion for a time and at a temperature sufficient to form an oxide.

  14. Motion preservation surgery in the spine.

    PubMed

    Murtagh, Ryan; Castellvi, Antonio E

    2014-05-01

    The primary goal of motion preservation surgery in the spine is to maintain normal or near normal motion in an attempt to prevent adverse outcomes commonly seen with conventional spinal fusion, most notably the development of adjacent-level degenerative disc disease. Several different surgical approaches have been developed to preserve motion in the lumbar spine, including total disc replacement, partial disc (nucleus) replacement, interspinous spacers, dynamic stabilization devices, and total facet replacement devices. The design of devices varies greatly. The devices are created using a similar rationale but are unique in design relative to their lumbar counterparts. PMID:24792608

  15. Innovations in Bariatric Surgery.

    PubMed

    Zhu, Catherine; Pryor, Aurora D

    2015-11-01

    Surgery has consistently been demonstrated to be the most effective long-term therapy for the treatment of obesity. However, despite excellent outcomes with current procedures, most patients with obesity- and weight-related comorbidities who meet criteria for surgical treatment choose not to pursue surgery out of fear of operative risks and complications or concerns about high costs. Novel minimally invasive procedures and devices may offer alternative solutions for patients who are hesitant to pursue standard surgical approaches. These procedures may be used for primary treatment of obesity, early intervention for patients approaching morbid obesity, temporary management prior to bariatric surgery, or revision of bypass surgery associated with weight regain. Novel bariatric procedures can in general be divided into four categories: endoluminal space-occupying devices, gastric suturing and restrictive devices, absorption-limiting devices, and neural-hormonal modulating devices. Many of these are only approved as short-term interventions, but these devices may be effective for patients desiring low-risk procedures or a transient effect. We will see the expansion of indications and alternatives for metabolic surgery as these techniques gain approval.

  16. Computer Assisted Surgery

    NASA Astrophysics Data System (ADS)

    Arámbula Cosío, F.; Padilla Castañeda, M. A.

    2003-09-01

    Computer assisted surgery (CAS) systems can provide different levels of assistance to a surgeon during training and execution of a surgical procedure. This is done through the integration of : measurements taken on medical images; computer graphics techniques; and positioning or tracking mechanisms which accurately locate the surgical instruments inside the operating site. According to the type of assistance that is provided to the surgeon, CAS systems can be classified as: Image guided surgery systems; Assistant robots for surgery; and Training simulators for surgery. In this work are presented the main characteristics of CAS systems. It is also described the development of a computer simulator for training on Transurethral Resection of the Prostate (TURP) based on a computer model of the prostate gland which is able to simulate, in real time, deformations and resections of tissue. The model is constructed as a 3D mesh with physical properties such as elasticity. We describe the main characteristics of the prostate model and its performance. The prostate model will also be used in the development of a CAS system designed to assist the surgeon during a real TURP procedure. The system will provide 3D views of the shape of the prostate of the patient, and the position of the surgical instrument during the operation. The development of new computer graphics models which are able to simulate, in real time, the mechanical behavior of an organ during a surgical procedure, can improve significantly the training and execution of other minimally invasive surgical procedures such as laparoscopic gall bladder surgery.

  17. Minimally invasive pancreatic surgery.

    PubMed

    Yiannakopoulou, E

    2015-12-01

    Minimally invasive pancreatic surgery is feasible and safe. Laparoscopic distal pancreatectomy should be widely adopted for benign lesions of the pancreas. Laparoscopic pancreaticoduodenectomy, although technically demanding, in the setting of pancreatic ductal adenocarcinoma has a number of advantages including shorter hospital stay, faster recovery, allowing patients to recover in a timelier manner and pursue adjuvant treatment options. Furthermore, it seems that progression-free survival is longer in patients undergoing laparoscopic pancreaticoduodenectomy in comparison with those undergoing open pancreaticoduodenectomy. Minimally invasive middle pancreatectomy seems appropriate for benign or borderline tumors of the neck of the pancreas. Technological advances including intraoperative ultrasound and intraoperative fluorescence imaging systems are expected to facilitate the wide adoption of minimally invasive pancreatic surgery. Although, the oncological outcome seems similar with that of open surgery, there are still concerns, as the majority of relevant evidence comes from retrospective studies. Large multicenter randomized studies comparing laparoscopic with open pancreatectomy as well as robotic assisted with both open and laparoscopic approaches are needed. Robotic approach could be possibly shown to be less invasive than conventional laparoscopic approach through the less traumatic intra-abdominal handling of tissues. In addition, robotic approach could enable the wide adoption of the technique by surgeon who is not that trained in advanced laparoscopic surgery. A putative clinical benefit of minimally invasive pancreatic surgery could be the attenuated surgical stress response leading to reduced morbidity and mortality as well as lack of the detrimental immunosuppressive effect especially for the oncological patients. PMID:26530291

  18. Ancient technology in contemporary surgery.

    PubMed

    Buck, B A

    1982-03-01

    Archaeologists have shown that ancient man developed the ability to produce cutting blades of an extreme degree of sharpness from volcanic glass. The finest of these prismatic blades were produced in Mesoamerica about 2,500 years ago. The technique of production of these blades was rediscovered 12 years ago by Dr. Don Crabtree, who suggested possible uses for the blades in modern surgery. Blades produced by Dr. Crabtree have been used in experimental microsurgery with excellent results. Animal experiments have shown the tensile strength of obsidian produced wounds to be equal to or greater than that of wounds produced by steel scalpels after 14 days of healing. We have been able to demonstrate neither flaking of glass blades into the wounds nor any foreign body reaction in healed wounds. Skin incisions in human patients have likewise healed well without complications. The prismatic glass blade is infinitely sharper than a honed steel edge, and these blades can be produced in a wide variety of shapes and sizes. It is therefore suggested that this type of blade may find an appropriate use in special areas of modern surgery. PMID:7046256

  19. Ancient technology in contemporary surgery.

    PubMed

    Buck, B A

    1982-03-01

    Archaeologists have shown that ancient man developed the ability to produce cutting blades of an extreme degree of sharpness from volcanic glass. The finest of these prismatic blades were produced in Mesoamerica about 2,500 years ago. The technique of production of these blades was rediscovered 12 years ago by Dr. Don Crabtree, who suggested possible uses for the blades in modern surgery. Blades produced by Dr. Crabtree have been used in experimental microsurgery with excellent results. Animal experiments have shown the tensile strength of obsidian produced wounds to be equal to or greater than that of wounds produced by steel scalpels after 14 days of healing. We have been able to demonstrate neither flaking of glass blades into the wounds nor any foreign body reaction in healed wounds. Skin incisions in human patients have likewise healed well without complications. The prismatic glass blade is infinitely sharper than a honed steel edge, and these blades can be produced in a wide variety of shapes and sizes. It is therefore suggested that this type of blade may find an appropriate use in special areas of modern surgery.

  20. Robotic Surgery for Thoracic Disease

    PubMed Central

    Yoshida, Yasuhiro; Iwasaki, Akinori

    2016-01-01

    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon’s hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor. PMID:26822625

  1. Stereolithography for craniofacial surgery.

    PubMed

    Sinn, Douglas P; Cillo, Joseph E; Miles, Brett A

    2006-09-01

    Advances in computer technology have aided in the diagnostic and clinical management of complex congenital craniofacial deformities. The use of stereolithographic models has begun to replace traditional milled models in the treatment of craniofacial deformities. Research has shown that stereolithography models are highly accurate and provide added information in treatment planning for the correction of craniofacial deformities. These include the added visualization of the complex craniofacial anatomy and preoperative surgical planning with a highly accurate three-dimensional model. While the stereolithographic process has had a beneficial impact on the field of craniofacial surgery, the added cost of the procedure continues to be a hindrance to its widespread acceptance in clinical practice. With improved technology and accessibility the utilization of stereolithography in craniofacial surgery is expected to increase. This review will highlight the development and current usage of stereolithography in craniofacial surgery and provide illustration of it use.

  2. [Perspectives in glaucoma surgery].

    PubMed

    Dietlein, T S

    2002-02-01

    Trabeculectomy is still considered to be the gold standard in the surgical treatment of the open-angle glaucomas. The additional application of local antimetabolites has reduced the rate of early filtering bled fibrosis, but increased the rate of essential late-postoperative complications. Growth factor inhibition and photodynamic therapy may be an alternative local treatment to enhance the results in filtering surgery. Non-penetrating glaucoma surgery and ab-interno trabecular surgery have several conceptual advantages, e.g. the lack of overfiltration or the untouched conjunctiva in the ab-interno approach. Clinical studies of these and other new procedures including antiglaucomatous retinectomy and subchoroidal shunt systems are currently performed in order to evaluate their potential and limits in the clinical management of glaucoma.

  3. Psychopharmacology and Bariatric Surgery.

    PubMed

    Roerig, James L; Steffen, Kristine

    2015-11-01

    Currently, it has been demonstrated that psychotropic drugs, particularly antidepressants, are frequently prescribed for patients who seek bariatric surgery. Many bariatric surgery patients have a history of a mood disorder. Unlike medications for diabetes, hypertension or hyperlipidemia, which are generally reduced and at times discontinued, postsurgery antidepressants use is only slightly reduced. The Roux-en-Y procedure is most frequently associated with alteration in drug exposure. Medication disintegration, dissolution, absorption, metabolism and excretion have been found to be altered in postbariatric patients, although data are sparse at this time. This paper will review the current evidence regarding the effect of bariatric surgery on drug treatment including mechanism of interference as well as the extent of changes identified to date. Data will be presented as controlled trials followed by case series and reports.

  4. [IMSS in numbers. Surgeries].

    PubMed

    2005-01-01

    Surgery occupies a priority place within the organization of health services. In the IMSS around 1.4 million surgeries are performed annually and 3934 take place each day. A great part of the resources goes to obstetric interventions, since 222,928 caesarean sections were performed in 2004, and along with curettages, tubal occlusions and hysterectomies, they sum 37.6% of the surgeries performed in 2004. Abdominal deliveries (caesarean sections) were done in 39% of the pregnancies delivered in the IMSS and 8.3% were done in adolescents. Simple surgical interventions were also important. Cholecystectomies were 6 times more frequent in women aged 20 to 59 years old than in men the same age. Among the main interventions we also describe hernioplasty, appendicectomies, amygdalectomies, rhinoplasties, biopsies and circumcisions. Scarce data on complications are registered and no data is available for infections of surgical wounds. Surgical procedures are more frequent in women and in certain specialities.

  5. Cosmetic Facial Surgery

    PubMed Central

    Adamson, Peter A.

    1987-01-01

    Canadians have committed themselves to a healthier lifestyle, and many are seeking to look as well as they feel. For patients with realistic expectations, modern techniques of cosmetic facial surgery can enhance appearance and be of psychological benefit. Today most procedures can be done under local anesthesia on an out-patient basis. Facial contour defects can be improved by means of procedures such as rhinoplasty, mentoplasty, otoplasty and malarplasty. Facial rejuvenation surgery to decrease the signs of aging includes the forehead lift, eyebrow and eyelid lift, rhytidectomy, liposuction and chemical peeling. Newer controversial trends in cosmetic facial surgery include collagen implantation and fat transfer for contour defects, and eyelid tattooing. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:21263984

  6. Partially supervised speaker clustering.

    PubMed

    Tang, Hao; Chu, Stephen Mingyu; Hasegawa-Johnson, Mark; Huang, Thomas S

    2012-05-01

    Content-based multimedia indexing, retrieval, and processing as well as multimedia databases demand the structuring of the media content (image, audio, video, text, etc.), one significant goal being to associate the identity of the content to the individual segments of the signals. In this paper, we specifically address the problem of speaker clustering, the task of assigning every speech utterance in an audio stream to its speaker. We offer a complete treatment to the idea of partially supervised speaker clustering, which refers to the use of our prior knowledge of speakers in general to assist the unsupervised speaker clustering process. By means of an independent training data set, we encode the prior knowledge at the various stages of the speaker clustering pipeline via 1) learning a speaker-discriminative acoustic feature transformation, 2) learning a universal speaker prior model, and 3) learning a discriminative speaker subspace, or equivalently, a speaker-discriminative distance metric. We study the directional scattering property of the Gaussian mixture model (GMM) mean supervector representation of utterances in the high-dimensional space, and advocate exploiting this property by using the cosine distance metric instead of the euclidean distance metric for speaker clustering in the GMM mean supervector space. We propose to perform discriminant analysis based on the cosine distance metric, which leads to a novel distance metric learning algorithm—linear spherical discriminant analysis (LSDA). We show that the proposed LSDA formulation can be systematically solved within the elegant graph embedding general dimensionality reduction framework. Our speaker clustering experiments on the GALE database clearly indicate that 1) our speaker clustering methods based on the GMM mean supervector representation and vector-based distance metrics outperform traditional speaker clustering methods based on the “bag of acoustic features” representation and statistical

  7. [Robotic surgery: marking time?].

    PubMed

    van der Poel, Henk G; Beerlage, Harry P; Klaver, Sjoerd O

    2013-01-01

    Robot-assisted surgery provides the next step in surgical evolution. Where laparoscopic surgery shortened both hospital stay and recovery, it often prolonged the surgical procedure. Novel laparoscopic instruments such as robotic systems improve visibility and patient outcome. Recent randomized studies show improved functional patient outcome after robot-assisted laparoscopic prostatectomy. Introduction of image-guided surgical technologies is aided by robotic systems. Outside medicine, randomized controlled studies in technological improvements are non-existent. A careful monitoring of study results is mandatory for the introduction of novel technologies in the field of medicine.

  8. Tourniquets in orthopedic surgery

    PubMed Central

    Sharma, Jai Prakash; Salhotra, Rashmi

    2012-01-01

    Tourniquets are commonly used in limb surgeries, be it orthopedic or plastic surgeries. But the inflation pressures, the duration, and release guidelines are still not clear. According to a survey, majority of orthopedic surgeons inflate the tourniquet to fixed pressures for the upper and the lower limbs without considering the baseline blood pressure of the patient on whom the tourniquets are being applied. This review was designed to recall and review the safe use of tourniquets and the various techniques that can be employed to minimize the complications of tourniquet use. Google, science direct, and pubmed were searched for appropriate literature and relevant articles were identified. PMID:22912509

  9. Surgery in Amphibians.

    PubMed

    Chai, Norin

    2016-01-01

    Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia.

  10. Minimally Invasive Valve Surgery

    PubMed Central

    Pope, Nicolas H.; Ailawadi, Gorav

    2014-01-01

    Cardiac valve surgery is life saving for many patients. The advent of minimally invasive surgical techniques has historically allowed for improvement in both post-operative convalescence and important clinical outcomes. The development of minimally invasive cardiac valve repair and replacement surgery over the past decade is poised to revolutionize the care of cardiac valve patients. Here, we present a review of the history and current trends in minimally invasive aortic and mitral valve repair and replacement, including the development of sutureless bioprosthetic valves. PMID:24797148

  11. Surgery in Amphibians.

    PubMed

    Chai, Norin

    2016-01-01

    Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia. PMID:26611925

  12. Advances in surgery.

    PubMed

    Weder, W

    2012-09-01

    In the last decade, technological advances, new staging tools, better understanding the role of surgery within multimodal treatment concepts in advanced stages and progress in the functional assessment of surgical candidates improved the quality of surgery in the management of patients with lung cancer. Lung resection with video-assisted thoracoscopic access gained wide acceptance, the indication for lobectomy or sublobar resection in early stages was applied based on new data and selection for multimodal treatment in stage III is better understood based on the data. a major impact on the outcome of patients with lung cancer has the treatment in specialized high-volume centers.

  13. [Robotic surgery in gynecology].

    PubMed

    Hibner, Michał; Marianowski, Piotr; Szymusik, Iwona; Wielgós, Mirosław

    2012-12-01

    Introduction of robotic surgery in the first decade of the 21 century was one of the biggest breakthroughs in surgery since the introduction of anesthesia. For the first time in history the surgeon was placed remotely from the patient and was able to operate with the device that has more degrees of freedom than human hand. Initially developed for the US Military in order to allow surgeons to be removed from the battlefield, surgical robots quickly made a leap to the mainstream medicine. One of the first surgical uses for the robot was cardiac surgery but it is urology and prostate surgery that gave it a widespread popularity Gynecologic surgeons caught on very quickly and it is estimated that 31% of hysterectomies done in the United States in 2012 will be done robotically. With over half a million hysterectomies done each year in the US alone, gynecologic surgery is one of the main driving forces behind the growth of robotic surgery Other applications in gynecology include myomectomy oophorectomy and ovarian cystectomy resection of endometriosis and lymphadenectomy Advantages of the surgical robot are clearly seen in myomectomy The wrist motion allows for better more precise suturing than conventional "straight stick" laparoscopy The strength of the arms allow for better pulling of the suture and the third arm for holding the suture on tension. Other advantage of the robot is scaling of the movements when big movement on the outside translates to very fine movement on the inside. This enables much more precise surgery and may be important in the procedures like tubal anastomosis and implantation of the ureter Three-dimensional vision provides excellent depth of field perception. It is important for surgeons who are switching from open surgeries and preliminary evidence shows that it may allow for better identification of lesions like endometriosis. Another big advantage of robotics is that the surgeon sits comfortably with his/her arms and head supported. This

  14. Shifting Paradigms in Minimally Invasive Surgery: Applications of Transanal Natural Orifice Transluminal Endoscopic Surgery in Colorectal Surgery

    PubMed Central

    Lee, Grace Clara; Sylla, Patricia

    2015-01-01

    Since the advent of laparoscopy, minimally invasive techniques such as single port laparoscopy, robotics, endoscopically assisted laparoscopy, and transanal endoscopic surgery continue to revolutionize the field of colorectal surgery. Transanal natural orifice transluminal endoscopic surgery (NOTES) represents a further paradigm shift by combining the advantages of these earlier techniques to reduce the size and number of abdominal incisions and potentially optimize rectal dissection, especially with respect to performance of an oncologically adequate total mesorectal excision (TME) for rectal cancer. Since the first experimental report of transanal rectosigmoid resection in 2007, the potential impact of transanal NOTES in colorectal surgery has been extensively investigated in experimental models and recently transitioned to clinical application. There have been 14 clinical trials of transanal TME (taTME) for rectal cancer that have demonstrated the feasibility and preliminary oncologic safety of this approach in carefully selected patients, with results comparable to outcomes after laparoscopic and open TME, including cumulative intraoperative and postoperative complication rates of 5.5 and 35.5%, respectively, 97.3% rate of complete or near-complete specimens, and 93.6% rate of negative margins. Transanal NOTES has also been safely applied to proctectomy and colectomy for benign indications. The consensus among published series suggests that taTME is most safely performed with transabdominal assistance by surgeons experienced with laparoscopic TME, transanal endoscopic surgery, and sphincter-preserving techniques including intersphincteric resection. Future applications of transanal NOTES may include evolution to a pure endoscopic transanal approach for TME, colectomy, and sentinel lymph node biopsy for rectal cancer, with a potential role for robotic assistance. PMID:26491411

  15. Partial face recognition: alignment-free approach.

    PubMed

    Liao, Shengcai; Jain, Anil K; Li, Stan Z

    2013-05-01

    Numerous methods have been developed for holistic face recognition with impressive performance. However, few studies have tackled how to recognize an arbitrary patch of a face image. Partial faces frequently appear in unconstrained scenarios, with images captured by surveillance cameras or handheld devices (e.g., mobile phones) in particular. In this paper, we propose a general partial face recognition approach that does not require face alignment by eye coordinates or any other fiducial points. We develop an alignment-free face representation method based on Multi-Keypoint Descriptors (MKD), where the descriptor size of a face is determined by the actual content of the image. In this way, any probe face image, holistic or partial, can be sparsely represented by a large dictionary of gallery descriptors. A new keypoint descriptor called Gabor Ternary Pattern (GTP) is also developed for robust and discriminative face recognition. Experimental results are reported on four public domain face databases (FRGCv2.0, AR, LFW, and PubFig) under both the open-set identification and verification scenarios. Comparisons with two leading commercial face recognition SDKs (PittPatt and FaceVACS) and two baseline algorithms (PCA+LDA and LBP) show that the proposed method, overall, is superior in recognizing both holistic and partial faces without requiring alignment.

  16. Partial face recognition: alignment-free approach.

    PubMed

    Liao, Shengcai; Jain, Anil K; Li, Stan Z

    2013-05-01

    Numerous methods have been developed for holistic face recognition with impressive performance. However, few studies have tackled how to recognize an arbitrary patch of a face image. Partial faces frequently appear in unconstrained scenarios, with images captured by surveillance cameras or handheld devices (e.g., mobile phones) in particular. In this paper, we propose a general partial face recognition approach that does not require face alignment by eye coordinates or any other fiducial points. We develop an alignment-free face representation method based on Multi-Keypoint Descriptors (MKD), where the descriptor size of a face is determined by the actual content of the image. In this way, any probe face image, holistic or partial, can be sparsely represented by a large dictionary of gallery descriptors. A new keypoint descriptor called Gabor Ternary Pattern (GTP) is also developed for robust and discriminative face recognition. Experimental results are reported on four public domain face databases (FRGCv2.0, AR, LFW, and PubFig) under both the open-set identification and verification scenarios. Comparisons with two leading commercial face recognition SDKs (PittPatt and FaceVACS) and two baseline algorithms (PCA+LDA and LBP) show that the proposed method, overall, is superior in recognizing both holistic and partial faces without requiring alignment. PMID:23520259

  17. Shoulder surgery - discharge

    MedlinePlus

    ... DO NOT place it directly on the dressing. Ice helps keep swelling down. Your sutures (stitches) will be removed about 1 week after surgery. Keep your bandage and your wound clean and dry . Ask your doctor if it is ok to ...

  18. Anesthesia for bench surgery

    PubMed Central

    Sachin, S.; Rajesh, M. C.; Ramdas, E. K.

    2016-01-01

    Surgical removal of the kidney tumor outside the body, (ex vivo renal bench surgery) followed by auto transplantation is an emerging and often done procedure to reconstruct the urinary tract. It possesses immense challenges to both the anesthesiologists and the surgeons. The risks are multiplied if you are performing the surgery on a solitary functioning kidney. Here, we are describing the anesthetic management of 70-year-old male post nephrectomy patient undergoing renal auto transplantation by bench surgery. Our primary goals for perioperative management were to maintain a stable hemodynamics throughout the procedure, to reduce fluid overload during the period of extracorporeal surgery, to maintain perfusion for the transplanted solitary kidney, to control bleeding to a minimum, and to provide adequate analgesia for the patient. We made use of a balanced anesthetic technique and stringent monitoring standards to bring forth a successful outcome for the patient. At the end of his hospital stay, patient went home with a healthy, normally functioning kidney. PMID:27746573

  19. Robotics in gynecologic surgery.

    PubMed

    Frick, A C; Falcone, T

    2009-06-01

    Robotic surgery has evolved from an investigational surgical approach to a clinically useful adjunct in multiple surgical specialties over the past decade. Advocates of robotic-assisted gynecologic surgery revere the system's wristed instrumentation, ergonomic positioning, and three-dimensional high-definition vision system as significant improvements over laparoscopic equipment's four degrees of freedom and two-dimensional laparoscope that demand the surgeon stand throughout a procedure. The cost, lack of haptic feedback, and the bulky size of the equipment make robotics less attractive to others. Studies evaluating outcomes in robotic-assisted gynecologic surgery are limited. Multiple small retrospective studies demonstrate the safety and feasibility of robotic hysterectomy. With increased surgeon experience, operative times are similar to, or shorter than, laparoscopic cases. Robotic assistance can facilitate suturing in laparoscopic myomectomies, and is associated with decreased blood loss and a shorter hospital stay, although may require longer operative times. Robotic assistance has also been applied to multiple procedures in the subspecialties of infertility, urogynecology and gynecologic oncology with good success and relatively low morbidity. However, further research is warranted to better evaluate the relative benefits and costs of robotic assisted gynecologic surgery.

  20. Evolving endoscopic surgery.

    PubMed

    Sakai, Paulo; Faintuch, Joel

    2014-06-01

    Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques.

  1. Remote access thyroid surgery

    PubMed Central

    Bhatia, Parisha; Mohamed, Hossam Eldin; Kadi, Abida; Walvekar, Rohan R.

    2015-01-01

    Robot assisted thyroid surgery has been the latest advance in the evolution of thyroid surgery after endoscopy assisted procedures. The advantage of a superior field vision and technical advancements of robotic technology have permitted novel remote access (trans-axillary and retro-auricular) surgical approaches. Interestingly, several remote access surgical ports using robot surgical system and endoscopic technique have been customized to avoid the social stigma of a visible scar. Current literature has displayed their various advantages in terms of post-operative outcomes; however, the associated financial burden and also additional training and expertise necessary hinder its widespread adoption into endocrine surgery practices. These approaches offer excellent cosmesis, with a shorter learning curve and reduce discomfort to surgeons operating ergonomically through a robotic console. This review aims to provide details of various remote access techniques that are being offered for thyroid resection. Though these have been reported to be safe and feasible approaches for thyroid surgery, further evaluation for their efficacy still remains. PMID:26425450

  2. Cosmetic breast surgery - discharge

    MedlinePlus

    ... have a loss of sensation in your breast skin and nipples after surgery. Sensation may return over time. You may need help with your everyday activities for a few days until your pain and swelling decrease. Incision scars may take several months to over a year ...

  3. Mohs micrographic surgery

    MedlinePlus

    ... treatment/skin/HealthProfessional . Accessed August 19, 2013. Upjohn E, Taylor RS. Mohs surgery. Rigel: Cancer of the Skin . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 47. Update Date 12/2/2014 Updated by: Richard J. Moskowitz, MD, dermatologist in private practice, Mineola, ...

  4. Evolving endoscopic surgery.

    PubMed

    Sakai, Paulo; Faintuch, Joel

    2014-06-01

    Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques. PMID:24628672

  5. Prone positioning for surgery.

    PubMed

    Bowers, Mark

    2012-05-01

    The role of the registered perioperative practitioner (Operating Department Practitioner or Registered Nurse) includes the responsibility for safely positioning patients for surgery. The prone position is in common use for a variety of surgical procedures. The formal term for this surgical position is ventral decubitus (meaning laying face down). PMID:22720505

  6. Cataract Surgery in Uveitis

    PubMed Central

    Agrawal, Rupesh; Murthy, Somashiela; Ganesh, Sudha K.; Phaik, Chee Soon; Sangwan, Virender; Biswas, Jyotimai

    2012-01-01

    Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors. PMID:22518338

  7. Chair of surgery.

    PubMed

    Scott-Conner, Carol; Hooks, Mary

    2010-10-01

    There are several essential qualities required for success as a chair of surgery. These include determination and resilience, thoughtful planning, superb organization skills, a balance of hard (accounting, management and finance) and soft skills (interpersonal including faculty development), and careful execution is absolutely essential as is a commitment to maintaining momentum. PMID:20887845

  8. Antibiotics before surgery.

    PubMed

    Kaatz, B

    1996-01-01

    The antimicrobial era (along with greater surgical skill and precision) has brought us relative safety for procedures that previously were fraught with danger. Civil War amputation surgeries, for example, had an extraordinarily high incidence of infections and mortality. Staying aware of and avoiding the small, but real, risks associated with surgical antibiotic prophylaxis will help sustain the advances we enjoy today. PMID:8650524

  9. Does strabismus surgery improve quality and mood, and what factors influence this?

    PubMed

    McBain, H B; MacKenzie, K A; Hancox, J; Ezra, D G; Adams, G G W; Newman, S P

    2016-05-01

    AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery. PMID:27126298

  10. Trigonometric Integrals via Partial Fractions

    ERIC Educational Resources Information Center

    Chen, H.; Fulford, M.

    2005-01-01

    Parametric differentiation is used to derive the partial fractions decompositions of certain rational functions. Those decompositions enable us to integrate some new combinations of trigonometric functions.

  11. Laparoendoscopic single site in pelvic surgery.

    PubMed

    Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

    2012-01-01

    Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

  12. Accidental burns during surgery.

    PubMed

    Demir, Erhan; O'Dey, Dan Mon; Pallua, Norbert

    2006-01-01

    The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.

  13. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Education FAQs Surgery for Stress Urinary Incontinence Patient Education Pamphlets - Spanish Surgery for Stress Urinary Incontinence FAQ166, July 2014 ... Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual ... Pamphlets Teen Health About ACOG About Us Leadership & ...

  14. [Contribution of ambulatory digestive surgery].

    PubMed

    Sales, J P

    2000-10-01

    In France, ambulatory surgery is controlled by specific regulations which outline the organization of the facilities. It is practiced less in France than in other countries, but specific governmental incentive policies have been instituted. The characteristic feature of digestive surgery is the high occurrence of post-operative nausea and vomiting due to the peritoneal incision. New surgical procedures and anesthetic regimens allow ambulatory care in children and adults. But the choice of ambulatory care is based on the patient's characteristics more than on surgical procedure and follows well-known selection criteria. The procedures concerned in general surgery are groin hernia repair, proctologic surgery, and subcutaneous tissue surgery. Laparoscopic cholecystectomy and neck surgery in increasing numbers of patients on an ambulatory basis is the first step before expanding ambulatory surgical procedures toward major surgery. Physicians must have a thorough knowledge of ambulatory surgery as an organizational concept.

  15. Heart bypass surgery - minimally invasive

    MedlinePlus

    ... MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery ... To perform this surgery: The heart surgeon will make a 3- to 5-inch-long surgical cut in the left part of your chest between your ribs ...

  16. Infant open heart surgery (image)

    MedlinePlus

    During open-heart surgery an incision is made through the breastbone (sternum) while the child is under general anesthesia. ... During open-heart surgery an incision is made through the breastbone (sternum) while the child is under general anesthesia.

  17. Using your shoulder after surgery

    MedlinePlus

    ... you it is ok. If you had rotator cuff surgery or other ligament or labral surgery, you ... Saunders; 2009:chap 20. Read More Osteoarthritis Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain ...

  18. Effects of preoperative carprofen on cardio-respiratory, hormonal and metabolic stress response in calves during umbilical surgery under isoflurane inhalation anaesthesia.

    PubMed

    Schulze, I; Poos, E M; Meyer, H; List, A K; Kaestner, S B R; Rehage, J

    2016-10-01

    The aim of this study was to examine the effects of preoperative carprofen on the cardiorespiratory, hormonal and metabolic stress response during umbilical surgery under isoflurane anaesthesia combined with local anaesthesia, in calves. A randomised, blinded experimental study was conducted in 24 calves. Carprofen (n = 12; 1.4 mg/kg) or physiological saline solution (controls; n = 12) was administered 1 h prior to surgery. Anaesthesia was induced with xylazine (0.1 mg/kg, IM) and, after the onset of sedation (i.e. after 5-8 min), ketamine was administered (2 mg/kg, IV). Anaesthesia was then maintained with isoflurane (ISO) in oxygen to effect and completed by infiltration of the incision line with 20 mL of 2% procaine. Cardiorespiratory, endocrine and metabolic parameters were examined before, during and after surgery at short intervals. In both groups, anaesthesia appeared adequate for the surgical intervention. Heart rate, stroke index and arterial blood pressure were significantly elevated after the onset of surgery. Oxygen partial pressure and oxygen delivery increased, while the oxygen extraction ratio decreased intraoperatively, ensuring sufficient oxygen supply. In the control group, the mean surge in serum cortisol concentrations tended to be higher (P = 0.089) and systemic vascular resistance (SVR) was significantly greater (P <0.05) than in the carprofen group during surgery. In conclusion, the anaesthetic protocol used in this study induced reliable analgesia in both groups. The lower serum cortisol levels and SVR may indicate a reduced surgical stress response in calves undergoing umbilical surgery under ISO anaesthesia after administering carprofen preoperatively. PMID:27687921

  19. Pediatric cardiac surgery with echocardiographic diagnosis alone.

    PubMed

    Sohn, Sejung; Kim, Hae Soon; Han, Jae Jin

    2002-08-01

    The diagnostic accuracy of echocardiography alone and the safety of cardiac surgery using this diagnostic approach were retrospectively assessed in 111 children operated for congenital heart defects (CHD) during a 3.5-yr period ending in October 2001. Preoperative diagnosis was compared with the intraoperative findings obtained by surgical inspection. Perioperative death was defined as death within 30 days postoperatively. Of the patients, 70% were operated on in infancy. Seventy-six percent (84 of 111) underwent surgery after echocardiographic diagnosis alone. A high percentage of patients with patent ductus arteriosus (100%), partial atrioventricular canal (100%), coarctation of the aorta (89%), ventricular septal defect (86%), atrial septal defect (85%), and total anomalous pulmonary venous connection (75%) was operated without prior catheterization. Diagnostic errors occurred in 2.4% (2 of 84) of patients with echocardiography only and in 7.4% of patients with catheterization. No error in either group was related to surgical morbidity or mortality. There were five (6.0%) perioperative deaths in the echocardiography group and two (7.4%) in the catheterization group, with no difference in the mortality between the groups. In conclusion, many patients with CHD can be accurately diagnosed by echocardiography alone, and can safely undergo surgery without catheterization, not increasing the overall risk.

  20. Stapes surgery under local anaesthesia

    PubMed Central

    Lavy, JA

    2013-01-01

    In the UK, stapes surgery is performed almost universally under general anaesthesia. In 1984 there was consensus that local anaesthesia should be the technique of choice in stapes surgery. Despite reports of successful use of local anaesthesia for middle ear surgery, this is still not widely accepted practice in the UK. We describe the senior author’s technique for local anaesthetic stapes surgery and present the hearing results for a series of 100 consecutive cases. PMID:23317725

  1. Ocular safety limits for 1030nm femtosecond laser cataract surgery

    NASA Astrophysics Data System (ADS)

    Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.

    2013-03-01

    Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.

  2. Virtual model surgery and wafer fabrication for orthognathic surgery.

    PubMed

    Choi, J-Y; Song, K-G; Baek, S-H

    2009-12-01

    Model surgery is one of the most important steps in the preoperative workup for orthognathic surgery. In cases of complicated two-jaw surgery, manual model surgery requires many laboratory based steps that are time-consuming and may contain potential errors. Recently, a three-dimensional virtual model surgery (3D-VMS) program (3Txer version 2, Orapix, Seoul, Korea) was introduced. The purpose of this article is to present a 3D-VMS case using combined data from 3D computed tomography and 3D virtual dental casts.

  3. Surgery for Breast Cancer in Men

    MedlinePlus

    ... therapy for breast cancer in men Surgery for breast cancer in men The thought of surgery can be ... 2 to 3 hours. What to expect after breast cancer surgery: After your surgery, you will be taken ...

  4. Partial-wave expansions of angular spectra of plane waves.

    PubMed

    Lock, James A

    2006-11-01

    Focused electromagnetic beams are frequently modeled by either an angular spectrum of plane waves or a partial-wave sum of spherical multipole waves. The connection between these two beam models is explored here. The partial-wave expansion of an angular spectrum containing evanescent components is found to possess only odd partial waves. On the other hand, the partial-wave expansion of an alternate angular spectrum constructed so as to be free of evanescent components contains all partial waves but describes a propagating beam with a small amount of standing-wave component mixed in. A procedure is described for minimizing the standing-wave component so as to more accurately model a purely forward propagating experimental beam.

  5. Partial-wave expansions of angular spectra of plane waves

    NASA Astrophysics Data System (ADS)

    Lock, James A.

    2006-11-01

    Focused electromagnetic beams are frequently modeled by either an angular spectrum of plane waves or a partial-wave sum of spherical multipole waves. The connection between these two beam models is explored here. The partial-wave expansion of an angular spectrum containing evanescent components is found to possess only odd partial waves. On the other hand, the partial-wave expansion of an alternate angular spectrum constructed so as to be free of evanescent components contains all partial waves but describes a propagating beam with a small amount of standing-wave component mixed in. A procedure is described for minimizing the standing-wave component so as to more accurately model a purely forward propagating experimental beam.

  6. Resistance to extinction after schedules of partial delay or partial reinforcement in rats with hippocampal lesions.

    PubMed

    Rawlins, J N; Feldon, J; Ursin, H; Gray, J A

    1985-01-01

    Two experimental procedures were employed to establish the reason why hippocampal lesions apparently block the development of tolerance for aversive events in partial reinforcement experiments, but do not do so in partial punishment experiments. Rats were trained to run in a straight alley following hippocampal lesions (HC), cortical control lesions (CC) or sham operations (SO), and resistance to extinction was assessed following differing acquisition conditions. In Experiment 1 a 4-8 min inter-trial interval (ITI) was used. Either every acquisition trial was rewarded immediately (Continuous Reinforcement, CR), or only a randomly selected half of the trials were immediately rewarded, the reward being delayed for thirty seconds on the other trials (Partial Delay, PD). This delay procedure produced increased resistance to extinction in rats in all lesion groups. In Experiment 2 the ITI was reduced to a few seconds, and rats were trained either on a CR schedule, or on a schedule in which only half the trials were rewarded (Partial Reinforcement, PR). This form of partial reinforcement procedure also produced increased resistance to extinction in rats in all lesion groups. It thus appears that hippocampal lesions only prevent the development of resistance to aversive events when the interval between aversive and subsequent appetitive events exceeds some minimum value. PMID:4029302

  7. Exocyclic push-pull conjugated compounds. Part 3. An experimental NMR and theoretical MO ab initio study of the structure, the electronic properties and barriers to rotation about the exocyclic partial double bond in 2- exo-methylene- and 2-cyanoimino-quinazolines and -benzodiazepines

    NASA Astrophysics Data System (ADS)

    Benassi, R.; Bertarini, C.; Hilfert, L.; Kempter, G.; Kleinpeter, E.; Spindler, J.; Taddei, F.; Thomas, S.

    2000-03-01

    The structure of a number of 2- exo-methylene substituted quinazolines and benzodiazepines, respectively, 1, 3a, b, 4( X=-CN, -COOEt ) and their 2-cyanoimino substituted analogues 2, 3c, d( X=-CN, -SO 2C 6H 4-Me (p) was completely assigned by the whole arsenal of 1D and 2D NMR spectroscopic methods. The E/ Z isomerism at the exo-cyclic double bond was determined by both NMR spectroscopy and confirmed by ab initio quantum chemical calculations; the Z isomer is the preferred one, its amount proved dependent on steric hindrance. Due to the push-pull effect in this part of the molecules the restricted rotation about the partial C 2,C 11 and C 2,N 11 double bonds, could also be studied and the barrier to rotation measured by dynamic NMR spectroscopy. The free energies of activation of this dynamic process proved very similar along the compounds studied but being dependent on the polarity of the solvent. Quantum chemical calculations at the ab initio level were employed to prove the stereochemistry at the exo-cyclic partial double bonds of 1- 4, to calculate the barriers to rotation but also to discuss in detail both the ground and the transition state of the latter dynamic process in order to better understand electronic, inter- and intramolecular effects on the barrier to rotation which could be determined experimentally. In the cyanoimino substituted compounds 2, 3c, d, the MO ab initio calculations evidence the isomer interconversion to be better described by the internal rotation process than by the lateral shift mechanism.

  8. Fraunhofer diffraction of a partially blocked spiral phase plate.

    PubMed

    Cottrell, Don M; Davis, Jeffrey A; Hernandez, Travis J

    2011-07-01

    The Fraunhofer diffraction pattern from a partially blocked spiral phase plate (SPP) produces a partial vortex output pattern that is rotated by 90 degrees compared with the input. The rotation direction depends on whether the angular phase pattern increases in the clockwise or counterclockwise direction. In this work, we present an explanation of this effect based on careful examination of classical diffraction theory and show new experimental results. This approach is very convenient for easily determining the sign of the vortex charge.

  9. [Indications, technic and results following Sedlacek-Kambic-Tucker reconstructive partial resection of the larynx].

    PubMed

    Schröder, U; Eckel, H E; Jungehülsing, M; Thumfart, W

    1997-11-01

    Management of laryngeal carcinoma located at the anterior commissure remains controversial. Local control rates with radiotherapy or surgery are not as good as those seen after treatment of midcord lesions. The vertical partial laryngectomy with epiglottic reconstruction (VPLER) may be a more successful approach to such lesions. The charts of all patients treated for larynx carcinoma between 1991 and 1996 at the authors' institutions were reviewed to identify those patients treated with VPLER as described by Sedlacek in 1965, Kambic in 1976 and Tucker in 1979. Indications for performing surgery and outcome data of patients were collected and analyzed according to the indications for surgery, surgical technique, perioperative complications, oncological outcomes and functional results. Twelve patients were identified that had been treated with VPLER. Indications for surgery included five patients with local recurrences following endoscopic laser partial laryngectomies, four cases with previously untreated primary tumors at the anterior commissure (T2 N0-2 M0), two with local recurrences following radiotherapy, and one with recurrence following frontolateral partial laryngectomy. There were no postoperative complications except for one laryngocutaneous fistula that required secondary repair. All patients were able to swallow at the tenth postoperative day. All had their tracheostomies closed after completion of wound healing, (a mean of 17 days after surgery). Phonatory results were usually poor. Two local recurrences occurred during the follow-up period. However, both patients were salvaged with total laryngectomies and have since been free from disease. All other patients are alive and well. Our findings show that VPLER is an effective surgical approach for carcinoma at the anterior commissure of the larynx that cannot be adequately managed with transoral laser surgery or simple frontolateral partial laryngectomy. This study demonstrates that the procedure can be

  10. Computer-guided surgery in implantology: review of basic concepts.

    PubMed

    de Almeida, Erika Oliveira; Pellizzer, Eduardo Piza; Goiatto, Marcelo Coelho; Margonar, Rogério; Rocha, Eduardo Passos; Freitas, Amilcar Chagas; Anchieta, Rodolfo Bruniera

    2010-11-01

    The aim of the present study was to conduct a critical literature review about the technique of computer-guided surgery in implantology to highlight the indications, purposes, immediate loading of implants and complications, protocol of fabrication, and functioning of virtual planning software. This literature review was based on OLDMEDLINE and MEDLINE databases from 2002 to 2010 using the key words "computer-guided surgery" and "implant-supported prosthesis." Thirty-four studies regarding this topic were found. According to the literature review, it was concluded that the computer-assisted surgery is an excellent treatment alternative for patients with appropriate bone quantity for implant insertion in complete and partially edentulous arches. The Procera Nobel Guide software (Nobel Biocare) was the most common software used by the authors. In addition, the flapless surgery is advantageous for positioning of implants but with accurate indication. Although the computer-guided surgery may be helpful for virtual planning of cases with severe bone resorption, the conventional surgical technique is more appropriate. The surgical guide is important for insertion of the implants regardless of the surgical technique, and the success of immediate loading after computer-guided surgery depends on the accuracy of clinical and/or laboratorial steps.

  11. Advances in craniofacial surgery.

    PubMed

    Tatum, Sherard A; Losquadro, William D

    2008-01-01

    The past 10 years have witnessed many advances in craniofacial surgery. Advances in surgical techniques, such as distraction osteogenesis and endoscopic procedures, combined with refinements in surgical equipment, such as resorbable plating and distractors, have improved surgical outcomes, while minimizing morbidity. Technological advances in 3-dimensional imaging, computer simulation, and intraoperative navigation facilitate diagnosis, preoperative planning, and surgical execution. Rising cases of deformational plagiocephaly owing to increased supine infant sleep positioning necessitated the development of appropriate diagnosis and treatment and the avoidance of unnecessary surgery. A greater understanding of the genetic basis of craniofacial disorders has allowed better preoperative assessment and counseling. Finally, efforts to develop better bone graft substitutes with gene therapy and nanotechnology are ongoing. PMID:19018057

  12. Refractive surgery for keratoconus.

    PubMed

    Ormonde, Sue

    2013-03-01

    Traditionally, keratoconus has been managed with glasses when mild, contact lenses when moderate and keratoplasty when severe. When cornea-based refractive surgery was first developed it appeared to be a useful option for keratoconus until reports of post-operative progressive ectasia emerged and thus keratoconus was considered a contraindication to refractive surgery. However, improvements in older techniques and the development of new techniques mean that there are now several viable options to avoid keratoplasty in contact lens-intolerant patients. This review discusses the risks and benefits of excimer laser refractive procedures, both with and without corneal collagen cross linking, as well as intra-corneal ring segments, phakic intraocular lenses and refractive lens exchange with toric intraocular lens implantation. PMID:23496655

  13. [Cosmetic eyelid surgery].

    PubMed

    Ruban, J-M; Barbier, J; Malet, T; Baggio, E

    2014-01-01

    Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary.

  14. Robotic mitral valve surgery.

    PubMed

    Kypson, Alan P; Nifong, L Wiley; Chitwood, W Randolph

    2003-12-01

    A renaissance in cardiac surgery has begun. The early clinical experience with computer-enhanced telemanipulation systems outlines the limitations of this approach despite some procedural success. Technologic advancements, such as the use of nitinol U-clips (Coalescent Surgical Inc., Sunnyvale, CA) instead of sutures requiring manual knot tying, have been shown to decrease operative times significantly. It is expected that with further refinements and development of adjunct technologies, the technique of computer-enhanced endoscopic cardiac surgery will evolve and may prove to be beneficial for many patients. Robotic technology has provided benefits to cardiac surgery. With improved optics and instrumentation, incisions are smaller. The ergometric movements and simulated three-dimensional optics project hand-eye coordination for the surgeon. The placement of the wristlike articulations at the end of the instruments moves the pivoting action to the plane of the mitral annulus. This improves dexterity in tight spaces and allows for ambidextrous suture placement. Sutures can be placed more accurately because of tremor filtration and high-resolution video magnification. Furthermore, the robotic system may have potential as an educational tool. In the near future, surgical vision and training systems might be able to model most surgical procedures through immersive technology. Thus, a "flight simulator" concept emerges where surgeons may be able to practice and perform the operation without a patient. Already, effective curricula for training teams in robotic surgery exist. Nevertheless, certain constraints continue to limit the advancement to a totally endoscopic computer-enhanced mitral valve operation. The current size of the instruments, intrathoracic instrument collisions, and extrathoracic "elbow" conflicts still can limit dexterity. When smaller instruments are developed, these restraints may be resolved. Furthermore, a working port incision is still required for

  15. Cataract Surgery Tool

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.

  16. Minor surgery in microgravity

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Krupa, Debra T.; Stonestreet, Robert; Kizzee, Victor D.

    1991-01-01

    The purpose is to investigate and demonstrate equipment and techniques proposed for minor surgery on Space Station Freedom (SSF). The objectives are: (1) to test and evaluate methods of surgical instrument packaging and deployment; (2) to test and evaluate methods of surgical site preparation and draping; (3) to evaluate techniques of sterile procedure and maintaining sterile field; (4) to evaluate methods of trash management during medical/surgical procedures; and (4) to gain experience in techniques for performing surgery in microgravity. A KC-135 parabolic flight test was performed on March 30, 1990 with the goal of investigating and demonstrating surgical equipment and techniques under consideration for use on SSF. The flight followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola.

  17. Advanced Hysteroscopic Surgery Training

    PubMed Central

    McLaren, Glenda R.; Erian, Anna-Marie

    2014-01-01

    Hysteroscopic surgery is pivotal in management of many gynecological pathologies. The skills required for performing advanced hysteroscopic surgery (AHS), eg, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy and myomectomy in the management of menorrhagia, hysteroscopic septulysis in fertility-related gynecological problems and hysteroscopic removal of chronically retained products of conception and excision of intramural ectopic pregnancy ought to be practiced by contemporary gynecological surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases. Whilst the outcome is of paramount importance, proper training should be adopted and followed through so that doctors, nurses, and institutions may deliver the highest standard of patient care. PMID:25392678

  18. Endoscopic Skull Base Surgery

    PubMed Central

    Senior, Brent A

    2008-01-01

    Endoscopic skull base surgery has undergone rapid advancement in the past decade moving from pituitary surgery to suprasellar lesions and now to a myriad of lesions extending from the cribriform plate to C2 and laterally out to the infratemporal fossa and petrous apex. Evolution of several technological advances as well as advances in understanding of endoscopic anatomy and the development of surgical techniques both in resection and reconstruction have fostered this capability. Management of benign disease via endoscopic methods is largely accepted now but more data is needed before the controversy on the role of endoscopic management of malignant disease is decided. Continued advances in surgical technique, navigation systems, endoscopic imaging technology, and robotics assure continued brisk evolution in this expanding field. PMID:19434274

  19. Simulation in laparoscopic surgery.

    PubMed

    León Ferrufino, Felipe; Varas Cohen, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Müller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza Wilson, Camilo

    2015-01-01

    Nowadays surgical trainees are faced with a more reduced surgical practice, due to legal limitations and work hourly constraints. Also, currently surgeons are expected to dominate more complex techniques such as laparoscopy. Simulation emerges as a complementary learning tool in laparoscopic surgery, by training in a safe, controlled and standardized environment, without jeopardizing patient' safety. Simulation' objective is that the skills acquired should be transferred to the operating room, allowing reduction of learning curves. The use of simulation has increased worldwide, becoming an important tool in different surgical residency programs and laparoscopic training courses. For several countries, the approval of these training courses are a prerequisite for the acquisition of surgeon title certifications. This article reviews the most important aspects of simulation in laparoscopic surgery, including the most used simulators and training programs, as well as the learning methodologies and the different key ways to assess learning in simulation. PMID:25039039

  20. Simulation in laparoscopic surgery.

    PubMed

    León Ferrufino, Felipe; Varas Cohen, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Müller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza Wilson, Camilo

    2015-01-01

    Nowadays surgical trainees are faced with a more reduced surgical practice, due to legal limitations and work hourly constraints. Also, currently surgeons are expected to dominate more complex techniques such as laparoscopy. Simulation emerges as a complementary learning tool in laparoscopic surgery, by training in a safe, controlled and standardized environment, without jeopardizing patient' safety. Simulation' objective is that the skills acquired should be transferred to the operating room, allowing reduction of learning curves. The use of simulation has increased worldwide, becoming an important tool in different surgical residency programs and laparoscopic training courses. For several countries, the approval of these training courses are a prerequisite for the acquisition of surgeon title certifications. This article reviews the most important aspects of simulation in laparoscopic surgery, including the most used simulators and training programs, as well as the learning methodologies and the different key ways to assess learning in simulation.

  1. Pediatric Sleep Surgery

    PubMed Central

    Sulman, Cecille G.

    2014-01-01

    Adenotonsillectomy is the most common surgery performed for sleep disordered breathing with good outcomes. Children with obesity, craniofacial disorders, and neurologic impairment are at risk for persistent sleep apnea after adenotonsillectomy. Techniques exist to address obstructive lesions of the palate, tongue base, or craniofacial skeleton in children with persistent sleep apnea. Children with obstructive sleep apnea have a higher rate of peri-operative complications. PMID:24926473

  2. [Computers in surgery].

    PubMed

    Grande, M; Torquati, A; Bellisario, A

    1990-01-01

    The introduction of computers in medicine, particularly for what surgery is concerned, has many implications related to its optimal utilization. Possible applications as well as advantages and limits of such recording system in a surgical ward are examined. Emphasis is placed on the clinical data management model and the ways the different structures of the system are related. The computer processing of these data provides valid material for either clinical and surgical research or statistical studies.

  3. [Maxillo-facial surgery].

    PubMed

    Navarro Vila, Carlos; Acero Sanz, Julio; Barrios Robredo, José María; Cuesta Gil, Matías; López Atalaya, Francisco Javier; Salmerón Escobar, José Ignacio; Verdaguer Martín, Juan José

    2005-03-01

    We describe the experience of the Maxillofacial Surgery Service of the Gregorio Maranon University Hospital in attending the victims of the terrorist attack of 11 March, 2004 in Madrid. The most important types of cranio-maxillofacial injury treated that day, their mechanisms of production, and the organization of the department to attend a large number of patients in a short space of time are described. The outcomes of the casuistics attended in the days after the attack are described.

  4. [Study of the Identification Rate of Sentinel Lymph Node Biopsy after Partial Breast Resection].

    PubMed

    Suzuki, Shuhei; Sakurai, Kenichi; Adachi, Keita; Masuo, Yuki; Nagashima, Saki; Hara, Yukiko; Amano, Sadao; Enomoto, Katsuhisa; Makishima, Makoto

    2015-11-01

    Sentinel lymph node biopsy using the dye method is generally performed for patients with breast cancer. However, identification of the sentinel lymph node in the mammary gland is occasionally difficult after breast partial resection, as lymph flow is changed under the influence of surgery. Sentinel lymph node biopsy for patients with breast cancer who underwent partial mastectomy without axillary lymph node dissection is grade C1 in the breast cancer clinical practice guideline ver.2 2013. We examined the identification rate of the sentinel lymph node for patients with breast cancer who underwent lumpectomy or partial mastectomy. Lumpectomy and partial mastectomy were performed in 4 and 3 patients, respectively. It was possible to identify the sentinel lymph node in 6 patients, and no metastasis of cancer cells was identified in any patient. In 1 patient who underwent partial mastectomy, it was impossible to identify the sentinel lymph node, and thus, Level Ⅰlymph node sampling was performed. However, the pathological diagnosis was no metastasis of cancer cells. This patient underwent partial mastectomy of the C area and a smaller volume of the mammary gland. Therefore, we consider that lymph flow changed under the influence of surgery. Sentinel lymph node biopsy using the dye method after partial breast resection is useful, but partial mastectomy of the C area makes it difficult to perform sentinel lymph node biopsy. PMID:26805174

  5. Robotic Surgery in Gynecology.

    PubMed

    Bouquet de Joliniere, Jean; Librino, Armando; Dubuisson, Jean-Bernard; Khomsi, Fathi; Ben Ali, Nordine; Fadhlaoui, Anis; Ayoubi, J M; Feki, Anis

    2016-01-01

    Minimally invasive surgery (MIS) can be considered as the greatest surgical innovation over the past 30 years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D) monitor reduction in-depth perception, camera instability, limited range of motion, and steep learning curves. The surgeon has a low force feedback, which allows simple gestures, respect for tissues, and more effective treatment of complications. Since the 1980s, several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon's skills, achieve accuracy and high precision during complex surgery, and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision. PMID:27200358

  6. Art and epilepsy surgery.

    PubMed

    Ladino, Lady Diana; Hunter, Gary; Téllez-Zenteno, José Francisco

    2013-10-01

    The impact of health and disease has led many artists to depict these themes for thousands of years. Specifically, epilepsy has been the subject of many famous works, likely because of the dramatic and misunderstood nature of the clinical presentation. It often evokes religious and even mythical processes. Epilepsy surgical treatment has revolutionized the care of selected patients and is a relatively recent advance. Epilepsy surgery has been depicted in very few artistic works. The first portrait showing a potential surgical treatment for patients with epilepsy was painted in the 12th century. During the Renaissance, Bosch famously provided artistic commentary on traditional beliefs in "The stone of madness". Several of these works demonstrate a surgeon extracting a stone from a patient's head, at one time believed to be the source of all "folly", including epileptic seizures, psychosis, intellectual disability, depression, and a variety of other illnesses. There are some contemporary art pieces including themes around epilepsy surgery, all of them depicting ancient Inca Empire procedures such as trepanning. This article reviews the most relevant artistic works related with epilepsy surgery and also its historical context at the time the work was produced. We also present a painting from the Mexican artist Eduardo Urbano Merino that represents the patient's journey through refractory epilepsy, investigations, and ultimately recovery. Through this work, the artist intends to communicate hope and reassurance to patients going through this difficult process.

  7. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  8. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE).

  9. Robotically assisted gynaecological surgery.

    PubMed

    Falcone, Tommaso; Steiner, Charles P

    2002-05-01

    Industry has used robots successfully for fine, delicate, repetitive tasks for decades. Recently, robots have been introduced into clinical medicine and specifically into the surgical suite. Voice algorithms have been developed that allow voice activation of some types of equipment in the operating room, such as the laparoscope or the light source. Advances in computer software have allowed a computer controller to translate a surgeon's movements from the handles located in a console to the robotic arms that hold the surgical instruments. This console is placed away from the surgical table. Clinical experience is limited and there are few published clinical trials. The initial trials have focused on laparoscopic microsuturing such as that performed during coronary bypass surgery or tubal anastomosis. Preliminary results have demonstrated that laparoscopic coronary bypass surgery with the internal mammary artery can be achieved. In gynaecological surgery, laparoscopic tubal reanastomosis can be performed using the same technique that has been used traditionally at laparotomy. Future clinical trials will assess whether other gynaecological procedures can be performed with robotic assistance. PMID:12082211

  10. Robotic systems in surgery.

    PubMed

    Bargar, W L; Carbone, E J

    1993-10-01

    Computer-driven robots and medical imaging technology may soon enable surgeons to plan and execute intricate procedures with unprecedented precision. Our experience in introducing a robotic system for use in an active role in cementless total hip replacement surgery has convinced us that the marriage of these two technologies-robotics and medical imaging-is likely to change the way many types of surgical procedures are performed. The ability to link an image-based preoperative plan with its surgical execution by a robot may be the key to improved outcomes. Research and development of robotic systems for a wide variety of medical applications is underway at a number of prestigious institutions. Grenoble University has developed the IGOR (Imaged Guided Operating Robot) system. This six-axis robot has performed more than 400 interventions, acting as a positioner for brain surgery in both biopsy and therapeutic procedures. AlephMed and Digital are currently assisting the developers in integrating image analysis into the system. Future development plans include an application for spinal surgery. PMID:25951597

  11. Robotically assisted gynaecological surgery.

    PubMed

    Falcone, Tommaso; Steiner, Charles P

    2002-05-01

    Industry has used robots successfully for fine, delicate, repetitive tasks for decades. Recently, robots have been introduced into clinical medicine and specifically into the surgical suite. Voice algorithms have been developed that allow voice activation of some types of equipment in the operating room, such as the laparoscope or the light source. Advances in computer software have allowed a computer controller to translate a surgeon's movements from the handles located in a console to the robotic arms that hold the surgical instruments. This console is placed away from the surgical table. Clinical experience is limited and there are few published clinical trials. The initial trials have focused on laparoscopic microsuturing such as that performed during coronary bypass surgery or tubal anastomosis. Preliminary results have demonstrated that laparoscopic coronary bypass surgery with the internal mammary artery can be achieved. In gynaecological surgery, laparoscopic tubal reanastomosis can be performed using the same technique that has been used traditionally at laparotomy. Future clinical trials will assess whether other gynaecological procedures can be performed with robotic assistance.

  12. Theatre of paediatric surgery.

    PubMed

    McBride, Craig A; Holland, Andrew J A

    2015-01-01

    In the 50 years since the first edition of this journal, operative paediatric surgery has undergone radical change. Many of the most common instruments are unchanged, both as a testament to their utility and in recognition of past surgeons remembered eponymously. Surrounding that basic core of instruments, theatre has changed radically as new tools and techniques have arisen. Surgeons have come down from their pedestals, recognising surgery as a team sport rather than a solo performance. More than half of the current paediatric surgical trainees are women, a higher proportion than in any other craft group of the Royal Australasian College of Surgeons. The appearance, and rapid development, of laparoscopy is to many observers the most notable change in surgery over the last 50 years. Placed in its context though, it is simply the most prominent example of a frameshift in surgical thinking. The patient as a whole is now the focus, rather than just the disease. Recent developments are as much about minimising harm to normal tissues as they are about extirpating pathology. As a surgical maxim, 'Primum non nocere' is even more in evidence in 2015 than it was in 1965. PMID:25586851

  13. Robotic Surgery in Gynecology

    PubMed Central

    Bouquet de Joliniere, Jean; Librino, Armando; Dubuisson, Jean-Bernard; Khomsi, Fathi; Ben Ali, Nordine; Fadhlaoui, Anis; Ayoubi, J. M.; Feki, Anis

    2016-01-01

    Minimally invasive surgery (MIS) can be considered as the greatest surgical innovation over the past 30 years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D) monitor reduction in-depth perception, camera instability, limited range of motion, and steep learning curves. The surgeon has a low force feedback, which allows simple gestures, respect for tissues, and more effective treatment of complications. Since the 1980s, several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon’s skills, achieve accuracy and high precision during complex surgery, and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision. PMID:27200358

  14. Radioguided Adrenal Surgery

    PubMed Central

    Deus, Javier; Millera, Alfonso; Andrés, Alejandro; Prats, Enrique; Gil, Ismael; Suarez, Manuel; Salcini, José L.; Lahoz, Manuel

    2015-01-01

    Abstract The laparoscopic adrenalectomy is considered as the procedure of choice for the treatment of adrenal hyperplasia and tumor lesions. However, some special situations may limit the use of this method due to the difficulty to locate the gland and perform the lesion excision. We analyze 2 patients of a left adrenal tumor, explaining how they have overcome the difficulties in both situations. The first case was a patient with a history of intra-abdominal surgery and the other patient suffered from severe obesity. We performed with the use of the gamma probe, and the 2 cases, was of great help to access and glandular localization. The help of gamma probe test was achieved in the surgical bed, that removal was complete. The use of the portable gamma probe facilitated the access to the left adrenal gland as well as conducting the glandular excision without delay, despite the difficulties due to the intra abdominal surgery caused by the previous surgery, and in the case of severe obesity. PMID:26426608

  15. Art and epilepsy surgery.

    PubMed

    Ladino, Lady Diana; Hunter, Gary; Téllez-Zenteno, José Francisco

    2013-10-01

    The impact of health and disease has led many artists to depict these themes for thousands of years. Specifically, epilepsy has been the subject of many famous works, likely because of the dramatic and misunderstood nature of the clinical presentation. It often evokes religious and even mythical processes. Epilepsy surgical treatment has revolutionized the care of selected patients and is a relatively recent advance. Epilepsy surgery has been depicted in very few artistic works. The first portrait showing a potential surgical treatment for patients with epilepsy was painted in the 12th century. During the Renaissance, Bosch famously provided artistic commentary on traditional beliefs in "The stone of madness". Several of these works demonstrate a surgeon extracting a stone from a patient's head, at one time believed to be the source of all "folly", including epileptic seizures, psychosis, intellectual disability, depression, and a variety of other illnesses. There are some contemporary art pieces including themes around epilepsy surgery, all of them depicting ancient Inca Empire procedures such as trepanning. This article reviews the most relevant artistic works related with epilepsy surgery and also its historical context at the time the work was produced. We also present a painting from the Mexican artist Eduardo Urbano Merino that represents the patient's journey through refractory epilepsy, investigations, and ultimately recovery. Through this work, the artist intends to communicate hope and reassurance to patients going through this difficult process. PMID:23933914

  16. Robot-Assisted Cardiac Surgery

    PubMed Central

    Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  17. Robot-assisted cardiac surgery.

    PubMed

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  18. Is robotic partial nephrectomy convenient for solitary kidney?

    PubMed

    Kaouk, Jihad H; Malkoç, Ercan

    2016-09-01

    Nephron sparing surgery (NSS) is the gold standard treatment option for patients with a solitary kidney in order to preserve renal function. Open partial nephrectomy (OPN) has been long considered the standard care for NSS. Robotic partial nephrectomy (RPN) is being gradually used more commonly even for solitary kidney and complex tumors. There was no difference between RPN and OPN regarding the rate of intraoperative-postoperative complications and positive surgical margin (PSM) (RPN: 7.5%, OPN: 8%) for patients with solitary kidney who underwent partial nephrectomy for small renal masses. Warm ischemia time (WIT) in all of our studies was within the safe range of <25 minutes which is acceptable ischemia time for robotic approaches. More studies are needed in order to evaluate kidney function. In conclusion with increasing experience, solitary kidney tumors can be managed safely with robotic approach. For patients having complex tumors with a potential of WIT >25 minutes, administration of intracorporeal ice slush during surgery may be considered. PMID:27635284

  19. Laparoscopic Partial Nephrectomy for Renal-Cell Carcinoma During Pregnancy

    PubMed Central

    Yuruk, Emrah; Ucpinar, Burak; Binbay, Zerrin; Colakerol, Aykut; Muslumanoglu, Ahmet Yaser

    2016-01-01

    Abstract Background: The incidence of renal-cell carcinoma (RCC) is low during pregnancy. There are different approaches for timing of surgery and treatment modalities for RCC in pregnant women in the literature. To our knowledge, this is the first laparoscopic partial nephrectomy case in a pregnant woman. Case Presentation: Herein, we present a 34-year-old woman with a renal mass at her 14th gestational week. She was admitted to our clinic after a right renal mass was incidentally diagnosed during routine antenatal ultrasonography. MRI revealed a completely endophytic tumor of 6 × 6.5 × 6.5 cm, located in the upper half of the right kidney. We performed laparoscopic partial nephrectomy in our patient and the postoperative course was uneventful. Conclusion: This is the first presented laparoscopic partial nephrectomy case in a pregnant patient. Nephron-sparing surgeries can be performed laparoscopically in appropriate sized renal tumors in suitable pregnant patients. PMID:27579405

  20. Is robotic partial nephrectomy convenient for solitary kidney?

    PubMed Central

    Kaouk, Jihad H.; Malkoç, Ercan

    2016-01-01

    Nephron sparing surgery (NSS) is the gold standard treatment option for patients with a solitary kidney in order to preserve renal function. Open partial nephrectomy (OPN) has been long considered the standard care for NSS. Robotic partial nephrectomy (RPN) is being gradually used more commonly even for solitary kidney and complex tumors. There was no difference between RPN and OPN regarding the rate of intraoperative-postoperative complications and positive surgical margin (PSM) (RPN: 7.5%, OPN: 8%) for patients with solitary kidney who underwent partial nephrectomy for small renal masses. Warm ischemia time (WIT) in all of our studies was within the safe range of <25 minutes which is acceptable ischemia time for robotic approaches. More studies are needed in order to evaluate kidney function. In conclusion with increasing experience, solitary kidney tumors can be managed safely with robotic approach. For patients having complex tumors with a potential of WIT >25 minutes, administration of intracorporeal ice slush during surgery may be considered. PMID:27635284

  1. Epilepsy Surgery: An Evidence Summary

    PubMed Central

    2012-01-01

    Background The Medical Advisory Secretariat, the predecessor of Health Quality Ontario, published an evidence-based analysis on functional brain imaging. This analysis highlighted the low uptake of epilepsy surgery in Ontario and internationally. Objective The objective of this analysis was to review the effectiveness of epilepsy surgery at reducing seizure frequency, as well as the safety of epilepsy surgery. Data Sources The literature search included studies published between January 1995 and March 2012. Search terms included epilepsy, surgery, resection, safety, and complications. Review Methods Studies were eligible for inclusion if they included at least 20 patients undergoing surgery; had a comparison group of patients with epilepsy who were not undergoing surgery; and reported follow-up periods of at least 1 year. Outcomes of interest included seizure frequency and complications associated with surgery. Results Six systematic reviews reported pooled seizure-free rates that ranged from 43% to 75%. Two randomized controlled trials compared the effectiveness of epilepsy surgery with no surgery in patients with drug-refractory epilepsy. Both trials reported significant improvements in the seizure frequency in the surgery group compared with the nonsurgery group. Eight retrospective cohort studies reported on the safety of epilepsy surgery. Of the 2,725 patients included in these studies, there were 3 deaths reportedly related to surgery. Other complications included hemiparesis, infection, and visual field defects. The studies had long follow-up periods ranging from a mean of 2 to 7 years. Limitations The most recent randomized controlled trial was stopped early due to slow enrolment rates. Thus results need to be interpreted with caution. Conclusions There is high quality evidence that epilepsy surgery is effective at reducing seizure frequency. Two randomized controlled trials compared surgery to no surgery in patients with drug-refractory epilepsy. Both

  2. Partial confinement photonic crystal waveguides

    SciTech Connect

    Saini, S.; Hong, C.-Y.; Pfaff, N.; Kimerling, L. C.; Michel, J.

    2008-12-29

    One-dimensional photonic crystal waveguides with an incomplete photonic band gap are modeled and proposed for an integration application that exploits their property of partial angular confinement. Planar apodized photonic crystal structures are deposited by plasma enhanced chemical vapor deposition and characterized by reflectivity as a function of angle and polarization, validating a partial confinement design for light at 850 nm wavelength. Partial confinement identifies an approach for tailoring waveguide properties by the exploitation of conformal film deposition over a substrate with angularly dependent topology. An application for an optoelectronic transceiver is demonstrated.

  3. Catastrophic Expenditure to Pay for Surgery: A Global Estimate

    PubMed Central

    Shrime, Mark G.; Dare, Anna J.; Alkire, Blake C.; O'Neill, Kathleen; Meara, John G.

    2015-01-01

    Purpose Approximately 150 million individuals face catastrophic expenditure each year from medical costs alone, and many more from the nonmedical costs of accessing care. The proportion of this expenditure arising from surgical conditions is unknown. Because World Bank has proposed eliminating medical impoverishment by 2030, the impact of surgical conditions on financial catastrophe must be quantified so that any financial risk protection mechanisms can appropriately incorporate surgery. Methods To determine the global incidence of catastrophic expenditure due to surgery, a stochastic model was built. The income distribution of each country, the probability of requiring surgery, and the medical and nonmedical costs faced for surgery were incorporated. Sensitivity analyses were run to test model robustness. Findings 3.7 billion people risk catastrophic expenditure if they need surgery. Every year, 33 million of them are driven to financial catastrophe from the costs of surgery alone, and 48 million from nonmedical costs, leading to 81 million cases worldwide. The burden of catastrophic expenditure is highest in low- and middle-income countries; within any country, it falls on the poor. Estimates are sensitive to the definition of catastrophic expenditure and the costs of care. The inequitable burden distribution is robust to model assumptions. Interpretation Half the global population is at risk of financial catastrophe from surgery. Annually, 81 million individuals, especially the poor, face catastrophic expenditure due to surgical conditions, of which less than half is attributable to medical costs. These findings highlight the need for financial risk protection for surgery in health system design. Funding Partial funding for Dr. Shrime from NIH/NCI R25CA92203. PMID:25926319

  4. Lensectomy-vitrectomy indications and techniques in cataract surgery.

    PubMed

    Sourdille, P

    1997-02-01

    Lensectomy-vitrectomy is the removal of the crystalline lens through a transscleral retrociliary incision (usually the pars plana) under clinical conditions in which the vitreous gel has to be partially or totally removed. It was designed in the early 1970s at the onset of modern vitreous surgery. The vitreous cutter was used to remove the lens and the vitreous (lensectomy as vitrectomy). With the development of small incision cataract surgery, foldable IOL, the term lensectomy-vitrectomy also applies to separate incisions in one procedure combining lens and vitreous surgery. With this in mind, it covers several very different situations from neonatal congenital cataracts to adult or senile-associated diseases. This type of surgery is widely accepted, and the main controversy is about the consequences of neonatal surgery and the age of IOL implantation in uni- or bilateral congenital cataracts. My personal work with laser flare and cellmetry demonstrates that pars plana vitrectomy alone creates very little trauma to the blood-aqueous barrier, as can be checked by the anterior chamber level of proteins (ie, flare). The postoperative flare in pars plana vitrectomy alone is very close to the preoperative level. Therefore, the association of pars plana vitrectomy and lens surgery should not be more traumatizing to the eye than lens surgery alone. This review will first report the consequences of neonatal lensectomy-vitrectomy to the eye. Subsequent indications for surgery and implantation will be discussed as well as special indications and complications in congenital cataracts, dislocated nucleus in cataract operation, cataract and associated vitreoretinal disorders in diabetes, and giant retinal tears and removal of the lens during vitrectomy. PMID:10168275

  5. The impact of marketing language on patient preference for robot-assisted surgery.

    PubMed

    Dixon, Peter R; Grant, Robert C; Urbach, David R

    2015-02-01

    Robot-assisted surgery is gaining momentum as a new trend in minimally invasive surgery. With limited evidence supporting its use in place of the far less expensive conventional laparoscopic surgery, it has been suggested that marketing pressure is partly responsible for its widespread adoption. The impact of phrases that promote the novelty of robot-assisted surgery on patient decision making has not been investigated. We conducted a discrete choice experiment to elicit preference of partial colectomy technique for a hypothetical diagnosis of colon cancer. A convenience sample of 38 participants in an ambulatory general surgery clinic consented to participate. Each participant made 2 treatment decisions between robot-assisted surgery and conventional laparoscopic surgery, with robot-assisted surgery described as "innovative" and "state-of-the-art" in one of the decisions (marketing frame), and by a disclosure of the uncertainty of available evidence in the other (evidence-based frame). The magnitude of the framing effect was large with 12 of 38 subjects (31.6%, P = .005) selecting robot-assisted surgery in the marketing frame and not the evidence-based frame. This is the first study to our knowledge to demonstrate that words that highlight novelty have an important influence on patient preference for robot-assisted surgery and that use of more neutral language can mitigate this effect.

  6. Anterior segment surgery early after corneal wound repair.

    PubMed Central

    Maul, E; Muga, R

    1977-01-01

    Penetrating wounds of the cornea require immediate repair, generally within 24 hours. Tight closure of the wound and a reformed anterior chamber are the primary goals of surgery. However, there is no guarantee that further surgery will not be required for maintaining the healthy function of the anterior segment. At the second operation the effect of the procedure on the previously repaired wound is of prime importance, since in many cases the operation needs to be done before corneal healing is completed. In our series the lens, which was either partially or completely cataractous at the initial operation, became intumescent at different times afterwards, and an immediate removal was necessary. No change in the preoperative wound sealing or transparency of the cornea could be detected after lens surgery performed between 24 hours and 21 days from the initial corneal repair. PMID:603786

  7. Scoliosis surgery and its effect on back shape.

    PubMed

    Jefferson, R J; Weisz, I; Turner-Smith, A R; Harris, J D; Houghton, G R

    1988-03-01

    Thirty-four patients with adolescent idiopathic scoliosis were assessed by radiography and the integrated shape imaging system (ISIS) both before and after spinal surgery. Twenty-seven patients underwent Harrington instrumentation, after which lateral indices of curvature were significantly improved, but changes in the transverse plane were less pronounced. Sublaminar wiring was carried out in two patients whose thoracic lordosis was corrected by the surgery. Five patients whose severe deformity had persisted after previous spinal surgery underwent costoplasty, which resulted in a significant improvement in back shape measurements. We conclude that the cosmetic deformity of the back in scoliosis is only partially corrected by operations on the spine itself, whilst costoplasty addresses the problem directly, and improves the surface shape. PMID:3346300

  8. Local excision by transanal endoscopic surgery

    PubMed Central

    García-Flórez, Luis J; Otero-Díez, Jorge L

    2015-01-01

    Transanal endoscopic surgery (TES) consists of a series of anorectal surgical procedures using different devices that are introduced into the anal canal. TES has been developed significantly since it was first used in the 1980s. The key point for the success of these techniques is how accurately patients are selected. The main indication was the resection of endoscopically unresectable adenomas. In recent years, these techniques have become more widespread which has allowed them to be applied in conservative rectal procedures for both benign diseases and selected cases of rectal cancer. For more advanced rectal cancers it should be considered palliative or, in some controlled trials, experimental. The role of newer endoscopic techniques available has not yet been defined. TES may allow for new strategies in the treatment of rectal pathology, like transanal natural orifice transluminal endoscopic surgery or total mesorectal excision. PMID:26309355

  9. Partial-Payload Support Structure

    NASA Technical Reports Server (NTRS)

    Mitchell, R.; Freeman, M.

    1984-01-01

    Partial-payload support structure (PPSS) is modular, bridge like structure supporting experiments weighing up to 2 tons. PPSS handles such experiments more economically than standard Spacelab pallet system.

  10. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    PubMed

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  11. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    PubMed

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning. PMID:26427363

  12. Complex partial status and schizophrenia.

    PubMed

    Ardila, A; Gómez, J

    1988-04-01

    Three cases of complex partial status which were diagnosed as psychotic episodes are presented. The scans of two of these cases show structural abnormalities in the left temporal lobe. It is proposed that there are similar neurophysiological mechanisms in primary schizophrenia and in the perceptual, affective and cognitive phenomena apparent is some complex and psychic partial seizures. The hippocampal-amygdaline system plays a central role in both cases.

  13. Retroperitoneal robotic renal surgery: technique and early results.

    PubMed

    Patel, Manish N; Kaul, Sanjeev A; Laungani, Rajesh; Eun, Daniel; Bhandari, Mahendra; Menon, Mani; Rogers, Craig G

    2009-03-01

    We describe a robotic retroperitoneal approach to renal surgery, optimized in porcine and cadaveric models, and applied to human patients. A retroperitoneal approach for robotic kidney surgery was developed in nonsurvival porcine and a fresh cadaver models, and then utilized in ten patients (three partial nephrectomy, three radical nephrectomy, two simple nephrectomy, one pyeloplasty, one cryoablation). Retroperitoneal access was successfully achieved for robotic renal procedures in six pigs and a human cadaver. Ten human patients (mean age 56 years, range 36-72 years) then underwent a successful retroperitoneal approach for robotic renal surgery. Mean console time was 166 (120-300) min. Mean blood loss was 82 (50-100) ml and average hospital stay was 2.6 (1-5) days. Pathology demonstrated clear cell renal cell carcinoma (four), papillary renal cell carcinoma (two), and xanthogranulomatous pyelonephritis (two). One patient with xanthogranulomatous pyelonephritis required open conversion for failure to progress due to dense adhesions. A retroperitoneal approach is a safe and feasible alternative to a transperitoneal approach for robotic renal surgery, including radical nephrectomy, partial nephrectomy, pyeloplasty, and cryoablation. PMID:27628446

  14. The First Pilot Comprehensive Evaluation of the Outcomes of Different Types of Robotic Surgeries in the Different Surgical Departments: The Penta, Tetra and Trifecta Achievements in Robotic Surgeries

    PubMed Central

    Sejima, Takehiro; Morizane, Shuichi; Fujiwara, Kazunori; Ashida, Keigo; Saito, Hiroaki; Taniguchi, Yuji; Nakamura, Hiroshige; Takenaka, Atsushi

    2016-01-01

    Background To ensure safe performance in robotic surgery, the Minimal Invasive Surgery Center (MISC) is composed of the anesthesiology department, five surgery departments and co-medical staff in our institution. The objective of this study was to evaluate the outcomes of different types of robotic surgeries for cancer treatment (n = 326) from different surgery departments in the MISC. Methods The outcomes of robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), transoral robotic surgery (TORS) for pharyngeal cancer, and robotic surgery for lung, gastric and rectal cancer were evaluated using the similar concept of pentafecta in RARP. Results The pentafecta rates of RARP and robotic surgery for rectal cancer were 33.3 and 56.5%, respectively. The tetrafecta rates of RARP (excluding potency evaluation from pentafecta) and TORS were 48.4 and 57.1%, respectively. The trifecta rates of RAPN, robotic surgeries for lung and gastric cancer were 75.9, 74.2 and 84.2%, respectively. The failure of tetrafecta in RARP achievement was significantly associated with high risk than with low risk according to National Comprehensive Cancer Network classification. Conclusion This is the world’s first comprehensive evaluation of different types of robotic surgeries for cancer treatment in the constitutional framework of an academic institution. MISC, which provides the constitutional framework of an academic institution, is providing immeasurable benefits in terms of robotic surgery quality, and it may ultimately lead to high penta-, tetra-, and trifecta rates for robotic surgeries for cancer treatment in all surgical departments. PMID:27493484

  15. [Acrylic resin removable partial dentures].

    PubMed

    de Baat, C; Witter, D J; Creugers, N H J

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of removable partial dentures, the acrylic resin removable partial denture has 3 favourable aspects: the economic aspect, its aesthetic quality and the ease with which it can be extended and adjusted. Disadvantages are an increased risk of caries developing, gingivitis, periodontal disease, denture stomatitis, alveolar bone reduction, tooth migration, triggering of the gag reflex and damage to the acrylic resin base. Present-day indications are ofa temporary or palliative nature or are motivated by economic factors. Special varieties of the acrylic resin removable partial denture are the spoon denture, the flexible denture fabricated of non-rigid acrylic resin, and the two-piece sectional denture. Furthermore, acrylic resin removable partial dentures can be supplied with clasps or reinforced by fibers or metal wires.

  16. [Minimally invasive breast surgery].

    PubMed

    Mátrai, Zoltán; Gulyás, Gusztáv; Kunos, Csaba; Sávolt, Akos; Farkas, Emil; Szollár, András; Kásler, Miklós

    2014-02-01

    Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases. In general , such interventions result in significantly reduced breast and chest wall scars, shorter hospitalization and less pain, but they require specific, expensive devices, longer surgical time compared to open surgery. Furthermore, indications or oncological safety have not been established yet. It is quite likely, that minimally invasive surgical procedures with high-tech devices - similar to other surgical subspecialties -, will gradually become popular and it may form part of routine breast surgery even. Vacuum-assisted core biopsy with a therapeutic indication is suitable for the removal of benign fibroadenomas leaving behind an almost invisible scar, while endoscopically assisted skin-sparing and nipple-sparing mastectomy, axillary staging and reconstruction with latissimus dorsi muscle flap are all feasible through the same short axillary incision. Endoscopic techniques are also suitable for the diagnostics and treatment of intracapsular complications of implant-based breast reconstructions (intracapsular fluid, implant rupture, capsular contracture) and for the biopsy of intracapsular lesions with uncertain pathology. Perception of the role of radiofrequency ablation of breast tumors requires further hands-on experience, but it is likely that it can serve as a replacement of surgical removal in a portion of primary tumors in the future due to the development in functional imaging and anticancer drugs. With the reduction of the price of ductoscopes routine examination of the ductal branch system, guided microdochectomy and targeted surgical removal of terminal ducto-lobular units or a "sick lobe" as an anatomical unit may become feasible. The paper presents the experience of the authors and provides a literature review, for the first time in Hungarian language on the subject. Orv. Hetil

  17. Minimally invasive mediastinal surgery

    PubMed Central

    Melfi, Franca M. A.; Mussi, Alfredo

    2016-01-01

    In the past, mediastinal surgery was associated with the necessity of a maximum exposure, which was accomplished through various approaches. In the early 1990s, many surgical fields, including thoracic surgery, observed the development of minimally invasive techniques. These included video-assisted thoracic surgery (VATS), which confers clear advantages over an open approach, such as less trauma, short hospital stay, increased cosmetic results and preservation of lung function. However, VATS is associated with several disadvantages. For this reason, it is not routinely performed for resection of mediastinal mass lesions, especially those located in the anterior mediastinum, a tiny and remote space that contains vital structures at risk of injury. Robotic systems can overcome the limits of VATS, offering three-dimensional (3D) vision and wristed instrumentations, and are being increasingly used. With regards to thymectomy for myasthenia gravis (MG), unilateral and bilateral VATS approaches have demonstrated good long-term neurologic results with low complication rates. Nevertheless, some authors still advocate the necessity of maximum exposure, especially when considering the distribution of normal and ectopic thymic tissue. In recent studies, the robotic approach has shown to provide similar neurological outcomes when compared to transsternal and VATS approaches, and is associated with a low morbidity. Importantly, through a unilateral robotic technique, it is possible to dissect and remove at least the same amount of mediastinal fat tissue. Preliminary results on early-stage thymomatous disease indicated that minimally invasive approaches are safe and feasible, with a low rate of pleural recurrence, underlining the necessity of a “no-touch” technique. However, especially for thymomatous disease characterized by an indolent nature, further studies with long follow-up period are necessary in order to assess oncologic and neurologic results through minimally

  18. Varicose vein surgery.

    PubMed

    Kendler, Micheal; Fellmer, Peter T; Wetzig, Tino

    2012-03-01

    Venous diseases are common in the general population. After a comprehensive diagnostic evaluation, an individual therapeutic approach should be selected on the basis of the findings, with the aim of treating the diseased vein segments and improving quality of life. Numerous therapeutic options are available for the treatment of varicose veins. In addition to conservative methods such as compression therapy, exercise or drugs, surgical procedures such as traditional surgery, thermal ablation techniques or sclerotherapy can be performed. Recent developments include the use of endoluminal water vapor or mechano-chemical endovenous ablation. PMID:22222053

  19. Robotics in colorectal surgery.

    PubMed

    Hance, J; Rockall, T; Darzi, A

    2004-01-01

    Minimally invasive surgery has been shown to offer many advantages to general surgical patients but has not been widely adopted for colorectal disease. Initial fears surrounding the oncological safety of laparoscopic colectomies have largely subsided but the technical challenges still remain. Surgical robots or telemanipulators present the laparoscopic surgeon with unrivaled dexterity and vision, which may allow colonic resections to be completed with greater ease. Although initial studies suggest promising results using currently available systems, it will take further time for patient benefits to be proven, therefore justifying the greater expense of operating with this new technology.

  20. Endoscopic excimer laser surgery

    NASA Astrophysics Data System (ADS)

    Salimbeni, Renzo; Pini, Roberto; Vannini, Matteo; Benaim, George; Mattioli, Stefano

    1994-02-01

    Long pulse excimer laser radiation can be efficiently coupled and transmitted through optical fibers allowing the achievement of both photoablative and photomechanical effects. In this work the investigation has been focussed on the urologic surgery field to demonstrate the effectiveness of an excimer laser system for very different therapeutic tasks: recanalization of urethral stenosis and lithotripsy. The choice of the suitable radiation dosimetry and the technical solutions employed provide to the surgeon a multipurpose laser system with a wide range of utility in comparison with other laser systems.

  1. [Robotics in pediatric surgery].

    PubMed

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  2. Solo hand surgery.

    PubMed

    Bell, Michael Sg; Reitsma, Bert J

    2005-01-01

    Unassisted hand surgery is being undertaken by necessity for both elective and emergency cases, due to hospital resource restrictions. The authors outline the principles of local anesthesia, surgeon-controlled tourniquet techniques, and a number of new instruments which allow a surgeon to work in comfort and safety, unassisted. The traditional surgical instruments designed for the days when trained surgical assistants were available to hold them are no longer suitable. We are entering a new era of surgical design with safer instruments that can complement our skills rather than challenge them. There are significant cost savings and efficiency when hand procedures are undertaken in the emergency and outpatient clinic settings.

  3. Robotic surgery - advance or gimmick?

    PubMed

    De Wilde, Rudy L; Herrmann, Anja

    2013-06-01

    Robotic surgery is increasingly implemented as a minimally invasive approach to a variety of gynaecological procedures. The use of conventional laparoscopy by a broad range of surgeons, especially in complex procedures, is hampered by several drawbacks. Robotic surgery was created with the aim of overcoming some of the limitations. Although robotic surgery has many advantages, it is also associated with clear disadvantages. At present, the proof of superiority over access by laparotomy or laparoscopy through large randomised- controlled trials is still lacking. Until results of such trials are present, a firm conclusion about the usefulness of robotic surgery cannot be drawn. Robotic surgery is promising, making the advantages of minimally invasive surgery potentially available to a large number of surgeons and patients in the future.

  4. Pediatric robotic urologic surgery-2014.

    PubMed

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide. PMID:25197187

  5. Gravity Effects Observed In Partially Premixed Flames

    NASA Technical Reports Server (NTRS)

    Puri, Ishwar K.; Aggarwal, Suresh K.; Lock, Andrew J.; Gauguly, Ranjan; Hegde, Uday

    2003-01-01

    Partially premixed flames (PPFs) contain a rich premixed fuel air mixture in a pocket or stream, and, for complete combustion to occur, they require the transport of oxidizer from an appropriately oxidizer-rich (or fuel-lean) mixture that is present in another pocket or stream. Partial oxidation reactions occur in fuel-rich portions of the mixture and any remaining unburned fuel and/or intermediate species are consumed in the oxidizer-rich portions. Partial premixing, therefore, represents that condition when the equivalence ratio (phi) in one portion of the flowfield is greater than unity, and in another section its value is less than unity. In general, for combustion to occur efficiently, the global equivalence ratio is in the range fuel-lean to stoichiometric. These flames can be established by design by placing a fuel-rich mixture in contact with a fuel-lean mixture, but they also occur otherwise in many practical systems, which include nonpremixed lifted flames, turbulent nonpremixed combustion, spray flames, and unwanted fires. Other practical applications of PPFs are reported elsewhere. Although extensive experimental studies have been conducted on premixed and nonpremixed flames under microgravity, there is a absence of previous experimental work on burner stabilized PPFs in this regard. Previous numerical studies by our group employing a detailed numerical model showed gravity effects to be significant on the PPF structure. We report on the results of microgravity experiments conducted on two-dimensional (established on a Wolfhard-Parker slot burner) and axisymmetric flames (on a coannular burner) that were investigated in a self-contained multipurpose rig. Thermocouple and radiometer data were also used to characterize the thermal transport in the flame.

  6. Serum metabolite profiles of postoperative fatigue syndrome in rat following partial hepatectomy

    PubMed Central

    Lu, Ye; Yang, Rui; Jiang, Xin; Yang, Yajuan; Peng, Fei; Yuan, Hongbin

    2016-01-01

    Postoperative fatigue syndrome is a general complication after surgery. However, there is no ‘‘gold standard’’ for fatigue assessment due to the lack of objective biomarkers. In this study, a rodent model of postoperative fatigue syndrome based on partial hepatectomy was firstly established and serum metabonomic method based on ultra-high performance liquid chromatography coupled with Q-TOF mass spectrometry was applied. Partial least-squares discriminant analysis was used to identify the differential metabolites in 70% partial hepatectomy rats relative to sham rats and 30% partial hepatectomy rats, which showed 70% partial hepatectomy group was significantly distinguishable from 30% partial hepatectomy group and sham group. Eighteen serum metabolites responsible for the discrimination were identified. The levels of hypoxanthine, kynurenine, tryptophan, uric acid, phenylalanine, palmitic acid, arachidonic acid and oleic acid showed progressive elevation from sham group to 30% partial hepatectomy group to 70% partial hepatectomy group, and levels of valine, tyrosine, isoleucine, linoleyl carnitine, palmitoylcarnitine, lysophosphatidylcholine (16:0), lysophosphatidylcholine (20:3), citric acid, succinic acid and hippuric acid showed progressive declining trend from sham group to 30% partial hepatectomy group to 70% partial hepatectomy group. These potential biomarkers help to understand of etiology, pathophysiology and treatment of postoperative fatigue syndrome. PMID:27257346

  7. Serum metabolite profiles of postoperative fatigue syndrome in rat following partial hepatectomy.

    PubMed

    Lu, Ye; Yang, Rui; Jiang, Xin; Yang, Yajuan; Peng, Fei; Yuan, Hongbin

    2016-05-01

    Postoperative fatigue syndrome is a general complication after surgery. However, there is no ''gold standard'' for fatigue assessment due to the lack of objective biomarkers. In this study, a rodent model of postoperative fatigue syndrome based on partial hepatectomy was firstly established and serum metabonomic method based on ultra-high performance liquid chromatography coupled with Q-TOF mass spectrometry was applied. Partial least-squares discriminant analysis was used to identify the differential metabolites in 70% partial hepatectomy rats relative to sham rats and 30% partial hepatectomy rats, which showed 70% partial hepatectomy group was significantly distinguishable from 30% partial hepatectomy group and sham group. Eighteen serum metabolites responsible for the discrimination were identified. The levels of hypoxanthine, kynurenine, tryptophan, uric acid, phenylalanine, palmitic acid, arachidonic acid and oleic acid showed progressive elevation from sham group to 30% partial hepatectomy group to 70% partial hepatectomy group, and levels of valine, tyrosine, isoleucine, linoleyl carnitine, palmitoylcarnitine, lysophosphatidylcholine (16:0), lysophosphatidylcholine (20:3), citric acid, succinic acid and hippuric acid showed progressive declining trend from sham group to 30% partial hepatectomy group to 70% partial hepatectomy group. These potential biomarkers help to understand of etiology, pathophysiology and treatment of postoperative fatigue syndrome. PMID:27257346

  8. Nonintubated anesthesia for thoracic surgery

    PubMed Central

    Wang, Bei

    2014-01-01

    Nonintubated thoracic surgery has been used in procedures including pleura, lungs and mediastinum. Appropriate anesthesia techniques with or without sedation allow thoracic surgery patients to avoid the potential risks of intubated general anesthesia, particularly for the high-risk patients. However, nonintubated anesthesia for thoracic surgery has some benefits as well as problems. In this review, the background, indication, perioperative anesthetic consideration and management, and advantages and disadvantages are discussed and summarized. PMID:25589994

  9. Recent developments in vitreoretinal surgery.

    PubMed

    Sharma, T; Gopal, L

    2000-12-01

    In the past three decades, a great improvement has occurred in microsurgical techniques used in the management of various eye diseases involving retina and vitreous. Advances in instrumentation has made the surgery easier and refined. The instruments used are narrated widely in this article. Various vitreous substitutes have been developed and are required in vitreoretinal surgery. These are gases, silicone oil, perfluorocarbon liquids and fluorosilicone oil. Anterior segment indications for vitreous surgery are: Vitreous loss during cataract surgery, thick after cataracts that can't be managed with Nd: YAG capsulotomy, vitreocorneal touch, updrawn pupils, incarcerated vitreous in the wound causing cystoid macular oedema, malignant glaucoma, penetrating keratoplasty in aphakic patients, congenital cataracts and filtering procedures in aphakic eyes. In posterior segment indications, vitrectomy is useful in penetrating trauma, haemorrhage, retinal deetachment, intra-ocular foreign bodies and infection endophthalmitis Macular surgery involves peeling of epimacular membrane or proliferation, treating vitreomacular traction syndrome, idiopathic macular holes, retinal detachment associated with optic pit, evacuation of submacular haemorrhage and excision of choroidal neovascular membranes. Available options to treat retinal detachments are pneumatic retinopexy, scleral buckling and vitreous surgery. Proliferative vitreoretinopathy remains the important cause of failure and occurs in about 8-10% cases after retinal detachment. Vitreous surgery for ocular trauma, vitrectomy for proliferative diabetic retinopathy, macular hole surgery, submacular surgery are also discussed in detail.

  10. [Minimally invasive iridocorneal angle surgery].

    PubMed

    Jordan, J F

    2012-07-01

    The classical filtration surgery with trabeculectomy or drainage of chamber fluid with episcleral implants is the most effective method for permanent reduction of intraocular pressure to lower and normal levels. Even though both operative procedures are well-established the high efficiency of the method causes potentially dangerous intraoperative as well as interoperative complications with a frequency which cannot be ignored. In the past this led to a search for low complication alternatives with non-penetrating glaucoma surgery (NPGS) and the search is still continuing. Trabecular meshwork surgery in particular with continuous development of new operation techniques steered the focus to a complication-poor and minimally invasive, gonioscopic glaucoma surgery.

  11. Laser surgery for allergic rhinitis.

    PubMed

    Fukutake, T; Yamashita, T; Tomoda, K; Kumazawa, T

    1986-12-01

    The inferior turbinates of 140 patients with perennial allergic rhinitis were vaporized by a defocused carbon dioxide (CO2) laser beam, using specially designed handpieces. Among these patients, 131 showed improvement in subjective symptoms one month after laser surgery. Excellent or good results were obtained in 27 of 35 patients who were followed up more than one year after laser surgery. The histopathologic changes observed in the nasal mucous membrane after surgery were fibrous proliferation and scar formation in the superficial layer of the submucosa. This surgery can be done under surface anesthesia as an outpatient procedure, and it is painless, with no bleeding.

  12. Aesthetic adjuncts with orthognathic surgery.

    PubMed

    Mohamed, Waheed V; Perenack, Jon D

    2014-11-01

    Traditional orthognathic surgery aligns the patient's bony jaws into a desired, more appropriate position but may leave other cosmetic issues unaddressed. Soft tissue deformities may be treated concomitantly with orthognathic surgery, including soft tissue augmentation (fillers), reduction (liposuction), hard tissue augmentation, cosmetic lip procedures, and rhinoplasty. Some cosmetic adjunctive procedures may be performed at a later date after soft tissue edema from orthognathic surgery has resolved to achieve a more predictable outcome. Undesired cosmetic changes may occur months to years after orthognathic surgery and may be addressed by adjunctive cosmetic procedures.

  13. [Subaortic diaphragm surgery].

    PubMed

    Moutakiallah, Younes; Maaroufi, Ilham; Aithoussa, Mahdi; Bamous, Mehdi; Abdou, Abdessamad; Atmani, Noureddine; Hatim, Abdedaïm; Amahzoune, Brahim; Bekkali, Youssef El; Boulahya, Abdelatif

    2016-01-01

    Subaortic diaphragm is characterized by a certain clinical latency and low morbi-mortality. Surgery remains the treatment of choice despite the real risk of long-term recurrence. Our study involved 18 patients with subaortic diaphragm operated between April 1994 and March 2011. The average age was 18.1 ± 9.7 years, 11 patients were male. The diaphragm was fibrous in 13 patients and fibromuscular in 5 patients. All patients underwent diaphragm resection associated with myectomy, aortic plasty, closure of ventricular septal defect and permeable ductus arteriosus ligation in 3, 3, 2 and 2 patients respectively. Operative mortality was zero and there were no cases of postoperative conduction disorder. With a median follow-up of 44.3±36.8 months, there was no late death. Two patients had a diaphragm recurrence which required reoperation with good evolution. The current trend in diaphragm surgery is towards early interventions and more extensive resections. However, the risk of recurrence requires a systematic and close ultrasound monitoring. PMID:27516830

  14. Surgery, sterilization and sterility.

    PubMed

    Green, V W

    1993-03-01

    The history of sterilization was not linked from the first with surgery. Surgery came first, fully 600 years before the principles of asepsis and anesthesia were even introduced in the middle of the 1800s. Also in the 1800s, the beginnings of thermal sterilization were being developed in the food industry. The basic principles of antisepsis and prevention of wound suppuration, including the destruction of germs on instruments, dressings, the hands of the surgeon and his assistants, and everything else in contact with the wound were clearly elucidated by Lister in the 1870s and remain the inviolate principles of surgical asepsis today. In general, the marriage between the surgeons and the sterilizers was a successful one; the major handicap to eternal bliss and harmony, however, was an incompatibility between the partners. As in many marriages, the partners made unwarranted demands upon each other, and became frustrated when these demands were unfulfilled. The field of surgical sterilization and surgical safety is less confused by technical inconsistencies than it is by semantic nightmares, such that we will never reach a universal definition of sterility. However, we do not really need a universal definition of sterility. Rather we should learn how to translate sterility tests in terms of the real world infections hazards.

  15. Adolescent bariatric surgery.

    PubMed

    Hsia, Daniel S; Fallon, Sara C; Brandt, Mary L

    2012-08-01

    Pediatric obesity has increased from a relatively uncommon problem to one of the most important public health problems facing children today. Typical "adult" diseases, such as type 2 diabetes mellitus, hypertension, and dyslipidemia, have become increasingly prevalent in the pediatric population. The earlier presentation of these comorbidities will have a significant impact for the future because this population of children will require more medical resources at an earlier age and will have a significantly decreased life expectancy. The significant morbidity of obesity in the pediatric population has led to consideration of more aggressive treatment protocols for obesity in children, including the introduction of surgical management at an earlier age. Surgery for obesity in adolescents has particular risks and benefits that must be accounted for when considering this approach. The unique psychological and emotional needs of adolescent patients make the patient selection process and perioperative management substantially different from those of adult patients. Initial outcomes of bariatric surgery in adolescents are comparable to those seen in adults in the short term. However, the long-term effects of these procedures on the adolescent population are not known. This review discusses the epidemiology of pediatric obesity, the indications for operative therapy in adolescent patients, the common surgical procedures used for weight loss, the reported outcomes of these procedures, and the importance of multidisciplinary management for this unique patient population.

  16. Eye Surgery Light

    NASA Technical Reports Server (NTRS)

    1978-01-01

    During eye surgery, the surgeon uses an illuminating instrument called an opthalmoscope for close examination of the retina or the interior of the eye. Ordinarily, electric power for the head-mounted light is supplied through a cord from an overhead swivel arm or a floor pedestal. Within limits of cord length and swivel arm movement, the surgeon has considerable freedom of motion. But when more than one opthalmoscope is involved, tangling and interference of the power cords becomes a problem. St. Luke's Hospital, Cleveland, Ohio asked Lewis Research Center for assistance in finding a solution. Lewis responded with a battery-powered system that totally frees the surgeon of attached cords and swivels. Borrowing from space technology, Lewis used small, lightweight nickel-cadmium batteries that can deliver high intensity light for an hour and can be recharged overnight. The Opthalmoscope Powerpack consists of eight batteries in three containers affixed to a webbed belt, and a novel on-off switch equipped with a springloaded plexiglass "flapper." The belt pack is worn underneath the surgical gown and the flapper permits the doctor to activate the switch by elbow pressure. Lewis built five units and they have been in service at St. Luke's Hospital for a year. Used for routine examinations as well as for surgery, they have demonstrated excellent reliability.

  17. Eye Surgery Light

    NASA Technical Reports Server (NTRS)

    1978-01-01

    During eye surgery, the surgeon uses an illuminating instrument called an opthalmoscope for close examination of the retina or the interior of the eye. Ordinarily, electric power for the head-mounted light is supplied through a cord from an overhead swivel arm or a floor pedestal. Within limits of cord length and swivel arm movement, the surgeon has considerable freedom of motion. But when more than one opthalmoscope is involved, tangling and interference of the power cords becomes a problem. St. Luke's Hospital, Cleveland, Ohio asked Lewis Research Center for assistance in finding a solution. Lewis responded with a battery-powered system that totally frees the surgeon of attached cords and swivels. Borrowing from space technology, Lewis used small, lightweight nickel-cadmium batteries that can deliver high intensity light for an hour and can be recharged overnight. The Opthalmoscope Powerpack consists of eight batteries in three containers affixed to a webbed belt, and a novel on-off switch equipped with a spring-loaded plexiglass 'flapper.' The belt pack is worn underneath the surgical gown and the flapper permits the doctor to activate the switch by elbow pressure. Lewis built five units and they have been in service at St. Luke's Hospital for a year. Used for routine examinations as well as for surgery, they have demonstrated excellent reliability.

  18. [Ethics in aesthetic surgery].

    PubMed

    de Fontaine, S

    2013-09-01

    The use of aesthetic medicine and surgery is increasingly popular, and becomes a true phenomenon of society. Many women and men are asking for such treatments. A large proportion of the population carry the idea that this branch of medicine is a true consumer product. The acts of aesthetic medicine and surgery are not without consequences. They produce important changes in the human body, and carry risks of complications that must be taken into account. The overrated media interest of this subject produce commercial drifts that act against the general health of the patients. The invasive acts of medical aesthetics must be placed in a precise legal and ethical framework to protect the patients. A project of a new Belgian law is on the way, awaiting for publication in "Le Moniteur": this law (proposed by Senator Dominique Tilmans) clarifies the competences required for performing non-surgical aesthetic treatments and specific aesthetic invasive treatments. Other projects of law are being studied, and will concern publicity, information of the public, and rules of private clinics where aesthetic invasive acts are performed. Recent international news have shown, with the PIP breast prosthesis scandal, that surveillance of the medical aesthetic field is mandatory. To provide a better protection of patients, the legislator has decided legislate over the subject.

  19. Laparoscopic endoscopic cooperative surgery.

    PubMed

    Hiki, Naoki; Nunobe, Souya; Matsuda, Tatsuo; Hirasawa, Toshiaki; Yamamoto, Yorimasa; Yamaguchi, Toshiharu

    2015-01-01

    Laparoscopic and endoscopic cooperative surgery (LECS) is a newly developed concept for tumor dissection of the gastrointestinal tract that was first investigated for local resection of gastric gastrointestinal stromal tumors (GIST). The first reported version of LECS for GIST has been named 'classical LECS' to distinguish it from other modified LECS procedures, such as inverted LECS, a combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET), and non-exposed endoscopic wall-inversion surgery (NEWS). These modified LECS procedures were developed for dissection of malignant tumors which may seed tumor cells into the abdominal cavity. While these LECS-related procedures might prevent tumor seeding, their application is limited by several factors, such as tumor size, location and technical difficulty. Currently, classical LECS is a safe and useful procedure for gastric submucosal tumors without mucosal defects, independent of tumor location, such as proximity to the esophagogastric junction or pyloric ring. For future applications of LECS-related procedures for other malignant diseases with mucosal lesions such as GIST with mucosal defects and gastric cancer, some improvements in the techniques are needed.

  20. Future of robotic surgery.

    PubMed

    Lendvay, Thomas Sean; Hannaford, Blake; Satava, Richard M

    2013-01-01

    In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade. Adoption of these new systems will be dependent on overcoming barriers to true telesurgery that range from legal to logistical. As additional surgical disciplines embrace robotics and open surgery continues to be replaced by robotic approaches, it will be imperative that adequate education and training keep pace with technology. Methods to enhance surgical performance in robotics through the use of simulation and telementoring promise to accelerate learning curves and perhaps even improve surgical readiness through brief virtual-reality warm-ups and presurgical rehearsal. All these advances will need to be carefully and rigorously validated through not only patient outcomes, but also cost efficiency.

  1. Leadership in cardiac surgery.

    PubMed

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance.

  2. Gender and cardiac surgery.

    PubMed

    Koch, Colleen Gorman; Nussmeier, Nancy A

    2003-09-01

    The increased operative mortality and morbidity of women compared with men undergoing CABG surgery results from multiple differences in presentation, preoperative risk profile, and surgical factors. Investigators have found consistently that women present with a different preoperative risk profile than do men. Women more commonly have factors associated with increased short- and long-term mortality, such as less frequent use of IMA grafts. Differences in study design and patient population may contribute to variability in short- and long-term mortality among the various studies. The lack of representation of women in older clinical trials has hindered our understanding of the management of CAD in women; this situation must be remedied in future studies, [95]. Known physiologic and anatomic differences must be evaluated for their effects on outcomes. Further studies are needed to evaluate gender-related differences in autonomic responses to acute coronary occlusion, complications related to cardiopulmonary bypass, susceptibility to abnormalities in coagulation, and other factors that might account for discrepant outcomes in men versus women undergoing CABG [96]. Beyond these factors, specific pharmacologic and therapeutic considerations, such as the role of estrogen replacement therapy, need to be clarified. As further knowledge accumulates, it is hoped that gender-specific risk factors can be mitigated and protective factors exploited, thereby improving the outcomes for all cardiac surgery patients.

  3. Prospective study on laser-assisted laparascopic partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Hennig, Georg; Zilinberg, Katja; Khoder, Wael Y.

    2012-02-01

    Introduction: Developments in laparoscopic partial nephrectomy (LPN) opened a demand for surgical tools compatible with laparoscopic manipulations to make laser assisted technique safe, feasible and reproducible. Warm ischemia and bleeding during laparoscopic partial nephrectomy place technical constraints on surgeons. Therefore it was the aim to develop a safe and effective laser assisted partial nephrectomy technique without need for ischemia. Patients and methods: A diode laser emitting light at 1318nm in cw mode was coupled into a bare fibre (core diameter 600 μm) thus able to transfer up to 100W to the tissue. After dry lab experience, a total of 10 patients suffering from kidney malformations underwent laparoscopic/retroperitoneoscopic partial nephrectomy. Clinically, postoperative renal function and serum c-reactive protein (CRP) were monitored. Laser induced coagulation depth and effects on resection margins were evaluated. Demographic, clinical and follow-up data are presented. Using a commercial available fibre guidance instrument for lanringeal intervention, the demands on an innovative laser fibre guidance instrument for the laser assisted laparoscopic partial nephrectomy (LLPN) are summarized. Results: Overall, all laparascopic intervention were succesfull and could be performed without conversion to open surgery. Mean operative time and mean blood loss were comparable to conventional open and laparascopic approaches. Laser assisted resection of the kidney tissue took max 15min. After extirpation of the tumours all patients showed clinical favourable outcome during follow up period. Tumour sizes were measured to be up 5cm in diameter. The depth of the coagulation on the removed tissue ranged between <1 to 2mm without effect on histopathological evaluation of tumours or resection margin. As the surface of the remaining kidney surface was laser assisted coagulated after removal. The sealing of the surface was induced by a slightly larger coagulation

  4. Bariatric metabolic surgery.

    PubMed

    Scopinaro, N

    2014-08-01

    According to the WHO, the worldwide prevalence of obesity body mass index (BMI) 30 kg/m² nearly doubled between 1980 and 2008, with 10% of men and 14% of women and a total of more than half a billion adults (aged >20 years old) being classed as obese. At least 2.8 million people die each year worldwide as a result of being overweight or obese, usually from the inevitable related comorbidities. It has been reported that approximately 65% of the worlds population inhabits countries where overweight and obesity are responsible for higher mortality than underweight. The recently published Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery note that despite the WHO stating that excess weight is considered the fifth leading risk for deaths worldwide, it has not yet been possible to successfully curb the obesity epidemic. Moreover, severe obesity (BMI>35 kg/m²) represents a rapidly growing segment of the epidemic in which the negative effects on health and disability are especially marked. Excess weight drastically elevates a persons risk of developing a number of non-communicable diseases, such as diabetes, hypertension, stroke, dyslipidaemia, sleep apnoea, cancer, non-alcoholic steatohepatitis, and other serious comorbidities. The WHO emphasises that 44% of type 2 diabetes mellitus, 23% of ischaemic heart disease and around 741% of certain cancers are attributable to overweight and obesity. In the majority of European countries, overweight and obesity are responsible for about 80% of cases of type 2 diabetes, 35% of cases of ischaemic heart disease and 55% of cases of hypertensive disease among adults. Additionally, a range of debilitating conditions such as osteoarthritis, respiratory difficulties, gallbladder disease, infertility, and psychosocial problems, among others, which lead to reduced life expectancy, quality of life and disability, are extremely costly in terms of both absence from work and use of health resources. Noteworthy, the

  5. Laparoscopic surgery in urology: current applications.

    PubMed

    Gill, I S; Kerbl, K; Clayman, R V

    1993-06-01

    Urologic applications of laparoscopy have increased exponentially in the past few years, and newer techniques continue to be described. This article considers the latest advances in the field and attempts to place laparoscopy in proper perspective in urologic therapy. From modest diagnostic maneuvers, urologic laparoscopy has progressed to ablation of large solid organs and complex reconstructive procedures. Reproducible clinical success has been achieved in localization of undescended testicles, varicocelectomy, dissection of pelvic lymph nodes, drainage of lymphoceles, and nephrectomy. Clinical reports on use of this technique for orchiectomy, ureterolysis, nephropexy, partial nephrectomy, nephroureterectomy, bladder diverticulectomy, dissection of retroperitoneal lymph nodes, and ileal conduit urinary diversion have been published. Exciting and rapid development of more advanced techniques is under way in the laboratory. Even at this early stage, when urologic applications of minimally invasive surgery are still being defined, it is likely that laparoscopy will have a lasting impact on the practice of urology.

  6. Long-term results of complete and partial ligation of congenital portosystemic shunts in dogs.

    PubMed

    Hottinger, H A; Walshaw, R; Hauptman, J G

    1995-01-01

    The medical records of 65 dogs that underwent complete or partial ligation of a single congenital portosystemic shunt (CPSS) were reviewed to determine the long-term clinical clinical results. Information retrieved from the records included age at surgery, preligation (baseline) portal pressure, postligation portal pressure, change in portal pressure from baseline, complete or partial occlusion of the shunting vessel and fasting, and 2-hour postprandial bile acids from the preoperative, early postoperative (PO), and greater than 1 year PO time periods. A clinical rating score derived from a follow-up examination greater than 1 year PO was assigned to each dog. Of the 56 dogs that survived the perioperative period, 29 (52%) had complete and 27 (48%) had partial ligations. Age at surgery, pre- and postligation portal pressure, change in portal pressure from baseline and serum bile acid concentrations were not related to long-term clinical outcome. Clinical rating scores were significantly greater for dogs with partial CPSS ligations compared with dogs with complete ligations, indicating a less favorable clinical outcome for partial ligations. Fasting and 2-hour postprandial bile acid values at both PO time intervals were significantly greater in partial versus complete ligation groups. Follow-up information for more than 1 year was available on 18 of 29 dogs (62%) with complete ligations. All were clinically normal. Of 27 dogs with partial ligations, 11 dogs (41%) developed recurrence of clinical signs resulting in presentation to the university or referring veterinarian for additional surgery, medical management, or euthanasia. Only three dogs with partial CPSS ligation (11%) were clinically normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7571385

  7. Reasonable partiality in professional relationships.

    PubMed

    Almond, Brenda

    2005-04-01

    First, two aspects of the partiality issue are identified: (1) Is it right/reasonable for professionals to favour their clients' interests over either those of other individuals or those of society in general? (2) Are special non-universalisable obligations attached to certain professional roles? Second, some comments are made on the notions of partiality and reasonableness. On partiality, the assumption that only two positions are possible--a detached universalism or a partialist egoism--is challenged and it is suggested that partiality, e.g. to family members, lies between these two positions, being neither a form of egoism, nor of impersonal detachment. On reasonableness, it is pointed out that 'reasonable' is an ambiguous concept, eliding the notions of the 'morally right' and the 'rational.' Third, a series of practical examples are taken from counselling, medicine, law, education and religious practice and some common principles are abstracted from the cases and discussed. These include truth-telling, confidentiality, conflicts of interest between clients and particular others and between clients and society. It is concluded that while partiality can be justified as a useful tool in standard cases, particular circumstances can affect the final verdict.

  8. Additional Surgery after Breast-Conserving Surgery Varies Widely

    Cancer.gov

    A study published in the Feb. 1, 2012, issue of JAMA found that the number of women who have one or more additional surgeries to remove suspected residual tumor tissue (re-excisions) following breast-conserving surgery (BCS) for breast cancer varies widely across surgeons and hospitals.

  9. Crystalloid-based cardioplegia for minimally invasive cardiac surgery.

    PubMed

    Misfeld, Martin; Davierwala, Piroze

    2012-01-01

    With the ever-increasing popularity of minimally invasive (MI) cardiac surgery, procedures like aortic valve replacement, with or without concomitant aortic surgery, and mitral and tricuspid valve procedures are now routinely performed through a minimal-access partial upper sternotomy and right anterolateral small thoracotomy, respectively, in our institution. To have optimal visualization through a small incision, it is extremely important to reduce the number of instruments, retractors, and cannulae passing through the incision to a bare minimum and to avoid repeated manipulation of the operative field. Repeated use of blood cardioplegia to maintain myocardial protection can sometimes prevent the surgeon from executing the aforementioned measures. However, if adequate myocardial protection can be achieved and maintained by administering a single dose of crystalloid cardioplegia, it would help expedite the operation with greater ease. At our institution, myocardial protection during aortic valve surgery is achieved using either blood or crystalloid cardioplegia according to surgeon preference. However, crystalloid cardioplegia has become the standard myocardial protection strategy for performing MI mitral valve surgery. Our experience with crystalloid cardioplegia for MI mitral valve surgery is the focus of this article.

  10. Oncoplastic breast surgery for centrally located breast cancer: a case series

    PubMed Central

    Yoshinaka, Heiji; Shinden, Yoshiaki; Hirata, Munetsugu; Nakajo, Akihiro; Arima, Hideo; Okumura, Hiroshi; Kurahara, Hiroshi; Ishigami, Sumiya; Natsugoe, Shoji

    2014-01-01

    Oncoplastic breast surgery (OBS), which combines the concepts of oncologic and plastic surgery, is becoming more common worldwide. We herein report the results of OBS in Japanese patients with centrally located breast cancer (CLBC) and Paget’s disease. We performed OBS combining partial mastectomy and immediate volume replacement on patients with non-ptotic and/or small breasts, and volume reduction surgery for patients with ptotic breasts, as reported in Western countries. Japanese encounters are described in this report as a case series. PMID:25083497

  11. Landsliding in partially saturated materials

    NASA Astrophysics Data System (ADS)

    Godt, Jonathan W.; Baum, Rex L.; Lu, Ning

    2009-01-01

    Rainfall-induced landslides are pervasive in hillslope environments around the world and among the most costly and deadly natural hazards. However, capturing their occurrence with scientific instrumentation in a natural setting is extremely rare. The prevailing thinking on landslide initiation, particularly for those landslides that occur under intense precipitation, is that the failure surface is saturated and has positive pore-water pressures acting on it. Most analytic methods used for landslide hazard assessment are based on the above perception and assume that the failure surface is located beneath a water table. By monitoring the pore water and soil suction response to rainfall, we observed shallow landslide occurrence under partially saturated conditions for the first time in a natural setting. We show that the partially saturated shallow landslide at this site is predictable using measured soil suction and water content and a novel unified effective stress concept for partially saturated earth materials.

  12. Landsliding in partially saturated materials

    USGS Publications Warehouse

    Godt, J.W.; Baum, R.L.; Lu, N.

    2009-01-01

    [1] Rainfall-induced landslides are pervasive in hillslope environments around the world and among the most costly and deadly natural hazards. However, capturing their occurrence with scientific instrumentation in a natural setting is extremely rare. The prevailing thinking on landslide initiation, particularly for those landslides that occur under intense precipitation, is that the failure surface is saturated and has positive pore-water pressures acting on it. Most analytic methods used for landslide hazard assessment are based on the above perception and assume that the failure surface is located beneath a water table. By monitoring the pore water and soil suction response to rainfall, we observed shallow landslide occurrence under partially saturated conditions for the first time in a natural setting. We show that the partially saturated shallow landslide at this site is predictable using measured soil suction and water content and a novel unified effective stress concept for partially saturated earth materials. Copyright 2009 by the American Geophysical Union.

  13. Synchronization and Partial Synchronization Experiments with Networks of Time-Delay Coupled Hindmarsh-Rose Neurons

    NASA Astrophysics Data System (ADS)

    Steur, Erik; Murguia, Carlos; Fey, Rob H. B.; Nijmeijer, Henk

    2016-06-01

    We study experimentally synchronization and partial synchronization in networks of Hindmarsh-Rose model neurons that interact through linear time-delay couplings. Our experimental setup consists of electric circuit board realizations of the Hindmarsh-Rose model neuron and a coupling interface in which the interaction between the circuits is defined. With this experimental setup we test the predictive value of theoretical results about synchronization and partial synchronization in networks.

  14. Olfactory Function and Quality of Life Following Microscopic Endonasal Transsphenoidal Pituitary Surgery

    PubMed Central

    Wang, Shousen; Chen, Yehuang; Li, Jianzhong; Wei, Liangfeng; Wang, Rumi

    2015-01-01

    Abstract Olfactory outcomes as well as oronasal postoperative complications of transsphenoidal pituitary surgery have not been well studied. The objective of this study was to investigate nasal symptoms including olfactory function as well as quality of life following transsphenoidal pituitary surgery. The study is designed as a prospective cohort study set in a single tertiary hospital. A total of 53 patients with pituitary adenomas were included. All patients underwent pituitary surgery with the right-sided endonasal transsphenoidal approach. Outcomes were assessed with the Chinese version of the Medical Outcomes Study Short Form-36 (SF-36) to survey patient health, the Chinese version of the 22-item Sinonasal Outcome Test (SNOT-22), and a Toyota and Takagi (T&T) olfactometer. Assessments were carried out before surgery and at 1 week, and 1 and 4 months after surgery. The overall SF-36 scores were significantly lower, but the SNOT-22 scores were higher at 1 week and 1 month postoperatively compared with baseline (all P < 0.001). The results of T&T olfactometer testing showed that there was a significant decline in the ability to detect odors postoperatively, even at 4 months. Multivariate linear regression analysis showed that lower education level, partial tumor removal, and longer duration of surgery were independent risk factors for a higher SNOT-22 score at 1 week after surgery. The findings show that microscopic endonasal transsphenoidal pituitary surgery impairs olfactory function in most patients for at least 4 months after surgery. PMID:25634190

  15. Pre-Operative History of Depression and Cognitive Changes in Bariatric Surgery Patients

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Strain, Gladys; Devlin, Michael; Cohen, Ronald; Crosby, Ross D.; Mitchell, James E.; Gunstad, John

    2016-01-01

    Obesity associated cognitive impairments may be partially reversible through bariatric surgery. Depression, a prevalent comorbidity in bariatric surgery candidates, is linked with cognitive impairment and poorer surgical outcomes in other populations. No study has examined the effects of pre-operative depression on cognitive changes in bariatric surgery patients. 67 bariatric surgery patients completed a computerized cognitive test battery prior to surgery and 12-months post-operatively. The Structured Clinical Interview for the DSM-IV Axis I disorders assessed Major Depressive Disorder (MDD). Pre-surgery history of MDD was found in 47.8% of patients, but was not associated with greater baseline cognitive impairments. Repeated measures revealed improved cognitive abilities 12-months after surgery. Pre-surgery history of MDD did not influence post-operative cognitive function. Pre-operative history of MDD did not limit post-operative cognitive improvements. Larger studies with extended follow-ups are needed to clarify our findings and identify factors (e.g., older age) that may modify cognitive changes following surgery. PMID:25222138

  16. Managing Drawbacks in Unconventional Successful Glaucoma Surgery: A Case Report of Stent Exposure

    PubMed Central

    Fea, Antonio; Cannizzo, Paola Maria Loredana; Consolandi, Giulia; Lavia, Carlo Alessandro; Pignata, Giulia; Grignolo, Federico M.

    2015-01-01

    Traditional options in managing failed trabeculectomy (bleb needling, revision, additional incisional surgery and tube surgery) have a relatively high failure and complication rate. The use of microinvasive glaucoma surgery (MIGS) has generally been reserved to mild to moderate glaucoma cases, proving good safety profiles but significant limitations in terms of efficacy. We describe a patient who underwent MIGS (XEN Aquesys subconjunctival shunt implantation) after a prior failed trabeculectomy. After the surgery, the IOP was well controlled but as the stent was close to an area of scarred conjunctiva of the previous trabeculectomy, it became partially exposed. As a complete success was achieved, we decided to remove the conjunctiva over the exposed area and replace it by an amniotic membrane transplantation and a conjunctiva autograft. Six months after surgery, the unmedicated IOP is still well controlled with complete visual acuity recovery. PMID:26294994

  17. Managing Drawbacks in Unconventional Successful Glaucoma Surgery: A Case Report of Stent Exposure.

    PubMed

    Fea, Antonio; Cannizzo, Paola Maria Loredana; Consolandi, Giulia; Lavia, Carlo Alessandro; Pignata, Giulia; Grignolo, Federico M

    2015-01-01

    Traditional options in managing failed trabeculectomy (bleb needling, revision, additional incisional surgery and tube surgery) have a relatively high failure and complication rate. The use of microinvasive glaucoma surgery (MIGS) has generally been reserved to mild to moderate glaucoma cases, proving good safety profiles but significant limitations in terms of efficacy. We describe a patient who underwent MIGS (XEN Aquesys subconjunctival shunt implantation) after a prior failed trabeculectomy. After the surgery, the IOP was well controlled but as the stent was close to an area of scarred conjunctiva of the previous trabeculectomy, it became partially exposed. As a complete success was achieved, we decided to remove the conjunctiva over the exposed area and replace it by an amniotic membrane transplantation and a conjunctiva autograft. Six months after surgery, the unmedicated IOP is still well controlled with complete visual acuity recovery.

  18. SFE/SFHTA/AFCE consensus on primary aldosteronism, part 6: Adrenal surgery.

    PubMed

    Steichen, Olivier; Amar, Laurence; Chaffanjon, Philippe; Kraimps, Jean-Louis; Ménégaux, Fabrice; Zinzindohoue, Franck

    2016-07-01

    Treatment of primary aldosteronism (PA) aims at preventing or correcting hypertension, hypokalemia and target organ damage. Patients with lateralized PA and candidates for surgery may be managed by laparoscopic adrenalectomy. Partial adrenalectomy and non-surgical ablation have no proven advantage over total adrenalectomy. Intraoperative morbidity and mortality are low in reference centers, and day-surgery is warranted in selected cases. Spironolactone administered during the weeks preceding surgery controls hypertension and hypokalemia and may prevent postoperative hypoaldosteronism. In most cases, surgery corrects hypokalemia, improves control of hypertension and reduces the burden of pharmacologic treatment; in about 40% of cases, it resolves hypertension. However, success in controlling hypertension and reversing target organ damage is comparable with mineralocorticoid receptor antagonists. Informed patient preference with regard to surgery is thus an important factor in therapeutic decision-making. PMID:27297451

  19. Surgery of ovarian tumors in children.

    PubMed

    Sarnacki, Sabine; Brisse, Hervé

    2011-01-01

    Surgery of ovarian tumors in children requires a good knowledge of these lesions. Complete resection is mandatory for malignant lesions, and in the case of benign tumors preservation of healthy ovarian tissue is crucial. Diagnosis is based on clinical features (age and hormonal status), imaging and tumor marker levels. Laparoscopy is of great help in making a diagnosis and staging when the lesion is malignant. Laparotomy by a supra-pubic approach is, however, the only way to ensure a safe treatment of the lesion by avoiding any risk of tumor spillage, which constitutes a chance loss. Surgical treatment consists of complete ovariectomy for a malignant tumor and partial ovariectomy when the lesion is surely benign. Preservation of fertility is based on conservative surgery for uni- or bilateral benign lesions, and may be discussed in some selected cases of bilateral malignant tumors. When the remaining ovarian tissue predicts precocious ovarian failure, ovarian tissue or oocyte cryopreservation may be proposed to patients and their families.

  20. Methods of positioning fish for surgery or other procedures out of water.

    PubMed

    Brattelid, T; Smith, A J

    2000-10-01

    Several methods are available for positioning fish and other aquatic species during surgery or other experimental procedures out of water. This paper reviews current methods in the light of criteria for humane handling, and suggests the implementation of a novel method, currently used for positioning mammals during surgery, that gives optimal support and a minimum of damage.

  1. Recent advances in metabolic and bariatric surgery

    PubMed Central

    Albaugh, Vance L.; Flynn, C. Robb; Tamboli, Robyn A.; Abumrad, Naji N.

    2016-01-01

    Obesity and its associated medical conditions continue to increase and add significant burden to patients, as well as health-care systems, worldwide. Bariatric surgery is the most effective treatment for severe obesity and its comorbidities, and resolution of diabetes is weight loss-independent in the case of some operations. Although these weight-independent effects are frequently described clinically, the mechanisms behind them are not well understood and remain an intense area of focus in the growing field of metabolic and bariatric surgery. Perceptions of the mechanisms responsible for the beneficial metabolic effects of metabolic/bariatric operations have shifted from being mostly restrictive and malabsorption over the last 10 to 15 years to being more neuro-hormonal in origin. In this review, we describe recent basic and clinical findings of the major clinical procedures (adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion) as well as other experimental procedures (ileal interposition and bile diversion) that recapitulate many of the metabolic effects of these complex operations in a simpler fashion. As the role of bile acids and the gut microbiome on metabolism is becoming increasingly well described, their potential roles in these improvements following metabolic surgery are becoming better appreciated. Bile acid and gut microbiome changes, in light of recent developments, are discussed in the context of these surgical procedures, as well as their implications for future study. PMID:27239296

  2. Partial pressure analysis of plasmas

    SciTech Connect

    Dylla, H.F.

    1984-11-01

    The application of partial pressure analysis for plasma diagnostic measurements is reviewed. A comparison is made between the techniques of plasma flux analysis and partial pressure analysis for mass spectrometry of plasmas. Emphasis is given to the application of quadrupole mass spectrometers (QMS). The interface problems associated with the coupling of a QMS to a plasma device are discussed including: differential-pumping requirements, electromagnetic interferences from the plasma environment, the detection of surface-active species, ion source interactions, and calibration procedures. Example measurements are presented from process monitoring of glow discharge plasmas which are useful for cleaning and conditioning vacuum vessels.

  3. Full and partial gauge fixing

    SciTech Connect

    Shirzad, A.

    2007-08-15

    Gauge fixing may be done in different ways. We show that using the chain structure to describe a constrained system enables us to use either a full gauge, in which all gauged degrees of freedom are determined, or a partial gauge, in which some first class constraints remain as subsidiary conditions to be imposed on the solutions of the equations of motion. We also show that the number of constants of motion depends on the level in a constraint chain in which the gauge fixing condition is imposed. The relativistic point particle, electromagnetism, and the Polyakov string are discussed as examples and full or partial gauges are distinguished.

  4. Liquid spreading under partial wetting conditions

    NASA Astrophysics Data System (ADS)

    Chen, M.; Pahlavan, A. A.; Cueto-Felgueroso, L.; McKinley, G. H.; Juanes, R.

    2013-12-01

    Traditional mathematical descriptions of multiphase flow in porous media rely on a multiphase extension of Darcy's law, and lead to nonlinear second-order (advection-diffusion) partial differential equations for fluid saturations. Here, we study horizontal redistribution of immiscible fluids. The traditional Darcy-flow model predicts that the spreading of a finite amount of liquid in a horizontal porous medium never stops; a prediction that is not substantiated by observation. To help guide the development of new models of multiphase flow in porous media [1], we draw an analogy with the flow of thin films. The flow of thin films over flat surfaces has been the subject of much theoretical, experimental and computational research [2]. Under the lubrication approximation, the classical mathematical model for these flows takes the form of a nonlinear fourth-order PDE, where the fourth-order term models the effect of surface tension [3]. This classical model, however, effectively assumes that the film is perfectly wetting to the substrate and, therefore, does not capture the partial wetting regime. Partial wetting is responsible for stopping the spread of a liquid puddle. Here, we present experiments of (large-volume) liquid spreading over a flat horizontal substrate in the partial wetting regime, and characterize the four spreading regimes that we observe. We extend our previous theoretical work of two-phase flow in a capillary tube [4], and develop a macroscopic phase-field modeling of thin-film flows with partial wetting. Our model naturally accounts for the dynamic contact angle at the contact line, and therefore permits modeling thin-film flows without invoking a precursor film, leading to compactly-supported solutions that reproduce the spreading dynamics and the static equilibrium configuration observed in the experiments. We anticipate that this modeling approach will provide a natural mathematical framework to describe spreading and redistribution of immiscible

  5. [Quality assessment in surgery].

    PubMed

    Espinoza G, Ricardo; Espinoza G, Juan Pablo

    2016-06-01

    This paper deals with quality from the perspective of structure, processes and indicators in surgery. In this specialty, there is a close relationship between effectiveness and quality. We review the definition and classification of surgical complications as an objective means of assessing quality. The great diversity of definitions and risk assessments of surgical complications hampered the comparisons of different surgical centers or the evaluation of a single center along time. We discuss the different factors associated with surgical risk and some of the predictive systems for complications and mortality. At the present time, standarized definitions and comparisons are carried out correcting for risk factors. Thus, indicators of mortality, complications, hospitalization length, postoperative quality of life and costs become comparable between different groups. The volume of procedures of a determinate center or surgeon as a quality indicator is emphasized. PMID:27598495

  6. Surgery for gliomas.

    PubMed

    Tate, Matthew C

    2015-01-01

    Surgical resection, with the goal of maximal tumor removal, is now standard of care for the overwhelming majority of newly diagnosed gliomas. In order to achieve this goal while minimizing the risk of postoperative neurologic deficits, intraoperative brain mapping remains the gold standard. Recent advances in technical aspects of preoperative and intraoperative brain mapping, as well as our understanding of the functional anatomy of the human brain with respect to language, movement, sensation, and cognition, particularly at the subcortical level, have improved our ability to safely perform aggressive resective surgeries in eloquent areas. In this chapter, the functional anatomy of the human brain relevant to intrinsic tumor resection is reviewed. In addition, general principles governing surgical management of patients are highlighted, with a particular emphasis on awake brain mapping.

  7. Branding of vascular surgery.

    PubMed

    Perler, Bruce A

    2008-03-01

    The Society for Vascular Surgery surveyed primary care physicians (PCPs) to understand how PCPs make referral decisions for their patients with peripheral vascular disease. Responses were received from 250 PCPs in 44 states. More than 80% of the respondents characterized their experiences with vascular surgeons as positive or very positive. PCPs perceive that vascular surgeons perform "invasive" procedures and refer patients with the most severe vascular disease to vascular surgeons but were more than twice as likely to refer patients to cardiologists, believing they are better able to perform minimally invasive procedures. Nevertheless, PCPs are receptive to the notion of increasing referrals to vascular surgeons. A successful branding campaign will require considerable education of referring physicians about the totality of traditional vascular and endovascular care increasingly provided by the contemporary vascular surgical practice and will be most effective at the local grassroots level.

  8. What is surgery?

    PubMed

    Krummel, Thomas M

    2006-11-01

    Progress in surgical science has been characterized by a continuous cycle of innovation from bedside to bench to bedside. Beginning 30,000 years ago with the first bone needles to surgical lasers and robotics of today, each quantum leap has resulted from the convergence of technical advances and creative surgeons, but always defined by an attitude of care toward the sick. One of the most innovative pediatric surgeons, Dr. Mark Ravitch, elucidated some simple yet profound principles in the precise answer to the question "What is Surgery?" This section outlines some simple concepts summarized as "Ravitch's Rules," which provide a useful framework for clarity in understanding the past and illuminating the road ahead. Surgeons must be thoughtful in how they define themselves and their craft, ignoring technological advances at their own peril. PMID:17055953

  9. Astigmatism following cataract surgery.

    PubMed

    Reading, V M

    1984-02-01

    The changes in corneal curvature were determined at regular intervals over a one-year period following intracapsular cataract extraction by microsurgical techniques. During the first postoperative month photokeratometric measurements showed rapid changes in astigmatism associated with large changes in the direction of the axis. Thereafter astigmatism against-the-rule predominated. Data from the small group of patients who underwent surgery in which the technique of phacoemulsification was used show that the smaller changes in corneal curvature are attributable to the smaller incision size and reduced number of sutures. With patients who underwent intracapsular extraction a comparison has been made between the effects of large and small section sizes, and a procedure is outlined whereby surgically induced astigmatism may be minimised.

  10. Impact of Radioimmunoguided Surgery.

    PubMed

    La Valle, G J; Chevinsky, A; Martin, E W

    1991-01-01

    Radioimmunoguided surgery (RIGS) is a technique employed to locate tumor deposits with the aid of intravenously injected, tumor-specific, radiolabeled monoclonal antibodies and a small gamma detecting device. The gamma detecting probe (GDP) is a small, portable unit which has the capacity to be used intraoperatively to survey the entire peritoneal surface for increased radioactivity indicative of targeted tumor tissue during abdominal exploration for colorectal cancer. Trials in humans have demonstrated the ability of this system to locate clinically nonpalpable tumor deposits in patients undergoing carcinoembryonic antigen second-look laparotomies. This feature may be of value in improving the definition of tumor location and extent as well as allowing a more thorough resection of tumor-bearing tissue to be performed and hopefully improving overall patient survival.

  11. Apparatus for generating partially coherent radiation

    DOEpatents

    Naulleau, Patrick P.

    2005-02-22

    Techniques for generating partially coherent radiation and particularly for converting effectively coherent radiation from a synchrotron to partially coherent EUV radiation suitable for projection lithography.

  12. A History of Shoulder Surgery

    PubMed Central

    Iqbal, S; Jacobs, U; Akhtar, A; Macfarlane, R.J; Waseem, M

    2013-01-01

    Shoulder surgery has emerged from being a marginalised sub-speciality to being an area of much research and advancement within the last seventy years. This has been despite the complexity of the joint, and success majorly rests on parallel development of biomedical technology. This article looks at the past and present of shoulder surgery and discusses future directions in the speciality. PMID:24082968

  13. Telemedicine, virtual reality, and surgery

    NASA Technical Reports Server (NTRS)

    Mccormack, Percival D.; Charles, Steve

    1994-01-01

    Two types of synthetic experience are covered: virtual reality (VR) and surgery, and telemedicine. The topics are presented in viewgraph form and include the following: geometric models; physiological sensors; surgical applications; virtual cadaver; VR surgical simulation; telesurgery; VR Surgical Trainer; abdominal surgery pilot study; advanced abdominal simulator; examples of telemedicine; and telemedicine spacebridge.

  14. What Is Coronary Bypass Surgery?

    MedlinePlus

    ... surgery, you go to an intensive care unit (ICU) for a few days. Your family can visit you briefly in ICU. What about after surgery? You’ll wake up in ICU and may feel confused at first. It’s busy ...

  15. Body dysmorphia and plastic surgery.

    PubMed

    Kyle, Allison

    2012-01-01

    Body dysmorphic disorder is a mental disorder characterized by a preoccupation with some aspect of one's appearance. In cosmetic surgery, this preoccupation can be overlooked by practitioners resulting in a discrepancy between expected and realistic outcome. Identifying the characteristics of this disorder may be crucial to the practitioner-patient relationship in the plastic surgery setting. PMID:22929194

  16. [Andreas Vesalius and surgery].

    PubMed

    Van Hee, R

    1993-01-01

    By publishing De Humani Corporis Fabrica Libri Septem in 1543, Andries van Wesel (1514-1564) gave surgical science an immense impulse. The revolutionary renovation in the knowledge of man's anatomical structure changed slowly and progressively into topographical and physiological understanding of surgical diseases. At the same time, this made better aimed and more secure operations possible. Apart from the importance of this anatomical publication, Andreas Vesalius also won his spurs as a surgeon. He taught surgery in Padua for many years. He was appointed court physician and surgeon at the Habsburg Court of Charles V and Philip II. He personally performed lots of operations known at the time as major ones. He not only quickly adopted the surgical innovations of his fellow-surgeon Ambroise Paré, but he even performed operations that had been forgotten during several centuries, among which thoracocentesis for pleural empyema. His clinical perspicacity in discovering the indication for some operations was staggering and was appreciated by all great monarchs of Europe in the 16th century. In his several consilia, numerous pieces of advice were given for the treatment of surgical patients. The surgical practice which Vesalius had in Brussels for many years, consequently became most successful. Many publications by Vesalius about surgery and blood-letting are well-known. His Chirurgia magna in septem Libros digesta still remains controversial; these books were published by Prospero Borgarruccio (1560) in 1568 by the Venetian editor Valgrisi. This book gives an excellent survey of surgical pathology as it was taught and treated in the 16th century. The scientific method that Vesalius used, not only in his anatomical studies but also in his surgical practice, deserves not only our full appraisal but should still be studied in our own time.

  17. [Andreas Vesalius and surgery].

    PubMed

    Van Hee, R

    1993-01-01

    By publishing De Humani Corporis Fabrica Libri Septem in 1543, Andries van Wesel (1514-1564) gave surgical science an immense impulse. The revolutionary renovation in the knowledge of man's anatomical structure changed slowly and progressively into topographical and physiological understanding of surgical diseases. At the same time, this made better aimed and more secure operations possible. Apart from the importance of this anatomical publication, Andreas Vesalius also won his spurs as a surgeon. He taught surgery in Padua for many years. He was appointed court physician and surgeon at the Habsburg Court of Charles V and Philip II. He personally performed lots of operations known at the time as major ones. He not only quickly adopted the surgical innovations of his fellow-surgeon Ambroise Paré, but he even performed operations that had been forgotten during several centuries, among which thoracocentesis for pleural empyema. His clinical perspicacity in discovering the indication for some operations was staggering and was appreciated by all great monarchs of Europe in the 16th century. In his several consilia, numerous pieces of advice were given for the treatment of surgical patients. The surgical practice which Vesalius had in Brussels for many years, consequently became most successful. Many publications by Vesalius about surgery and blood-letting are well-known. His Chirurgia magna in septem Libros digesta still remains controversial; these books were published by Prospero Borgarruccio (1560) in 1568 by the Venetian editor Valgrisi. This book gives an excellent survey of surgical pathology as it was taught and treated in the 16th century. The scientific method that Vesalius used, not only in his anatomical studies but also in his surgical practice, deserves not only our full appraisal but should still be studied in our own time. PMID:8209577

  18. Vitreous surgery in children.

    PubMed

    Aznabayev, M T; Aznabayev, R A; Kazakbayev, A G; Iskandarov, R H

    1994-01-01

    This study examines the results of research on the surgical treatment of children with various vitreous diseases. Vitrectomy was performed on 44 eyes in children, from four months to fifteen years of age, suffering from the following diseases: lensectomy complications as vitreocorneal adhesions or immersion of lens mass into the vitreous; persistent hyperplastic primary vitreous (PHPV), trauma consequences, uveitis and eyeball subatrophy. Preoperational examination included measurement of visual acuity, biomicroscopy, direct and indirect ophthalmoscopy, tonography, ultrasonography and electrophysiological examinations. Vitreotome 'ocutome' was used to perform the operations. A transcyliar approach was used in all but 14 cases, for which the operations were performed by limbal incision. Improvement of visual functions was noted in 28 eyes (63.3%), and relatively good visual function was achieved in 7 eyes (16.9%). Visual acuity remained unchanged in 6 eyes (13.6%) because of severe amblyopia, although the transparency of optic zone was restored and the fundus did become visible. IN 10 (22.7%) of the children visual acuity could not be measured because of too young an age. One day after surgery a cellular suspension in the vitreous was observed in many eyes. This however, resolved within 3 days. Intraocular pressure usually returned during the first week after surgery. Hypotonia remained for 1-2 months after subtotal vitrectomy. The transcyliar extraction of pathological vitreous in children is generally a less traumatic and more convenient means of intravitreal manipulation, but 2 cases of intraoperational hemophthalmia suggested that iridiocyclitis is a contraindication for transcyliar approach. Transcorneal extraction is a less traumatic surgical method in such cases. PMID:7835175

  19. Study of iron homeostasis following partial hepatectomy in rats with chronic aluminum intoxication.

    PubMed

    Contini, María del Carmen; Ferri, Alejandro; Bernal, Claudio A; Carnovale, Cristina E

    2007-01-01

    Effects of both chronic aluminum (Al) exposure and partial hepatectomy on iron (Fe) homeostasis were studied. Male Wistar rats were intraperitoneally administered either 27 mg Al/kg body weight (as aluminum hydroxide) or the vehicle saline, three times a week for 3 mo. After this time, half of the rats of each group was sham operated (SH) and the other half was partially hepatectomized (PH). Animals of the four experimental groups (vehicle+SH [SH]; Al+SH; vehicle+PH [PH], and Al+PH) were killed 48 h after the surgical procedure. Serum, hepatic, and intestinal Al levels were found to be increased both for Al+SH and Al+PH. The serum Fe concentration and transferrin saturation percentage were significantly diminished in the rats of the Al+PH group, thus showing interaction between Al administration and PH. The 59Fe mucosal-to-serosal transport, studied in the intestinal loop in situ, was not affected by Al or PH. The malregulation of intestinal Fe absorption in Al exposure and/or PH when the serum Fe concentration was diminished could be the result of the increased lipid peroxidation (thiobarbituric acid-reactive substances [TBARS]) observed in this tissue. Mucosal TBARS were increased by Al exposure (+26%) and PH (+37%) and interaction between Al and PH was observed (+44%). These results show that when liver surgery is performed after prolonged Al exposure, it leads to impairment of Fe homeostasis. We underline the importance of the exposure to Al, a potentially toxic element, in the study of risk assessment in patients who must be submitted to major liver resection. PMID:17406072

  20. Study of iron homeostasis following partial hepatectomy in rats with chronic aluminum intoxication.

    PubMed

    Contini, María del Carmen; Ferri, Alejandro; Bernal, Claudio A; Carnovale, Cristina E

    2007-01-01

    Effects of both chronic aluminum (Al) exposure and partial hepatectomy on iron (Fe) homeostasis were studied. Male Wistar rats were intraperitoneally administered either 27 mg Al/kg body weight (as aluminum hydroxide) or the vehicle saline, three times a week for 3 mo. After this time, half of the rats of each group was sham operated (SH) and the other half was partially hepatectomized (PH). Animals of the four experimental groups (vehicle+SH [SH]; Al+SH; vehicle+PH [PH], and Al+PH) were killed 48 h after the surgical procedure. Serum, hepatic, and intestinal Al levels were found to be increased both for Al+SH and Al+PH. The serum Fe concentration and transferrin saturation percentage were significantly diminished in the rats of the Al+PH group, thus showing interaction between Al administration and PH. The 59Fe mucosal-to-serosal transport, studied in the intestinal loop in situ, was not affected by Al or PH. The malregulation of intestinal Fe absorption in Al exposure and/or PH when the serum Fe concentration was diminished could be the result of the increased lipid peroxidation (thiobarbituric acid-reactive substances [TBARS]) observed in this tissue. Mucosal TBARS were increased by Al exposure (+26%) and PH (+37%) and interaction between Al and PH was observed (+44%). These results show that when liver surgery is performed after prolonged Al exposure, it leads to impairment of Fe homeostasis. We underline the importance of the exposure to Al, a potentially toxic element, in the study of risk assessment in patients who must be submitted to major liver resection.