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Sample records for r0 radical surgery

  1. [Immunotherapy in radical surgery of colorectal carcinoma].

    PubMed

    Brivio, Fernando; Fumagalli, Luca; Chiarelli, Marco; Denova, Marianna; Bertolini, Aimone; Cetta, Marco; Nespoli, Angelo

    2007-01-01

    analysis of variance, as appropriate. The overall survival curves were plotted with the Kaplan-Mayer method. After a median follow-up of 69 months (range: 12-169) the progression rate was 15/67 (22%) vs 68/173 (39%) in controls (p = 0.02). Important results were obtained in Dukes-B patients: progression rate 7/46 (15%) vs 37/114 (32,4%) in controls (p = 0.03). We can conclude that immunotherapy is well tolerated. IL-2 is capable of counteracting surgery-induced immunodeficiency. The amplification of the immune response in the post-operative period is capable of controlling minimal residual disease after radical surgery, of reducing the progression rate, and of improving the prognosis and overall survival.

  2. Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations

    PubMed Central

    2012-01-01

    Background Surgery is still the standard treatment for aggressive fibromatosis (AF); however, local control remains a significant problem and the impact of R0 surgery on cumulative recurrence (CR) is objective of contradictory reports. Methods This is a single-institution study of 62 consecutive patients affected by extra-abdominal and intra-abdominal AF who received macroscopically radical surgery within a time period of 15 years. Results Definitive pathology examination confirmed an R0 situation in 49 patients and an R1 in 13 patients. Five-year CR for patients who underwent R0 vs R1 surgery was 7.1% vs 46.4% (P = 0.04) and for limbs vs other localizations 33.3% vs 9.9% (P = 0.02) respectively. In 17 patients who had intraoperative frozen section (IFS) margin evaluation R0 surgery was more common (17 of 17 vs 32 of 45, P = 0.01) and CR lower (five-year CR 0% vs 19.1%, respectively, P = 0.04). However, in multivariate analysis only limb localization showed a negative impact on CR (HR: 1.708, 95% CI 1.03 to 2.84, P = 0.04). Conclusions IFS evaluation could help the surgeon to achieve R0 surgery in AF. Non-surgical treatment, including watchful follow-up, could be indicated for patients with limb AF localization, because of their high risk of recurrence even after R0 surgery. PMID:22963172

  3. [Cholangiocarcinoma in the middle third of the bile duct treated with radical surgery in Guillermo Almenara Hospital, Lima, Peru].

    PubMed

    Núñez Ju, Juan José; Anchante Castillo, Eduardo; Torres Cueva, Victor; Yeren Paredes, Cecilia; Carrasco Mascaro, Felix; Becerra, Oscar; Cordero Palomino, Ernesto; Sumire, Julia

    2015-01-01

    We report the case of a patient who had the initial diagnosis of tumor in the bile duct in the middle third. Patient presented with lost weight of 10 kilograms in two months and moderate epigastric pain, no jaundice. The patient underwent radical surgery of the bile duct with multiple freeze biopsy surgical margins, intraoperative choledochoscopy, intraoperative cholangiography and reconstruction bilioenteric anastomosis Y Roux transmesocolic, he had a great recovery and early discharge. The pathological results showed moderately differentiated tubular adenocarcinoma on the basis of an adenoma. Negatives retroperitoneal, retropancreatic, pericholedochal, lesser curvature and negative hepatic artery nodes, and extension of surgical margins free of neoplasia proximal and distal edges. R0 surgery. pT1N0Mx. Stage 1. After the optimal surgical outcomes, is managed by liver and biliary tract surgery service and medical oncology service for regular monitoring and controls. We present here the sequence of events and a review of the literature.

  4. Robot-Assisted Radical Prostatectomy After Previous Prostate Surgery

    PubMed Central

    Tugcu, Volkan; Sahin, Selcuk; Kargi, Taner; Gokhan Seker, Kamil; IlkerComez, Yusuf; IhsanTasci, Ali

    2015-01-01

    Background and Objectives: Our objective is to clarify the effect of previous transurethral resection of the prostate (TURP) or open prostatectomy (OP) on surgical, oncological, and functional outcomes after robot-assisted radical prostatectomy (RARP). Methods: Between August 1, 2009, and March 31, 2013, 380 patients underwent RARP. Of these, 25 patients had undergone surgery for primary bladder outlet obstruction (TURP, 20 patients; OP, 5 patents) (group 1). A match-paired analysis was performed to identify 36 patients without a history of prostate surgery with equivalent clinicopathologic characteristics to serve as a control group (group 2). Patients followed up for 12 months were assessed. Results: Both groups were similar with respect to preoperative characteristics, as mean age, body mass index, median prostate-specific antigen, prostate volume, clinical stage, the biopsy Gleason score, D'Amico risk, the American Society of Anesthesiologists (ASA) classification score, the International Prostate Symptom Score, continence, and potency status. RARP resulted in longer console and anastomotic time, as well as higher blood loss compared with surgery-naive patients. We noted a greater rate of urinary leakage (pelvic drainage, >4 d) in group 1 (12% vs 2,8%). The anastomotic stricture rate was significantly higher in group 1 (16% vs 2.8%). No difference was found in the pathologic stage, positive surgical margin, and nerve-sparing procedure between the groups. Biochemical recurrence was observed in 12% (group 1) and 11.1% (group 2) of patients, respectively. No significant difference was found in the continence and potency rates. Conclusions: RARP after TURP or OP is a challenging but oncologically promising procedure with a longer console and anastomosis time, as well as higher blood loss and higher anastomotic stricture rate. PMID:26648678

  5. Radical Surgery for Endometriosis: Analysis of Quality of Life and Surgical Procedure

    PubMed Central

    De la Hera-Lazaro, Cristina M.; Muñoz-González, Jose L.; Perez, Reyes Oliver; Vellido-Cotelo, Rocío; Díez-Álvarez, Alvaro; Muñoz-Hernando, Leticia; Alvarez-Conejo, Carmen; Jiménez-López, Jesús S.

    2016-01-01

    OBJECTIVE The main aim of this study is to determine the improvement in quality of life in patients who have undergone radical surgery because of severe endometriosis. PATIENTS AND METHODS This nonrandomized interventional study (quasi experimental) was carried out between January 2009 and September 2014. A total of 46 patients with diagnosis of severe endometriosis were included. Radical surgery, including hysterectomy, was performed. Acting as their own control group, the patients were asked to fill in a validated questionnaire of quality of life [Endometriosis Health Profile-5 (EHP-5)] and a visual analog scale of pain at the moment of the preoperative visit (one month prior to surgery) and six months after the surgery. RESULTS Radical surgery for endometriosis was performed in 46 patients at our center over the period of six years. Among the patients, 73.9% of them had undergone previous surgery for endometriosis. In 82.6% of cases, a complete laparoscopic resection was carried out. Gastrointestinal tract resection was performed in 21.7%, and urinary tract resection was necessary in 8.7%. The mean age of the patients was 38.6 years. The rate of complications was 30.4%. Six months after the surgery, all items of the EHP-5 questionnaire had a lower score, which means an improvement in all aspects of quality of life related to endometriosis. The difference obtained between the scores before and after the surgery was statistically significant. The mean visual analog scale score before the surgery was 8.5, whereas it decreased to 1.4 after the surgery (P < 0.001). CONCLUSION Performing a radical surgery is a difficult decision to make; however, it can provide optimal results in terms of improvement of quality of life and, therefore, should be considered when conservative therapy fails. PMID:26966396

  6. [Evaluation of the capacity of work using upper limbs after radical latero-cervical surgery].

    PubMed

    Capodaglio, P; Strada, M R; Grilli, C; Lodola, E; Panigazzi, M; Bernardo, G; Bazzini, G

    1998-01-01

    Evaluation of arm work capacity after radical neck surgery. The aim of this paper is to describe an approach for the assessment of work capacity in patients who underwent radical neck surgery, including those treated with radiation therapy. Nine male patients, who underwent radical neck surgery 2 months before being referred to our Unit, participated in the study. In addition to manual muscle strength test, we performed the following functional evaluations: 0-100 Constant scale for shoulder function; maximal shoulder strength in adduction/abduction and intrarotation/extrarotation; instrumental. We measured maximal isokinetic strength (10 repetitions) with a computerized dynamometer (Lido WorkSET) set at 100 degrees/sec. During the rehabilitation phase, the patients' mechanical parameters, the perception of effort, pain or discomfort, and the range of movement were monitored while performing daily/occupational task individually chosen on the simulator (Lido WorkSET) under isotonic conditions. On this basis, patients were encouraged to return to levels of daily physical activities compatible with the individual tolerable work load. The second evaluation at 2 month confirmed that the integrated rehabilitation protocol successfully increased patients' capacities and "trust" in their physical capacity. According to the literature, the use of isokinetic and isotonic exercise programs appears to decrease shoulder rehabilitation time. In our experience an excellent compliance has been noted. One of the advantages of the method proposed is to provide quantitative reports of the functional capacity and therefore to facilitate return-to-work of patients who underwent radical neck surgery.

  7. Can We Be Less Radical with Surgery for Early Cervical Cancer?

    PubMed

    Macdonald, Madeleine C; Tidy, John A

    2016-03-01

    Although a rare cancer in the developed world due to the success of cervical screening programmes, cervical cancer remains one of the most common cancers diagnosed in women under the age of 35 years old. Radical hysterectomy and more recently radical trachelectomy have been highly effective in curing the majority of women with early stage disease. Many, however, are left with long-term 'survivorship' issues including bowel, bladder and sexual dysfunction. In view of these chronic co-morbidities, many clinicians now consider whether a less radical approach to surgery may be an option for some women. This review focuses on the current evidence for the safety of conservative surgery for early stage cervical cancer with regard to cure rates in comparison to standard management, as well as any improvement in short and long-term morbidity associated with a more conservative approach.

  8. Treatment of early stage breast cancer by limited surgery and radical irradiation

    SciTech Connect

    Chu, A.M.; Cope, O.; Russo, R.; Wang, C.C.; Schulz, M.D.; Wang, C.; Rodkey, G.

    1980-01-01

    Eighty-five female patients with early stage breast cancer, i.e., Stage I and II were treated by limited surgery followed by radical radiation therapy at Massachusetts General Hospital between January, 1956 and December, 1974. Patients included those who were medically inoperable or who refused mastectomy. The 5-year survival rate was 83% and 76% for Stage I and II, respectively. The corresponding disease free survival (absolute) was 67% and 42%. Although the number of patients so treated is small, there was no significant difference in survival from the results of the radical mastectomy series at the same institution. No major complications were encountered. Seventeen of eighty-five patients developed minor problems; mostly fibrosis and minimal arm lymphedema stemmming from older orthovoltage equipment and treatment techniques. With the current availability of megavoltage equipment, improvements in techniques and dosimetry, complications should decrease. Combined limited surgery and radical radiation therapy should be considered in those patients where a radical mastectomy is not feasible because of psychological or medical problems. Since this procedure results in a cosmetically acceptable breast, radical radiation in early stage breast cancer seems a reasonable alternative to radical mastectomy.

  9. Appendiceal carcinoid tumor in children: implications for less radical surgery?

    PubMed

    Malkan, A D; Wahid, F N; Fernandez-Pineda, I; Sandoval, J A

    2015-03-01

    The discovery of an appendiceal carcinoid tumor found incidentally or during the course of diagnostic or therapeutic procedures is a burden to both the patient and clinician. The role of the correct surgical operation is paramount for lesions suspected to be malignant. In the pediatric population, appendiceal carcinoids continue to challenge the clinician in choosing the optimal treatment when lesions are larger than 2 cm or involve the appendical base. While the criteria used to define these distinct lesions are available in most cases, the management and treatment are still debated and controversial when considering more radical surgical intervention. The purpose of this article is to give an overview regarding the history, diagnosis, histopathology, management, and controversies associated with appendiceal carcinoid in the pediatric population.

  10. Radicality of initial surgery for primary malignant melanoma of the vagina.

    PubMed

    Todo, Yukiharu; Okamoto, Kazuhira; Suzuki, Yoshihiro; Minobe, Shinichiro; Kato, Hidenori

    2016-04-01

    Radical surgery is considered not to improve the prognosis of primary malignant melanoma of the vagina (PMMV). This study was carried out to review the general consensus. A systematic review was performed on the basis of data from 10 patients in our cohort and 147 patients in the previous literature. The radicality of the initial surgery (RAINS) score was defined as the total number of points in terms of the resected organs. The target organs were the vagina, vulva, urethra, bladder, uterus, anus, rectum, pelvic lymph nodes, and inguinal lymph nodes. Overall survival (OS) according to the RAINS score was analyzed using the Kaplan-Meier method. Information on tumor stage, size, and depth of invasion was not obtained in 15, 47, and 43% of patients, respectively. The median follow-up period was 18 months. OS with a RAINS score of at least 7 was significantly longer than that with a RAINS score of up to 6 (median survival time, 41 vs. 19 months; log-rank test, P=0.037), despite the fact that the former group included significantly more patients with advanced-stage disease. A significant difference in OS was not found between patients with a RAINS score of at least 6 and up to 5. The therapeutic significance of radical surgery for PMMV has not been assessed appropriately in previous studies because of the lack of comparability among groups and differences in the definitions of surgical radicality. Patients with PMMV might benefit from initial surgery with appropriate surgical radicality, despite incomplete validation of the RAINS score.

  11. Robotic Compartment-Based Radical Surgery in Early-Stage Cervical Cancer

    PubMed Central

    Toptas, Tayfun; Uysal, Aysel; Ureyen, Isin; Erol, Onur; Simsek, Tayup

    2016-01-01

    A radical hysterectomy with pelvic lymphadenectomy is the recommended treatment option in patients with early-stage cervical cancer. Although various classifications were developed in order to define the resection margins of this operation, no clear standardization could be achieved both in the nomenclature and in the extent of the surgery. Total mesometrial resection (TMMR) is a novel procedure which aims to remove all components of the compartment formed by Müllerian duct in which female reproductive organs develop. TMMR differs from the conventional radical hysterectomy techniques in that its surgical philosophy, terminology, and partly resection borders are different. In this paper, a TMMR with therapeutic pelvic lymphadenectomy operation that we performed for the first time with robot-assisted laparoscopic (robotic) approach in an early-stage cervical cancer patient was presented. This procedure has already been described in open surgery by Michael Höckel and translated to the robotic surgery by Rainer Kimmig. Our report is the second paper, to our knowledge, to present the initial experience regarding robotic TMMR in the English literature. PMID:27195167

  12. Evaluation of Prognostic Nutritional Index in Patients Undergoing Radical Surgery with Nonsmall Cell Lung Cancer.

    PubMed

    Qiu, Chen; Qu, Xiao; Shen, Hongchang; Zheng, Chunlong; Zhu, Linhai; Meng, Long; Du, Jiajun

    2015-01-01

    The prognostic nutritional index (PNI) has been reported to be a prognostic indicator in some malignant tumors. However, its prognostic value in nonsmall cell lung cancer (NSCLC) has not been fully investigated. A retrospective review of 1416 patients with NSCLC who underwent radical surgery between January 2006 and December 2011 was conducted. To obtain optimal cutoff levels of PNI, running log-rank statistics was applied. Survival was calculated by the Kaplan-Meier method. The prognostic significance of PNI, together with various clinicopathological factors, was evaluated by multivariate analysis. The optimal cutoff point for PNI was 52. The 1-, 3-, and 5-yr survival rates in patients with PNI of less than 52 were 80.0%, 61.3%, and 50.4%, respectively, and were significantly more unfavorable than those in patients with PNI 52 or higher (84.7%, 71.5%, and 60.3%, respectively, P < 0.001). Multivariate analysis suggested that gender (P = 0.026), age (P < 0.001), PNI (P = 0.005), differentiation (P = 0.024), pathology T category (P = 0.003), and pathology N category (P < 0.001) were revealed to be independent prognostic factors. Our results indicate that PNI is an independent predictor of survival for patients undergoing radical surgery with NSCLC.

  13. Long-term survival after endoscopic resection for early gastric cancer in the remnant stomach: comparison with radical surgery

    PubMed Central

    Yamashina, Takeshi; Uedo, Noriya; Dainaka, Katsuyuki; Aoi, Kenji; Matsuura, Noriko; Ito, Takashi; Fujii, Mototsugu; Kanesaka, Takashi; Yamamoto, Sachiko; Akasaka, Tomofumi; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Ishihara, Ryu; Kishi, Kentaro; Fujiwara, Yoshiyuki; Iishi, Hiroyasu

    2015-01-01

    Background Endoscopic resection (ER) has recently become standard treatment, even for early gastric cancer (EGC) in the remnant stomach. We aimed to compare long-term survival after ER versus radical surgery for EGC in the remnant stomach. Methods We retrospectively compared overall and cause-specific survival of patients who had undergone ER or radical surgery for EGC in the remnant stomach from 1998 to 2012. Results During the study period, 32 patients with intramucosal (M), two with shallow submucosal (SM1) and eight with deep submucosal (SM2) cancers had undergone ER (ER group) whereas six with M and seven with SM2 cancers had undergone surgery (surgery group). All patients were followed up for a median of 60 months; during follow up, 15 patients died, including three in the ER group with SM2 cancer who died of gastric cancer. The overall 5-year survival rates of M-SM1 and SM2 cancer patients in the ER and surgery groups were 89%, 48%, 80%, and 67%, respectively (P=0.079). The disease-specific 5-year survival rates of M-SM1 and SM2 cancer patients in the ER and surgery groups were 100%, 48%, 100%, and 100%, respectively (P=0.000). Operation time and hospital stay were significantly shorter in the ER than the surgery group (P<0.001). Grade 2 perforation occurred in two patients in the ER group and Grade 3 anastomotic leakage in two patients in the surgery group. Conclusion ER provides excellent outcomes, comparable with those of radical surgery, in patients with M-SM1 gastric cancer in the remnant stomach; however, patients with SM2 cancer require radical surgery. PMID:25608929

  14. [Forequarter amputation of the right upper chest: limitations of ultra radical interdisciplinary oncological surgery].

    PubMed

    Dragu, A; Hohenberger, W; Lang, W; Schmidt, J; Horch, R E

    2011-09-01

    Total forearm free flap procedures after forequarter amputations have been sparsely described in the literature. Using the amputated arm as a "free filet flap" remains a viable surgical option after radical forequarter amputations performed for the resection of large, invasive tumors of the shoulder or thoracic wall region. Using the forequarter specimen as a donor site seems favorable in that it eliminates the usual donor site morbidity. Nevertheless, in our patient with invasive ductal carcinoma of the breast and a fibrosarcoma suffering from severe pain and septic conditions - which failed to respond properly to conservative therapy - as well as rapidly progressive tumor ulceration despite repeated radiation therapy, we decided to attempt complete tumor removal by hemithoracectomy as a last resort. This decision was taken following multiple interdisciplinary consultations and thorough patient information. Although technically feasible with complete tumor removal and safe soft tissue free flap coverage, the postoperative course raises questions about the advisability of such ultra radical surgical procedures, as well as about the limitations of respiratory recovery after hemithoracectomy with removal of the sternum. Hence, based on our experience with such radical tumor surgery, we discuss the issues of diminished postoperative pulmonary function, intensive care possibilities and ethical issues. The English full-text version of this article is available at SpringerLink (under "Supplemental").

  15. The spinal accessory nerve plexus, the trapezius muscle, and shoulder stabilization after radical neck cancer surgery.

    PubMed Central

    Brown, H; Burns, S; Kaiser, C W

    1988-01-01

    A clinical and anatomic study of the spinal accessory, the eleventh cranial nerve, and trapezius muscle function of patients who had radical neck cancer surgery was conducted. This study was done not only to document the indispensibility of the trapezius muscle to shoulder-girdle stability, but also to clarify the role of the eleventh cranial nerve in the variable motor and sensory changes occurring after the loss of this muscle. Seventeen male patients, 49-69 years of age, (average of 60 years of age) undergoing a total of 23 radical neck dissections were examined for upper extremity function, particularly in regard to the trapezius muscle, and for subjective signs of pain. The eleventh nerve, usually regarded as the sole motor innervation to the trapezius, was cut in 17 instances because of tumor involvement. Dissection of four fresh and 30 preserved adult cadavers helped to reconcile the motor and sensory differences in patients who had undergone loss of the eleventh nerve. The dissections and clinical observations corroborate that the trapezius is a key part of a "muscle continuum" that stabilizes the shoulder. Variations in origins and insertions of the trapezius may influence its function in different individuals. As regards the spinal accessory nerve, it is concluded that varying motor and sensory connections form a plexus with the eleventh nerve, accounting, in part, for the variations in motor innervation and function of the trapezius, as well as for a variable spectrum of sensory changes when the eleventh nerve is cut. For this reason, it is suggested that the term "spinal accessory nerve plexus" be used to refer to the eleventh nerve when it is considered in the context of radical neck cancer surgery. Images Fig. 4. Fig. 6. Fig. 7. Fig. 8. PMID:3056289

  16. Geometric extension through Schwarzschild R = 0

    NASA Astrophysics Data System (ADS)

    Lynden-Bell, D.; Katz, J.

    1990-12-01

    A very simple conservation theorem pertaining to embeddings of Tolman solutions into flat space has been found which, in nonsingular regions of space-time, follows from Einstein's equations and the equations that define the embedding. If the conservation is extended to cover the singular 'surface' r = 0, it furnishes the requisite physical and geometrical supplement to Einstein's equations at the singularity; by thus bridging the singular region, a unique extension is found beyond the singularity. The passage of an extended particle through the singularity is illustrated by a classical toy model that demonstrates both the expected crushing and the emergence into extended space.

  17. The Role of Radical Surgery in the Management of Acquired Uterine Arteriovenous Malformation

    PubMed Central

    Moulder, Janelle K.; Garrett, Leslie A.; Salazar, Gloria M.; Goodman, Annekathryn

    2013-01-01

    Background Acquired arteriovenous malformations (AVMs) can develop after uterine instrumentation. The increased risks of vascular changes, including abnormal placentation, after repeated cesarean sections are well studied. Herein, we describe a patient with delayed hemorrhage from a uterine AVM, following dilation and curettage for a cesarean scar pregnancy. Case A 32-year-old G3P2 presented with a cesarean scar ectopic pregnancy managed with dilation and curettage, which incurred a 1,500-ml blood loss. Within 6 weeks, she returned with 2 episodes of vaginal bleeding. Initial angiography demonstrated a high-flow arteriovenous fistula, which was coiled. Vaginal hemorrhage recurred; repeat angiography demonstrated a large AVM. Gelfoam embolization of the bilateral internal iliac arteries reduced the vascularity of the AVM. The AVM's location, starting at the left lateral apex of the cesarean scar and extending into the parametrium, necessitated a radical hysterectomy. Pathologic examination revealed a placenta percreta extending into the parametrium. Conclusion The prevalence of uterine AVMs has increased with the rise in surgical obstetrics. In patients with a failed prior interventional procedure, surgical management is necessary to prevent life-threatening hemorrhage. The location of the AVM within the abnormal uterine scar tissue requires familiarity with radical pelvic surgical techniques that are normally used in cancer surgery in order to definitively treat this delayed obstetrical complication. PMID:23898273

  18. Role of salvage radiotherapy for regional lymph node recurrence after radical surgery in advanced gastric cancer

    PubMed Central

    Kim, Byoung Hyuck; Kim, Jae-Sung; Kim, Hyung-Ho; Park, Do Joong

    2013-01-01

    Purpose To evaluate the role of salvage radiotherapy (RT) for the treatment of regional lymph node recurrence (RLNR) after radical surgery in advanced gastric cancer. Materials and Methods We retrospectively analyzed medical records of 26 patients who underwent salvage treatment after diagnosis of RLNR between 2006 and 2011. Patients with peritoneal seeding or distant metastasis were excluded. Eighteen patients received RT with or without chemotherapy and the other 8 did chemotherapy only without RT. A three-dimensional conformal RT was performed with median dose of 56 Gy (range, 44 to 60 Gy). Sixteen patients had fluoropyrimidine-based chemotherapy, 5 did taxane-based chemotherapy, and irinotecan was applied in 4. Results With a median follow-up of 20 months (range, 5 to 57 months), median overall survival (OS) and progression-free survival (PFS) after diagnosis of RLNR were 29 months and 12 months in the entire patients, respectively. Radiotherapy (p = 0.007) and disease-free interval (p = 0.033) were statistically significant factors for OS in multivariate analysis. Median OS was 36 months in patients who received RT and 16 months in those who did not. Furthermore, delivery of RT (p < 0.001), complete remission after salvage treatment (p = 0.040) and performance status (p = 0.023) were associated with a significantly better PFS. Gastrointestinal toxicities from RT were mild in most patients. Conclusion Salvage RT combined with systemic chemotherapy may be an effective treatment managing RLNR from advanced gastric cancer. PMID:24137560

  19. Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial

    PubMed Central

    Amiri, Hamid Reza; Mirzaei, Mojtaba; Beig Mohammadi, Mohammad Taghi; Tavakoli, Farhad

    2016-01-01

    Background Preemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consumption. Different regimens are suggested, but there is currently no standard. Objectives The aim was to measure the efficacy of preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery for reducing the intensity of pain and morphine consumption. Patients and Methods This study was conducted as a randomized double-blind clinical trial. Eighty adult patients (18 to 60 years of age) under the American society of anesthesiologists (ASA) physical status I and II undergoing elective radical neck dissection were enrolled. Patients were randomized into two groups of 40 with a simple randomization method. The case group received a combination of 15 mg/kg acetaminophen, 2.5 mg/kg pregabalin, 7 mg/kg naproxen, and 0.3 mg/kg dextromethorphan administered orally one hour prior to surgery. Postoperative pain was assessed with the universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, and 24 hours after surgery. Subjects received morphine based on postoperative pain control protocol. Total administered morphine doses were noted. Results Postoperative pain rates at 0, 2, 4, 6, 12, and 24 hours after surgery were significantly lower for the case group than the control group (P values = 0.014, 0.003, 0.00, 0.00, and 0.00, respectively). Total morphine doses for the preemptive analgesia group were 45% lower than those of the other group. Side effects were similar for both groups. Conclusions A single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection. PMID:27843771

  20. Cryopreservation of in vitro matured oocytes after ex vivo oocyte retrieval from gynecologic cancer patients undergoing radical surgery

    PubMed Central

    Park, Chan Woo; Lee, Sun Hee; Yang, Kwang Moon; Lee, In Ho; Lim, Kyung Teak; Lee, Ki Heon

    2016-01-01

    Objective The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). Methods Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. Results A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. Conclusion Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays. PMID:27358831

  1. 26 CFR 1.414(r)-0 - Table of contents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Table of contents. 1.414(r)-0 Section 1.414(r)-0...) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(r)-0 Table of contents. (a) In general. Sections 1.414(r)-1 through 1.414(r)-11 provide rules for determining whether...

  2. 26 CFR 1.414(r)-0 - Table of contents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Table of contents. 1.414(r)-0 Section 1.414(r)-0...) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(r)-0 Table of contents. (a) In general. Sections 1.414(r)-1 through 1.414(r)-11 provide rules for determining whether an employer...

  3. Novel lymph node ratio predicts prognosis of colorectal cancer patients after radical surgery when tumor deposits are counted as positive lymph nodes: a retrospective multicenter study

    PubMed Central

    Li, Jun; Yang, Shengke; Hu, Junjie; Liu, Hao; Du, Feng; Yin, Jie; Liu, Sai; Li, Ci; Yuan, Jiatian; Lv, Bo

    2016-01-01

    The lymph node ratio (LNR), defined as the relation of tumor-infiltrated to resected lymph nodes, has been identified as an independent prognostic factor for colorectal cancer (CRC) after radical surgery. Recently, new guidelines propose counting tumor deposits (TDs) as positive lymph nodes (pLNs). The aim of this study was to investigate whether a novel LNR (nLNR) that considers TDs as pLNs can be used to accurately predict the long-term outcome of CRC patients. In this multicenter retrospective study, clinicopathological and outcome data from 2,051 stage III CRC patients who underwent R0 resection were collected between January 2004 and December 2011. Disease-free survival (DFS) and overall survival (OS) according to the nLNR category were analyzed using Kaplan-Meier survival curves. Univariate and multivariate analyses were performed to determine significant prognostic factors, and ROC curves were computed to measure the predictive capacity of the nLNR category. The 5-year DFS rates of nLNR1-4 were 68.3%, 48.4%, 33.3% and 16.5%, respectively (P<0.0001), and the 5-year OS rate of nLNR1-4 were 71.8%, 60.1%, 42.7% and 21.8%, respectively (P<0.0001). The area of under curve (AUC) of the nLNR was 0.686 (95% CI 0.663-0.710) and 0.672 (95% CI 0.648-0.697) for predicting DFS and OS. Our results demonstrate that the nLNR predicted long-term outcomes better than the LNR, npN and pN, using the cutoff points 0.250, 0.500 and 0.750. PMID:27655716

  4. A Preliminary Report: Radical Surgery and Stem Cell Transplantation for the Treatment of Patients With Pancreatic Cancer.

    PubMed

    Omazic, Brigitta; Ayoglu, Burcu; Löhr, Matthias; Segersvärd, Ralf; Verbeke, Caroline; Magalhaes, Isabelle; Potacova, Zuzana; Mattsson, Jonas; Terman, Alexei; Ghazi, Sam; Albiin, Nils; Kartalis, Nikolaos; Nilsson, Peter; Poiret, Thomas; Zhenjiang, Liu; Heuchel, Rainer; Schwenk, Jochen M; Permert, Johan; Maeurer, Markus J; Ringden, Olle

    2017-03-23

    We examined the immunologic effects of allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of pancreatic ductal adenocarcinoma, a deadly disease with a median survival of 24 months for resected tumors and a 5-year survival rate of 6%. After adjuvant chemotherapy, 2 patients with resected pancreatic ductal adenocarcinoma underwent HSCT with HLA-identical sibling donors. Comparable patients who underwent radical surgery, but did not have a donor, served as controls (n=6). Both patients developed humoral and cellular (ie, HLA-A*01:01-restricted) immune responses directed against 2 novel tumor-associated antigens (TAAs), INO80E and UCLH3 after HSCT. Both TAAs were highly expressed in the original tumor tissue suggesting that HSCT promoted a clinically relevant, long-lasting cellular immune response. In contrast to untreated controls, who succumbed to progressive disease, both patients are tumor-free 9 years after diagnosis. Radical surgery combined with HSCT may cure pancreatic adenocarcinoma and change the cellular immune repertoire capable of responding to clinically and biologically relevant TAAs.

  5. Awakening from anesthesia using propofol or sevoflurane with epidural block in radical surgery for senile gastric cancer

    PubMed Central

    Zhang, Ling; Chen, Chen; Wang, Lin; Cheng, Gao; Wu, Wei-Wei; Li, Yuan-Hai

    2015-01-01

    Objective: To study the awakening of the elderly patients from propofol intravenous general anesthesia or sevoflurane inhalation general anesthesia combined with epidural block after radical gastric cancer surgery. Method: Eighty cases receiving selective radical surgery for gastric cancer were included. They were aged 65-78 years and classified as ASA grade I-II. Using a random number table, the cases were divided into 4 groups (n = 20): propofol intravenous general anesthesia (P group), sevoflurane inhalation general anesthesia (S group), propofol intravenous general anesthesia combined with epidural block (PE group), and sevoflurane inhalation general anesthesia combined with epidural block (SE group). For P and PE group, target controlled infusion of propofol was performed; for S and SE group, sevoflurane was inhaled to induce and maintain general anesthesia; for PE and SE group, before general anesthesia induction, epidural puncture and catheterization at T7-8 was performed. After surgery, perform patient controlled intravenous analgesia (PCIA) or patient controlled epidural analgesia (PCEA), and maintain VAS ≤ 3. The recorded indicators were as follows: time to recovery of spontaneous respiration, time to awakening, time of endotracheal tube removal, time to orientation, time to achieve modified Aldrete scores ≥ 9, modified OAA/S and Aldrete scores upon endotracheal tube removal (T1), 5 min after removal (T2), 15 min after removal (T3) and 30 min after removal (T4), dose of intraoperative remifentanil, intraoperative hypotension, and emergence agitation. Results: Time to awakening, time of endotracheal tube removal, time to orientation, and time to achieve modified Aldrete scores ≥ 9 in PE and SE group were obviously shortened compared with P and S group (P < 0.05); modified OAA/S and Aldrete scores at T1 and T2 in PE and SE group were significantly higher than those in P and S group (P < 0.05), and the scores of SE group at T1 were much higher compared

  6. Radiotherapy With or Without Concurrent Chemotherapy for Lymph Node Recurrence After Radical Surgery of Thoracic Esophageal Squamous Cell Carcinoma

    SciTech Connect

    Lu Jincheng; Kong Cheng; Tao Hua

    2010-11-01

    Purpose: To retrospectively compare the outcomes of patients with lymph node recurrence after radical surgery of esophageal cancer, when given radiotherapy with or without concurrent chemotherapy. Methods and Materials: Between January 1996 and December 2005, the data from 73 patients with lymph node recurrence after radical surgery of thoracic esophageal squamous cell carcinoma were retrospectively reviewed. The patients were separated into two groups: radiochemotherapy (RC, 31 patients) and radiotherapy alone (RA, 42 patients). Patients in the RC group received at least two cycles of 5-fluorouracil/cisplatin chemotherapy concurrently with radiotherapy. Results: The median duration of follow-up was 11 months (range, 2-48). The overall survival rate for all patients was 46.7% and 4.7% at 1 and 3 years, respectively. The median overall survival time was 9 months (95% confidence interval, 6.96-11.04) and 17 months (95% confidence interval, 13.61-20.39) for RA and RC groups, respectively. The survival rate at 1 and 3 years was 62.5% and 10.5% in the RC group and 33.8% and 0% in the RA group (p = .0049, log-rank test; hazard ratio for death, 0.52; 95% confidence interval, 0.30-0.92). Acute toxicities were more frequent in the RC group than in the RA group. No significant differences were found in the late toxicity profiles between the two groups. Conclusion: The results of the present retrospective analysis suggest that RC should be considered an effective and well-tolerated treatment of patients with thoracic esophageal squamous cell carcinoma and postoperative lymph node recurrence.

  7. Carcinoma of the base of the tongue: results of radical irradiation with surgery reserved for irradiation failure

    SciTech Connect

    Parsons, J.T.; Million, R.R.; Cassisi, N.J.

    1982-06-01

    Between 1964 and 1977, 95 previously untreated patients with squamous cell carcinoma of the base of the tongue received treatment with curative intent at the University of Florida. Eighty-six of the 95 patients (91%) had Stage III or IV disease at presentation. Eighty-nine patients received radical courses of irradiation to the primary with or without neck dissection(s), with surgery reserved for salvage of irradiation failure. Six patients underwent planned combined treatment of the primary lesion. Of the 89 patients whose primary lesions were radically irradiated, failure at the primary site occurred in 24% of those with T1-3 lesions and 78% with T4 lesions. Control results were related to irradiation treatment technique. None of the 9 patients with Stage I-II disease died of the cancer. Actuarial survival at 5 years for Stage III patients was 46%. Within the Stage IV population there is a subgroup of patients with highly treatable and curable disease. The addition of a neck dissection following irradiation of N2-N3 neck disease decreased the incidence of failure in the neck. No patient developed severe soft tissue necrosis or required mandibulectomy for bone exposure following irradiation.

  8. Giant condyloma acuminatum of the anorectum: successful radical surgery with anal reconstruction.

    PubMed

    Battaglia, Luigi; Vannelli, Alberto; Belli, Filiberto; Rampa, Mario; Milione, Massimo; Gasparini, Patrizia; Leo, Ermanno

    2011-01-01

    Buschke-Löwenstein tumor, or giant condyloma acuminatum, is a relatively uncommon lesion of the anus with aggressive local invasive behavior which may present as a large warty tumor of the genital region with expansive and destructive growth. Many sporadic reports have been published suggesting various therapeutic strategies. We report a case of Buschke-Löwenstein tumor treated with conservative surgery followed by reconstructive procedures without a loop colostomy

  9. Readmission Rate and Causes at 90-Day after Radical Cystectomy in Patients on Early Recovery after Surgery Protocol

    PubMed Central

    Altobelli, Emanuela; Buscarini, Maurizio; Gill, Harcharan S.; Skinner, Eila C.

    2017-01-01

    Background: Radical cystectomy (RC) is associated with high risk of early and late perioperative complications, and readmissions. The Enhanced Recovery After Surgery (ERAS) protocol has been applied to RC showing decreased hospital stay without increased morbidity. Objective: To evaluate the specific causes of hospital readmissions in RC patients treated before and after adoption of an ERAS protocol at our institution. Methods: We retrospectively evaluated the outcome of 207 RC patients on ERAS protocol at the Stanford University Hospital from January 2012 to December 2014. We focused on early (30-day) and late (90-day) postoperative readmission rate and causes. Results were compared with a pre-ERAS consecutive series of 177 RC patients from January 2009 to December 2011. Results: In the post-ERAS time period a total of 56 patients were readmitted, 41 within the first 30 days after surgery (20%) and 15 within the following 60 days (7%). Fever, often associated with dehydration, was the most common reason for presentation to the hospital, accounting for 57% of all readmissions. At 90 days infection accounted for 53% of readmissions. Of all the patients readmitted during the first 90 days after surgery, 32 had positive urine cultures, mostly caused by Enterococcus faecalis isolated in 18 (56%). Readmission rates did not increase since the introduction of the ERAS protocol, with an incidence of 27% in the post-ERAS group versus 30% in the pre-ERAS group. Conclusions: Despite accurate adherence to most recent perioperative antibiotic guidelines, the incidence of readmissions after RC due to infection still remains significant. PMID:28149935

  10. Readmission Rate and Causes at 90-Day after Radical Cystectomy in Patients on Early Recovery after Surgery Protocol.

    PubMed

    Altobelli, Emanuela; Buscarini, Maurizio; Gill, Harcharan S; Skinner, Eila C

    2017-01-27

    Background: Radical cystectomy (RC) is associated with high risk of early and late perioperative complications, and readmissions. The Enhanced Recovery After Surgery (ERAS) protocol has been applied to RC showing decreased hospital stay without increased morbidity. Objective: To evaluate the specific causes of hospital readmissions in RC patients treated before and after adoption of an ERAS protocol at our institution. Methods: We retrospectively evaluated the outcome of 207 RC patients on ERAS protocol at the Stanford University Hospital from January 2012 to December 2014. We focused on early (30-day) and late (90-day) postoperative readmission rate and causes. Results were compared with a pre-ERAS consecutive series of 177 RC patients from January 2009 to December 2011. Results: In the post-ERAS time period a total of 56 patients were readmitted, 41 within the first 30 days after surgery (20%) and 15 within the following 60 days (7%). Fever, often associated with dehydration, was the most common reason for presentation to the hospital, accounting for 57% of all readmissions. At 90 days infection accounted for 53% of readmissions. Of all the patients readmitted during the first 90 days after surgery, 32 had positive urine cultures, mostly caused by Enterococcus faecalis isolated in 18 (56%). Readmission rates did not increase since the introduction of the ERAS protocol, with an incidence of 27% in the post-ERAS group versus 30% in the pre-ERAS group. Conclusions: Despite accurate adherence to most recent perioperative antibiotic guidelines, the incidence of readmissions after RC due to infection still remains significant.

  11. Open radical retropubic prostatectomy 2007: the true minimally invasive surgery for localized prostate cancer?

    PubMed

    Nosnik, Israel P; Gan, Tong J; Moul, Judd W

    2007-09-01

    The introduction of robotic laparoscopic assisted prostatectomy at our institution and nationwide has been a great advancement and has caused us to focus and fine-tune our goal for improvements in prostate cancer outcomes whether the patient elects for robotic laparoscopic assisted prostatectomy or open minimally invasive radical retropubic prostatectomy. While these authors favor the open technique performed by highly skilled urologic surgical oncologists, the lessons we have learned to date suggest that it is the skill of the surgeon that determines outcome, regardless of whether or not the operation is performed by an open or robotic laparoscopic technique. The concepts we have articulated here are related to resection and avoidance of positive margins, limited intraoperative blood loss and pain control, which allow equivalence in these outcome areas, regardless of technique.

  12. A historical account of breast cancer surgery: beware of local recurrence but be not radical.

    PubMed

    Halsted, Charles P; Benson, John R; Jatoi, Ismail

    2014-01-01

    In the late 19th century, William Halsted proposed the radical mastectomy, which became the standard surgical treatment of breast cancer for nearly 100 years. Later in this period, theories suggesting that breast cancer was a systemic disease at inception were championed by Bernard Fisher. This alternative hypothesis of biological predeterminism was based upon results of randomized clinical trials comparing breast conserving therapy with mastectomy, which showed similar overall survival outcomes. Nonetheless, data from meta-analyses suggest that inadequate local therapy can increase risk of local recurrence, which can subsequently increase mortality. In this review, the authors provide an historical account of how local therapy of breast cancer has evolved in the face of improved adjuvant therapies and better understanding of disease biology.

  13. 26 CFR 1.414(r)-0 - Table of contents.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Establishment of industry categories. (4) Examples. (d) Safe harbor for separate lines of business that are...) Transition period. (4) Examples. (e) Safe harbor for separate lines of business reported as industry segments... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Table of contents. 1.414(r)-0 Section...

  14. CEA Level, Radical Surgery, CD56 and CgA Expression Are Prognostic Factors for Patients With Locoregional Gastrin-Independent GNET.

    PubMed

    Li, Yuan; Bi, Xinyu; Zhao, Jianjun; Huang, Zhen; Zhou, Jianguo; Li, Zhiyu; Zhang, Yefan; Li, Muxing; Chen, Xiao; Hu, Xuhui; Chi, Yihebali; Zhao, Dongbing; Zhao, Hong; Cai, Jianqiang

    2016-05-01

    Gastrin-independent gastric neuroendocrine tumors (GNETs) are highly malignant. Radical resections and lymphadenectomy are considered to be the only possible curative treatment for these tumors. However, the prognosis of gastrin-independent GNETs is not well defined. In this study, we identified prognostic factors of locoregional gastrin-independent GNETs.All patients diagnosed with locoregional gastrin-independent GNETs between 2000 and 2014 were included in this retrospective study. Clinical characteristics, blood tests, pathological characteristics, treatments, and follow-up data of the patients were collected and analyzed.Of the 66 patients diagnosed with locoregional gastrin-independent GNETs, 57 (86.4%) received radical resections, 7 (10.6%) with palliative resection, 1 (1.5%) with gastrojejunostomy, and 1 (1.5%) with exploration surgeries. The median survival time for these patients was 19.0 months (interquartile range, 11.0-38.0). The 1-, 3-, and 5-year survival rates were 72%, 34%, and 28%, respectively. Multivariate analysis indicated that carcinoembryonic antigen (CEA) level (P = 0.04), radical resection (P = 0.04), and positive Cluster of Differentiation 56 (CD56) expression (P = 0.016) were significant prognostic factors on overall survival rate. Further univariate and multivariate analysis of 57 patients who received radical resections found that CgA expression (P = 0.35) and CEA level (P = 0.33) are independent prognostic factors.Gastrin-independent GNETs had poor prognosis. Serum CEA level, radical surgery, CD56 and CgA expression are markers to evaluate the survival of patients with locoregional gastrin-independent GNETs.

  15. New three-dimensional head-mounted display system, TMDU-S-3D system, for minimally invasive surgery application: procedures for gasless single-port radical nephrectomy.

    PubMed

    Kihara, Kazunori; Fujii, Yasuhisa; Masuda, Hitoshi; Saito, Kazutaka; Koga, Fumitaka; Matsuoka, Yoh; Numao, Noboru; Kojima, Kazuyuki

    2012-09-01

    We present an application of a new three-dimensional head-mounted display system that combines a high-definition three-dimensional organic electroluminescent head-mounted display with a high-definition three-dimensional endoscope to minimally invasive surgery, using gasless single-port radical nephrectomy procedures as a model. This system presents the surgeon with a higher quality of magnified three-dimensional imagery in front of the eyes regardless of head position, and simultaneously allows direct vision by moving the angle of sight downward. It is also significantly less expensive than the current robotic surgery system. While carrying out gasless single-port radical nephrectomy, the system provided the surgeon with excellent three-dimensional imagery of the operative field, direct vision of the outside and inside of the patient, and depth perception and tactile feedback through the devices. All four nephrectomies were safely completed within the operative time, blood loss was within usual limits and there were no complications. The display was light enough to comfortably be worn for a long operative time. Our experiences show that the three-dimensional head-mounted display system might facilitate maneuverability and safety in minimally invasive procedures, without prohibitive cost, and thus might mitigate the drawbacks of other three-dimensional vision systems. Because of the potential benefits that this system offers, it deserves further refinements of its role in various minimally invasive surgeries.

  16. Outcome of penile prosthesis implantation: are malleable prostheses an appropriate treatment option in patients with erectile dysfunction caused by prior radical surgery?

    PubMed

    Sevinc, Cuneyd; Ozkaptan, Orkunt; Balaban, Muhsin; Yucetas, Ugur; Karadeniz, Tahir

    2016-04-26

    The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction (ED). The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years (range: 31-71 years). The study group contained 162 patients (89.5%) with malleable prostheses and 19 (10.5%) with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% (n = 58). The number of complications with inflatable and malleable prostheses was 7 (3.9%) and 51 (28.1%), respectively. Overall, 21 prostheses (11.6%) had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates (ƛ = 14.606, P < 0.05, Chi-square test). The main reasons for removal were erosion (n = 11; 6.1%) and infection (n = 3; 2.1%). With respect to satisfaction during intercourse, we found that 104 (57.5%) patients described themselves as very satisfied with the prosthesis, while 21 (11.6%) were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.

  17. Failed Mask Ventilation due to Air Leakage around the Orbit in a Patient with a History of Radical Maxillofacial Surgery with Orbital Exenteration

    PubMed Central

    Horishita, Reiko; Kayashima, Kenji

    2016-01-01

    A 72-year-old male (height: 160 cm, weight: 53 kg) was scheduled to undergo left renal and male with ans uterine tract resection. The patient had previously undergone right radical maxillofacial surgery with orbital exenteration 14 years before the present operation to treat squamous cell carcinoma of the right maxillary sinus, with tumour invasion to the orbital floor. An anaesthesiologist encountered difficulty in performing mask ventilation during the induction of anaesthesia in the patient, despite a good mask fit on the face, because the adhesive tape around the orbit had moved. Urgent endotracheal intubation was successful without desaturation. A postoperative examination revealed that a communication between the nasal cavity and the orbit was visible on computed tomograms obtained nine years before the surgery. The patient felt the air leakage around the adhesive tape. The anaesthesiologist should have removed the adhesive tape to directly observe the lesion and should have realised that the communication might cause difficulty in mask ventilation. Careful examination of the airways using computed tomography and precise interviews may improve the understanding of patients’ airways and may help avoid similar events. PMID:28058144

  18. Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes.

    PubMed

    Pareja, Rene; Rendón, Gabriel J; Vasquez, Monica; Echeverri, Lina; Sanz-Lomana, Carlos Millán; Ramirez, Pedro T

    2015-06-01

    Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishing to preserve fertility. Radical trachelectomy can be performed with a vaginal, abdominal, or laparoscopic/robotic approach. Vaginal radical trachelectomy (VRT) is generally not offered to patients with tumors 2cm or larger because of a high recurrence rate. There are no conclusive recommendations regarding the safety of abdominal radical trachelectomy (ART) or laparoscopic radical trachelectomy (LRT) in such patients. Several investigators have used neoadjuvant chemotherapy in patients with tumors 2 to 4cm to reduce tumor size so that fertility preservation may be offered. However, to our knowledge, no published study has compared outcomes between patients with cervical tumors 2cm or larger who underwent immediate radical trachelectomy and those who underwent neoadjuvant chemotherapy followed by radical trachelectomy. We conducted a literature review to compare outcomes with these 2 approaches. Our main endpoints for evaluation were oncological and obstetrical outcomes. The fertility preservation rate was 82.7%, 85.1%, 89%; and 91.1% for ART (tumors larger than >2cm), ART (all sizes), NACT followed by surgery and VRT (all sizes); respectively. The global pregnancy rate was 16.2%, 24% and 30.7% for ART, VRT, and NACT followed by surgery; respectively. The recurrence rate was 3.8%, 4.2%, 6%, 7.6% and 17% for ART (all sizes), VRT (all sizes), ART (tumors>2cm), NACT followed by surgery, and VRT (tumors>2cm). These outcomes must be considered when offering a fertility sparing technique to patients with a tumor larger than 2cm.

  19. [A Case of Advanced Esophageal Cancer and Tongue Cancer Treated with Induction DCF Chemotherapy Followed by Radical Surgery].

    PubMed

    Tanaka, Motomu; Koyanagi, Kazuo; Sugiura, Hitoshi; Kakefuda, Toshihiro

    2015-11-01

    A man in his 60s was admitted for the treatment of advanced cervical esophageal cancer with metastasis to the lymph nodes and advanced tongue cancer with metastasis to the lymph nodes. Esophageal cancer was suspected to have invaded the trachea. The tongue cancer was located on the left side and had invaded beyond the median line of the tongue. Both cancers were pathologically diagnosed as squamous cell carcinomas. Therefore, it was determined that pharyngo-laryngo- esophagectomy and total glossectomy were required prior to the treatment. However, after 2 courses of docetaxel/cisplatin/ 5-FU combined induction chemotherapy, both cancers remarkably decreased; consequently, an esophagectomy to preserve laryngeal function and partial glossectomy could be performed simultaneously. The patient is well without recurrence 1 year post-surgery.

  20. Lack of evidence of HPV etiology of prostate cancer following radical surgery and higher frequency of the Arg/Pro genotype in turkish men with prostate cancer

    PubMed Central

    Aydin, Merve; Bozkurt, Aliseydi; Cikman, Aytekin; Gulhan, Baris; Karabakan, Mehmet; Gokce, Aysun; Alper, Murat; Kara, Murat

    2017-01-01

    ABSTRACT Objectives The aim of this study was to assess the possible role of HPV in the development of prostate cancer (PCa) and investigate the distribution of the p53 codon 72 polymorphism in PCa in a Turkish population. Materials and methods A total of 96 tissues, which had been obtained using a radical surgery method, formalin-fixed and parafin-embedded, were used in this study. The study group consisted of 60 PCa tissues (open radical prostatectomy) and the control group contained 36 benign prostatic hyperplasia tissues (BPH) (transvesical open prostatectomy). The presence of HPV and the p53 codon 72 polymorphism was investigated in both groups using real-time PCR and pyrosequencing. Results The results of the real-time PCR showed no HPV DNA in any of the 36 BPH tissue samples. HPV-DNA was positive in only 1 of the 60 PCa samples (1.7%). The HPV type of this sample was identified as HPV-57. The distribution of the three genotypes, Arg/Arg, Arg/Pro and Pro/Pro was found to be 45.6, 45.6, and 8.8% in the PCa group and 57.1%, 34.3% and 8.6% in the control group, respectively. Compared with the control group, patients with PCa had a higher frequency of the Arg/Pro genotype and Proline allele (odds ratio (OR)=1.67, 95% confidence interval (CI)=0.68-4.09, p=0.044; OR=1.13, 95% CI=0.76-1.68, p=0.021, respectively). Conclusions The results of the study do not support the hyphothesis that prostate cancer is associated with HPV infection but indicated that Proline allele can be a risk factor in the development of PCa in the Turkish population. PMID:28124524

  1. A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer: a prospective, randomized, controlled study.

    PubMed

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S; Morita, Satoshi; Yoshikawa, Takaki

    2015-02-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue-assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy.

  2. Predictors of Distant Metastasis after Radical Surgery Followed by Postoperative Radiotherapy with or without Chemotherapy for Oropharyngeal Cancer

    PubMed Central

    Chung, Mi Joo; Kim, Yeon Sil; Kim, Ji Yoon; Lee, Yun Hee; Jang, Ji Hyun; Kang, Jin Hyoung; Yoo, Ie Ryung; Lee, Youn Soo

    2016-01-01

    Purpose We investigated the prognostic factors for distant metastasis (DM) in patients with locally advanced oropharyngeal cancer (OPC) treated with surgery and adjuvant radiotherapy with or without concurrent chemotherapy. Materials and Methods Eighty-five patients treated between January 1995 and August 2014 were evaluated retrospectively. Data regarding the pathological tumour and nodal status, human papillomavirus (HPV) status, treatment characteristics, and pretreatment maximum standardized uptake value (SUVmax) of 18-fluoro-2-deoxyglucose positron emission tomography–computed tomography scan (18F-FDG PET-CT) were evaluated, and their influence on DM and survival outcomes were analyzed. Results Median follow-up period was 48.0 months. Recurrence was observed in 20 patients, including locoregional recurrence and DM. DM was observed in 13 patients. A multivariate analysis confirmed that the presence of lymphovascular invasion (p=0.031), lower neck lymph node (LN) involvement (p=0.006), SUVmax ≥ 9.7 (p=0.014), and tumour size ≥ 3 cm (p=0.037) significantly affected DM. HPV status was not associated with DM. Perineural invasion (p=0.048), lower neck LNinvolvement (p=0.008), SUVmax ≥ 9.7 (p=0.019), and tumour size ≥ 3 cm (p=0.033) were also significant factors for the DM-free survival rate. Conclusion Lower neck LN involvement, high SUVmax in pretreatment 18F-FDG PET-CT, and large tumour size were predictive factors for DM in patients of OPC. PMID:26987396

  3. Change in Free Radical and Antioxidant Enzyme Levels in the Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass

    PubMed Central

    Ozan, Gonca; Kıbar, Kurtuluş; Erışır, Mine

    2016-01-01

    Objective. The purpose of this study is to determine the changes in oxidative damage and antioxidant parameters in open heart surgeries with cardiopulmonary bypass (CPB) in preoperative and early postoperative periods. Methods. A total of three consecutive arterial blood samples were obtained from the patients in the study group, in preoperative, early postoperative, and postoperative periods, respectively. Oxidative damage indicator (MDA) and antioxidant indicators (GPx, GSH, CAT, and SOD) were examined. Results. A statistically significant increase was observed in MDA level in postoperative period compared to preoperative and early postoperative periods. GSH levels and CAT activities increased significantly in early postoperative and postoperative periods. Analyses revealed an increase in GPx and SOD enzyme activities only in the postoperative period. Conclusion. Even though the increase in MDA level was suppressed by the increased GSH level and CAT activity like in early postoperative period, efficiency can be brought for the increases in insufficient significant antioxidant parameters in postoperative period by administering antioxidant supplements to the patients and thus the increase in MDA in postoperative period can be significantly suppressed. PMID:28101295

  4. Chemoradiation With Concomitant Boosts Followed by Radical Surgery in Locally Advanced Cervical Cancer: Long-term Results of the ROMA-2 Prospective Phase 2 Study

    SciTech Connect

    Ferrandina, Gabriella; Gambacorta, Antonietta; Gallotta, Valerio; Smaniotto, Daniela; Fagotti, Anna; Tagliaferri, Luca; Foti, Elvira; Fanfani, Francesco; Autorino, Rosa; Scambia, Giovanni; Valentini, Vincenzo

    2014-11-15

    Purpose: This prospective, phase 2 study aimed at assessing the efficacy of accelerated fractionation radiation therapy by concomitant boosts (CBs) associated with chemoradiation therapy (CRT) of the whole pelvis, in improving the rate of pathological complete response (pCR) to treatment in patients with International Federation of Gynaecology and Obstetrics (FIGO) stage IB2-IVA locally advanced cervical cancer. Methods and Materials: Neoadjuvant CRT included conformal irradiation of the whole pelvis with a total dose of 39.6 Gy (1.8 cGy/fraction, 22 fractions), plus additional irradiation of primary tumor and parametria with 10.8 Gy administered with CBs (0.9 cGy/fraction, 12 fractions, every other day). Concomitant chemotherapy included cisplatin (20 mg/m{sup 2}, days 1-4 and 26-30 of treatment), and capecitabine (1300 mg/m{sup 2}/daily, orally) during the first 2 and the last 2 weeks of treatment. Radical hysterectomy plus pelvic with or without aortic lymphadenectomy was performed within 6 to 8 weeks from CRT. Toxicity was recorded according to Radiation Therapy Oncology Group toxicity criteria and Chassagne grading system. Based on the Simon design, 103 cases were required, and the regimen would be considered active if >45 pCR were registered (α error = 0.05; β error = 0.1). Results: pCR was documented in 51 cases (50.5%), and the regimen was considered active, according to the planned statistical assumptions. At median follow-up of 36 months (range: 7-85 months), the 3-year local failure rate was 7%, whereas the 3-year disease-free and overall survival rates were 73.0% and 86.1%, respectively. Grade 3 leukopenia and neutropenia were reported in only 1 and 2 cases, respectively. Gastrointestinal toxicity was always grade 1 or 2. Conclusions: Addition of CBs in the accelerated fractionation modality to the whole pelvis chemoradiation followed by radical surgery results in a high rate of pathologically assessed complete response to CRT and a very

  5. Simultaneous metal-insulator and antiferromagnetic transitions in orthorhombic perovskite iridate S r0.94I r0.78O2.68 single crystals

    NASA Astrophysics Data System (ADS)

    Zheng, H.; Terzic, J.; Ye, Feng; Wan, X. G.; Wang, D.; Wang, Jinchen; Wang, Xiaoping; Schlottmann, P.; Yuan, S. J.; Cao, G.

    2016-06-01

    The orthorhombic perovskite SrIr O3 is a semimetal, an intriguing exception in iridates where the strong spin-orbit interaction coupled with electron correlations tends to impose an insulating state. We report results of our investigation of bulk single-crystal S r0.94I r0.78O2.68 or Ir-deficient, orthorhombic perovskite SrIr O3 . It retains the same crystal structure as stoichiometric SrIr O3 but exhibits a sharp, simultaneous antiferromagnetic (AFM) and metal-insulator (MI) transition occurring in the basal-plane resistivity at 185 K. Above it, the basal-plane resistivity features an extended regime of almost linear temperature dependence up to 800 K but the strong electronic anisotropy renders an insulating behavior in the out-of-plane resistivity. The Hall resistivity undergoes an abrupt sign change and grows below 40 K, which along with the Sommerfeld constant of 20 mJ /mol K2 suggests a multiband effect. All results including our first-principles calculations underscore a delicacy of the paramagnetic, metallic state in SrIr O3 that is in close proximity to an AFM insulating state. The contrasting ground states in isostructural S r0.94I r0.78O2.68 and SrIr O3 illustrate a critical role of lattice distortions and Ir deficiency in rebalancing the ground state in the iridates. Finally, the concurrent AFM and MI transitions reveal a direct correlation between the magnetic transition and formation of an activation gap in the iridate, which is conspicuously absent in S r2Ir O4 .

  6. Surgery for lung cancer invading the mediastinum

    PubMed Central

    Al-Ayoubi, Adnan M.

    2016-01-01

    Lung cancer infiltrating the mediastinum is a subset of locally advanced lung tumors for which surgery is not routinely offered. Radical operations that involve removal of adjacent mediastinal structures to obtain free margins may provide a realistic cure. Such extended resections are typically reserved to highly motivated patients seeking more aggressive management, and are only offered following complete evaluation on a case-by-case basis. Positive prognosis depends on complete R0 resection and lack of mediastinal nodal metastases. Careful and exhaustive preoperative planning as well as surgical expertise cannot be overemphasized for successful surgical outcomes. Here we provide a brief summary of the literature as well as our own experience managing these rare and sometimes challenging surgeries. PMID:27942411

  7. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer: A retrospective study in a single minimally invasive surgery center.

    PubMed

    Hao, Yingxue; Yu, Peiwu; Qian, Feng; Zhao, Yongliang; Shi, Yan; Tang, Bo; Zeng, Dongzhu; Zhang, Chao

    2016-06-01

    Laparoscopy-assisted gastrectomy (LAG) has gained international acceptance for the treatment of early gastric cancer (EGC). However, the use of laparoscopic surgery in the management of advanced gastric cancer (AGC) has not attained widespread acceptance. This retrospective large-scale patient study in a single center for minimally invasive surgery assessed the feasibility and safety of LAG for T2 and T3 stage AGC. A total of 628 patients underwent LAG and 579 patients underwent open gastrectomy (OG) from Jan 2004 to Dec 2011. All cases underwent radical lymph node (LN) dissection from D1 to D2+. This study compared short- and long-term results between the 2 groups after stratifying by pTNM stages, including the mean operation time, volume of blood loss, number of harvested LNs, average days of postoperative hospital stay, mean gastrointestinal function recovery time, intra- and post-operative complications, recurrence rate, recurrence site, and 5-year survival curve. Thirty-five patients (5.57%) converted to open procedures in the LAG group. There were no significant differences in retrieved LN number (30.4 ± 13.4 vs 28.1 ± 17.2, P = 0.43), proximal resection margin (PRM) (6.15 ± 1.63 vs 6.09 ± 1.91, P = 0.56), or distal resection margin (DRM) (5.46 ± 1.74 vs 5.40 ± 1.95, P = 0.57) between the LAG and OG groups, respectively. The mean volume of blood loss (154.5 ± 102.6 vs 311.2 ± 118.9 mL, P < 0.001), mean postoperative hospital stay (7.6 ± 2.5 vs 10.7 ± 3.6 days, P < 0.001), mean time for gastrointestinal function recovery (3.3 ± 1.4 vs 3.9 ± 1.5 days, P < 0.001), and postoperative complications rate (6.4% vs 10.5%, P = 0.01) were clearly lower in the LAG group compared to the OG group. However, the recurrence pattern and site were not different between the 2 groups, even they were stratified by the TNM stage. The 5-year overall survival (OS) rates were 85.38%, 79.70%, 57

  8. Magnetostructural coupling, magnetic ordering, and cobalt spin reorientation in metallic P r0.5S r0.5Co O3 cobaltite

    NASA Astrophysics Data System (ADS)

    García-Muñoz, José Luis; Padilla-Pantoja, Jessica; Torrelles, Xavier; Blasco, Javier; Herrero-Martín, Javier; Bozzo, Bernat; Rodríguez-Velamazán, José A.

    2016-07-01

    In half-doped P r0.50A0.50Co O3 metallic perovskites, the spin-lattice coupling brings about distinct magnetostructural transitions for A =Ca and A =Sr at temperatures close to ˜100 K. However, the ground magnetic properties of P r0.50S r0.50Co O3 (PSCO) strongly differ from P r0.50C a0.50Co O3 ones, where a partial P r3 + to P r4 + valence shift and Co spin transition makes the system insulating below the transition. This paper investigates and describes the relationship between the I m m a →I 4 /m c m symmetry change [Padilla-Pantoja, García-Muñoz, Bozzo, Jirák, and Herrero-Martín, Inorg. Chem. 53, 12297 (2014)] and the original magnetic behavior of PSCO versus temperature and external magnetic fields. The FM1 and FM2 ferromagnetic phases, above and below the magnetostructural transition (TS 1˜120 K ) have been investigated. The FM2 phase of PSCO is composed of [100] FM domains, with magnetic symmetry I m'm'a (mx≠0 , mz=0 ). The magnetic space group of the FM1 phase is F m'm'm (with mx=my ). Neutron data analyses in combination with magnetometry and earlier reports results agrees with a reorientation of the magnetization axis by 45∘ within the a b plane across the transition, in which the system retains its metallic character. The presence below TS 1 of conjugated magnetic domains, both of F m'm'm symmetry but having perpendicular spin orientations along the diagonals in the x y plane of the tetragonal unit cell, is at the origin of the anomalies observed in the macroscopic magnetization. A relatively small field μ0H [⊥ z ] ≳30 mT is able to reorient the magnetization within the a b plane, whereas a higher field (μ0H [∥z ] ≳1.2 T at 2 K) is necessary to align the Co moments perpendicular to the a b plane. Such a spin reorientation, in which the orbital and spin components of the Co moment rotate joined by 45∘, was not observed previously in analogous cobaltites without praseodymium.

  9. Comparing methods for estimating R0 from the size distribution of subcritical transmission chains.

    PubMed

    Blumberg, S; Lloyd-Smith, J O

    2013-09-01

    Many diseases exhibit subcritical transmission (i.e. 0<R0<1) so that infections occur as self-limited 'stuttering chains'. Given an ensemble of stuttering chains, information about the number of cases in each chain can be used to infer R0, which is of crucial importance for monitoring the risk that a disease will emerge to establish endemic circulation. However, the challenge of imperfect case detection has led authors to adopt a variety of work-around measures when inferring R0, such as discarding data on isolated cases or aggregating intermediate-sized chains together. Each of these methods has the potential to introduce bias, but a quantitative comparison of these approaches has not been reported. By adapting a model based on a negative binomial offspring distribution that permits a variable degree of transmission heterogeneity, we present a unified analysis of existing R0 estimation methods. Simulation studies show that the degree of transmission heterogeneity, when improperly modeled, can significantly impact the bias of R0 estimation methods designed for imperfect observation. These studies also highlight the importance of isolated cases in assessing whether an estimation technique is consistent with observed data. Analysis of data from measles outbreaks shows that likelihood scores are highest for models that allow a flexible degree of transmission heterogeneity. Aggregating intermediate sized chains often has similar performance to analyzing a complete chain size distribution. However, truncating isolated cases is beneficial only when surveillance systems clearly favor full observation of large chains but not small chains. Meanwhile, if data on the type and proportion of cases that are unobserved were known, we demonstrate that maximum likelihood inference of R0 could be adjusted accordingly. This motivates the need for future empirical and theoretical work to quantify observation error and incorporate relevant mechanisms into stuttering chain models used

  10. Inferring R0 in emerging epidemics—the effect of common population structure is small

    PubMed Central

    Ball, Frank; Dhersin, Jean-Stéphane; Tran, Viet Chi; Wallinga, Jacco; Britton, Tom

    2016-01-01

    When controlling an emerging outbreak of an infectious disease, it is essential to know the key epidemiological parameters, such as the basic reproduction number R0 and the control effort required to prevent a large outbreak. These parameters are estimated from the observed incidence of new cases and information about the infectious contact structures of the population in which the disease spreads. However, the relevant infectious contact structures for new, emerging infections are often unknown or hard to obtain. Here, we show that, for many common true underlying heterogeneous contact structures, the simplification to neglect such structures and instead assume that all contacts are made homogeneously in the whole population results in conservative estimates for R0 and the required control effort. This means that robust control policies can be planned during the early stages of an outbreak, using such conservative estimates of the required control effort. PMID:27581480

  11. Utility of R0 as a predictor of disease invasion in structured populations

    USGS Publications Warehouse

    Cross, P.C.; Johnson, P.L.F.; Lloyd-Smith, J. O.; Getz, W.M.

    2007-01-01

    Early theoretical work on disease invasion typically assumed large and well-mixed host populations. Many human and wildlife systems, however, have small groups with limited movement among groups. In these situations, the basic reproductive number, R0, is likely to be a poor predictor of a disease pandemic because it typically does not account for group structure and movement of individuals among groups. We extend recent work by combining the movement of hosts, transmission within groups, recovery from infection and the recruitment of new susceptibles into a stochastic model of disease in a host metapopulation. We focus on how recruitment of susceptibles affects disease invasion and how population structure can affect the frequency of superspreading events (SSEs). We show that the frequency of SSEs may decrease with the reduced movement and the group sizes due to the limited number of susceptible individuals available. Classification tree analysis of the model results illustrates the hierarchical nature of disease invasion in host metapopulations. First, the pathogen must effectively transmit within a group (R0 > 1), and then the pathogen must persist within a group long enough to allow for movement among the groups. Therefore, the factors affecting disease persistence - such as infectious period, group size and recruitment of new susceptibles - are as important as the local transmission rates in predicting the spread of pathogens across a metapopulation. ?? 2006 The Royal Society.

  12. Prognostic Factors and Patterns of Relapse in Ewing Sarcoma Patients Treated With Chemotherapy and R0 Resection

    SciTech Connect

    Pan, Hubert Y.; Morani, Ajaykumar; Wang, Wei-Lien; Hess, Kenneth R.; Paulino, Arnold C.; Ludwig, Joseph A.; Lin, Patrick P.; Daw, Najat C.; Mahajan, Anita

    2015-06-01

    Purpose: To identify prognostic factors and patterns of relapse for patients with Ewing sarcoma who underwent chemotherapy and R0 resection without radiation therapy (RT). Methods and Materials: We reviewed the medical records of patients who underwent surgical resection at our institution between 2000 and 2013 for an initial diagnosis of Ewing sarcoma. The associations of demographic and clinical factors with local control (LC) and patient outcome were determined by Cox regression. Time to events was measured from the time of surgery. Survival curves were estimated by the Kaplan-Meier method and compared by the log-rank test. Results: A total of 66 patients (median age 19 years, range 4-55 years) met the study criteria. The median follow-up was 5.6 years for living patients. In 43 patients (65%) for whom imaging studies were available, the median tumor volume reduction was 73%, and at least partial response by Response Evaluation Criteria in Solid Tumors was achieved in 17 patients (40%). At 5 years, LC was 78%, progression-free survival (PFS) was 59%, and overall survival (OS) was 65%. Poor histologic response (necrosis ≤95%) was an independent predictor of LC (hazard ratio [HR] 6.8, P=.004), PFS (HR 5.2, P=.008), and OS (HR 5.0, P=.008). Metastasis on presentation was also an independent predictor of LC (HR 6.3, P=.011), PFS (HR 6.8, P=.002), and OS (HR 6.7, P=.002). Radiologic partial response was a predictor of PFS (HR 0.26, P=.012), and postchemotherapy tumor volume was associated with OS (HR 1.06, P=.015). All deaths were preceded by distant relapse. Of the 8 initial local-only relapses, 5 (63%) were soon followed by distant relapse. Predictors of poor postrecurrence survival were time to recurrence <1 year (HR 11.5, P=.002) and simultaneous local and distant relapse (HR 16.8, P=.001). Conclusions: Histologic and radiologic response to chemotherapy were independent predictors of outcome. Additional study is needed to determine the role of adjuvant

  13. Port-site metastasis as a primary complication following retroperitoneal laparoscopic radical resection of renal pelvis carcinoma or nephron-sparing surgery: A report of three cases and review of the literature

    PubMed Central

    WANG, NING; WANG, KAI; ZHONG, DACHUAN; LIU, XIA; SUN, JI; LIN, LIANXIANG; GE, LINNA; YANG, BO

    2016-01-01

    The present study reports the clinical data of two patients with renal pelvis carcinoma and one patient with renal carcinoma who developed port-site metastasis following retroperitoneal laparoscopic surgery. The current study aimed to identify the cause and prognosis of the occurrence of port-site metastasis subsequent to laparoscopic radical resection of renal pelvis carcinoma and nephron-sparing surgery. Post-operative pathology confirmed the presence of high-grade urothelial cell carcinoma in two patients and Fuhrman grade 3 renal clear cell carcinoma in one patient. Port-site metastasis was initially detected 1–7 months post-surgery. The two patients with renal pelvis carcinoma succumbed to the disease 2 and 4 months following the identification of the port-site metastasis, respectively, whereas the patient with renal carcinoma survived with no disease progression during the targeted therapy period. The occurrence of port-site metastasis may be attributed to systemic and local factors. Measures to reduce the development of this complication include strict compliance with the operating guidelines for tumor surgery, avoidance of air leakage at the port-site, complete removal of the specimen with an impermeable bag, irrigation of the laparoscopic instruments and incisional wound with povidone-iodine when necessary, and enhancement of the body's immunity. Close post-operative follow-up observation for signs of recurrence or metastasis is essential, and systemic chemotherapy may be required in patients with high-grade renal pelvis carcinoma and renal carcinoma in order to prolong life expectancy. PMID:27313720

  14. [Radical prostatectomy - pro robotic].

    PubMed

    Gillitzer, R

    2012-05-01

    Anatomical radical prostatectomy was introduced in the early 1980s by Walsh and Donker. Elucidation of key anatomical structures led to a significant reduction in the morbidity of this procedure. The strive to achieve similar oncological and functional results to this gold standard open procedure but with further reduction of morbidity through a minimally invasive access led to the establishment of laparoscopic prostatectomy. However, this procedure is complex and difficult and is associated with a long learning curve. The technical advantages of robotically assisted surgery coupled with the intuitive handling of the device led to increased precision and shortening of the learning curve. These main advantages, together with a massive internet presence and aggressive marketing, have resulted in a rapid dissemination of robotic radical prostatectomy and an increasing patient demand. However, superiority of robotic radical prostatectomy in comparison to the other surgical therapeutic options has not yet been proven on a scientific basis. Currently robotic-assisted surgery is an established technique and future technical improvements will certainly further define its role in urological surgery. In the end this technical innovation will have to be balanced against the very high purchase and running costs, which remain the main limitation of this technology.

  15. Radical prostatectomy

    MedlinePlus

    ... Sometimes, laparoscopic surgery is performed using a robotic system. The surgeon moves the instruments and camera using robotic arms while sitting at a control console near the operating table. Not every hospital offers robotic surgery. Perineal : ...

  16. 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

  17. Upfront Systemic Chemotherapy and Short-Course Radiotherapy with Delayed Surgery for Locally Advanced Rectal Cancer with Distant Metastases: Outcomes, Compliance, and Favorable Prognostic Factors

    PubMed Central

    Kim, Tae Hyung; Ahn, Joong Bae; Jung, Minkyu; Kim, Tae Il; Kim, Hoguen; Shin, Sang Joon; Kim, Nam Kyu

    2016-01-01

    Purpose/Objective(s) Optimal treatment for locally advanced rectal cancer (LARC) with distant metastasis remains elusive. We aimed to evaluate upfront systemic chemotherapy and short-course radiotherapy (RT) followed by delayed surgery for such patients, and to identify favorable prognostic factors. Materials/Methods We retrospectively reviewed 50 LARC patients (cT4 or cT3, <2 mm from the mesorectal fascia) with synchronous metastatic disease. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival, treatment-related toxicity, and compliance. We considered P values <0.05 significant. Results At 22 months median follow-up, the median PFS time was 16 months and the 2-year PFS rate was 34.8%. Thirty-five patients who received radical surgery for primary and metastatic tumors were designated the curable group. Six patients with clinical complete response (ypCR) of metastases who underwent radical surgery for only the primary tumor were classified as potentially curable. Nine patients who received no radical surgery (3 received palliative surgery) were deemed the palliative group. The ypCR rate among surgery patients was 13.6%. PFS rates for the curable or potentially curable groups were significantly longer than that of the palliative group (P<0.001). On multivariate analysis, solitary organ metastasis and R0 status were independent prognostic factors for PFS. Conclusions These findings demonstrated that a strong possibility that upfront chemotherapy and short-course RT with delayed surgery are an effective alternative treatment for LARC with potentially resectable distant metastasis, owing to achievement of pathologic down-staging, R0 resection, and favorable compliance and toxicity, despite the long treatment duration. PMID:27536871

  18. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study.

    PubMed

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten; Høgdall, Estrid; Schnack, Tine Henrichsen; Christensen, Ib Jarle; Nedergaard, Lotte; Lundvall, Lene; Lydolph, Magnus Christian; Engelholm, Svend Aage; Høgdall, Claus

    2016-09-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor removal. One hundred fifty patients with advanced epithelial ovarian cancer were treated with primary debulking surgery (PDS). Complete PDS was achieved in 41 cases (27 %). The receiver operating characteristic curves demonstrated an area under the curve of 0.785 for HE4, 0.678 for CA125, and 0.688 for age. The multivariate model (Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index), consisting of HE4, age, and performance status, demonstrated an AUC of 0.853. According to the Danish indicator level, macro-radical PDS should be achieved in 60 % of patients admitted to primary surgery (positive predictive value of 60 %), resulting in a negative predictive value of 87.5 %, sensitivity of 68.3 %, specificity of 83.5 %, and cutoff of 0.63 for the CONATS index. Non-invasive prediction of complete PDS is possible with the CONATS index. The CONATS index is meant as a supplement to the standard preoperative evaluation of each patient. Evaluation of the CONATS index combined with radiological and/or laparoscopic findings may improve the assessment of the optimal treatment strategy in patients with advanced epithelial ovarian cancer.

  19. Decreased pretreatment lymphocyte/monocyte ratio is associated with poor prognosis in stage Ib1–IIa cervical cancer patients who undergo radical surgery

    PubMed Central

    Chen, Liang; Zhang, Fang; Sheng, Xiu-gui; Zhang, Shi-qian

    2015-01-01

    Background Recently, pretreatment monocyte counts and the lymphocyte/monocyte ratio (LMR) have been proven to be significantly associated with the clinical outcomes of several types of cancer. In this study, we analyzed the prognostic significance of the LMR in stage Ib1–IIa cervical cancer patients who underwent a radical operation. Methods A total of 485 patients with stage Ib1–IIa cervical cancer were included in this retrospective study. We evaluated the prognostic values of the absolute lymphocyte count, absolute monocyte count, and LMR by applying receiver operating characteristic curves. Kaplan–Meier curves and multivariate Cox proportional analyses were used to determine the recurrence-free survival (RFS) and overall survival (OS). Results The area under the curve was 0.640 for the RFS and 0.647 for the OS using the LMR. In the univariate analysis, an elevated preoperative LMR was significantly associated with an increased RFS (hazard ratio [HR], 0.373; 95% confidence interval [CI]: 0.247–0.563; P<0.001), and this result remained significant in the multivariate analysis (HR, 0.439; 95% CI: 0.279–0.693; P<0.001). In the univariate analysis, an elevated LMR was also significantly associated with an increased OS (HR, 0.381; 95% CI: 0.233–0.622; P<0.001), and the significance persisted in the multivariate analysis (HR, 0.417; 95% CI: 0.244–0.714; P=0.001). Conclusion A decreased pretreatment LMR is associated with a poor prognosis in stage Ib1–IIa cervical cancer patients who undergo a radical operation. A prospective study is warranted for further validation of our findings. PMID:26089685

  20. On the definition and utilization of heritable variation among hosts in reproduction ratio R0 for infectious diseases.

    PubMed

    Anche, M T; de Jong, M C M; Bijma, P

    2014-10-01

    Infectious diseases have a major role in evolution by natural selection and pose a worldwide concern in livestock. Understanding quantitative genetics of infectious diseases, therefore, is essential both for understanding the consequences of natural selection and for designing artificial selection schemes in agriculture. The basic reproduction ratio, R0, is the key parameter determining risk and severity of infectious diseases. Genetic improvement for control of infectious diseases in host populations should therefore aim at reducing R0. This requires definitions of breeding value and heritable variation for R0, and understanding of mechanisms determining response to selection. This is challenging, as R0 is an emergent trait arising from interactions among individuals in the population. Here we show how to define breeding value and heritable variation for R0 for genetically heterogeneous host populations. Furthermore, we identify mechanisms determining utilization of heritable variation for R0. Using indirect genetic effects, next-generation matrices and a SIR (Susceptible, Infected and Recovered) model, we show that an individual's breeding value for R0 is a function of its own allele frequencies for susceptibility and infectivity and of population average susceptibility and infectivity. When interacting individuals are unrelated, selection for individual disease status captures heritable variation in susceptibility only, yielding limited response in R0. With related individuals, however, there is a secondary selection process, which also captures heritable variation in infectivity and additional variation in susceptibility, yielding substantially greater response. This shows that genetic variation in susceptibility represents an indirect genetic effect. As a consequence, response in R0 increased substantially when interacting individuals were genetically related.

  1. Detection of circulating prostatic cells during radical prostatectomy.

    PubMed

    Planz, B; Szyska, P; Valdor, M; Boeckmann, W; Füzesi, L; Jakse, G

    1997-01-01

    The detection of micrometastasis of prostate cancer could help to decide more appropriate therapeutic strategies in an individual patient. We have developed a flow cytometric method for detecting cytokeratin-positive cells in the peripheral blood before, during and after radical prostatectomy in patients with prostatic carcinoma. By means of this technique we were able to detect a higher number of cytokeratin-positive cells in the intraoperative blood sample than in the pre- and postoperative blood sample in 15 patients with prostate cancer (P < 0.05). Our results show an increase in the number of cytokeratin-positive cells with increasing tumor stage and grade, as well a good correlation of prostate-specific antigen (PSA) value with the number of cytokeratin-positive cells (r > 0.6). Our results underline the importance of no-touch techniques at prostatectomy to minimize release of tumor cells into the circulation during surgery. In the light of our results we consider that the indication for cell savers during radical prostatectomy should be reevaluated. The possibility of detecting single metastatic cells in peripheral blood will enable better individual patient management, and open up new modalities for diagnosing early prostate cancer and enhancing patient monitoring in relapse and tumor progression.

  2. Robotic radical hysterectomy in the management of gynecologic malignancies.

    PubMed

    Pareja, Rene; Ramirez, Pedro T

    2008-01-01

    Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 cases were reported in the literature of radical hysterectomy performed with robotic surgery. When comparing robotic surgery with laparoscopy or laparotomy in performing a radical hysterectomy, the literature shows that robotic surgery offers an advantage over the other 2 surgical approaches with regard to operative time, blood loss, and length of hospitalization. Future studies are needed to further elucidate the equivalence or superiority of robotic surgery to laparoscopy or laparotomy in performing a radical hysterectomy.

  3. Osteoclast radicals.

    PubMed

    Silverton, S

    1994-11-01

    In biological research, new ideas arise and quickly spread to encompass the entire field. Thus, the evolution of molecular biology has significantly changed our methods of approaching our research. A similar far-reaching finding has been the advent of radical reactions into biology. Although radical chemistry has been utilized for many technological advances that affect our daily lives, the appreciation of this same process within our cells has opened an unexplored arena for research enquiry. As cellular messengers, radical molecules seem whimsically designed: they are evanescent, rapidly and apparently indiscriminately reactive, and barely detectable by most biological methods. Yet, our initial probing of these reactive agents in cells and organisms has led us to postulate a virtually undescribed system of communication within and among cells which may have significant effects in multiple organs. In bone, radical reactants have been attributed with an important role in the control of bone resorption.

  4. Metastasized pancreatic carcinoma with neoadjuvant FOLFIRINOX therapy and R0 resection

    PubMed Central

    Schneitler, Sophie; Kröpil, Patric; Riemer, Jasmin; Antoch, Gerald; Knoefel, Wolfram Trudo; Häussinger, Dieter; Graf, Dirk

    2015-01-01

    Patients with metastasized carcinoma of the pancreas have a very poor prognosis, and long-term survival cannot be expected. This case report describes two patients with an initial diagnosis of metastatic pancreatic cancer, both with hepatic metastases and one with an additional peritoneal carcinomatosis. Initially, both patients were treated intravenously with the FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. Surprisingly, the FOLFIRINOX treatment resulted in complete resolution of the hepatic metastases in both patients, with no lesions detectable by computed tomography scan. Furthermore, treatment response included decreased diameter of the primary tumor in the tail of the pancreas and disappearance of the additional peritoneal carcinomatosis. Both patients were discussed by our multidisciplinary tumor board, which recommended surgical resections of the carcinoma. The R0 resection of the primary tumor was successful in both cases and, interestingly, the resected tissues showed no evidence of the hepatic metastases intraoperatively. In the first case, the patient received a postoperative 6-mo course of adjuvant chemotherapy with gemcitabine. In the second case, the patient continued to receive the FOLFIRINOX regimen for an additional 6 mo postoperatively. At 12 mo after the operation, a nonresectable retroperitoneal lymph node metastasis was detected in the first patient, whereas the second patient remained in complete remission at the time of this report (5 mo after the adjuvant therapy was discontinued). This case report is the first of its kind to describe two cases of hepatic metastatic pancreatic carcinoma that were resectable following treatment with FOLFIRINOX. Further studies are required to examine the role of FOLFIRINOX as a neoadjuvant treatment option in subgroups of patients with initially metastasized pancreatic carcinoma. PMID:26034375

  5. Gamma-ray bursts: discovering the progenitors and understanding the explosion - visits A0-R0

    NASA Astrophysics Data System (ADS)

    Kulkarni, Shrinivas

    2000-07-01

    Gamma-ray burst astronomy, one of the most active and exciting frontiers in astrophysics, is now entering a critical stage - with dramatic leaps in our understanding of these events, as well as new discoveries imminent. In the upcoming year, improvements in triggering and positioning accuracy provided by the SAX and HETE-2 gamma-ray satellites will allow entirely new classes of events to be studied. Given the recent progress in this field, we are now in a position to design precision, broadband measurements that can provide quantitative information on the as-yet unknown energy sources, the explosion geometry, and the surrounding medium. In particular, the growing evidence of an intimate connection between SNe and GRBs can be definitively tested. Who can activate the proposal: Shri Kulkarni srk@astro.caltech.edu Work: {626} 395-4010 Mobile: {626} 676-4721 Home: {626} 795-7894 Alan Diercks ad@astro.caltech.edu Work: {626} 395-4970 Mobile {626} 676-4724 Home: {626} 577-7390 Titus Galama tjg@astro.caltech.edu Work: {626} 395-8495 Mobile {626} 676-4723 Home: {626} 568-3937-The STIS CCD imaging should occur as quickly as possible after activiation. {visits 1-72.}-The UV sepctroscopy {Visits UW and UV} should begin 2-3 days after activation.-The STIS UV imaging should occur approximately {A0, C0, E0, G0, I0, K0, M0, O0, Q0} 1 week after activation. and goes with The WFPC2 imaging {A1-B0, C1-D0, E1-F0, G1-H0, I1-J0, K1-L0, M1-N0, O1-P0, Q1-R0} should start 15-20 daysafter activation depending on redshfit.

  6. Different survival outcomes after curative R0-resection for Eastern Asian and European gastric cancer

    PubMed Central

    Kim, Young-Woo; Joo, Jungnam; Yoon, Hong Man; Eom, Bang Wool; Ryu, Keun Won; Choi, Il Ju; Kook, Myeong Cherl; Schuhmacher, Christoph; Siewert, Joerg Ruediger; Reim, Daniel

    2016-01-01

    Abstract Several retrospective analyses on patients who underwent gastric cancer (GC) surgery revealed different survival outcomes between Eastern (Korean, Japanese) and Western (USA, Europe) countries due to potential ethnical and biological differences. This study investigates treatment outcomes between specialized institution for GC in Korea and Germany. The prospectively documented databases of the Gastric Cancer Center of the National Cancer Center, Korea (NCCK) and the Department of Surgery of the Technische Universitaet Muenchen (TUM), Germany were screened for patients who underwent primary surgical resection for GC between 2002 and 2008. Baseline characteristics were compared using χ2 testing, and 2 cohorts were matched using a propensity score matching (PSM) method. Patients’ survival was estimated using Kaplan–Meier method, and multivariable Cox proportional hazard model was used for comparison. Three thousand seven hundred ninety-five patients were included in the final analysis, 3542 from Korea and 253 from Germany. Baseline characteristics revealed statistically significant differences for age, tumor location, pT stage, grading, lymphatic vessel infiltration (LVI), comorbidities, number of dissected lymph nodes (LN), postoperative complications, lymph-node ratio stage, and application of adjuvant chemotherapy. After PSM, 171 patients in TUM were matched to NCCK patients, and baseline characteristics for both cohorts were well balanced. Patients in Korea had significantly longer survival than those in Germany both before and after PSM. When the analysis was performed for each UICC stage separately, same trend was found over all UICC stages before PSM. However, significant difference in survival was observed only for UICC I after PSM. This analysis demonstrates different survival outcomes after surgical treatment of GC on different continents in specialized centers after balancing of baseline characteristics by PSM. PMID:27428238

  7. Successful treatment of primary extramedullary leukemia (EML) of the uterus with radical surgery, chemotherapy, autologous bone marrow transplantation (BMT) and prophylactic local irradiation.

    PubMed

    Huter, O; Brezinka, C; Nachbaur, D; Schwaighofer, H; Lang, A; Niederwieser, D

    1996-09-01

    Extramedullary myeloid cell tumors are rare manifestations of acute nonlymphocytic leukemia (ANLL). While many advances in diagnosis have been made, dilemmas remain concerning the treatment of this disease. In primary extramedullary leukemia (EML) most reports agree upon a local therapy followed by systemic chemotherapy such as is used for ANLL. However, further prophylactic local or systemic therapy with stem cell support remains controversial. A 20-year-old patient was diagnosed as having granulocytic sarcoma (GS) of the uterus without evidence of ANLL in 1991. After resection of the tumor at the uterine cervix and chemotherapy with daunorubicin 50 mg/m2 (days 1-3) and cytosine-arabinoside 200 mg/m2 (days 1-7) in September 1991, complete remission was achieved. In October 1991 cytosine-arabinoside 1000 mg/m2 every 12 h from day 1 to day 6 and amsacrine 200 mg from day 5 to day 7 were given as consolidation. Two years later relapse occurred in the adnexae. After radical hysterectomy, the same induction and consolidation chemotherapy was administrated. Subsequently, cytoxane 60 mg/m2 and fractionated total body irradiation (6 x 200 cGy) were given as conditioning and the previously cryopreserved bone marrow was reinfused. Finally, after hematopoietic engraftment, prophylactic local irradiation (4500 cGy) to the pelvis was given resulting in a disease-free long-term survival of more than 36 months after relapse. Although this experience is confined to one patient, it may contribute to the design of prospective therapeutic studies in patients with primary EML.

  8. [Anatomic changes after radical surgery and reconstruction with pedunculated or revascularized flaps in advanced head and neck tumors: computerized tomography and magnetic resonance findings].

    PubMed

    Osti, M F; Scattoni Padovan, F; Ricciardi, D; De Angelis D'Ossat, M; Sbarbati, S; Pirolli, C; Maurizi Enrici, R; Anaveri, G

    1997-04-01

    January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps wer used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The postoperative scar around the flap exhibited soft-tissue density with slight post-contrast enhancement at CT and slightly hypodense on T2-weighted MR images. Post-contrast CT and MRI showed slight scar enhancement with no signal changes in the fatty component. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the structure used to repair the surgical defect: jejunal and radial flaps appeared as mostly fatty thickened layers with both imaging methods. Temporal and latissimus dorsi flaps are made basically of muscular tissue, fatty tissue and occasionally skin (used to repair a mucosal defect): consequently, CT showed a structure with mostly parenchymal density in all cases and MRI depicted intermediate signal intensity. MRI was useful to detect 12 revascularized jejunal or radial flaps thanks to its higher contrast resolution and multiplanar capabilities showing even such thin structures as these flaps. Moreover, MRI permitted to study skull base reconstruction with revascularized (latissimus dorsi) flaps in 5 of our patients.

  9. Mast Cells Density Positive to Tryptase Correlate with Microvascular Density in both Primary Gastric Cancer Tissue and Loco-Regional Lymph Node Metastases from Patients That Have Undergone Radical Surgery.

    PubMed

    Ammendola, Michele; Sacco, Rosario; Zuccalà, Valeria; Luposella, Maria; Patruno, Rosa; Gadaleta, Pietro; Zizzo, Nicola; Gadaleta, Cosmo Damiano; De Sarro, Giovambattista; Sammarco, Giuseppe; Oltean, Mihai; Ranieri, Girolamo

    2016-11-15

    Mast Cells (MCs) play a role in immune responses and more recently MCs have been involved in tumoral angiogenesis. In particular MCs can release tryptase, a potent in vivo and in vitro pro-angiogenic factor via proteinase-activated receptor-2 (PAR-2) activation and mitogen-activated protein kinase (MAPK) phosphorylation. MCs can release tryptase following c-Kit receptor activation. Nevertheless, no data are available concerning the relationship among MCs Density Positive to Tryptase (MCDPT) and Microvascular Density (MVD) in both primary gastric cancer tissue and loco-regional lymph node metastases. A series of 75 GC patients with stage T2-3N2-3M₀ (by AJCC for Gastric Cancer Seventh Edition) undergone to radical surgery were selected for the study. MCDPT and MVD were evaluated by immunohistochemistry and by image analysis system and results were correlated each to other in primary tumor tissue and in metastatic lymph nodes harvested. Furthermore, tissue parameters were correlated with important clinico-pathological features. A significant correlation between MCDPT and MVD was found in primary gastric cancer tissue and lymph node metastases. Pearson t-test analysis (r ranged from 0.74 to 0.79; p-value ranged from 0.001 to 0.003). These preliminary data suggest that MCDPT play a role in angiogenesis in both primary tumor and in lymph node metastases from GC. We suggest that MCs and tryptase could be further evaluated as novel targets for anti-angiogenic therapies.

  10. Mast Cells Density Positive to Tryptase Correlate with Microvascular Density in both Primary Gastric Cancer Tissue and Loco-Regional Lymph Node Metastases from Patients That Have Undergone Radical Surgery

    PubMed Central

    Ammendola, Michele; Sacco, Rosario; Zuccalà, Valeria; Luposella, Maria; Patruno, Rosa; Gadaleta, Pietro; Zizzo, Nicola; Gadaleta, Cosmo Damiano; De Sarro, Giovambattista; Sammarco, Giuseppe; Oltean, Mihai; Ranieri, Girolamo

    2016-01-01

    Mast Cells (MCs) play a role in immune responses and more recently MCs have been involved in tumoral angiogenesis. In particular MCs can release tryptase, a potent in vivo and in vitro pro-angiogenic factor via proteinase-activated receptor-2 (PAR-2) activation and mitogen-activated protein kinase (MAPK) phosphorylation. MCs can release tryptase following c-Kit receptor activation. Nevertheless, no data are available concerning the relationship among MCs Density Positive to Tryptase (MCDPT) and Microvascular Density (MVD) in both primary gastric cancer tissue and loco-regional lymph node metastases. A series of 75 GC patients with stage T2–3N2–3M0 (by AJCC for Gastric Cancer Seventh Edition) undergone to radical surgery were selected for the study. MCDPT and MVD were evaluated by immunohistochemistry and by image analysis system and results were correlated each to other in primary tumor tissue and in metastatic lymph nodes harvested. Furthermore, tissue parameters were correlated with important clinico-pathological features. A significant correlation between MCDPT and MVD was found in primary gastric cancer tissue and lymph node metastases. Pearson t-test analysis (r ranged from 0.74 to 0.79; p-value ranged from 0.001 to 0.003). These preliminary data suggest that MCDPT play a role in angiogenesis in both primary tumor and in lymph node metastases from GC. We suggest that MCs and tryptase could be further evaluated as novel targets for anti-angiogenic therapies. PMID:27854307

  11. Radicality of Resection and Survival After Multimodality Treatment is Influenced by Subsite of Locally Recurrent Rectal Cancer

    SciTech Connect

    Kusters, Miranda; Dresen, Raphaela C.; Martijn, Hendrik; Nieuwenhuijzen, Grard A.; Velde, Cornelis J.H. van de; Berg, Hetty A. van den; Beets-Tan, Regina G.H.; Rutten, Harm J.T.

    2009-12-01

    Purpose: To analyze results of multimodality treatment in relation to subsite of locally recurrent rectal cancer (LRRC). Method and Materials: A total of 170 patients with LRRC who underwent treatment between 1994 and 2008 were studied. The basic principle of multimodality treatment was preoperative (chemo)radiotherapy, intended radical surgery, and intraoperative radiotherapy. The subsites of LRRC were classified as presacral, posterolateral, (antero)lateral, anterior, anastomotic, or perineal. Subsites were related to radicality of the resection, local re-recurrence rate, distant metastasis rate, and cancer-specific survival. Results: R0 resections were achieved in 54% of the patients, and 5-year cancer-specific survival was 40.5%. The worst outcomes were seen in presacral LRRC, with only 28% complete resections and 19% 5-year survival (p = 0.03 vs. other subsites). Anastomotic LRRC resulted in the most favorable outcomes, with 77% R0 resections and 60% 5-year survival (p = 0.04). Generally, if a complete resection was achieved, survival improved, except in posterolateral LRRC. Local re-recurrence and metastasis rate were lowest in anastomotic LRRC. Conclusions: Classification of the subsite of LRRC is a predictor of potentially resectable and consequently curable disease. Treatment of posterior LRRC imposes poor results, whereas anastomotic LRRC location shows superior results.

  12. 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 ...

  13. Estimating the Basic Reproductive Number (R0) for African Swine Fever Virus (ASFV) Transmission between Pig Herds in Uganda.

    PubMed

    Barongo, Mike B; Ståhl, Karl; Bett, Bernard; Bishop, Richard P; Fèvre, Eric M; Aliro, Tony; Okoth, Edward; Masembe, Charles; Knobel, Darryn; Ssematimba, Amos

    2015-01-01

    African swine fever (ASF) is a highly contagious, lethal and economically devastating haemorrhagic disease of domestic pigs. Insights into the dynamics and scale of virus transmission can be obtained from estimates of the basic reproduction number (R0). We estimate R0 for ASF virus in small holder, free-range pig production system in Gulu, Uganda. The estimation was based on data collected from outbreaks that affected 43 villages (out of the 289 villages with an overall pig population of 26,570) between April 2010 and November 2011. A total of 211 outbreaks met the criteria for inclusion in the study. Three methods were used, specifically; (i) GIS- based identification of the nearest infectious neighbour based on the Euclidean distance between outbreaks, (ii) epidemic doubling time, and (iii) a compartmental susceptible-infectious (SI) model. For implementation of the SI model, three approaches were used namely; curve fitting (CF), a linear regression model (LRM) and the SI/N proportion. The R0 estimates from the nearest infectious neighbour and epidemic doubling time methods were 3.24 and 1.63 respectively. Estimates from the SI-based method were 1.58 for the CF approach, 1.90 for the LRM, and 1.77 for the SI/N proportion. Since all these values were above one, they predict the observed persistence of the virus in the population. We hypothesize that the observed variation in the estimates is a consequence of the data used. Higher resolution and temporally better defined data would likely reduce this variation. This is the first estimate of R0 for ASFV in a free range smallholder pig keeping system in sub-Saharan Africa and highlights the requirement for more efficient application of available disease control measures.

  14. Neoadjuvant Gemcitabine Chemotherapy followed by Concurrent IMRT Simultaneous Boost Achieves High R0 Resection in Borderline Resectable Pancreatic Cancer Patients

    PubMed Central

    Huang, Xiaolun; Knoble, Jeanna L.; Aguila, Fernando N.; Patel, Tara; Chambers, Lowell W.; Hu, Honglin; Liu, Hao

    2016-01-01

    Background To study the feasibility of down stage the borderline resectable pancreatic cancer (BRPC) to resectable disease, we reported our institutional results using an intensity-modulated radiation therapy (IMRT) simultaneous integrated boost (SIB) dose escalation approach to improve R0 resectability. Methods We reviewed our past 7 years of experience of using neoadjuvant induction chemotherapy with Gemcitabine followed by concurrent chemoradiaiton for BRPC. During the concurrent, chemo was 5-FU and radiation were IMRT with SIB technique to target the key areas with dose escalation to 5600 in 28 fractions. The key areas were defined by PET positive area. This was followed by restaging imaging to rule out distant metastases before resection. Results 25 finished dose escalation protocol. 2 of the 25 cases developed distant metastases, 23 (92%) patients without distant metastases underwent pancreatectomy. Among the those received pancreatectomy, 22 (95%) achieved negative margin (R0). The gastrointestinal toxicity > grade 2 was 8% and there was no grade 4 toxicity. Conclusion Neoadjuvant Gemcitabine-based induction chemotherapy followed by 5-FU-based IMRT-SIB is a feasible option in improving the likelihood of R0 resection rate in BRPC without compromising the organs at risk for toxicity. PMID:27935952

  15. Structure in the variability of the basic reproductive number (R0) for Zika epidemics in the Pacific islands

    PubMed Central

    Champagne, Clara; Salthouse, David Georges; Paul, Richard; Cao-Lormeau, Van-Mai; Roche, Benjamin; Cazelles, Bernard

    2016-01-01

    Before the outbreak that reached the Americas in 2015, Zika virus (ZIKV) circulated in Asia and the Pacific: these past epidemics can be highly informative on the key parameters driving virus transmission, such as the basic reproduction number (R0). We compare two compartmental models with different mosquito representations, using surveillance and seroprevalence data for several ZIKV outbreaks in Pacific islands (Yap, Micronesia 2007, Tahiti and Moorea, French Polynesia 2013-2014, New Caledonia 2014). Models are estimated in a stochastic framework with recent Bayesian techniques. R0 for the Pacific ZIKV epidemics is estimated between 1.5 and 4.1, the smallest islands displaying higher and more variable values. This relatively low range of R0 suggests that intervention strategies developed for other flaviviruses should enable as, if not more effective control of ZIKV. Our study also highlights the importance of seroprevalence data for precise quantitative analysis of pathogen propagation, to design prevention and control strategies. DOI: http://dx.doi.org/10.7554/eLife.19874.001 PMID:27897973

  16. Results of radical surgery for rectal cancer.

    PubMed

    Heald, R J; Karanjia, N D

    1992-01-01

    This paper examines the hypothesis that a reduction in the distal mural margin during anterior resection for sphincter conservation in rectal cancer excision is safe, provided total mesorectal excision is undertaken with wash-out of the clamped rectum. One hundred ninety-two patients underwent anterior resection and 21 (less than 10%) patients underwent abdomino-perineal excision (APE) by one surgeon (RJH). Anterior resections were classified as "curative" (79%) and "non-curative" (21%); in the "curative" sub-group less than 4% of patients developed local recurrence. The series was retrospectively analyzed for the effect of mural margins on local recurrence with 152 patients undergoing "curative" anterior resections and 40 patients undergoing "non-curative" resections. In the 152 specimens from curative resections, 110 had a resection margin greater than 1 cm and 42 had a resection margin less than 1 cm. Four patients developed local recurrence in the greater than 1 cm margin group (95% confidence interval: 0.8%-7.8%) and no patients developed local recurrence in the less than or equal to 1 cm margin group (95% confidence interval: 0%-5.9%). In each patient with local recurrence a cause for failure was apparent. There was no statistically significant difference in local recurrence rate between the less than or equal to 1 cm margin group and the greater than 1 cm margin group. A reduction in resection margin therefore did not compromise survival after anterior resection. The significance of lateral resection margins is discussed. The role of deep radiotherapy and cytotoxics are considered.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Early multifocal recurrence of hepatoblastoma in the residual liver after R0 liver resection with ALPPS procedure: a case report

    PubMed Central

    Syed, Aamir Ali; Khan, Ahsun W.; Hanif, Faisal

    2016-01-01

    Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been successfully employed in adults to avoid potential liver insufficiency in patient with small future liver volume (FLV) when subjected to conventional right trisectionectomy. We are reporting an infant with hepatoblastoma, who underwent a technically successful ALPPS procedure with R0 resection. However he developed very early recurrence within the first month after the procedure. We present this report with a view to share our unexpected finding of early multifocal recurrence of hepatoblastoma in the residual liver after ALPPS procedure in a very young patient. PMID:27826578

  18. Plastic Surgery

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness 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 " ...

  19. Outpatient Surgery

    MedlinePlus

    ... Outpatient Surgery Share this Page Preparing For Surgery Effects of Anesthesia Children and Anesthesia Pregnancy and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery ...

  20. Spotting Epidemic Keystones by R0 Sensitivity Analysis: High-Risk Stations in the Tokyo Metropolitan Area

    PubMed Central

    Yashima, Kenta; Sasaki, Akira

    2016-01-01

    How can we identify the epidemiologically high-risk communities in a metapopulation network? The network centrality measure, which quantifies the relative importance of each location, is commonly utilized for this purpose. As the disease invasion condition is given from the basic reproductive ratio R0, we have introduced a novel centrality measure based on the sensitivity analysis of this R0 and shown its capability of revealing the characteristics that has been overlooked by the conventional centrality measures. The epidemic dynamics over the commute network of the Tokyo metropolitan area is theoretically analyzed by using this centrality measure. We found that, the impact of countermeasures at the largest station is more than 1,000 times stronger compare to that at the second largest station, even though the population sizes are only around 1.5 times larger. Furthermore, the effect of countermeasures at every station is strongly dependent on the existence and the number of commuters to this largest station. It is well known that the hubs are the most influential nodes, however, our analysis shows that only the largest among the network plays an extraordinary role. Lastly, we also found that, the location that is important for the prevention of disease invasion does not necessarily match the location that is important for reducing the number of infected. PMID:27607239

  1. O 2 interaction with Pt{100}-hex-R0.7°: scattering, sticking and saturating

    NASA Astrophysics Data System (ADS)

    Guo, X.-C.; Bradley, J. M.; Hopkinson, A.; King, D. A.

    1994-05-01

    The interaction of oxygen with the Pt{100}-hex-R0.7° surface has been studied using supersonic molecular beams at incident translational energies from 0.06 to 0.9 eV and surface temperatures from 300 to 600 K. Scattering measurements show the existence of both intrinsic and extrinsic precursor states, and the trapping probability into these states is high at low incident energies. However, sticking probability measurements on the clean surface indicate that O 2 dissociative adsorption on Pt{100}-hex-R0.7° is a direct activated process, in contrast to that on Pt{100}-(1 × 1) or Pt{111}. Strong temperature enhancement of the initial sticking probability has been observed and accounted for partly by a dynamical barrier model. The sticking probability varies strongly with oxygen coverage, which is explained through computer simulations of island formation. The formation of small islands is demonstrated by TEAS measurements. Thermal desorption measurements show that, at high incident energies above 0.5 eV, new states are populated and higher coverages, up to a full monolayer, are reached.

  2. 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

  3. Comparison of Different Risk Classification Systems in 558 Patients with Gastrointestinal Stromal Tumors after R0-Resection

    PubMed Central

    Schmieder, Michael; Henne-Bruns, Doris; Mayer, Benjamin; Knippschild, Uwe; Rolke, Claudia; Schwab, Matthias; Kramer, Klaus

    2016-01-01

    Background: Due to adjuvant treatment concepts for patients with R0-resected gastrointestinal stromal tumors (GIST), a reproducible and reliable risk classification system proved of utmost importance for optimal treatment of patients and prediction of prognosis. The aim of this study was to reevaluate the impact of five widely-applied and well-established GIST risk classification systems (i.e., scores by Fletcher, Miettinen, Huang, Joensuu, and TNM classification) on a series of 558 GIST patients with long-term follow-up after R0 resection. Methods: Tumor size, mitotic count and site were used in variable combination to predict high- and low risk patients by the use of the five risk classification models. For survival analyses disease-specific survival, disease-free survival and overall-survival were investigated. Patients with initial metastatic disease or incompletely resectable tumors were excluded. Results: All GIST classification models distinguished well between patients with high-risk and low-risk tumors and none of the five risk systems was superior to predict patient outcome. The models showed significant heterogeneity. There was no significant difference between the different risk-groups regarding overall-survival. Subdivision of GIST patients with very low- and low-risk appeared to be negligible. Conclusions: Currently applied GIST risk classification systems are comparable to predict high- or low-risk patients with initial non-metastatic and completely resected GIST. However, the heterogeneity of the high-risk group and the absence of differences in overall survival indicate the need for more precise tumor- and patient-related criteria for better stratification of GIST and identification of patients who would benefit best from adjuvant tyrosine kinase inhibitor therapy. PMID:28082898

  4. Neuroprotective strategies in radical prostatectomy.

    PubMed

    Schiff, Jonathan D; Mulhall, John P

    2005-01-01

    In this section, authors from New York give their views on the various neuroprotective strategies for patients having a radical prostatectomy, such as the use of nerve grafts and other approaches. A joint study from Korea, the USA, Canada and the UK is presented in a paper on the importance of patient perception in the clinical assessment and management of BPH. There is also a review of robotic urological surgery. Finally, authors from New York give a review on the life of Isaac Newton. This is a new historical review in the journal, but one that will be of general interest.

  5. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...

  6. Perineal radical prostatectomy in the minimally invasive era.

    PubMed

    Rioja, Jorge; Rincon Mayans, Anibal; Parra, Raul O

    2012-10-01

    Radical prostatectomy is currently the standard of care for localized prostate cancer. In the last decade, the minimally invasive surgery, especially the robotic surgery has been growing and open techniques are less frequent performed. A non-systematic review of the literature is performed, highlighting the current situation of the perineal radical prostatectomy in the minimally invasive era, its indications, and functional and oncological outcomes. Radical perineal prostatectomy, when compared with other surgical approaches, still experience favorable outcomes. Urologist might be abandoning an underused surgical approach.

  7. A high reliability survey of discrete Epoch of Reionization foreground sources in the MWA EoR0 field

    NASA Astrophysics Data System (ADS)

    Carroll, P. A.; Line, J.; Morales, M. F.; Barry, N.; Beardsley, A. P.; Hazelton, B. J.; Jacobs, D. C.; Pober, J. C.; Sullivan, I. S.; Webster, R. L.; Bernardi, G.; Bowman, J. D.; Briggs, F.; Cappallo, R. J.; Corey, B. E.; de Oliveira-Costa, A.; Dillon, J. S.; Emrich, D.; Ewall-Wice, A.; Feng, L.; Gaensler, B. M.; Goeke, R.; Greenhill, L. J.; Hewitt, J. N.; Hurley-Walker, N.; Johnston-Hollitt, M.; Kaplan, D. L.; Kasper, J. C.; Kim, HS.; Kratzenberg, E.; Lenc, E.; Loeb, A.; Lonsdale, C. J.; Lynch, M. J.; McKinley, B.; McWhirter, S. R.; Mitchell, D. A.; Morgan, E.; Neben, A. R.; Oberoi, D.; Offringa, A. R.; Ord, S. M.; Paul, S.; Pindor, B.; Prabu, T.; Procopio, P.; Riding, J.; Rogers, A. E. E.; Roshi, A.; Shankar, N. Udaya; Sethi, S. K.; Srivani, K. S.; Subrahmanyan, R.; Tegmark, M.; Thyagarajan, Nithyanandan; Tingay, S. J.; Trott, C. M.; Waterson, M.; Wayth, R. B.; Whitney, A. R.; Williams, A.; Williams, C. L.; Wu, C.; Wyithe, J. S. B.

    2016-10-01

    Detection of the epoch of reionization H I signal requires a precise understanding of the intervening galaxies and AGN, both for instrumental calibration and foreground removal. We present a catalogue of 7394 extragalactic sources at 182 MHz detected in the RA = 0 field of the Murchison Widefield Array Epoch of Reionization observation programme. Motivated by unprecedented requirements for precision and reliability we develop new methods for source finding and selection. We apply machine learning methods to self-consistently classify the relative reliability of 9490 source candidates. A subset of 7466 are selected based on reliability class and signal-to-noise ratio criteria. These are statistically cross-matched to four other radio surveys using both position and flux density information. We find 7369 sources to have confident matches, including 90 partially resolved sources that split into a total of 192 sub-components. An additional 25 unmatched sources are included as new radio detections. The catalogue sources have a median spectral index of -0.85. Spectral flattening is seen towards lower frequencies with a median of -0.71 predicted at 182 MHz. The astrometric error is 7 arcsec compared to a 2.3 arcmin beam FWHM. The resulting catalogue covers ˜1400 deg2 and is complete to approximately 80 mJy within half beam power. This provides the most reliable discrete source sky model available to date in the MWA EoR0 field for precision foreground subtraction.

  8. Free Radical Oxidation in Rat Myocardium after Maximum Permissible Hepatic Resection.

    PubMed

    Ermolaev, P A; Khramykh, T P; Barskaya, L O

    2016-03-01

    Free radical oxidation in rat myocardial homogenate was studied by chemiluminescent assay during the early terms after maximum permissible liver resection. During this period, activation of free radical oxidation was biphasic. The critical terms characterized by dramatic intensification of free radical oxidation in the myocardium are the first hour and the first day after surgery. The period from 3 to 12 h after surgery, in which the indices of chemiluminescence decrease, can be tentatively termed as the period of "putative wellbeing". Normalization of the free radical oxidation processes in the myocardium occurred by day 7 after surgery.

  9. Over surgery in breast cancer.

    PubMed

    MacNeill, Fiona; Karakatsanis, Andreas

    2017-02-01

    Breast surgery remains the original and most effective 'targeted' therapy: excision of early cancer is curative and for more advanced disease surgery improves local disease control. However in well intentioned pursuit of cure and local disease control, some cancers are over-treated resulting in major physical and emotional morbidity. Less breast surgery is safe, as evidenced by steady reductions in mortality and local recurrence; earlier diagnosis and widespread use of systemic therapies and radiotherapy have allowed more conservative surgery. As tumour biology dictates cancer outcomes not surgery extent, surgery can safely be 'minimum required' rather than 'more is better' with the focus on removal of disease rather than healthy tissue. Surgeons can reduce the burden of surgery further but it is important that less surgery is not over-compensated by more radical or unnecessary systemic therapies and/or radiotherapy with their own toxicities and morbidity. We all need to be alert to the potential drivers of over treatment and over surgery such as failure to work within a multidisciplinary team, failure to design a multimodality treatment plan at diagnosis or overuse of novel assessment technologies of uncertain clinical utility. Pursuit of wide margins and the removal of the contra-lateral healthy breast for marginal risk-reduction gains are also to be discouraged as is routine local/regional surgery in stage 4 disease. The surgeon has a pivotal role in minimizing breast surgery to what is required to achieve the best oncological, functional and aesthetic outcomes.

  10. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    MedlinePlus

    ... 1- to 2-Year-Old Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... or bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  11. Contemporary Radical Economics.

    ERIC Educational Resources Information Center

    Sherman, Howard J.

    1984-01-01

    The origins of contemporary radical economics are examined. Applications of radical economics to price and value theory, labor segmentation theory, business cycles, industrial organization, government and business, imperialism and development, and comparative systems are reviewed. (Author/RM)

  12. Lung surgery

    MedlinePlus

    ... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using a ... clot from the pulmonary artery ( pulmonary embolism ) Treat complications of tuberculosis Video-assisted thoracoscopic surgery can be used to treat many of these ...

  13. The radical amplifier

    NASA Technical Reports Server (NTRS)

    Hastie, D. R.

    1994-01-01

    The radical amplifier as a method for measuring radical concentrations in the atmosphere has received renewed attention lately. In principle, it can measure the total concentration of HO(x) and RO(x) radicals by reacting ambient air with high concentrations of CO (3-10 percent) and NO (2-6 ppmv), and measuring the NO2 produced.

  14. Evolution of radical mastectomy for breast cancer

    PubMed Central

    Plesca, M; Bordea, C; El Houcheimi, B; Ichim, E; Blidaru, A

    2016-01-01

    Surgical treatment of breast cancer has been marked by a constant evolution since the Halsted radical mastectomy described in the late 19th century has become the current standard Madden radical mastectomy, a breast surgery that involves the ablation of tissue with the axillary lymphatic preserving both pectoral muscles. The purpose of this paper was to present the stages that have marked the evolution of this intervention and to provide an overview of the way breast cancer has been understood and treated in the last century. PMID:27453752

  15. A new vision for day surgery.

    PubMed

    Baskerville, Paul

    2006-07-01

    The premise that underlines this article (based on a presentation delivered at AfPP's Annual Congress in October 2006) is that all elective surgery performed in this country should be day surgery. This should eventually include patients undergoing hip replacements, radical prostatectomies, aortic aneurysm repair and hepatectomies, to name a few. All of these procedures we should perform, safely and well, under the British definition of day surgery as 'going home at the end of the day'.

  16. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    PubMed Central

    2014-01-01

    Background The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Methods Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Results Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Conclusions Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy. PMID:24495453

  17. [Lavoisier and radicals].

    PubMed

    Lafont, Olivier

    2007-01-01

    Lavoisier and his co-workers (Guyton de Morveau, Bertholet, Fourcroy) considered that acids were constituted of oxygen and of something else that they called radicals. These radicals were known in some cases, i.e. nitrogen for nitrous acid, carbon for carbonic acid, phosphorus for phosphoric acid. In the case of sulfur, the sulfuric radical could be associated with different quantities of oxigen leading to sulfuric or sulfurous acids. In other cases radicals remained unknown at the time i.e. muriatic radical for muriatic acid, or benzoyl radical for benzoic acid. It is interesting to notice that Lavoisier evoked the case of compound radicals constituted of different substances such as carbon and hydrogen.

  18. Challenges in pancreatic adenocarcinoma surgery - National survey and current practice guidelines

    PubMed Central

    Dhayat, Sameer A.; Mirgorod, Philip; Lenschow, Christina; Senninger, Norbert

    2017-01-01

    Background Pancreatic ductal adenocarcinoma (PDAC) remains one of the most deadly cancers in Europe and the USA. There is consensus that radical tumor surgery is the only viable option for any long-term survival in patients with PDAC. So far, limited data are available regarding the routine surgical management of patients with advanced PDAC in the light of surgical guidelines. Methods A national survey on perioperative management of patients with PDAC and currently applied criteria on their tumor resectability in German university and community hospitals was carried out. Results With a response rate of 81.6% (231/283) a total of 95 (41.1%) participating departments practicing pancreatic surgery in Germany are certified as competence and reference centers for surgical diseases of the pancreas in 2016. More than 95% of them indicate to carry out structured and interdisciplinary therapies along with an interdisciplinary pre- and postoperative tumor board. The majority of survey respondents prefer the pylorus-preserving partial pancreatoduodenectomy (93.1%) with standard lymphadenectomy for cancer of the pancreatic head. Intraoperative histological evaluation of the resection margins is used regularly by 99% of the survey respondents. 98.7% of survey respondents carry out partial or complete vein resection, 126 respondents (54.5%) would resect tumor adjacent arteries, and 102 respondents (44.2%) would perform metastasectomy if complete PDAC resection (R0) is possible. Conclusion Evidence-based and standardized pancreatic surgery is practiced by a large number of hospitals in Germany. However, a significant number of survey respondents support an extended radical tumor resection in patients with advanced PDAC even when not indicated by current clinical guidelines. PMID:28267771

  19. Maze Surgery

    MedlinePlus

    ... surgery to treat an arrhythmia called chronic atrial fibrillation (AF). AF is a fast, irregular heart rhythm ... Surgeons http://www.sts.org/node/2275 Atrial Fibrillation Surgery – Maze Procedure Updated August 2016 Please contact ...

  20. 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 ...

  1. 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 ...

  2. Current status of robot-assisted surgery.

    PubMed

    Ng, Ada T L; Tam, P C

    2014-06-01

    The introduction of robot-assisted surgery, and specifically the da Vinci Surgical System, is one of the biggest breakthroughs in surgery since the introduction of anaesthesia, and represents the most significant advancement in minimally invasive surgery of this decade. One of the first surgical uses of the robot was in orthopaedics, neurosurgery, and cardiac surgery. However, it was the use in urology, and particularly in prostate surgery, that led to its widespread popularity. Robotic surgery, is also widely used in other surgical specialties including general surgery, gynaecology, and head and neck surgery. In this article, we reviewed the current applications of robot-assisted surgery in different surgical specialties with an emphasis on urology. Clinical results as compared with traditional open and/or laparoscopic surgery and a glimpse into the future development of robotics were also discussed. A short introduction of the emerging areas of robotic surgery were also briefly reviewed. Despite the increasing popularity of robotic surgery, except in robot-assisted radical prostatectomy, there is no unequivocal evidence to show its superiority over traditional laparoscopic surgery in other surgical procedures. Further trials are eagerly awaited to ascertain the long-term results and potential benefits of robotic surgery.

  3. Forgotten Radicals in Biology

    PubMed Central

    Luc, Rochette; Vergely, Catherine

    2008-01-01

    Redox reactions play key roles in intra- and inter-cellular signaling, and in adaptative processes of tissues towards stress. Among the major free radicals with essential functions in cells are reactive oxygen species (ROS) including superoxide anion (O2•-), hydroxyl radical (•OH) and reactive nitrogen species (RNS) such as nitric oxide (•NO). In this article, we review the forgotten and new radicals with potential relevance to cardiovascular pathophysiology. Approximately 0.3% of O2•- present in cytosol exists in its protonated form: hydroperoxyl radical (HO2•). Water (H2O) can be split into two free radicals: •OH and hydrogen radical (H•). Several free radicals, including thiyl radicals (RS•) and nitrogen dioxide (NO2•) are known to isomerize double bonds. In the omega-6 series of poly-unsaturated fatty acids (PUFAs), cis-trans isomerization of γ-linolenate and arachidonate catalyzed by RS• has been investigated. Evidence is emerging that hydrogen disulphide (H2S) is a signaling molecule in vivo which can be a source of free radicals. The Cu-Zn superoxide dismutase (SOD) enzyme can oxidize the ionized form of H2S to hydro-sulphide radical: HS•. Recent studies suggest that H2S plays an important function in cardiovascular functions. Carbonate radical, which can be formed when •OH reacts with carbonate or bicarbonate ions, is also involved in the activity of Cu-Zn-SOD. Recently, it has been reported that carbonate anion were potentially relevant oxidants of nucleic acids in physiological environments. In conclusion, there is solid evidence supporting the formation of many free radicals by cells leading which may play an important role in their homeostasis. PMID:23675099

  4. Radical prostatectomy - discharge

    MedlinePlus

    ... prostatectomy - discharge; Laparoscopic radical prostatectomy - discharge; LRP - discharge; Robotic-assisted laparoscopic prostatectomy - discharge ; RALP - discharge; Pelvic lymphadenectomy - discharge; Prostate cancer - prostatectomy

  5. Performance of a Nomogram Predicting Disease-Specific Survival After an R0 Resection for Gastric Cancer in Patients Receiving Postoperative Chemoradiation Therapy

    SciTech Connect

    Dikken, Johan L.; Coit, Daniel G.; Baser, Raymond E.; Gönen, Mithat; Goodman, Karyn A.; Brennan, Murray F.; Jansen, Edwin P.M.; Boot, Henk; Velde, Cornelis J.H. van de; Cats, Annemieke; Verheij, Marcel

    2014-03-01

    Purpose: The internationally validated Memorial Sloan-Kettering Cancer Center (MSKCC) gastric carcinoma nomogram was based on patients who underwent curative (R0) gastrectomy, without any other therapy. The purpose of the current study was to assess the performance of this gastric cancer nomogram in patients who received chemoradiation therapy after an R0 resection for gastric cancer. Methods and Materials: In a combined dataset of 76 patients from the Netherlands Cancer Institute (NKI), and 63 patients from MSKCC, who received postoperative chemoradiation therapy (CRT) after an R0 gastrectomy, the nomogram was validated by means of the concordance index (CI) and a calibration plot. Results: The concordance index for the nomogram was 0.64, which was lower than the CI of the nomogram for patients who received no adjuvant therapy (0.80). In the calibration plot, observed survival was approximately 20% higher than the nomogram-predicted survival for patients receiving postoperative CRT. Conclusions: The MSKCC gastric carcinoma nomogram significantly underpredicted survival for patients in the current study, suggesting an impact of postoperative CRT on survival in patients who underwent an R0 resection for gastric cancer, which has been demonstrated by randomized controlled trials. This analysis stresses the need for updating nomograms with the incorporation of multimodal strategies.

  6. Estimation of the reproduction ratio (R(0)) of bluetongue based on serological field data and comparison with other BTV transmission models.

    PubMed

    Santman-Berends, I M G A; Stegeman, J A; Vellema, P; van Schaik, G

    2013-03-01

    Bluetongue virus serotype 8 (BTV-8) emerged in north-western Europe in 2006. In 2007, one of the affected countries (the Netherlands) implemented a sentinel network in dairy cattle. This data offered the opportunity to estimate transmission parameters. From our field data, the number of secondary infected cows that became infected by one infectious cow in a completely susceptible herd through the bites of infectious Culicoides i.e. the basic reproduction ratio (R(0)) was calculated. With that information, the R(0) of BTV-8 was estimated using an formulae of a general SIR model. In 2007, the BTV-8 epidemic started in the south and spread northwards in the following months. R(0) could be estimated for 197 herds in which transmission occurred. The median R(0) was 2.3 and the mean R(0) was 3.7 (5th percentile=1.8; 95th percentile=11.0). In the northern region where BTV-8 transmission occurred later in the season with less favorable conditions for transmission, R(0) remained significantly lower than in the south. Our model differed from earlier published more theoretical models on BTV-8 transmission because we estimated transmission from serological field data while other models used literature based assumptions for the majority of the parameters included in their models. Although there were many differences between our model and the previously developed more theoretical models, the results showed similar ranges of R(0) for BTV-8. The reasons for the similarity between the results may be that, although the part of the vector was not included with parameters in our model, the transmission based on serological field data in cows represented both BTV-8 transmission influenced by cows and by its vector, Culicoides. Furthermore, in the earlier models the assumptions made on the vector part, although derived from literature, probably gave a good representation of the true behavior of the Culicoides species that were associated with BTV-8 transmission in north-western Europe.

  7. FTIR absorption indices for thermal maturity in comparison with vitrinite reflectance R0 in type-II kerogens from Devonian black shales

    USGS Publications Warehouse

    Lis, G.P.; Mastalerz, Maria; Schimmelmann, A.; Lewan, M.D.; Stankiewicz, B.A.

    2005-01-01

    FTIR absorbance signals in kerogens and macerals were evaluated as indices for thermal maturity. Two sets of naturally matured type-II kerogens from the New Albany Shale (Illinois Basin) and the Exshaw Formation (Western Canada Sedimentary Basin) and kerogens from hydrous pyrolysis artificial maturation of the New Albany Shale were characterized by FTIR. Good correlation was observed between the aromatic/aliphatic absorption ratio and vitrinite reflectance R 0. FTIR parameters are especially valuable for determining the degree of maturity of marine source rocks lacking vitrinite. With increasing maturity, FTIR spectra express four trends: (i) an increase in the absorption of aromatic bands, (ii) a decrease in the absorption of aliphatic bands, (iii) a loss of oxygenated groups (carbonyl and carboxyl), and (iv) an initial decrease in the CH2/CH3 ratio that is not apparent at higher maturity in naturally matured samples, but is observed throughout increasing R0 in artificially matured samples. The difference in the CH2/CH 3 ratio in samples from natural and artificial maturation at higher maturity indicates that short-term artificial maturation at high temperatures is not fully equivalent to slow geologic maturation at lower temperatures. With increasing R0, the (carboxyl + carbonyl)/aromatic carbon ratio generally decreases, except that kerogens from the Exshaw Formation and from hydrous pyrolysis experiments express an intermittent slight increase at medium maturity. FTIR-derived aromaticities correlate well with R0, although some uncertainty is due to the dependence of FTIR parameters on the maceral composition of kerogen whereas R0 is solely dependent on vitrinite. ?? 2005 Elsevier Ltd. All rights reserved.

  8. [Facial surgery].

    PubMed

    Meningaud, Jean-Paul

    2010-11-20

    The patient who has to sustain facial surgery is doubly concerned by the functional issues of his case and his cosmetic appearance. Fortunately, in the recent period of time, huge advancements have been done permitting to offer a solution in more and more difficult situations. The aim of the present article is to give a panorama of facial plastic surgery for non-specialized physicians. The main aspects of the specialty are approached through the surgical techniques born from the progress of technology and biology. This paper treats issues of orthognatic surgery, endoscopic techniques, osteogenic distraction, different types of graft, cosmetic surgery, skin expander-balloons.

  9. Radical chemistry of artemisinin

    NASA Astrophysics Data System (ADS)

    Denisov, Evgenii T.; Solodova, S. L.; Denisova, Taisa G.

    2010-12-01

    The review summarizes physicochemical characteristics of the natural sesquiterpene peroxide artemisinin. The kinetic schemes of transformations of artemisinin radicals under anaerobic conditions are presented and analyzed. The sequence of radical reactions of artemisinin in the presence of oxygen is considered in detail. Special emphasis is given to the intramolecular chain oxidation resulting in the transformation of artemisinin into polyatomic hydroperoxide. The kinetic characteristics of elementary reaction steps involving alkyl, alkoxyl, and peroxyl radicals generated from artemisinin are discussed. The results of testing of artemisinin and its derivatives for the antimalarial activity and the scheme of the biochemical synthesis of artemisinin in nature are considered.

  10. Radical aminomethylation of imines.

    PubMed

    Fujii, Shintaro; Konishi, Takehito; Matsumoto, Yusuke; Yamaoka, Yousuke; Takasu, Kiyosei; Yamada, Ken-Ichi

    2014-09-05

    Taking advantage of the high level of performance of N-alkoxycarbonyl-imines, we achieved the first example of addition of the aminomethyl radical to imine. The reaction efficiency depended on the structure of the radical precursor, whether it is an iodide or a xanthate, and an electron-withdrawing group on the nitrogen atom of the radical. This reaction allows direct introduction of an N-substituted aminomethyl group onto imine to provide 1,2-diamine as well as the short-step synthesis of ICI-199,441.

  11. The daily computed weighted averaging basic reproduction number R>0,k,ωn for MERS-CoV in South Korea

    NASA Astrophysics Data System (ADS)

    Jeong, Darae; Lee, Chang Hyeong; Choi, Yongho; Kim, Junseok

    2016-06-01

    In this paper, we propose the daily computed weighted averaging basic reproduction number R0,k,ωn for Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, May to July 2015. We use an SIR model with piecewise constant parameters β (contact rate) and γ (removed rate). We use the explicit Euler's method for the solution of the SIR model and a nonlinear least-square fitting procedure for finding the best parameters. In R0,k,ωn, the parameters n, k, and w denote days from a reference date, the number of days in averaging, and a weighting factor, respectively. We perform a series of numerical experiments and compare the results with the real-world data. In particular, using the predicted reproduction number based on the previous two consecutive reproduction numbers, we can predict the future behavior of the reproduction number.

  12. Laparoscopic surgery - series (image)

    MedlinePlus

    ... performed laparoscopically, including gallbladder removal (laparoscopic cholecystectomy), esophageal surgery (laparoscopic fundoplication), colon surgery (laparoscopic colectomy), and surgery on ...

  13. 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 ...

  14. Surgery for gastric cancer patients of age 85 and older: Multicenter survey

    PubMed Central

    Konishi, Hirotaka; Ichikawa, Daisuke; Itoh, Hiroshi; Fukuda, Kenichiro; Kakihara, Naoki; Takemura, Manabu; Okugawa, Kaori; Uchiyama, Kiyoshi; Nakata, Masashi; Nishi, Hiroshi; Kosuga, Toshiyuki; Komatsu, Shuhei; Okamoto, Kazuma; Otsuji, Eigo

    2017-01-01

    AIM To investigate the surgical therapies for gastric cancer (GC) patients of age 85 or older in a multicenter survey. METHODS Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated. The relationships between surgical therapies and clinicopathological or prognostic features were analyzed. RESULTS Eighty-nine of the patients (66%) presented with a comorbidity, and 26 (19% overall) presented with more than two comorbidities. Radical lymphadenectomy was performed in 59 patients (44%), and no patient received pre- or post-operative chemotherapy. Forty of the patients (30%) experienced perioperative complications, but no surgical or perioperative mortality occurred. Laparoscopic surgery was performed in only 12 of the patients (9.0%). Univariate and multivariate analyses of the 113 patients who underwent R0 or R1 resection identified the factors of pT3/4 and limited lymphadenectomy as predictive of worse prognosis (HR = 4.68, P = 0.02 and HR =2.19, P = 0.05, respectively). Non-cancer-specific death was more common in cStage I patients than in cStage II or III patients. Limited lymphadenectomy correlated with worse cancer-specific survival (P = 0.01), particularly in cStage II patients (P < 0.01). There were no relationships between limited lymphadenectomy and any comorbidities, except for cerebrovascular disease (P = 0.07). CONCLUSION Non-cancer-specific death was not negligible, particularly in cStage I, and gastrectomy with radical lymphadenectomy appears to be an effective treatment for cStage II elderly GC patients. PMID:28275301

  15. Refractive Surgery

    PubMed Central

    Kellum, Keith

    2000-01-01

    The concept of surgically altering the eye to correct refractive errors has been considered for hundreds of years, but only in the past 60 years has interest grown considerably due to the development of modern refractive surgery techniques such as astigmatic keratotomies to correct astigmatism induced by cataract surgery and future technologies currently being investigated. Modern refractive surgery is more involved than setting the correct parameters on the laser. Patient selection and examination, proper technique, and postoperative follow-up for potential complications are essential for a successful refractive procedure. Critical evaluation of new techniques is vital to avoid the pitfall of overly exuberant enthusiasm for new and unproven methods of refractive surgery. Kellum K. Refractive surgery. The Ochsner Journal 2000; 2:164-167. PMID:21765686

  16. SU-E-P-33: Critical Role of T2-Weighted Imaging Combined with Diffusion-Weighted Imaging of MRI in Diagnosis of Loco-Regional Recurrent Esophageal Cancer After Radical Surgery

    SciTech Connect

    Deng, G; Qiao, L; Liang, N; Xie, J; Zhang, J; Luo, H; Zhang, J

    2015-06-15

    Purpose: We perform this study to investigate the diagnostic efficacy of T2-weighted MRI (T2WI) and diffusion-weighted MRI (DWI) in confirming local relapses of esophageal cancer in patients highly suspected of recurrence after eradicating surgery. Methods: Forty-two postoperative esophageal cancer patients with clinical suspicions of cancer recurrence underwent 3.0T MRI applying axial, coronal, sagittal T2WI and axial DWI sequences. Two experienced radiologists (R1 and R2) both used two methods (T2WI, T2WI+DWI) to observe the images, and graded the patients ranging from 1 to 5 to represent severity of the disease based on visual signal intensity (patients equal to or more than grade 3 was confirmed as recurrent disease) Results: 27/42patients were verified of recurrent disease by pathologic findings and/or imaging findings during follow-up. The sensitivity, specificity and accuracy of R1 applying T2WI+DWI are 96%, 87% and 93% versus 81%, 80% and 77% on T2WI, these figures by R2 were 96%, 93% and 95% versus 89%, 93% and 90%. The receiver operating curve (ROC) analyses suggest that both of the two readers can obtain better accuracy when adding DWI to T2WI compared with T2WI alone. Kappa test between R1 and R2 indicates excellent inter-observer agreement on T2WI+DWI. Conclusion: Standard T2WI in combination DWI can achieve better accuracy than T2WI alone in diagnosing local recurrence of esophageal cancer, and improve consistency between different readers.

  17. Determination of absorbed dose in water at the reference point d(r0, theta0) for an 192Ir HDR brachytherapy source using a Fricke system.

    PubMed

    Austerlitz, C; Mota, H C; Sempau, J; Benhabib, S M; Campos, D; Allison, R; DeAlmeida, C E; Zhu, D; Sibata, C H

    2008-12-01

    A ring-shaped Fricke device was developed to measure the absolute dose on the transverse bisector of a 192Ir high dose rate (HDR) source at 1 cm from its center in water, D(r0, theta0). It consists of a polymethylmethacrylate (PMMA) rod (axial axis) with a cylindrical cavity at its center to insert the 192Ir radioactive source. A ring cavity around the source with 1.5 mm thickness and 5 mm height is centered at 1 cm from the central axis of the source. This ring cavity is etched in a disk shaped base with 2.65 cm diameter and 0.90 cm thickness. The cavity has a wall around it 0.25 cm thick. This ring is filled with Fricke solution, sealed, and the whole assembly is immersed in water during irradiations. The device takes advantage of the cylindrical geometry to measure D(r0, theta0). Irradiations were performed with a Nucletron microselectron HDR unit loaded with an 192Ir Alpha Omega radioactive source. A Spectronic 1001 spectrophotometer was used to measure the optical absorbance using a 1 mL quartz cuvette with 1.00 cm light pathlength. The PENELOPE Monte Carlo code (MC) was utilized to simulate the Fricke device and the 192Ir Alpha Omega source in detail to calculate the perturbation introduced by the PMMA material. A NIST traceable calibrated well type ionization chamber was used to determine the air-kerma strength, and a published dose-rate constant was used to determine the dose rate at the reference point. The time to deliver 30.00 Gy to the reference point was calculated. This absorbed dose was then compared to the absorbed dose measured by the Fricke solution. Based on MC simulation, the PMMA of the Fricke device increases the D(r0, theta0) by 2.0%. Applying the corresponding correction factor, the D(r0, theta0) value assessed with the Fricke device agrees within 2.0% with the expected value with a total combined uncertainty of 3.43% (k=1). The Fricke device provides a promising method towards calibration of brachytherapy radiation sources in terms of D(r0

  18. The evolution of robotic general surgery.

    PubMed

    Wilson, E B

    2009-01-01

    Surgical robotics in general surgery has a relatively short but very interesting evolution. Just as minimally invasive and laparoscopic techniques have radically changed general surgery and fractionated it into subspecialization, robotic technology is likely to repeat the process of fractionation even further. Though it appears that robotics is growing more quickly in other specialties, the changes digital platforms are causing in the general surgical arena are likely to permanently alter general surgery. This review examines the evolution of robotics in minimally invasive general surgery looking forward to a time where robotics platforms will be fundamental to elective general surgery. Learning curves and adoption techniques are explored. Foregut, hepatobiliary, endocrine, colorectal, and bariatric surgery will be examined as growth areas for robotics, as well as revealing the current uses of this technology.

  19. Free Radical Reactions in Food.

    ERIC Educational Resources Information Center

    Taub, Irwin A.

    1984-01-01

    Discusses reactions of free radicals that determine the chemistry of many fresh, processed, and stored foods. Focuses on reactions involving ascorbic acid, myoglobin, and palmitate radicals as representative radicals derived from a vitamin, metallo-protein, and saturated lipid. Basic concepts related to free radical structure, formation, and…

  20. Chemistry of ascorbic acid radicals

    SciTech Connect

    Bielski, B.H.J.

    1982-01-01

    The chemistry of ascorbic acid free radicals is reviewed. Particular emphasis is placed on identification and characterization of ascorbate radicals by spectrophotometric and electron paramagnetic resonance techniques, the kinetics of formation and disappearance of ascorbate free radicals in enzymatic and nonenzymatic reactions, the effect of pH upon the spectral and kinetic properties of ascorbate anion radical, and chemical reactivity of ascorbate free radicals.

  1. [Surgery in complicated colorectal cancer].

    PubMed

    Kreisler, Esther; Biondo, Sebastiano; Martí-Ragué, Joan

    2006-07-01

    Colorectal cancer continues to have a serious social impact. A large proportion of patients are diagnosed at an advanced stage of the disease. Approximately one-third of patients with colorectal cancer will undergo emergency surgery for a complicated tumor, with a high risk of mortality and poorer long-term prognosis. The most frequent complications are obstruction and perforation, while massive hemorrhage is rare. The curative potential of surgery, whether urgent or elective, depends on how radical the resection is, among other factors. In the literature on the management of urgent colorectal disease, there are few references to the oncological criteria for resection. Uncertainly about the optimal treatment has led to wide variability in the treatment of this entity. The present article aims to provide a critical appraisal of the controversies surrounding the role of surgery and its impact on complicated colorectal cancer.

  2. Current Status of Robot-Assisted Radical Cystectomy: What is the Real Benefit?

    PubMed

    Takenaka, Atsushi

    2015-09-01

    In recent years, robot-assisted radical cystectomy has received attention worldwide as a useful procedure that helps to overcome the limitations of open radical cystectomy. We compared the surgical technique, perioperative and oncological outcomes, and learning curve of robot-assisted radical cystectomy with those of open radical cystectomy. The indications for robot-assisted radical cystectomy are identical to those of open radical cystectomy. Relative contraindications are due to patient positioning in the Trendelenburg position for long periods. Urinary diversion is performed either extracorporeally with a small skin incision or intracorporeally with a totally robotic-assisted maneuver. Accordingly, robot-assisted radical cystectomy can be performed safely with an acceptable operative time, little blood loss, and low transfusion rates. The lymph node yield and positive surgical margin rate were not significantly different between robot-assisted radical cystectomy and open radical cystectomy. The survival rates after robot-assisted radical cystectomy are estimated to be similar to that after open radical cystectomy. However, the recurrence pattern is different between robot-assisted radical cystectomy and open radical cystectomy, i.e., extrapelvic lymph node recurrence and peritoneal carcinomatosis were more frequently found in patients who underwent robot-assisted radical cystectomy than in those who underwent open radical cystectomy. Further validation is necessary to prove the feasibility of oncological control. A steep learning curve is one of the benefits of the new technique. The experience of only 50 robot-assisted radical prostatectomies is a minimum requirement for performing feasible robot-assisted radical cystectomy, and surgeons who have performed only 30 surgeries can reach an acceptable level of quality for robot-assisted radical cystectomy.

  3. 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 ...

  4. Hemorrhoid surgery

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002939.htm Hemorrhoid surgery To use the sharing features on this page, please enable JavaScript. Hemorrhoids are swollen veins around the anus. They may ...

  5. Plastic Surgery

    MedlinePlus

    ... procedure that can help smooth or camouflage severe acne scars) — sometimes feel more comfortable with their appearance ... procedures teens choose include nose reshaping, ear surgery, acne and acne scar treatment, and breast reduction. previous ...

  6. Cosmetic Surgery

    MedlinePlus

    ... image Body image and your kids Cosmetic surgery Eating disorders Pregnancy and body image Subscribe to Body Image ... Association of America http://www.adaa.org National Eating Disorders Association National Institute of Mental Health Information Center, ...

  7. Foot Surgery

    MedlinePlus

    ... be advised by a podiatrist, depending on your test results or a specific medical condition. Postoperative Care The type of foot surgery performed determines the length and kind of aftercare required ...

  8. Laparoscopic Surgery

    MedlinePlus

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  9. Radicals in ionic liquids.

    PubMed

    Strehmel, Veronika

    2012-05-14

    Stable radicals and recombination of photogenerated lophyl radicals are investigated in ionic liquids. The 2,2,6,6-tetramethylpiperidine-1-yloxyl derivatives contain various substituents at the 4-position to the nitroxyl group, including hydrogen-bond-forming or ionic substituents that undergo additional interactions with the individual ions of the ionic liquids. Some of these spin probes contain similar ions to ionic liquids to avoid counter-ion exchange with the ionic liquid. Depending on the ionic liquid anion, the Stokes-Einstein theory or the Spernol-Gierer-Wirtz theory can be applied to describe the temperature dependence of the average rotational correlation time of the spin probe in the ionic liquids. Furthermore, the spin probes give information about the micropolarity of the ionic liquids. In this context the substituent at the 4-position to the nitroxyl group plays a significant role. Covalent bonding of a spin probe to the imidazolium ion results in bulky spin probes that are strongly immobilized in the ionic liquid. Furthermore, lophyl radical recombination in the dark, which is chosen to understand the dynamics of bimolecular reactions in ionic liquids, shows a slow process at longer timescale and a rise time at a shorter timescale. Although various reactions may contribute to the slower process during lophyl radical recombination, it follows a second-order kinetics that does not clearly show solvent viscosity dependence. However, the rise time, which may be attributed to radical pair formation, increases with increasing solvent viscosity.

  10. [Aesthetic surgery].

    PubMed

    Bruck, Johannes C

    2006-01-01

    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  11. Tennis elbow surgery

    MedlinePlus

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  12. Plastic Surgery Statistics

    MedlinePlus

    ... PRS GO PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the ... Plastic Surgery Statistics 2005 Plastic Surgery Statistics 2016 Plastic Surgery Statistics Stats Report 2016 National Clearinghouse of ...

  13. Heart valve surgery - discharge

    MedlinePlus

    ... surgery - minimally invasive Aortic valve surgery - open Bicuspid aortic valve Endocarditis Heart valve surgery Mitral valve prolapse Mitral valve surgery - minimally invasive Mitral valve surgery - open Pulmonary valve stenosis Smoking - tips on how to quit Patient Instructions ...

  14. The basic reproduction number R0 and effectiveness of reactive interventions during dengue epidemics: the 2002 dengue outbreak in Easter Island, Chile.

    PubMed

    Chowell, Gerardo; Fuentes, R; Olea, A; Aguilera, X; Nesse, H; Hyman, J M

    2013-01-01

    We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number R0 during the initial epidemic phase, prior to the start of control interventions. We estimated R0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

  15. Spin-phonon coupling in epitaxial S r0.6B a0.4Mn O3 thin films

    NASA Astrophysics Data System (ADS)

    Goian, V.; Langenberg, E.; Marcano, N.; Bovtun, V.; Maurel, L.; Kempa, M.; Prokscha, T.; Kroupa, J.; Algarabel, P. A.; Pardo, J. A.; Kamba, S.

    2017-02-01

    Spin-phonon coupling is investigated in epitaxially strained S r1 -xB axMn O3 thin films with perovskite structure by means of microwave (MW) and infrared (IR) spectroscopy. In this work we focus on the S r0.6B a0.4Mn O3 composition grown on (LaAlO3) 0.3(Sr2AlTaO6 ) 0.7 substrate. The MW complex electromagnetic response shows a decrease in the real part and a clear anomaly in the imaginary part around 150 K. Moreover, it coincides with a 17 % hardening of the lowest-frequency polar phonon seen in IR reflectance spectra. In order to further elucidate this phenomenon, low-energy muon-spin spectroscopy was carried out, signaling the emergence of antiferromagnetic order with Néel temperature (TN) around 150 K. Thus, our results confirm that epitaxial S r0.6B a0.4Mn O3 thin films display strong spin-phonon coupling below TN, which may stimulate further research on tuning the magnetoelectric coupling by controlling the epitaxial strain and chemical pressure in the S r1 -xB axMn O3 system.

  16. Phase 3 Trial of Postoperative Chemotherapy Alone Versus Chemoradiation Therapy in Stage III-IV Gastric Cancer Treated With R0 Gastrectomy and D2 Lymph Node Dissection

    SciTech Connect

    Kim, Tae Hyun; Park, Sook Ryun; Ryu, Keun Won; Kim, Young-Woo; Bae, Jae-Moon; Lee, Jun Ho; Choi, Il Ju; Kim, Yeon-Joo; Kim, Dae Yong

    2012-12-01

    Purpose: To compare chemotherapy alone with chemoradiation therapy in stage III-IV(M0) gastric cancer treated with R0 gastrectomy and D2 lymph node dissection. Methods and Materials: The chemotherapy arm received 5 cycles of fluorouracil and leucovorin (FL), and the chemoradiation therapy arm received 1 cycle of FL, then radiation therapy of 45 Gy concurrently with 2 cycles of FL, followed by 2 cycles of FL. Intent-to-treat analysis and per-protocol analyses were performed. Results: Between May 6, 2002 and June 29, 2006, a total of 90 patients were enrolled. Forty-four were randomly assigned to the chemotherapy arm and 46 to the chemoradiation therapy arm. Treatment was completed as planned by 93.2% of patients in the chemotherapy arm and 87.0% in the chemoradiation therapy arm. Overall intent-to-treat analysis showed that addition of radiation therapy to chemotherapy significantly improved locoregional recurrence-free survival (LRRFS) but not disease-free survival. In subgroup analysis for stage III, chemoradiation therapy significantly prolonged the 5-year LRRFS and disease-free survival rates compared with chemotherapy (93.2% vs 66.8%, P=.014; 73.5% vs 54.6%, P=.056, respectively). Conclusions: Addition of radiation therapy to chemotherapy could improve the LRRFS in stage III gastric cancer treated with R0 gastrectomy and D2 lymph node dissection.

  17. Photochemical Formation of Hydroxyl Radical in Red-Soil-Polluted Seawater in Okinawa, Japan -Potential Impacts on Marine Organisms

    NASA Astrophysics Data System (ADS)

    Arakaki, T.; Hamdun, A. M.; Okada, K.; Kuroki, Y.; Ikota, H.; Fujimura, H.; Oomori, T.

    2004-12-01

    Development of pineapple farmlands and construction of recreational facilities caused runoff of red soil into coastal ocean (locally termed as red-soil-pollution) in the north of Okinawa Island, Japan. In an attempt to understand the impacts of red soil on oxidizing power of the seawater, we studied formation of hydroxyl radical (OH radical), the most potent oxidant in the environment, in red-soil-polluted seawaters, using 313 nm monochromatic light. Photo-formation rates of OH radical showed a good correlation with dissolved iron concentrations (R = 0.98). The major source of OH radical was found to be the Fenton reaction (a reaction between Fe(II) and HOOH). The un-filtered red-soil-polluted seawater samples exhibited faster OH radical formation rates than the filtered samples, suggesting that iron-bearing red soil particles enhanced formation of OH radical.

  18. Radical Socioeducational Analysis.

    ERIC Educational Resources Information Center

    Sigmon, Scott B.

    This book describes an interactive-interdisciplinary way of looking at the social conditions which impinge upon schooling, and which impact upon the social facts of life. It examines current schooling problems from the perspective of radical social democratic thought. The book is organized into four major sections. Part 1 provides an overview and…

  19. Against Radical Multiculturalism.

    ERIC Educational Resources Information Center

    Zorn, Jeff

    This essay presents two strands of arguments against radical or critical emancipatory multiculturalism. In strand 1, "'Culture' is...whatever..." the looseness of the core concept of "culture," which can refer to anything at all concerning a social group that itself may exist only theoretically, is shown. In strand 2, "From ideology to leveling,…

  20. Beyond Radical Educational Cynicism.

    ERIC Educational Resources Information Center

    Wood, George H.

    1982-01-01

    An alternative is presented to counter current radical arguments that the schools cannot bring about social change because they are instruments of capitalism. The works of Samuel Bowles, Herbert Gintis, and Louis Althusser are discussed. Henry Giroux's "Ideology, Culture and the Process of Schooling" provides an alternative to cynicism.…

  1. Radically enhanced molecular recognition

    NASA Astrophysics Data System (ADS)

    Trabolsi, Ali; Khashab, Niveen; Fahrenbach, Albert C.; Friedman, Douglas C.; Colvin, Michael T.; Cotí, Karla K.; Benítez, Diego; Tkatchouk, Ekaterina; Olsen, John-Carl; Belowich, Matthew E.; Carmielli, Raanan; Khatib, Hussam A.; Goddard, William A.; Wasielewski, Michael R.; Stoddart, J. Fraser

    2010-01-01

    The tendency for viologen radical cations to dimerize has been harnessed to establish a recognition motif based on their ability to form extremely strong inclusion complexes with cyclobis(paraquat-p-phenylene) in its diradical dicationic redox state. This previously unreported complex involving three bipyridinium cation radicals increases the versatility of host-guest chemistry, extending its practice beyond the traditional reliance on neutral and charged guests and hosts. In particular, transporting the concept of radical dimerization into the field of mechanically interlocked molecules introduces a higher level of control within molecular switches and machines. Herein, we report that bistable and tristable [2]rotaxanes can be switched by altering electrochemical potentials. In a tristable [2]rotaxane composed of a cyclobis(paraquat-p-phenylene) ring and a dumbbell with tetrathiafulvalene, dioxynaphthalene and bipyridinium recognition sites, the position of the ring can be switched. On oxidation, it moves from the tetrathiafulvalene to the dioxynaphthalene, and on reduction, to the bipyridinium radical cation, provided the ring is also reduced simultaneously to the diradical dication.

  2. Radical School Reform.

    ERIC Educational Resources Information Center

    Gross, Beatrice, Ed.; Gross, Ronald, Ed.

    This book provides a comprehensive examination of the nature of the school crisis and the ways in which radical thinkers and educators are dealing with it. Excerpts from the writings of Jonathan Kozol, John Holt, Kenneth Clark, and others are concerned with the realities of education in ghettos and suburbs. Paul Goodman, Marshall McLuhan, Sylvia…

  3. [Radical surgical treatment for bone metastasis from thyroid carcinoma. Report of four cases].

    PubMed

    Dolores-Velázquez, Rigoberto; Padilla-Rosciano, Alejandro; Durán-Hernández, Myrna; Pérez-Montiel, Delia; Martínez-Said, Héctor

    2005-01-01

    Most patients with thyroid bone metastases have been evaluated in accordance with other sites of disease. Overall survival is impacted and the results with surgery, radiation therapy, or radioactive iodine show variable results. Four cases are presented: three women and one man with an age range of 43-53 years and all with radical surgery. Good local control in three of the patients was observed. All patients had hormonal suppression with levothyroxine. Radical surgery showed an improvement in survival in patients with bone metastases for thyroid carcinoma.

  4. [Endoscopic surgery].

    PubMed

    Rushfeldt, Christian; Pham, Khanh Do-Cong; Aabakken, Lars

    2016-05-01

    Endoscopic surgery of the stomach/gastrointestinal tract was developed in the 1990s in Japan as a minimally invasive method of removing early-stage tumours, using a gastro-/coloscope instead of open or laparoscopic surgery. Its advantages are obvious, in that the patient is spared more major surgery, the hospital saves on resources as well as admission to a ward, and society is spared the costs of days of sickness absence. Endoscopic submucosal dissection is considered the most difficult technique, but it allows for the accurate dissection of large tumours. In 1999, Japanese surgeon Takuji Gotoda and his team were the first to perform these types of dissections of early cancers in the rectum using a diathermic needle and a flexible scope.

  5. [Organ-sparing surgery in andrology].

    PubMed

    Song Ning-hong

    2015-12-01

    Penile and testicular tumors, especially those of the malignant nature, usually require radical excision, which alters the organ image, affects sexual and urinary functions, and consequently undermines the self-confidence and quality of life of the patient. Recent studies show that organ-sparing surgery can be an alternative to radical excision for superficial tumors and small masses. Penis-sparing surgery (PSS) has been indicated for superficial penile cancer, such as Tis and T1a lesions, and testis-sparing surgery (TSS) is feasible for benign small bilateral or solitary testicular masses (TIN). Long-term follow-ups after PSS or TSS show that the patients may retain a satisfactory appearance of the organ as well as desirable sexual and reproductive functions.

  6. [Foreskin surgery].

    PubMed

    Kolehmainen, Maija; Taskinen, Seppo; Ossi, Lindell

    2010-01-01

    Balanitis, phimosis and foreskin adhesions are common indications for foreskin surgery during childhood. In phimosis, the foreskin cannot be drawn behind the glans penis because of the narrow external opening of the former. It is important to be able to distinguish between physiologic and pathologic phimosis, since their treatment is different. In adulthood, the need for surgery can be caused by phimosis, a difficult sequel of paraphimosis, recurrent inflammations of the glans penis and foreskin, diseases and cancers of the skin as well as difficulties at intercourse due to the shortness of the frenulum of the prepuce of the penis.

  7. Acne Surgery

    PubMed Central

    Dilworth, G. R.

    1983-01-01

    Acne surgery consists of comedone extraction of non-inflamed lesions, triamcinolone acetate injections of some inflamed lesions, and extraction of milia. Prevention is a very important part of comedone treatment, especially avoidance of picking, moisturizers and harsh soaps. Instruments are also very important: even the finest may be too thick and may have to be filed down. Acne surgery is only an adjunct of good medical therapy. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7 PMID:21283373

  8. Microwave properties of /Fe(0.82)B(0.18)/(0.90)La(0.05)R(0.05) amorphous metal alloys

    NASA Astrophysics Data System (ADS)

    Vittoria, C.; Koon, N. C.; Lubitz, P.; Geohegan, J. A.

    1984-03-01

    Microwave properties of amorphous metal alloys of /Fe(0.82)B(0.18)/(0.90)La(0.05)R(0.05), where R = La, Pr, Nd, Sm, Gd, Tb, Dy, Ho, and Er, are reported. The microwave measurements consisted of fixed (9 GHz) and swept (0.01-18 GHz) frequency magnetic resonance experiments. The ferromagnetic resonance linewidth, Delta H, and g factor were measured. Delta H has a minimum for R = Gd and is equal to 100 Oe. Delta H appears to scale with the product of the spin and orbital angular momentum operators of the R ion. The measured g factor obeys the Wangsness relation as R is varied.

  9. Tuning the magnetic properties of L a0.67S r0.33Co O3-δ films by oxygen pressure

    NASA Astrophysics Data System (ADS)

    Liu, Bin; Wang, Yiqian; Liu, Guiju; Feng, Honglei; Yang, Huaiwen; Xue, Xuyan; Sun, Jirong

    2016-03-01

    In this paper, oxygen-deficient L a0.67S r0.33Co O3 (LSCO) thin films are prepared by adjusting the oxygen pressure during the deposition. As oxygen vacancies are introduced into the LSCO films, the out-of-plane lattices are elongated, as revealed by x-ray diffraction and high-resolution transmission electron microscopy (HRTEM). Modulated bright and dark stripes observed in the HRTEM images of the oxygen-deficient LSCO films are induced by cation ordering and oxygen vacancy ordering, respectively. Magnetic measurements and first-principles calculations show that the oxygen vacancies depress the magnetism of the LSCO films greatly. We also demonstrate that doping Sr into LaCo O3 and removing oxygen from LSCO have a similar effect on the magnetic properties, which is correlated with a derived formula.

  10. Data Qualification Report For: Thermodynamic Data File, DATA0.YMP.R0 For Geochemical Code, EQ3/6 

    SciTech Connect

    P.L. Cloke

    2001-10-16

    The objective of this work is to evaluate the adequacy of chemical thermodynamic data provided by Lawrence Livermore National Laboratory (LLNL) as DataO.ymp.ROA in response to an input request submitted under AP-3.14Q. This request specified that chemical thermodynamic data available in the file, Data0.com.R2, be updated, improved, and augmented for use in geochemical modeling used in Process Model Reports (PMRs) for Engineered Barrier Systems, Waste Form, Waste Package, Unsaturated Zone, and Near Field Environment, as well as for Performance Assessment. The data are qualified in the temperature range 0 to 100 C. Several Data Tracking Numbers (DTNs) associated with Analysis/Model Reports (AMR) addressing various aspects of the post-closure chemical behavior of the waste package and the Engineered Barrier System that rely on EQ316 outputs to which these data are used as input, are Principal Factor affecting. This qualification activity was accomplished in accordance with the AP-SIII.2Q using the Technical Assessment method. A development plan, TDP-EBS-MD-000044, was prepared in accordance with AP-2.13Q and approved by the Responsible Manager. In addition, a Process Control Evaluation was performed in accordance with AP-SV.1Q. The qualification method, selected in accordance with AP-SIII.2Q, was Technical Assessment. The rationale for this approach is that the data in File Data0.com.R2 are considered Handbook data and therefore do not themselves require qualification. Only changes to Data0.com.R2 required qualification. A new file has been produced which contains the database Data0.ymp.R0, which is recommended for qualification as a result of this action. Data0.ymp.R0 will supersede Data0.com.R2 for all Yucca Mountain Project (YMP) activities.

  11. Association of HER2 status with prognosis in gastric cancer patients undergoing R0 resection: A large-scale multicenter study in China

    PubMed Central

    Shen, Guo-Shuang; Zhao, Jiu-Da; Zhao, Jun-Hui; Ma, Xin-Fu; Du, Feng; Kan, Jie; Ji, Fa-Xiang; Ma, Fei; Zheng, Fang-Chao; Wang, Zi-Yi; Xu, Bing-He

    2016-01-01

    AIM: To determine whether the positive status of human epidermal growth receptor 2 (HER2) can be regarded as an effective prognostic factor for patients with gastric cancer (GC) undergoing R0 resection. METHODS: A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical (IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-node-metastasis (TNM) stage, with additional adjustment for potential prognostic factors. RESULTS: Among 1562 patients, 548 (positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender (P = 0.004), minority (P < 0.001), tumor location (P = 0.001), pathological grade (P < 0.001), TNM stage (P < 0.001) and adjuvant radiotherapy (74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival (HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival (HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages (I and II). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival. CONCLUSION: The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population. PMID:27340357

  12. Characterizing LipR from Pseudomonas sp. R0-14 and Applying in Enrichment of Polyunsaturated Fatty Acids from Algal Oil.

    PubMed

    Yang, Wenjuan; Xu, Li; Zhang, Houjin; Yan, Yunjun

    2015-11-01

    In this study, Pseudomonas R0-14, which was isolated from Arctic soil samples, showed a clear halo when grown on M9 medium agarose plates containing olive oil-rhodamine B as substrate, suggesting that it expressed putative lipase(s). A putative lipase gene, lipR, was cloned from R0-14 by genome walking and Touchdown PCR. lipR encodes a 562-amino-acid polypeptide showing a typical α/β hydrolase structure with a catalytic triad consisting of Ser153-Asp202-His260 and one α-helical lid (residues 103-113). A phylogenetic analysis revealed that LipR belongs to the lipase subfamily I.3. LipR was successfully expressed in Escherichia coli, purified, and biochemically characterized. Recombinant LipR exhibited its maximum activity towards p-nitrophenyl butyrate at pH 8.5 and 60°C with a Km of 0.37 mM and a kcat of 6.42 s(-1). It retained over 90% of its original activity after incubation at 50°C for 12 h. In addition, LipR was activated by Ca(2+), Mg(2+), Ba(2+), and Sr(2+), while strongly inhibited by Cu(2+), Zn(2+), Mn(2+), and ethylenediaminetetraacetic acid. Moreover, it showed a certain tolerance to organic solvents, including acetonitrile, isopropanol, acetone, methanol, and tert-butanol. When algal oil was hydrolyzed by LipR for 24 h, there was an enrichment of n-3 long-chain polyunsaturated fatty acids, including eicosapentaenoic acid (1.22%, 1.65-fold), docosapentaenoic acid (21.24%, 2.04-fold), and docosahexaenoic acid (36.98%, 1.33-fold), and even a certain amount of diacylglycerols was also produced. As a result, LipR has great prospect in industrial applications, especially in food and/or cosmetics applications.

  13. Complex magnetic phase diagram with multistep spin-flop transitions in L a0.25P r0.75C o2P2

    NASA Astrophysics Data System (ADS)

    Tan, Xiaoyan; Garlea, V. Ovidiu; Kovnir, Kirill; Thompson, Corey M.; Xu, Tongshuai; Cao, Huibo; Chai, Ping; Tener, Zachary P.; Yan, Shishen; Xiong, Peng; Shatruk, Michael

    2017-01-01

    L a0.25P r0.75C o2P2 crystallizes in the tetragonal ThC r2S i2 structure type and shows multiple magnetic phase transitions driven by changes in temperature and magnetic field. The nature of these transitions was investigated by a combination of magnetic and magnetoresistance measurements and both single crystal and powder neutron diffraction. The Co magnetic moments order ferromagnetically (FM) parallel to the c axis at 282 K, followed by antiferromagnetic (AFM) ordering at 225 K. In the AFM structure, the Co magnetic moments align along the c axis with FM [C o2P2] layers arranged in an alternating sequence, ↑↑↓↓ , which leads to the doubling of the c axis in the magnetic unit cell. Another AFM transition is observed at 27 K, due to the ordering of a half of Pr moments in the a b plane. The other half of Pr moments undergoes AFM ordering along the c axis at 11 K, causing simultaneous reorientation of the previously ordered Pr moments into an AFM structure with the moments being canted with respect to the c axis. This AFM transition causes an abrupt decrease in electrical resistivity at 11 K. Under applied magnetic field, two metamagnetic transitions are observed in the Pr sublattice at 0.8 and 5.4 T. They correlate with two anomalies in magnetoresistance measurements at the same critical fields. A comparison of the temperature- and field-dependent magnetic properties of L a0.25P r0.75C o2P2 to the magnetic behavior of PrC o2P2 is provided.

  14. [Minimally invasive thymus surgery].

    PubMed

    Rückert, J C; Ismail, M; Swierzy, M; Braumann, C; Badakhshi, H; Rogalla, P; Meisel, A; Rückert, R I; Müller, J M

    2008-01-01

    There are absolute and relative indications for complete removal of the thymus gland. In the complex therapy of autoimmune-related myasthenia gravis, thymectomy plays a central role and is performed with relative indication. In case of thymoma with or without myasthenia, thymectomy is absolutely indicated. Thymus resection is further necessary for cases of hyperparathyroidism with ectopic intrathymic parathyroids or with certain forms of multiple endocrine neoplasia. The transcervical operation technique traditionally reflected the well-founded desire for minimal invasiveness for thymectomy. Due to the requirement of radicality however, most of these operations were performed using sternotomy. With the evolution of therapeutic thoracoscopy in thoracic surgery, several pure or extended minimally invasive operation techniques for thymectomy have been developed. At present uni- or bilateral, subxiphoid, and modified transcervical single or combination thoracoscopic techniques are in use. Recently a very precise new level of thoracoscopic operation technique was developed using robotic-assisted surgery. There are special advantages of this technique for thymectomy. An overview of the development and experiences with minimally invasive thymectomy is presented, including data from the largest series published so far.

  15. [Free radicals and hepatic ischemia-reperfusion].

    PubMed

    Szijártó, Attila

    2015-11-22

    The critical importance of the ischemic-reperfusive injury is well documented with regards to numerous organs and clinical conditions. Oxygen free radicals play a central role in the mediation of the injury, which dominantly influences the prevalence of postoperative complications, (long term) organ damage, and the potential manifestation of systemic reactions. The both anatomically and pathophysiologically unique ischemic-reperfusive injury of the liver, which is expressively vulnerable to free radicals, is of utmost importance in liver surgery. Several techniques (adaptive maneuvers, chemical agents) are known to ameliorate the reperfusive injury. Based on the prior research of the workgroup of the author, the aim of the current article is to overview the set of measures capable of attenuating ischemic-reperfusive injury (ischemic preconditioning, -perconditioning, administration of adenosine, -inosine, -levosimendan, and -poly-ADP-ribose-polymerase inhibitor), with special attention to the ischemic-reperfusive injury of the liver, as well as the special pathophysiological role of free radicals in mediating hepatic damage.

  16. Replantation surgery.

    PubMed

    Sabapathy, S Raja; Venkatramani, Hari; Bharathi, R Ravindra; Bhardwaj, Praveen

    2011-06-01

    The current concepts of replantation surgery, a procedure that has been practiced for half a century, can be discussed in terms of patients' demands and expectations, present indications for the procedure, available evidence that influences decision making, and technical refinements practiced to produce better outcomes.

  17. 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

  18. Nose Surgery

    MedlinePlus

    ... requests or policy questions to our media and public relations staff at newsroom@entnet.org . Improving Form And Function Of The Nose Each year thousands of people undergo surgery of the ... plan to avoid appearing in public for about a week due to swelling and ...

  19. Toward Radicalizing Community Service Learning

    ERIC Educational Resources Information Center

    Sheffield, Eric C.

    2015-01-01

    This article advocates a radicalized theoretical construction of community service learning. To accomplish this radicalization, I initially take up a discussion of traditional understandings of CSL rooted in pragmatic/progressive thought. I then suggest that this traditional structural foundation can be radicalized by incorporating Deborah…

  20. International Robotic Radical Cystectomy Consortium: A way forward.

    PubMed

    Raza, Syed Johar; Field, Erinn; Kibel, Adam S; Mottrie, Alex; Weizer, Alon Z; Wagner, Andrew; Hemal, Ashok K; Scherr, Douglas S; Schanne, Francis; Gaboardi, Franco; Wu, Guan; Peabody, James O; Koauk, Jihad; Redorta, Joan Palou; Pattaras, John G; Rha, Koon-Ho; Richstone, Lee; Balbay, M Derya; Menon, Mani; Hayn, Mathew; Stoeckle, Micheal; Wiklund, Peter; Dasgupta, Prokar; Pruthi, Raj; Ghavamian, Reza; Khan, Shamim; Siemer, Stephan; Maatman, Thomas; Wilson, Timothy; Poulakis, Vassilis; Wilding, Greg; Guru, Khurshid A

    2014-07-01

    Robot-assisted radical cystectomy (RARC) is an emerging operative alternative to open surgery for the management of invasive bladder cancer. Studies from single institutions provide limited data due to the small number of patients. In order to better understand the related outcomes, a world-wide consortium was established in 2006 of patients undergoing RARC, called the International Robotic Cystectomy Consortium (IRCC). Thus far, the IRCC has reported its findings on various areas of operative interest and continues to expand its capacity to include other operative modalities and transform it into the International Radical Cystectomy Consortium. This article summarizes the findings of the IRCC and highlights the future direction of the consortium.

  1. Radicals in melanin biochemistry.

    PubMed

    Riley, P A

    1988-01-01

    Melanins are light-absorbant polymeric pigments found widely dispersed in nature. They possess many interesting physicochemical properties. One of these is the expression in the polymer of stable free radicals which appear to have a protective action in cells, probably by acting as a sink for diffusible free-radical species. Polymer formation is thought to occur by a free-radical process in which semiquinones are added to the chain. Semiquinones are formed by redox equilibration interactions between metabolic intermediates formed during the tyrosinase-catalyzed oxidation process. In the continued presence of substrate, steady-state concentrations of reactive species are predicted in the reaction system, and the melanogenic pathway may be considered as potentially hazardous for pigment-generating cells. This feature has been exploited by the use of analogue substrates to generate cytotoxic species as a possible rational approach to the treatment of malignant melanoma. One such substance is 4-hydroxyanisole, the oxidation of which gives rise to semiquinone radical species. The possibility that the anisyl semiquinone initiates a mechanism leading to cell damage has not been excluded. However, the current view is that the major cytotoxicity due to the oxidation products of this compound is the result of the action of the corresponding orthoquinone. A number of mechanisms exist for detoxifying quinones if they reach the cytosol such as O-methylation and the formation of thiol adducts with cysteine or glutathione, and these can be used as markers of melanogenesis. In general, however, only small amounts of reactive intermediates of melanogenesis escape from the confines of the melanosome, probably because of their limited lipid solubility. The selective toxic action of anisyl quinone in the treatment of melanoma may, in part, be due to membrane defects in the melanosomes of malignant melanocytes.

  2. Free radical explosive composition

    DOEpatents

    Walker, Franklin E.; Wasley, Richard J.

    1979-01-01

    An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a getter additive comprising a compound or mixture of compounds capable of capturing or deactivating free radicals or ions under mechanical or electrical shock conditions and which is not an explosive. Exemplary getter additives are isocyanates, olefins and iodine.

  3. Probability and radical behaviorism

    PubMed Central

    Espinosa, James M.

    1992-01-01

    The concept of probability appears to be very important in the radical behaviorism of Skinner. Yet, it seems that this probability has not been accurately defined and is still ambiguous. I give a strict, relative frequency interpretation of probability and its applicability to the data from the science of behavior as supplied by cumulative records. Two examples of stochastic processes are given that may model the data from cumulative records that result under conditions of continuous reinforcement and extinction, respectively. PMID:22478114

  4. Free radical propulsion concept

    NASA Technical Reports Server (NTRS)

    Hawkins, C. E.; Nakanishi, S.

    1981-01-01

    The concept of a free radical propulsion system, utilizing the recombination energy of dissociated low molecular weight gases to produce thrust, is analyzed. The system, operating at a theoretical impulse with hydrogen, as high as 2200 seconds at high thrust to power ratio, is hypothesized to bridge the gap between chemical and electrostatic propulsion capabilities. A comparative methodology is outlined by which characteristics of chemical and electric propulsion for orbit raising mission can be investigated. It is noted that free radicals proposed in rockets previously met with difficulty and complexity in terms of storage requirements; the present study proposes to eliminate the storage requirements by using electric energy to achieve a continuous-flow product of free radicals which are recombined to produce a high velocity propellant. Microwave energy used to dissociate a continuously flowing gas is transferred to the propellant via three-body-recombination for conversion to propellant kinetic energy. Microwave plasma discharge was found in excess of 90 percent over a broad range of pressure in preliminary experiments, and microwave heating compared to electrothermal heating showed much higher temperatures in gasdynamic equations.

  5. THERMOCHEMISTRY OF HYDROCARBON RADICALS

    SciTech Connect

    Kent M. Ervin, Principal Investigator

    2004-08-17

    Gas phase negative ion chemistry methods are employed to determine enthalpies of formation of hydrocarbon radicals that are important in combustion processes and to investigate the dynamics of ion-molecule reactions. Using guided ion beam tandem mass spectrometry, we measure collisional threshold energies of endoergic proton transfer and hydrogen atom transfer reactions of hydrocarbon molecules with negative reagent ions. The measured reaction threshold energies for proton transfer yield the relative gas phase acidities. In an alternative methodology, competitive collision-induced dissociation of proton-bound ion-molecule complexes provides accurate gas phase acidities relative to a reference acid. Combined with the electron affinity of the R {center_dot} radical, the gas phase acidity yields the RH bond dissociation energy of the corresponding neutral molecule, or equivalently the enthalpy of formation of the R{center_dot} organic radical, using equation: D(R-H) = {Delta}{sub acid}H(RH) + EA(R) - IE(H). The threshold energy for hydrogen abstraction from a hydrocarbon molecule yields its hydrogen atom affinity relative to the reagent anion, providing the RH bond dissociation energy directly. Electronic structure calculations are used to evaluate the possibility of potential energy barriers or dynamical constrictions along the reaction path, and as input for RRKM and phase space theory calculations. In newer experiments, we have measured the product velocity distributions to obtain additional information on the energetics and dynamics of the reactions.

  6. Types of radical hysterectomies

    PubMed Central

    Marin, F; Plesca, M; Bordea, CI; Moga, MA; Blidaru, A

    2014-01-01

    Abstract The treatment for cervical cancer is a complex, multidisciplinary issue, which applies according to the stage of the disease. The surgical elective treatment of cervical cancer is represented by the radical abdominal hysterectomy. In time, many surgeons perfected this surgical technique; the ones who stood up for this idea were Thoma Ionescu and Ernst Wertheim. There are many varieties of radical hysterectomies performed by using the abdominal method and some of them through vaginal and mixed way. Each method employed has advantages and disadvantages. At present, there are three classifications of radical hysterectomies which are used for the simplification of the surgical protocols: Piver-Rutledge-Smith classification which is the oldest, GCG-EORTC classification and Querlow and Morrow classification. The last is the most evolved and recent classification; its techniques can be adapted for conservative operations and for different types of surgical approaches: abdominal, vaginal, laparoscopic or robotic. Abbreviations: GCG-EORTC = Gynecologic Cancer Group of the European Organization of Research and Treatment of Cancer; LEEP = loop electrosurgical excision procedure; I.O.B. = Institute of Oncology Bucharest; PRS = Piver-Rutledge-Smith PMID:25408722

  7. 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 - ...

  8. Surgery for Breast Cancer

    MedlinePlus

    ... Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment for breast cancer, ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  9. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... Tumor Treating Lung Carcinoid Tumors 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 ( ...

  10. Refractive corneal surgery - discharge

    MedlinePlus

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  11. Catalysis of Radical Reactions: A Radical Chemistry Perspective.

    PubMed

    Studer, Armido; Curran, Dennis P

    2016-01-04

    The area of catalysis of radical reactions has recently flourished. Various reaction conditions have been discovered and explained in terms of catalytic cycles. These cycles rarely stand alone as unique paths from substrates to products. Instead, most radical reactions have innate chains which form products without any catalyst. How do we know if a species added in "catalytic amounts" is a catalyst, an initiator, or something else? Herein we critically address both catalyst-free and catalytic radical reactions through the lens of radical chemistry. Basic principles of kinetics and thermodynamics are used to address problems of initiation, propagation, and inhibition of radical chains. The catalysis of radical reactions differs from other areas of catalysis. Whereas efficient innate chain reactions are difficult to catalyze because individual steps are fast, both inefficient chain processes and non-chain processes afford diverse opportunities for catalysis, as illustrated with selected examples.

  12. Interleukin 12 exerts a differential effect on the maturation of neonatal and adult human CD45R0- CD4 T cells.

    PubMed Central

    Shu, U; Demeure, C E; Byun, D G; Podlaski, F; Stern, A S; Delespesse, G

    1994-01-01

    It is now recognized that IL-12 plays a predominant role in protective immunity against intracellular pathogens by promoting the development of T helper type 1 (Th1) responses. We here report the unexpected observations that IL-12 exerts differential effects on the maturation of "native" human CD4 T cells isolated from umbilical cord blood or from the blood of healthy adults. After priming in the presence of IL-12, naive cells of adult donors, defined as CD45R0- CD4+ T cells, acquire a Th1 phenotype whereas neonatal cells develop into effector cells producing high levels of IL-4 in addition to IFN-gamma. This effect of IL-12 on neonatal T cells is direct inasmuch as it is observed on highly purified CD4 T cells, however, it is not inhibited by CD8 T cells and natural killer cells. Unstimulated neonatal T cells which have been preincubated with IL-12 before the priming behave like adult T cells and acquire a Th1 phenotype after stimulation in the presence of IL-12. Given that IL-4 is a potent antagonist of Th1 responses, the finding that IL-12 promotes the maturation of neonatal T cells into IL-4 producers may explain the increased susceptibility of neonates to intracellular pathogens and should be taken into account for the development of vaccines to be used in the perinatal period. Images PMID:7929809

  13. Spin reorientation, magnetization reversal, and negative thermal expansion observed in R F e0.5C r0.5O3 perovskites (R =Lu ,Yb ,Tm )

    NASA Astrophysics Data System (ADS)

    Pomiro, Fernando; Sánchez, Rodolfo D.; Cuello, Gabriel; Maignan, Antoine; Martin, Christine; Carbonio, Raúl E.

    2016-10-01

    Three members of the perovskite family R F e0.5C r0.5O3 (R =Lu ,Yb , and Tm) have been synthesized and characterized. A systematic study of the crystal and magnetic structures was performed by neutron powder diffraction combined with magnetization measurements. All these compounds crystallize in a Pbnm orthorhombic unit cell and they are already antiferromagnetic at room temperature. The study of the magnetic structure vs temperature showed the occurrence of a progressive spin reorientation from Γ4TM to Γ2TM for the transition metal sublattice, and in the Tm-based sample, a long-range magnetic order of the T m3 + sublattice was found (Γ8R) . These results are in excellent agreement with the magnetic susceptibility measurements. No spin reorientation is observed in the Lu-based sample for which a magnetization reversal at a compensation temperature Tcomp= 225 K was detected. A clear magnetostrictive effect was observed in the samples with R =Yb and Tm associated with a negative thermal expansion and was assigned to a magnetoelastic effect produced by repulsion between the magnetic moments of neighboring transition metal ions.

  14. Differential steric effects in Cl reactions with aligned CHD3(v1 = 1) by the R(0) and Q(1) transitions. II. Abstracting the unexcited D-atoms

    NASA Astrophysics Data System (ADS)

    Wang, Fengyan; Liu, Kopin

    2016-10-01

    A complete set of four polarization-dependent differential cross sections in the reactions of Cl + aligned-CHD 3 ( v 1 = 1 , |" separators=" jK > ) → DCl ( v = 0 ) + CHD 2 ( v 1 = 1 ) is reported here for two different, rotationally polarized states with j = 1: specifically the |" separators=" jK > = |" separators=" 10 > state prepared via the R(0) excitation and the |" separators=" 1 ± 1 > state via Q(1). In stark contrast to the complicated situation of the HCl(v) + CD3(v = 0) channel reported in Paper-I, the stereo-requirement of this isotopic channel for both polarized reactants appears quite straightforward and consistent with a direct rebound mechanism. The extent of steric effects is moderate and relatively smaller than the alternative H-atom abstraction channel. All major findings reported here can qualitatively be understood by first noting that the present reaction invokes abstracting a D-atom, which is the spectator in the IR-excitation process. Next, it is recognized that the directional properties of two polarized states of CHD 3 ( v 1 = 1 , |" separators=" jK > ) should manifest primarily in the IR-excited C-H bond, leaving secondary imprints in the unexcited CD3-moiety. The stereo-specificity of the DCl + CHD2 product channel is further reduced by the fact that the abstraction can occur with any one of the three spatially distinct D-atoms.

  15. Future perspectives in robotic surgery.

    PubMed

    Wedmid, Alexei; Llukani, Elton; Lee, David I

    2011-09-01

    • Robotics of the current day have advanced significantly from early computer-aided design/manufacturing systems to modern master-slave robotic systems that replicate the surgeon's exact movements onto robotic instruments in the patient. • Globally >300,000 robotic procedures were completed in 2010, including ≈98,000 robot-assisted radical prostatectomies. • Broadening applications of robotics for urological procedures are being investigated in both adult and paediatric urology. • The use of the current robotic system continues to be further refined. Increasing experience has optimized port placement reducing arm collisions to allow for more expedient surgery. Improved three-dimensional camera magnification provides improved intraoperative identification of structures. • Robotics has probably improved the learning curve of laparoscopic surgery while still maintaining its patient recovery advantages and outcomes. • The future of robotic surgery will take this current platform forward by improving haptic (touch) feedback, improving vision beyond even the magnified eye, improving robot accessibility with a reduction of entry ports and miniaturizing the slave robot. • Here, we focus on the possible advancements that may change the future landscape of robotic surgery.

  16. Oligorotaxane Radicals under Orders.

    PubMed

    Wang, Yuping; Frasconi, Marco; Liu, Wei-Guang; Sun, Junling; Wu, Yilei; Nassar, Majed S; Botros, Youssry Y; Goddard, William A; Wasielewski, Michael R; Stoddart, J Fraser

    2016-02-24

    A strategy for creating foldameric oligorotaxanes composed of only positively charged components is reported. Threadlike components-namely oligoviologens-in which different numbers of 4,4'-bipyridinium (BIPY(2+)) subunits are linked by p-xylylene bridges, are shown to be capable of being threaded by cyclobis(paraquat-p-phenylene) (CBPQT(4+)) rings following the introduction of radical-pairing interactions under reducing conditions. UV/vis/NIR spectroscopic and electrochemical investigations suggest that the reduced oligopseudorotaxanes fold into highly ordered secondary structures as a result of the formation of BIPY(•+) radical cation pairs. Furthermore, by installing bulky stoppers at each end of the oligopseudorotaxanes by means of Cu-free alkyne-azide cycloadditions, their analogous oligorotaxanes, which retain the same stoichiometries as their progenitors, can be prepared. Solution-state studies of the oligorotaxanes indicate that their mechanically interlocked structures lead to the enforced interactions between the dumbbell and ring components, allowing them to fold (contract) in their reduced states and unfold (expand) in their fully oxidized states as a result of Coulombic repulsions. This electrochemically controlled reversible folding and unfolding process, during which the oligorotaxanes experience length contractions and expansions, is reminiscent of the mechanisms of actuation associated with muscle fibers.

  17. Oligorotaxane Radicals under Orders

    PubMed Central

    2016-01-01

    A strategy for creating foldameric oligorotaxanes composed of only positively charged components is reported. Threadlike components—namely oligoviologens—in which different numbers of 4,4′-bipyridinium (BIPY2+) subunits are linked by p-xylylene bridges, are shown to be capable of being threaded by cyclobis(paraquat-p-phenylene) (CBPQT4+) rings following the introduction of radical-pairing interactions under reducing conditions. UV/vis/NIR spectroscopic and electrochemical investigations suggest that the reduced oligopseudorotaxanes fold into highly ordered secondary structures as a result of the formation of BIPY•+ radical cation pairs. Furthermore, by installing bulky stoppers at each end of the oligopseudorotaxanes by means of Cu-free alkyne–azide cycloadditions, their analogous oligorotaxanes, which retain the same stoichiometries as their progenitors, can be prepared. Solution-state studies of the oligorotaxanes indicate that their mechanically interlocked structures lead to the enforced interactions between the dumbbell and ring components, allowing them to fold (contract) in their reduced states and unfold (expand) in their fully oxidized states as a result of Coulombic repulsions. This electrochemically controlled reversible folding and unfolding process, during which the oligorotaxanes experience length contractions and expansions, is reminiscent of the mechanisms of actuation associated with muscle fibers. PMID:27163033

  18. Radically innovative steelmaking technologies

    NASA Astrophysics Data System (ADS)

    Szekely, Julian

    1980-09-01

    The steel industry is faced with serious problems caused by the increasing cost of energy, labor and capital and by tough overseas competition, employing new highly efficient process plants. The very high cost of capital and of capital equipment renders the construction of new green field site plants, exemplifying the best available technology economically unattractive. For this reason, over the long term the development radically innovative steelmaking technologies appears to be the only satisfactory resolution of this dilemma. The purpose of this article is to present a critical review of some of the radically innovative steelmaking technologies that have been proposed during the past few years and to develop the argument that these indeed do deserve serious consideration at the present time. It should be stressed, however, that these innovative technologies can be implemented only as part of a carefully conceived long range plan, which contains as a subset short term solutions, such as trigger prices improved investment credits, and so forth and intermediate term solutions, such as more extensive use of continuous casting, external desulfurization and selective modernization in general.

  19. [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.

  20. Radiotherapy combined with surgery as treatment for advanced cervical cancer.

    PubMed

    Perches, R D; Lobaton, A T; Garcia, M C

    1983-12-01

    Experience obtained in a group of 44 patients with advanced cervical cancer is reported here. In this study, patients with residual cancer underwent laparotomy eight weeks after one or two different radiotherapy protocols. Sixty-eight percent of patients underwent radical surgery, 85% of patients pelvic exenterations, and 15% radical hysterectomies. In 27% of patients, no evidence of residual cancer was found in surgical specimens. Radical surgery was well tolerated, and one-third of patients were free of disease for one year or more. Control of disease was obtained in 50% of pelvic exenterations and in 60% of radical hysterectomies, regardless of prognosis, clinical stage or radiotherapy scheme. Although results show an improvement of up to 22% when comparing this to other more conventional treatments, we have concluded that we must obtain a wider experience in order to support our findings.

  1. Surgery for invasive gynecologic cancer in the elderly female population.

    PubMed

    Lawton, F G; Hacker, N F

    1990-08-01

    Radical, curative surgery may not be considered in elderly patients with gynecologic cancer, yet the morbidity for this population from radiotherapy and cytotoxics may be high. This study compared the feasibility and outcome of such surgery in 226 consecutive patients, 72 women over 70 years old and 154 younger patients, in our institution over a 26-month period. Older patients presented with more advanced-stage cancers and, as a group, had significantly poorer presurgical performance status and more intercurrent medical problems. Nevertheless, the planned radical surgical procedure could be carried out in 90% of elderly patients, with a postoperative mortality of 1.5%. Minor postoperative complication rates were similar for the two groups and, except for vulvectomy patients, the mean inpatient stay was the same for both groups. Chronological age alone is a poor determinant of surgical risk, and elderly patients withstand radical surgery almost as well as their younger counterparts.

  2. 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

  3. Observation as Good as Surgery for Some Men with Prostate Cancer

    Cancer.gov

    Many men diagnosed with early-stage prostate cancer could forego radical prostatectomy and live as long as men who have immediate surgery, according to long-awaited results from a clinical trial published July 19, 2012, in NEJM.

  4. Radicals in Berkeley?

    PubMed Central

    Linn, Stuart

    2015-01-01

    In a previous autobiographical sketch for DNA Repair (Linn, S. (2012) Life in the serendipitous lane: excitement and gratification in studying DNA repair. DNA Repair 11, 595–605), I wrote about my involvement in research on mechanisms of DNA repair. In this Reflections, I look back at how I became interested in free radical chemistry and biology and outline some of our bizarre (at the time) observations. Of course, these studies could never have succeeded without the exceptional aid of my mentors: my teachers; the undergraduate and graduate students, postdoctoral fellows, and senior lab visitors in my laboratory; and my faculty and staff colleagues here at Berkeley. I am so indebted to each and every one of these individuals for their efforts to overcome my ignorance and set me on the straight and narrow path to success in research. I regret that I cannot mention and thank each of these mentors individually. PMID:25713083

  5. Radicals in Berkeley?

    PubMed

    Linn, Stuart

    2015-04-03

    In a previous autobiographical sketch for DNA Repair (Linn, S. (2012) Life in the serendipitous lane: excitement and gratification in studying DNA repair. DNA Repair 11, 595-605), I wrote about my involvement in research on mechanisms of DNA repair. In this Reflections, I look back at how I became interested in free radical chemistry and biology and outline some of our bizarre (at the time) observations. Of course, these studies could never have succeeded without the exceptional aid of my mentors: my teachers; the undergraduate and graduate students, postdoctoral fellows, and senior lab visitors in my laboratory; and my faculty and staff colleagues here at Berkeley. I am so indebted to each and every one of these individuals for their efforts to overcome my ignorance and set me on the straight and narrow path to success in research. I regret that I cannot mention and thank each of these mentors individually.

  6. Free radical propulsion concept

    NASA Technical Reports Server (NTRS)

    Hawkins, C. E.; Nakanishi, S.

    1981-01-01

    A free radical propulsion concept utilizing the recombination energy of dissociated low molecular weight gases to produce thrust was examined. The concept offered promise of a propulsion system operating at a theoretical impulse, with hydrogen, as high as 2200 seconds at high thrust to power ratio, thus filling the gas existing between chemical and electrostatic propulsion capabilities. Microwave energy used to dissociate a continuously flowing gas was transferred to the propellant via three body recombination for conversion to propellant kinetic energy. Power absorption by the microwave plasma discharge was in excess of 90 percent over a broad range of pressures. Gas temperatures inferred from gas dynamic equations showed much higher temperatures from microwave heating than from electrothermal heating. Spectroscopic analysis appeared to corroborate the inferred temperatures of one of the gases tested.

  7. Nephrocutaneous fistula as the initial manifestation of asymptomatic nephrolithiasis: A call for radical management.

    PubMed

    Tanwar, Raman; Rathore, Kirti Vijay; Rohilla, Mahesh Kumar

    2015-01-01

    Renal stones are a common affliction presenting in an acute setting. We report a case of asymptomatic renal stone in an elderly gentleman presenting initially as a discharging lumbar sinus managed by subcapsular nephrectomy and radical excision of the fistula tract. Nephrocutaneous fistula is most commonly associated with tuberculosis, xanthogranulomatous pyelonephritis, and rarely with complicated calyceal stones, and its occurrence with asymptomatic pelvic stones is rare. We present the points in favor of radical open surgery in the management of such patients.

  8. 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.

  9. Endodontic surgery.

    PubMed

    Lieblich, Stuart E

    2012-01-01

    Conventional endodontic therapy is successful approximately 80-85% of the time. Many of these failures will occur after one year. The presence of continued pain, drainage, mobility or an increasing size of a radiolucent area are some of the indications to treat the case surgically. Since many of these cases may have had final restorations placed by the dentist, the salvage of these cases is of importance to the patient. Advances in periapical surgery have included the use of ultrasonic root end preparation. With the use of these piezoelectric devices, a more controlled apical preparation can be achieved. Additionally, isthmus areas between canals can be appropriately prepared and sealed. The precision afforded with these devices reduces the chances for a malpositioned fill and a more successful outcome.

  10. [RADICAL LAPAROSCOPIC NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY].

    PubMed

    Perlin, D V; Aleksandrov, I V; Zipunnikov, V P; Ljaljuev, A M

    2015-01-01

    Laparoscopic radical nephrectomy has proven itself as the "gold standard" treatment of renal cell carcinoma. Inferior vena cava (IVC) tumor thrombus is a complicating factor that occurs in 5% to 10% of patients with renal cell carcinoma. In world literature, there are only anecdotal reports on using laparoscopic approach for IVC thrombectomy in patients with renal cell carcinoma. Herein we report our experience of laparoscopic radical nephrectomy and thrombectomy of the level II tumor thrombus in the IVC. Two patients (79-year-old female and 48-year-old male) underwent radical nephrectomy with thrombectomy from IVC for renal cell carcinoma T3bNxM0 complicated by the formation of a tumor thrombus in the IVC. To do this, IVC was isolated, the right gonadal and lumbar veins were ligated and transected. The IVC and the left renal vein blood flow were controlled with a plastic clip and Satinski clamp. After thrombectomy and resection of the IVC, the wall the defect was sutured with continuous Prolene suture. Laparoscopic radical nephrectomy with thrombectomy without conversion to open surgery was successfully carried out in both patients. During 6-18 months follow-up no local recurrence or distant metastasis were observed. Laparoscopic radical nephrectomy with thrombectomy for renal cell carcinoma complicated with tumor thrombus level II is a safe and reproducible method, which can be applied to a specific population of patients.

  11. Radical Change by Entrepreneurial Design

    DTIC Science & Technology

    1998-01-01

    This article offers a conceptual framework to understand radical change. It opens with a typology that defines change in terms of its pace and scope...known entrepreneurs who have been successful in molding and shaping the radical change process. The implications of this conceptual framework to

  12. Radical hysterectomy versus radiation therapy for stage IB squamous cell cancer of the cervix

    SciTech Connect

    Hopkins, M.P.; Morley, G.W. )

    1991-07-15

    Three hundred forty-five patients with Stage IB squamous cell carcinoma of the cervix were treated at the University of Michigan Medical Center from 1970 to 1985. The overall cumulative 5-year survival rate was 89% and the mean age was 44.6 years. In 213 patients undergoing radical hysterectomy the cumulative 5-year survival rate was 92%; 14 patients were explored for radical hysterectomy that was not performed due to high risk features and their survival rate was 50%. Ninety-seven patients underwent radiation therapy as initial treatment and had a 5-year survival rate of 86%. There was no significant difference when radiation therapy was compared with radical hysterectomy (P = 0.098). The survival rates for lesions 3 cm or smaller were 94% for radical hysterectomy and 88% for radiation therapy. When the lesion was larger than 3 cm, the survival rates were 82% with radical surgery and 73% with radiation therapy. Metastatic disease to lymph nodes was present in 26 of the 213 patients undergoing radical hysterectomy. When 1 to 3 nodes were involved 16 of 19 patients survived and when 4 to 10 nodes were involved 3 of 7 patients survived. The addition of radiation therapy did not influence survival. Complications were similar in both treatment groups. Fistulas occurred in 4 of 213 patients undergoing radical hysterectomy and 1 of 111 undergoing radiation. Second surgery for a complication was required in 6 of 213 patients undergoing radical hysterectomy and 7 of 111 undergoing radiation. Survival and complication rates in early stage squamous cell carcinoma of the cervix are equal with either radical surgery or radiation therapy.

  13. [Minimally invasive surgery and robotic surgery: surgery 4.0?].

    PubMed

    Feußner, H; Wilhelm, D

    2016-03-01

    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  14. Studies of radiation-produced radicals and radical ions

    SciTech Connect

    Williams, T.F.

    1991-01-01

    The radiolytic oxidation of anti-5-methylbicyclo(2.1.0)pentane gives the 1-methylcyclopentene radical cation as the sole rearrangement product H migration whereas oxidation of its syn isomer results in the highly selective formation of the 3-methylcyclopentene radical cation by methyl group migration. Since exactly the same stereoselectivity of olefin formation was observed in corresponding PET (photosensitized electron transfer) studies in the liquid phase, it is concluded that the rearrangement in this case also occurs through the intermediacy of radical cations. Clearly, the radical cation rearrangement must occur very rapidly (10{sup {minus}8}--10{sup {minus}9}s) under liquid-phase conditions at room temperature to compete with back electron transfer, and therefore the hydrogen (or methyl) migration is a fast process under these conditions. An intramolecular cycloaddition reaction was demonstrated in the radical cation rearrangement of 4-vinylcyclohexene to bicyclo(3.2.1)oct-2-ene. ESR studies show that the radiolytic oxidation of quadricyclane in Freon matrices under conditions of high substrate dilution leads to the bicyclo(3.2.0)hepta-2,6-diene radical cation as well as the previously reported norbornadiene radical cation, the former species predominating at sufficiently low concentrations.

  15. What Is Heart Surgery?

    MedlinePlus

    ... Another type of heart surgery is called off-pump, or beating heart, surgery. It's like traditional open- ... heart-lung bypass machine isn't used. Off-pump heart surgery is limited to CABG. Surgeons can ...

  16. Dental Implant Surgery

    MedlinePlus

    Dental implant surgery Overview By Mayo Clinic Staff Dental implant surgery is a procedure that replaces tooth roots with ... look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures ...

  17. Weight Loss Surgery

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Weight Loss Surgery KidsHealth > For Teens > Weight Loss Surgery A A ... Risks and Side Effects? What Is Weight Loss Surgery? For some people, being overweight is about more ...

  18. Surgery for Testicular Cancer

    MedlinePlus

    ... type of retroperitoneal lymph node surgery called nerve-sparing surgery that is very successful when done by ... children. These men may wish to discuss nerve-sparing surgery with their doctors, as well as sperm ...

  19. Tennis elbow surgery - discharge

    MedlinePlus

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  20. Alternative Refractive Surgery Procedures

    MedlinePlus

    ... LASIK Alternative Refractive Surgery Procedures Laser Surgery Recovery Alternative Refractive Surgery Procedures Dec. 12, 2015 Today's refractive ... that releases controlled amounts of radio frequency (RF) energy, instead of a laser, to apply heat to ...

  1. Surgery for pancreatic cancer

    MedlinePlus

    ... medlineplus.gov/ency/article/007649.htm Surgery for pancreatic cancer To use the sharing features on this page, ... surgery are used in the surgical treatment of pancreatic cancer. Whipple procedure: This is the most common surgery ...

  2. 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 ...

  3. Weight Loss Surgery

    MedlinePlus

    ... serious medical problems. Weight loss surgery (also called bariatric surgery) can help very obese people lose weight. But ... Gastric banding is the simplest of the three weight loss surgeries. People who get it might not lose as ...

  4. Bariatric Surgery Procedures

    MedlinePlus

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... minimally invasive techniques (laparoscopic surgery). The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric ...

  5. Gastric Sleeve Surgery

    MedlinePlus

    ... doctors recommend weight loss surgery (also known as bariatric surgery ) for very overweight teens if they've tried ... it is at a children's hospital with a bariatric surgery program that involves a team of specialists. Members ...

  6. Seeking beauty: understanding the psychology behind orthognathic surgery.

    PubMed

    Oluwajana, F

    2015-12-01

    Orthognathic surgery to correct serious skeletal discrepancies of the jaw improves both function and appearance, but patients should spend a lot of time thinking about, discussing, and planning operations that have such a considerable impact. The drive to improve appearance by such radical means is based on social and personal reasons, and this must be understood before treatment is considered. In this paper, we will review studies on the psychology of orthognathic surgery.

  7. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    MedlinePlus

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  8. [Current operative techniques and strategies in endocrine surgery].

    PubMed

    Gürtler, Thomas; Weber, Markus

    2011-06-01

    Technical advances and focusing on subsets modified endocrine surgery in the last ten years tremendously. There is on one side a clear trend towards minimal invasive approaches, first of all in the surgery of the adrenal glands, where the transperitoneal or retroperitoneal laparoscopic adrenalectomy has become the gold standard for tumors up to a size of 10 cm in diameter. But also in pancreatic endocrine surgery for small tumors localized in the pancreas tail and up to a certain extend in thyroid and parathyroid surgery, laparoscopic or video assisted techniques are used. On the other side more precise techniques allow a more complete and radical removal of endocrine tissue, especially in thyroid surgery. This article presents a summary of current operative techniques and strategies in endocrine surgery.

  9. Nerve-sparing robotic radical hysterectomy: our technique.

    PubMed

    Puntambekar, Shailesh P; Lawande, Akhil; Desai, Riddhi; Kenawadekar, Rahul; Joshi, Saurabh; Joshi, Geetanjali Agarwal

    2014-03-01

    Robotic surgery is now becoming accepted for treatment of gynaecological malignancies. Nerve preservation during radical hysterectomy is increasingly being offered due to improved post-operative bladder and sexual function. We aimed to demonstrate the feasibility of performing a nerve-sparing radical hysterectomy robotically and to assess the oncological and functional outcomes associated with this surgery. Between August 2011 and January 2013, a total of 12 non-consecutive patients underwent robotic surgery for early stage cervical cancer at our institution. Patients comprising FIGO stage IA2 to IB1 were treated with nerve-sparing robotic radical hysterectomy using a C1 (Querleu-Morrow classification) type technique. The feasibility, operative time, blood loss, oncological outcome and post-operative bladder function were assessed. All the procedures were completed robotically without conversion to laparoscopy or laparotomy. The mean age of the patients was 56 years (range 44-76) and their mean body mass index was 22.6 kg/m(2) (range 18.1-26.4). The mean operative time was 156 min (range 120-250); the mean blood loss was 120 ml (50-250). The Foley catheter was removed on the third post-operative day, with full recovery of bladder function in all patients except one who required prolonged catheterisation for 3 weeks. Residual urine was 40 ml (range 30-80). Parametrial margins of 2.5-3 cm, distal vaginal margins of 2-2.5 cm and a mean nodal harvest of 24 (range 18-30) were achieved. The mean hospital stay was 3 days (range 2-6). The median follow-up is 12 months. There is no loco-regional recurrence. All the patients are sexually active. Robotic nerve-sparing radical hysterectomy is technically feasible to perform, and is oncologically safe for early stage cervical carcinoma.

  10. Perioperative visual loss in ocular and nonocular surgery

    PubMed Central

    Berg, Kathleen T; Harrison, Andrew R; Lee, Michael S

    2010-01-01

    Incidence estimates for perioperative vision loss (POVL) after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION), either anterior (AION) or posterior (PION). We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO), 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period. PMID:20596508

  11. Conformational stability from variable temperature infrared spectra of krypton solutions, ab initio calculations, vibrational assignment, and r0 structural parameters of 1,3-difluoropropane.

    PubMed

    Durig, James R; Zheng, Chao; Williams, Michael J; Stidham, Howard D; Guirgis, Gamil A

    2004-06-01

    well as for the Cs conformers than the MP2 values. A complete vibrational assignment is proposed for the C2 conformer and many of the fundamentals have been identified for the C1 form based on the force constants, relative intensities and rotational-vibrational band contours obtained from the predicted equilibrium geometry parameters. By combining previously reported rotational constants for the C2 and C1 conformers with ab initio MP2/6-311 + G(d, p) predicted parameters, adjusted r0 parameters have been obtained for both conformers. Comparisons are made with the parameters obtained for some other molecules containing the FCH2 group. The spectroscopic and theoretical results are compared to the corresponding properties for some similar molecules.

  12. Free radicals and male reproduction.

    PubMed

    Agarwal, Ashok; Allamaneni, Shyam S R

    2011-03-01

    Male factor accounts for almost 50% cases of infertility. The exact mechanism of sperm dysfunction is not known in many cases. Extensive research in the last decade has led to the identification of free radicals (reactive oxygen species) as mediators of sperm dysfunction in both specific diagnoses and idiopathic cases of male infertility. Elevated levels of reactive oxygen species are seen in up to 30-80% of men with male infertility. The role of free radicals has been studied extensively in the process of human reproduction. We know now that a certain level of free radicals is necessary for normal sperm function, whereas an excessive level of free radicals can cause detrimental effect on sperm function and subsequent fertilisation and offspring health. Oxidative stress develops when there is an imbalance between generation of free radicals and scavenging capacity of anti-oxidants in reproductive tract. Oxidative stress has been shown to affect both standard semen parameters and fertilising capacity. In addition, high levels of free radicals have been associated with lack of or poor fertility outcome after natural conception or assisted reproduction. Diagnostic techniques to quantify free radicals in infertile patients can assist physicians treating patients with infertility to plan for proper treatment strategies. In vivo anti-oxidants can be used against oxidative stress in male reproductive tract. Supplementation of in vitro anti-oxidants can help prevent the oxidative stress during sperm preparation techniques in assisted reproduction.

  13. [Baldness surgery].

    PubMed

    Dardour, J-C; Hennebert, H

    2003-10-01

    Redistribution from hair-rich to hair-poor areas is the fundamental principle of baldness surgery. Success of hair transplantation is based on the fact that transplanted hair follicles will behave as they did in their original area and continue to grow. Three basic techniques are employed: scalp flaps, scalp reductions and hair grafts. Each technique has undergone considerable refinements answering to initial wrong results and criticisms. The typical doll-hair tufted effect of old macro-grafts has disappeared with micro-graft shift. The unaesthetic cheese-like Hippocratic crown donor defect aspect ended when harvesting a long strip of occipital hair bearing scalp. The posteriorly directed hair growth has disappeared by using superiorly based flaps. Respective indications and tension-free closure ensure that the incidence of necrosis is low. Limited results of old scalp reductions have decreased by testing preoperative laxity of the scalp and using extensive undermining of the scalp. The future may release on medical treatment avoiding dihydrotestosterone to act on genetically predisposed follicles avoiding miniaturization of the hair and baldness development. However, when baldness has appeared, as the hair follicle's culture is not actually effective, the state of art is still to plan a surgical strategy using successive stages of this large panel of techniques to reach a natural effect with the best hair orientation and density.

  14. Outcome After Conformal Salvage Radiotherapy in Patients With Rising Prostate-Specific Antigen Levels After Radical Prostatectomy

    SciTech Connect

    Geinitz, Hans; Riegel, Martina G.; Thamm, Reinhard; Astner, Sabrina T.; Lewerenz, Carolin; Zimmermann, Frank; Molls, Michael; Nieder, Carsten

    2012-04-01

    Purpose: This study attempts to improve our understanding of the role of salvage radiotherapy (SRT) in patients with prostate-specific antigen (PSA) relapse after radical prostatectomy with regard to biochemical control, rate of distant metastasis, and survival. Methods and Materials: We performed a retrospective analysis of 96 men treated with conformal prostate bed SRT (median, 64.8 Gy) at a single institution (median follow-up, 70 months). The majority had intermediate- or high-risk prostate cancer. Fifty-four percent underwent a resection with positive margins (R1 resection). The median time interval between surgery and SRT was 22 months. Results: After SRT, 66% of patients reached a PSA nadir of less than 0.2 ng/mL. However, the 5-year biochemical no evidence of disease rate was 35%. Seminal vesicle involvement was predictive for a significantly lower biochemical no evidence of disease rate. All patients with a preoperative PSA level greater than 50 ng/mL relapsed biochemically within 2 years. The 5-year distant metastasis rate was 18%, the 5-year prostate cancer-specific survival rate was 90%, and the 5-year overall survival rate was 88%. Significantly more distant metastases developed in patients with a PSA nadir greater than 0.05 ng/mL after SRT, and they had significantly inferior prostate cancer-specific and overall survival rates. Resection status (R1 vs. R0) was not predictive for any of the endpoints. Conclusions: Men with postoperative PSA relapse can undergo salvage treatment by prostate bed radiotherapy, but durable PSA control is maintained only in about one-third of the patients. Despite a high biochemical failure rate after SRT, prostate cancer-specific survival does not decrease rapidly.

  15. EPR detection of hydroxyl radical generation and its interaction with antioxidant system in Carassius auratus exposed to pentachlorophenol.

    PubMed

    Luo, Yi; Wang, Xiao-rong; Ji, Liang-liang; Su, Yan

    2009-11-15

    In the present study, direct evidence of hydroxyl radical production in livers of Carassius auratus exposed to pentachlorophenol (PCP) was provided using electron paramagnetic resonance (EPR) with spin-trapping. A dose-effect relationship was obtained between hydroxyl radical intensities and PCP exposure. It was observed that hydroxyl radical was significantly induced by 0.001 mg l(-1) (below the criteria for Chinese fishery water quality) of PCP exposure. A strong positive correlation (r=0.9581, p<0.001) was observed between PCP liver concentrations and hydroxyl radical intensities within 7d of PCP exposure, which suggests that hydroxyl radical are mainly produced from PCP itself. However, no correlation was observed between PCP liver concentrations and hydroxyl radical intensities after 7d, and a higher intensity of hydroxyl radical could still be observed when the PCP liver concentrations decreased to a lower level, which suggests that other mechanisms may possibly contribute to hydroxyl radical production after 7d. The glutathione/oxidized glutathione (GSH/GSSG) ratio decreased below that of the control level during the entire period of PCP exposure (0.05 mg l(-1)), which suggested oxidative stress occurred.

  16. 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

  17. Current status of robotic surgery in Japan.

    PubMed

    Nishimura, Kazuo

    2015-03-01

    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.

  18. Changes in Plasma Levels of N-Arachidonoyl Ethanolamine and N-Palmitoylethanolamine following Bariatric Surgery in Morbidly Obese Females with Impaired Glucose Homeostasis

    PubMed Central

    Mallipedhi, Akhila; Prior, Sarah L.; Dunseath, Gareth; Bracken, Richard M.; Barry, Jonathan; Caplin, Scott; Eyre, Nia; Morgan, James; Baxter, John N.; O'Sullivan, Saoirse E.; Sarmad, Sarir; Barrett, David A.; Bain, Stephen C.; Luzio, Steve D.

    2015-01-01

    Aim. We examined endocannabinoids (ECs) in relation to bariatric surgery and the association between plasma ECs and markers of insulin resistance. Methods. A study of 20 participants undergoing bariatric surgery. Fasting and 2-hour plasma glucose, lipids, insulin, and C-peptide were recorded preoperatively and 6 months postoperatively with plasma ECs (AEA, 2-AG) and endocannabinoid-related lipids (PEA, OEA). Results. Gender-specific analysis showed differences in AEA, OEA, and PEA preoperatively with reductions in AEA and PEA in females postoperatively. Preoperatively, AEA was correlated with 2-hour glucose (r = 0.55, P = 0.01), HOMA-IR (r = 0.61, P = 0.009), and HOMA %S (r = −0.71, P = 0.002). OEA was correlated with weight (r = 0.49, P = 0.03), waist circumference (r = 0.52, P = 0.02), fasting insulin (r = 0.49, P = 0.04), and HOMA-IR (r = 0.48, P = 0.05). PEA was correlated with fasting insulin (r = 0.49, P = 0.04). 2-AG had a negative correlation with fasting glucose (r = −0.59, P = 0.04). Conclusion. Gender differences exist in circulating ECs in obese subjects. Females show changes in AEA and PEA after bariatric surgery. Specific correlations exist between different ECs and markers of obesity and insulin and glucose homeostasis. PMID:25874237

  19. Redox Properties of Free Radicals.

    ERIC Educational Resources Information Center

    Neta, P.

    1981-01-01

    Describes pulse radiolysis as a useful means in studing one-electron redox potentials. This method allows the production of radicals and the determination of their concentration and rates of reaction. (CS)

  20. [Simultaneous radical retropubic prostatectomy, diverticulectomy].

    PubMed

    Loran, O B; Sokolov, A E; Guspanov, R I; Polegen'kiĭ, V V

    2014-01-01

    Presented clinical case demonstrates a combination of rare congenital abnormality - giant true diverticula of the bladder - and high-risk prostate cancer, as well as a successful result of simultaneous operation - a radical prostatectomy with diverticulectomy.

  1. Free radical inactivation of pepsin

    NASA Astrophysics Data System (ADS)

    Josimović, Lj; Ruvarac, I.; Janković, I.; Jovanović, S. V.

    1994-06-01

    Alkylperoxy radicals containing one, two or three chlorine atoms, CO -2, O 2 - were reacted with pepsin in aqueous solutions. It was found that only Cl 3COO and CO -2 inactive pepsin, attacking preferentially the disulfide bridge. Transient spectra obtained upon completion of the Cl 3COO + pepsin reaction at pH 5 indicate that 20% of initially produced Cl 3COO radicals oxidizes tryptophan residues, and 40% disulfide bridges. The inactivation induced by the Cl 3COO radical increases at lower pH, and the maximal inactivation, Gin = 5.8, was observed at pH 1.5. The inactivation of pepsin by CO -2 radicals depends on the absorbed dose. The maximal inactivation, Gin = 4.5, was determined in the dose range from 38 to 53 Gy.

  2. Pediatric heart surgery - discharge

    MedlinePlus

    ... get enough calories to heal and grow. After heart surgery, most babies and infants (younger than 12 to 15 months) can take ... valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... open heart surgery References Bernstein D. General principles ...

  3. Craniofacial surgery: present and future.

    PubMed Central

    Whitaker, L A; Schut, L; Randall, P

    1976-01-01

    The possibilities for radical craniofacial restructuring have increased dramatically in the past 6 years with the development of craniofacial surgery. The field developed from a background of patients with major craniofacial birth defects allowing orderly planning and expansion to correction of a multitude of other craniofacial structural problems. The procedures concentrate upon changing the skeletal structures using extensive subperiostial dissection of soft tissue, and adding bone to fill in areas of deficiency. There are three grades of complexity in craniofacial procedures. After extensive soft tissue sub-periostial stripping about the orbits and upper face, the simplest form consists of onlay bone grafts. The next most complicated involves osteotomies to shift the face into a more normal position. In its most complicated form, abnormal proportions of bone are removed and the orbits or cranium are shifted into a new or normal position. We have had experience with 69 patients since September, 1972. Thirty-six have had intracranial procedures. Infection has been the most serious problem, and there have been no instances of death or blindness. A number of lesser problems occur. Future applications of craniofacial surgery are appearing with great frequency as more experience is gained with its uses. It has particular application in acute and late reconstruction of patients with traumatic defects about the face. Preventive osteotomies are an area with great potential, by releasing stenotic areas of bone and allowing the developing brain to mold the upper face and orbits. There is also applicability in surgery of tumors about the craniofacial structure and in cosmetic surgery. Images Fig. 1a. Fig. 1b. Fig. 1c. Fig. 1d. Fig. 1e. Fig. 2a. Fig. 2b. Fig. 2c. PMID:984925

  4. Maxillary orthognathic surgery.

    PubMed

    Bauer, Richard E; Ochs, Mark W

    2014-11-01

    Maxillary surgery to correct dentofacial deformity has been practiced for almost 100 years. Significant advances have made maxillary surgery a safe and efficient means of correcting midface deformities. Anesthetic techniques, specifically hypotensive anesthesia, have allowed for safer working conditions. Landmark studies have proven manipulation and segmentalization of the maxilla is safe and allowed this surgery to become a mainstay in corrective jaw surgery. This article provides an overview of surgical techniques and considerations as they pertain to maxillary surgery for orthognathic surgery. Segmental surgery, openbite closure, vertical excess, grafting, and a technology update are discussed.

  5. The Role of Preoperative TIPSS to Facilitate Curative Gastric Surgery

    SciTech Connect

    Norton, S.A.; Vickers, J.; Callaway, M.P. Alderson, D.

    2003-08-15

    The use of TIPSS to facilitate radical curative upper gastrointestinal surgery has not been reported. We describe a case in which curative gastric resection was performed for carcinoma of the stomach after a preoperative TIPSS and embolization of a large gastric varix in a patient with portal hypertension.

  6. [Multiple organ resections in surgery of the colon and rectum].

    PubMed

    Fradique, Caldeira; Azevedo, Vaz; Vasconcelos, Vasco; Pupo, Alexandra; Quaresma, Luísa; Carreira, Noémia; Vicente, Pilar

    2002-01-01

    Colorectal cancer patients with regional invasion or metastatic disease present low life expectancy. Radical surgical treatment is the only potentially curative procedure, with significant good results being reported. Thirty two patients with either regional invasion or metastatic disease were submitted to surgery with good survival rate.

  7. Robotic surgery for gastric cancer: a technical review.

    PubMed

    Hyung, Woo Jin; Woo, Yanghee; Noh, Sung Hoon

    2011-12-01

    Minimally invasive gastric cancer surgery is gaining acceptance, especially in the treatment of patients with early gastric cancer. While offering patients the benefits of minimally invasive surgery, laparoscopic surgery is limited by several disadvantages such as altered operating view and lack of versatility in surgical instrumentation. Robotic surgery offers the surgeon the benefit of superior 3D visualization, the freedom of the EndoWrist function, and the tremble-filtered control of the four robotic arms. Due to the technical advantages of the robotic surgical system, robotic surgery may facilitate the expansion of minimally invasive surgery over laparoscopy. The application of robotic surgery for gastric cancer is increasing in experienced centers. Most reports of the robotic operating methods are only slightly modified from the laparoscopic technique. Robotic gastric cancer surgery including radical subtotal gastrectomy with D2 lymph node dissection is technically feasible and safe and results in similar short-term postoperative outcomes when compared to laparoscopic surgery. The role of robotic surgery in gastric cancer is promising but awaits further comparative studies of long-term results and cost-effectiveness.

  8. Radical prostatectomy in high-risk prostate cancer.

    PubMed

    Ischia, Joseph; Gleave, Martin

    2013-03-01

    One consistent finding in the studies regarding treating men with prostate cancer is that men with high-risk disease have the most to gain from treatment with curative intent. Men with high-risk or locally-advanced prostate cancer require treatment to the primary cancer or risk dying prematurely from their disease. Increasingly, combined androgen deprivation therapy + radiation treatment is seen as the standard treatment as a result of prospective studies in this space, and the perceived increased morbidity of radical prostatectomy in the setting of a "low" cure rate as monotherapy. In the absence of a well-conducted randomized trial, there is no definite evidence that one treatment is superior to the other. The advantages of radical prostatectomy are that it provides excellent local control of the primary tumor without an increase in morbidity, accurately stages the disease to guide further therapy, and removes benign sources of prostate-specific antigen so that failures can be promptly identified and subsequent treatment can be initiated in a timely manner. Although several guidelines recommend radiation treatment over radical prostatectomy as first-line treatment, there is no evidence that surgery is inferior and radical prostatectomy should remain part of any informed discussion regarding treatment options for men with high-risk prostate cancer.

  9. [Macro surgery: a merge of minimal invasive surgery, membrane anatomy, and industry].

    PubMed

    Gong, Jianping

    2015-08-01

    Minimal invasive surgery (MIS), which is presented by laparoscopy, has developed for more than a quarter of century. More and more surgical operations can be finished by laparoscopy, not only for cholecystectomy, but also for some complex operations, even radical operation for gastrointestinal cancer, such as radical rectectomy, D3 colectomy, D2 gastrectomy. These operations have small incisions only, but with extensive injury and bleeding in the abdomen. Meanwhile, total mesorectal excision (TME) for rectal cancer and complete mesocolic excision (CME) for colon cancer have been proposed by surgeons in the field of open surgery. During those procedures, they suggested that it is very important to find out a "space", then expand it to a "holly plane", to achieve resection en bloc and less bleeding, namely "plane surgery". In fact, the "plane" is consisted of two membranes under laparoscopy, that is the membranes (fascia or serous) which come from the mesentery in broad sense(or tissue bloc) and its bed. Understanding of the membrane anatomy we proposed, which includes the mesentery in broad sense(or tissue bloc) and the mesentery bed, will help the surgeons identify the correct anatomy or plane intentionally or accurately, and perform operations more easily, more precisely with less bleeding, more radically and less side injury. However, It is not easy to identify the membrane anatomy by naked eyes or traditional laparoscopy. It is not only dependent on the development of knowledge of membrane anatomy, but also the instruments developed by industry. Now, it seems to become possible when industry of optic or glass developed some instruments, such as 3D laparoscopy, binocular loupe, which have the proper magnifying power and high density resolution, and can identify the membrane anatomy at macro level (not micro level). Wearing these instruments, based on the membrane anatomy(macro anatomy), the classical operations, which include traditional laparoscopy or open

  10. Crystalline bipyridinium radical complexes and uses thereof

    DOEpatents

    Fahrenbach, Albert C.; Barnes, Jonathan C.; Li, Hao; Stoddart, J. Fraser; Basuray, Ashish Neil; Sampath, Srinivasan

    2015-09-01

    Described herein are methods of generating 4,4'-bipyridinium radical cations (BIPY.sup..cndot.+), and methods for utilizing the radical-radical interactions between two or more BIPY.sup..cndot.+ radical cations that ensue for the creation of novel materials for applications in nanotechnology. Synthetic methodologies, crystallographic engineering techniques, methods of physical characterization, and end uses are described.

  11. [Extended surgery in locally invasive pancreatic cancer. An original revascularization technique].

    PubMed

    Fradique, Caldeira; Azevedo, Vaz; Vasconcelos, Vasco; Pupo, Alexandra; Quaresma, Luísa; Carreira, Noémia

    2002-01-01

    The end results of surgery for pancreatic tumors remains very poor. In patients with locally invasive tumors a by-pass type of surgery is usually performed with low survival and poor life quality. Seven patients with locally invasive pancreatic tumors were operated by the authors and extensive radical surgery was done with good results. An original revascularization technique of the hepatic artery is described.

  12. Laparoendoscopic single-site radical hysterectomy for early stage cervical cancer

    PubMed Central

    Park, Ju Young; Kim, Yoo Min; Lee, Yoo-Young; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

    2017-01-01

    Technical developments have made laparoendoscopic single-site (LESS) surgery increasingly more feasible for treating gynecological conditions, including cancer. However, complex surgeries such as radical hysterectomy have rarely been performed with single-port access because of technical difficulties. The majority of the difficulties are due to the inefficient retraction of tissue during dissection. Here, we report a detailed description of LESS radical hysterectomy plus pelvic lymph node dissection that was successfully performed in two patients with stage IB1 cervical cancer. We used our expertise with LESS to perform space development as much as possible before the ligaments were resected. The oncologic clearance was comparable to that of conventional laparoscopic radical hysterectomy. PMID:28217681

  13. [Reconstructive surgery in larynx cancer].

    PubMed

    Szmeja, Z; Szyfter, W; Leszczyńska, M; Wierzbicka, M; Golusiński, W; Dabrowski, P; Karlik, M

    2000-01-01

    Subtotal laryngectomies with larynx reconstruction are an acceptable alternative to the total laryngectomy in T2, T3 larynx cancer treatment. One procedure resection and reconstruction allow for radical oncological treatment with simultaneous preservation of air passage continuity and the function of the neolarynx. In the years 1988-1997 in ENT Dept. of Karol Marcinkowski University of Medical Sciences 38 subtotal laryngectomies with larynx reconstruction were performed. They were: 34 supracricoid laryngectomies with cricohyoidopexy, 2 with epiglotohyoidopexy and 3 supraglotic laryngectomies with reconstruction. The basic criterion of the evaluation of such procedures effectiveness was their oncological radicality. The follow-up period ranged from 2 to 9 years. Local relapse was observed in none of the cases, nodal relapse was started in 2 patients. Another aspect taken into consideration was the function of the neolarynx. In 3 cases two or three laser procedures were performed because of neolarynx lumen structure which were followed by T-dren plasty. In 10 patients temporary swallowing difficulties, especially liquids, were observed in the first three month. Gastrostomy was performed in one case. The authors discuss indications to this type of surgery, operation technique, oncological and functional results. Spirometry results and voice analyses after larynx resection and reconstruction in these patients are presented.

  14. [Robotic surgery -- the modern surgical treatment of prostate cancer].

    PubMed

    Szabó, Ferenc János; Alexander, de la Taille

    2014-09-01

    Minimally invasive laparoscopic surgery replaces many open surgery procedures in urology due to its advantages concerning post-operative morbidity. However, the technical challenges and need of learning have limited the application of this method to the work of highly qualified surgeons. The introduction of da Vinci surgical system has offered important technical advantages compared to the laparoscopic surgical procedure. Robot-assisted radical prostatectomy became a largely accepted procedure. It has paved the way for urologists to start other, more complex operations, decreasing this way the operative morbidity. The purpose of this article is to overview the history of robotic surgery, its current and future states in the treatment of the cancer. We present our robot-assisted radical prostatectomy and the results.

  15. Laparoscopic Surgery in the University Hospital in Monterrey, Mexico

    PubMed

    Garza-Leal; Oscar; Iglesias

    1996-08-01

    From October 1992 to February 1996, 1506 gynecologic surgeries were performed in our hospital. Of these, 270 (17.9%) were done by laparoscopy: 204 (75.5%) operative and 66 (24.5%) diagnostic. The procedures were 59 (28.9%) hysterectomies, 15 (25.4%) of them radical hysterectomies, 6 laparoscopic-assisted stagings for endometrial cancer, and 38 laparoscopic-assisted vaginal hysterectomies. Fifty-eight (28.4%) surgeries were performed for adnexal masses and 16 (7.8%) for ectopic pregnancies. We also did 7 (3.4%) Burch procedures, 5 (2.4%) ligamentopexies, and 65 other surgeries including coagulation of endometriosis, adhesiolysis, uterosacral nerve ablations, and tubal ligations. The six complications (2.22%) were two patients with fever, one infection in the vaginal cuff, one vaginal hematoma, one ureteral injury during radical hysterectomy, and one bladder injury during a Burch procedure. We believe operative laparoscopy should be part of the training of every gynecologist.

  16. Standard Electrode Potentials Involving Radicals in Aqueous Solution: Inorganic Radicals

    SciTech Connect

    Armstrong, David A.; Huie, Robert E.; Koppenol, Willem H.; Lymar, Sergei V.; Merenyi, Gabor; Neta, Pedatsur; Ruscic, Branko; Stanbury, David M.; Steenken, Steen; Wardman, Peter

    2015-12-01

    Recommendations are made for standard potentials involving select inorganic radicals in aqueous solution at 25 °C. These recommendations are based on a critical and thorough literature review and also by performing derivations from various literature reports. The recommended data are summarized in tables of standard potentials, Gibbs energies of formation, radical pKa’s, and hemicolligation equilibrium constants. In all cases, current best estimates of the uncertainties are provided. An extensive set of Data Sheets is appended that provide original literature references, summarize the experimental results, and describe the decisions and procedures leading to each of the recommendations

  17. Robotic surgery in Italy national survey (2011).

    PubMed

    Santoro, Eugenio; Pansadoro, Vito

    2013-03-01

    Robotic surgery in Italy has become a clinical reality that is gaining increasing acceptance. As of 2011 after the United States, Italy together with Germany is the country with the largest number of active Robotic centers, 46, and da Vinci Robots installed, with at least 116 operators already trained. The number of interventions performed in Italy in 2011 exceeded 6,000 and in 2010 were 4,784, with prevalence for urology, general surgery and gynecology, however these interventions have also begun to be applied in other fields such as cervicofacial, cardiothoracic and pediatric surgery. In Italy Robotic centers are mostly located in Northern Italy, while in the South there are only a few centers, and four regions are lacking altogether. Of the 46 centers which were started in 1999, the vast majority is still operational and almost half handle over 200 cases a year. The quality of the work is also especially high with large diffusion of radical prostatectomy in urology and liver resection and colic in general surgery. The method is very well accepted among operators, over 80 %, and among patients, over 95 %. From the analysis of world literature and a survey carried out in Italy, Robotic surgery, which at the moment could be better defined as telesurgery, represents a significant advantage for operators and a consistent gain for the patient. However, it still has important limits such as high cost and non-structured training of operators.

  18. Nutritional Predictors of Complications Following Radical Cystectomy

    PubMed Central

    Johnson, David C.; Riggs, Stephen B.; Nielsen, Matthew E.; Matthews, Jonathan E.; Woods, Michael E.; Wallen, Eric M.; Pruthi, Raj S.; Smith, Angela B.

    2016-01-01

    Purpose To determine the impact of preoperative nutritional status on the development of surgical complications following cystectomy using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Methods We performed a retrospective review of the NSQIP 2005–2012 Participant Use Data Files. ACS-NSQIP collects data on 135 variables, including pre- and intraoperative data and 30-day post-operative complications and mortality on all major surgical procedures at participating institutions. Preoperative albumin (<3.5 or >3.5 g/dl), weight loss 6 months before surgery (>10%), and BMI were identified as nutritional variables within the database. The overall complication rate was calculated and predictors of complications were identified using multivariable logistic regression models. Results 1,213 patients underwent cystectomy for bladder cancer between 2005–2012. The overall 30-day complication rate was 55.1% (n=668). While 14.7% (n=102) had a preoperative albumin <3.5 g/dL, 3.4% had >10% weight loss in the 6 months prior to surgery, and the mean BMI was 28 kg/m2. After controlling for age, sex, medical comorbidities, medical resident involvement, operation year, operative time and prior operation, only albumin <3.5g/dl was a significant predictor of experiencing a postoperative complication (p=0.03). This remained significant when albumin was evaluated as a continuous variable (p=0.02) Conclusions Poor nutritional status measured by serum albumin is predictive of an increased rate of surgical complications following radical cystectomy. This finding supports the importance of preoperative nutritional status in this population and highlights the need for the development of effective nutritional interventions in the preoperative setting. PMID:25240535

  19. Radical-Mediated Enzymatic Polymerizations

    PubMed Central

    Zavada, Scott R.; Battsengel, Tsatsral; Scott, Timothy F.

    2016-01-01

    Polymerization reactions are commonly effected by exposing monomer formulations to some initiation stimulus such as elevated temperature, light, or a chemical reactant. Increasingly, these polymerization reactions are mediated by enzymes―catalytic proteins―owing to their reaction efficiency under mild conditions as well as their environmental friendliness. The utilization of enzymes, particularly oxidases and peroxidases, for generating radicals via reduction-oxidation mechanisms is especially common for initiating radical-mediated polymerization reactions, including vinyl chain-growth polymerization, atom transfer radical polymerization, thiol–ene step-growth polymerization, and polymerization via oxidative coupling. While enzyme-mediated polymerization is useful for the production of materials intended for subsequent use, it is especially well-suited for in situ polymerizations, where the polymer is formed in the place where it will be utilized. Such polymerizations are especially useful for biomedical adhesives and for sensing applications. PMID:26848652

  20. Epistemological barriers to radical behaviorism.

    PubMed

    O'Donohue, W T; Callaghan, G M; Ruckstuhl, L E

    1998-01-01

    The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers.

  1. Epistemological barriers to radical behaviorism

    PubMed Central

    O'Donohue, William T.; Callaghan, Glenn M.; Ruckstuhl, L. E.

    1998-01-01

    The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers. PMID:22478314

  2. Heavy atom nitroxyl radicals. VI. The electronic spectrum of jet-cooled H2PO, the prototypical phosphoryl free radical

    NASA Astrophysics Data System (ADS)

    Gharaibeh, Mohammed A.; Clouthier, Dennis J.; Tarroni, Riccardo

    2011-12-01

    The previously unknown electronic spectrum of the H2PO free radical has been identified in the 407-337 nm region using a combination of laser-induced fluorescence and single vibronic level emission spectroscopy. High level ab initio predictions of the properties of the ground and first two excited doublet states were used to identify the spectral region in which to search for the electronic transition and were used to aid in the analysis of the data. The band system is assigned as the {tilde B}2A'-{tilde X}2A' electronic transition which involves promotion of an electron from the π to the π* molecular orbital. The excited state r0 molecular structure was determined by rotational analysis of high resolution LIF spectra to be r(PO) = 1.6710(2) Å, r(PH) = 1.4280(6) Å, θ(HPO) = 105.68(7)°, θ(HPH) = 93.3(2)°, and the out-of-plane angle = 66.8(2)°. The structural changes on electronic excitation, which include substantial increases in the PO bond length and out-of-plane angle, are as expected based on molecular orbital theory and our previous studies of the isoelectronic H2AsO, Cl2PS, and F2PS free radicals.

  3. VUV Photoionisation of hydrocarbon radicals

    NASA Astrophysics Data System (ADS)

    Alcaraz, C.; Noller, Bastian; Hemberger, Patrick; Fischer, Ingo; Gans, Bérenger; Boyé-Peronne, Séverine; Douin, Stéphane; Gauyacq, Dolorès; Soldi-Lose, Héloïse; Garcia, Gustavo

    2008-09-01

    Hydrocarbon radicals CxHy are constituents of various planetary atmospheres, in particular Titan, as a result of the methane photochemistry induced by the solar radiation. They contribute to the neutral chemistry, but are also important for the ionosphere through their photoionisation leading to their cations CxHy +. These cations are also produced by ion-molecule reactions starting from the reaction of the primary ions CH4 + and CH3 + which are created in the non-dissociative and dissociative photoionisation of CH4. This work aims at caracterizing the VUV photoionisation of small hydrocarbon radicals as a function of photon energy. The objective is to provide laboratory data for modelers on the spectroscopy, the thermochemistry, and the reactivity of the radicals and their cations. The hydrocarbon radicals are much less caracterized than stable molecules since they have to be produced in situ in the laboratory experiment. We have adapted at Orsay [1-3] a pyrolysis source (Figure 1) well suited to produce cold beams of hydrocarbon radicals to our experimental setups. Available now at Orsay, we have two new sources of VUV radiation, complementary in terms of tunability and resolution, that can be used for these studies. The first one is the DESIRS beamline [4] at the new french synchrotron, SOLEIL. The second one is the VUV laser developped at the Centre Laser de l'Université Paris-Sud (CLUPS) [5]. At SOLEIL, a photoelectron-photoion coincidence spectrometer is used to monitor the photoionisation on a large photon energy range. At the CLUPS, a pulsedfield ionisation (PFI-ZEKE) spectrometer allows studies at higher resolution on selected photon energies. The first results obtained with these new setups will be presented. References [1] Fischer, I., Schussler, T., Deyerl, H.J., Elhanine, M. & Alcaraz, C., Photoionization and dissociative photoionization of the allyl radical, C3H5. Int. J. Mass Spectrom., 261 (2-3), 227-233 (2007) [2] Schüßler, T., Roth, W., Gerber

  4. Donor free radical explosive composition

    DOEpatents

    Walker, Franklin E. [15 Way Points Rd., Danville, CA 94526; Wasley, Richard J. [4290 Colgate Way, Livermore, CA 94550

    1980-04-01

    An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a donor additive comprising an organic compound or mixture of organic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and which is not an explosive, or an inorganic compound or mixture of inorganic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and selected from ammonium or alkali metal persulfates.

  5. Laparoscopic radical and partial cystectomy

    PubMed Central

    Challacombe, Ben J.; Rose, Kristen; Dasgupta, Prokar

    2005-01-01

    Radical cystectomy remains the standard treatment for muscle invasive organ confined bladder carcinoma. Laparoscopic radical cystoprostatectomy (LRC) is an advanced laparoscopic procedure that places significant demands on the patient and the surgeon alike. It is a prolonged procedure which includes several technical steps and requires highly developed laparoscopic skills including intra-corporeal suturing. Here we review the development of the technique, the indications, complications and outcomes. We also examine the potential benefits of robotic-assisted LRC and explore the indications and technique of laparoscopic partial cystectomy. PMID:21206662

  6. Effect of Cryotherapy after Spine Surgery

    PubMed Central

    Yoshimoto, Mitsunori; Takebayashi, Tsuneo; Ida, Kazunori; Nakano, Kazuhiko; Yamashita, Toshihiko

    2014-01-01

    Study Design Historical controlled trial. Purpose To clarify the usefulness of cryotherapy after spine surgery. Overview of Literature Cryotherapy has generally been performed subsequent to surgery on joints and in this application its clinical effects are well understood. However, cryotherapy has yet to be used following spine surgery. Its clinical efficacy in this context is unknown. Methods Thirty six patients had undergone one level microendoscopic surgery. Sixteen were enrolled into the cooling group, with the remaining 20 making up the no postoperative cryotherapy control group. Cryotherapy was performed at 5℃ using an icing system. A silicone balloon catheter with a thermo sensor on the tip was placed in the surgical wound. The temperature in the wound was recorded every 30 minutes until the next morning. The relationship between the depth of the sensor and the temperature in the wound were investigated using simple linear regression analysis. Laboratory data, visual analogue scale (VAS) for wound pain and postoperative bleeding were investigated. Results The mean temperature in the surgical wound was 37.0 in the control group and 35.0℃ in the cooling group (p<0.001). There was a positive correlation between the depth of the thermo sensor and the temperature in the wound in the cooling group (y=0.91x+30.2, r=0.67, p=0.004). There were no significant differences between the groups in terms of laboratory data, VAS or postoperative bleeding. Conclusions The temperature in the wound was decreased significantly by spinal surgery cryotherapy. PMID:25558317

  7. 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 ...

  8. Heart valve surgery

    MedlinePlus

    ... techniques are used: Percutaneous surgery (through the skin) Robot-assisted surgery If your surgeon can repair your ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  9. Surgery for Bone Cancer

    MedlinePlus

    ... amputation. This is called limb-salvage or limb-sparing surgery . In going over treatment options, it is ... 2016 Treating Bone Cancer Surgery for Bone Cancer Radiation Therapy for Bone Cancer Chemotherapy for Bone Cancer Targeted ...

  10. Laparoscopic Spine Surgery

    MedlinePlus

    ... Opportunities Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you ...

  11. What Is Refractive Surgery?

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses ...

  12. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses ...

  13. Breast Reduction Surgery

    MedlinePlus

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction ... risk of complications from breast reduction surgery. Your plastic surgeon will likely: Evaluate your medical history and ...

  14. Smoking and surgery

    MedlinePlus

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general ...

  15. Cosmetic breast surgery - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  16. Shoulder surgery - discharge

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000179.htm Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around ...

  17. 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 ...

  18. Hip fracture surgery

    MedlinePlus

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  19. Ear Plastic Surgery

    MedlinePlus

    ... Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written ... Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, VA 22314 tel (703) ...

  20. Gastric bypass surgery - discharge

    MedlinePlus

    Bariatric surgery - gastric bypass - discharge; Roux-en-Y gastric bypass - discharge; Gastric bypass - Roux-en-Y - discharge; Obesity ... Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic ...

  1. Abdominal wall surgery

    MedlinePlus

    ... the results of abdominoplasty. Many feel a new sense of self-confidence. Alternative Names Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty Images Abdominoplasty - series Abdominal muscles References McGrath MH, Pomerantz J. Plastic surgery. In: Townsend ...

  2. 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

  3. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  4. 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.

  5. Spine surgery - discharge

    MedlinePlus

    ... symptoms should get better in a few weeks. Recovery after laminectomy and fusion surgery is longer. You will not be able ... discharge; Anterior spinal fusion - discharge; Spine surgery - spinal fusion - discharge Images Spinal surgery -- cervical - series References Agrawal BM, Zeidman SM, Rhines L, ...

  6. Students' Ideas and Radical Constructivism

    ERIC Educational Resources Information Center

    Sánchez Gómez, Pedro J.

    2016-01-01

    In this article, I study, from the point of view of the analytic philosophy of mind, the compatibility of students' ideas studies (SIS) with radical constructivism (RC). I demonstrate that RC is based on a psychology of "narrow mental states"; that is, the idea that the mental content of an individual can be fully characterised without…

  7. The Other Women: Radicalizing Feminism.

    ERIC Educational Resources Information Center

    Puigvert, Lidia; Darder, Antonia; Merrill, Barbara; de los Reyes, Eileen; Stromquist, Nelly

    A recent international symposium on radicalizing feminism explored ways of developing a dialogic feminism that emphasizes working in different settings under the common goal of including women who have been invisible in the dominant feminist literature by furthering theories and practices based on the principles of dialogic feminism. The seminar…

  8. Mitigating Radicalism in Northern Nigeria

    DTIC Science & Technology

    2013-08-01

    radicalization in northern Nigeria. u Active engagement of youth and communities in peacebuilding programs that facilitate interactions among individuals...leaders, sustained development investments in marginalized communities , promotion of values of inclusivity to mitigate the spread of extremist ideology...claiming to have repelled Boko Haram, the militants return, regroup, and seek revenge. As a result, social and economic activities in the northern

  9. Contribution of the n-side to the R 0A product of long wavelength n+n-pHg1- xCdxTe photodiodes in the diffusion controlled regime

    NASA Astrophysics Data System (ADS)

    Gonzalez, C.; Centeno, J. M.; Sangrador, J.

    The contribution of the n-side to the total differential resistance by area product in the dark (R 0A) of longwavelength n+n-p photodiodes made in Hg 1- xCd xTe (MCT) is analyzed in the diffusion controlled regime based on a model of an abrupt junction. The results of the modeling indicate that the p-side contribution determines an upper limit to R 0A whose actual value is decreased by the n-side contribution. In many practical diodes, the n-side contribution is negligible, but it can be important under some particular conditions that can occur, as is discussed in this study.

  10. Computer-assisted surgery in orthopedic oncology

    PubMed Central

    Gerbers, Jasper G; Stevens, Martin; Ploegmakers, Joris JW; Bulstra, Sjoerd K; Jutte, Paul C

    2014-01-01

    Background and purpose — In orthopedic oncology, computer-assisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore describe possible applications of CAS and report preliminary results in 130 procedures. Patients and methods — We conducted a retrospective cohort study of all oncological CAS procedures in a single institution from November 2006 to March 2013. Mean follow-up time was 32 months. We categorized and analyzed 130 procedures for clinical parameters. The categories were image-based intralesional treatment, image-based resection, image-based resection and reconstruction, and imageless resection and reconstruction. Results — Application to intralesional treatment showed 1 inadequate curettage and 1 (other) recurrence in 63 cases. Image-based resections in 42 cases showed 40 R0 margins; 16 in 17 pelvic resections. Image-based reconstruction facilitated graft creation with a mean reconstruction accuracy of 0.9 mm in one case. Imageless CAS was helpful in resection planning and length- and joint line reconstruction for tumor prostheses. Interpretation — CAS is a promising new development. Preliminary results show a high number of R0 resections and low short-term recurrence rates for curettage. PMID:25140984

  11. Broadening of the R(0) and P(2) Lines in the 13CO Fundamental by Helium Atoms from 300 K down to 12 K: Measurements and Comparison with Close-Coupling Calculations

    NASA Technical Reports Server (NTRS)

    Thibault, F.; Mantz, A. W.; Claveau, C.; Valentin, A.; Hurtmans, D.

    2007-01-01

    We present measurements of He-broadening parameters for the R(0) and O(2) lines in the fundamental band of 13CO at different temperatures between 12K and room temperature. The broadening parameters are determined, taking into account confinement narrowing, by simultaneous least-squares fitting of spectra recorded using a frequency stabilized diode laser spectrometer. The pressure broadening cross sections are deduced and compared to close-coupling calculations and earlier results obtained for rotational transitions of 12 CO.

  12. Percutaneously Assisted "Two-Ports" Transperitoneal Radical Nephrectomy: Initial Series.

    PubMed

    Porpiglia, Francesco; Bertolo, Riccardo; Morra, Ivano; Fiori, Cristian

    2016-06-01

    Looking for a virtually "scarless" surgery mini-laparoscopy (ML) could be a viable alternative to conventional laparoscopy. ML is a reproducible technique and allows for the preservation of the triangulation concept, the cornerstone of laparoscopic surgery. Drawback of ML could be the poor performance of miniaturized instruments that could affect the confidence of the surgeon and limit the indications. The recent availability of a novel mini-laparoscopic platform in our center expanded the indications of ML to radical nephrectomy even in cases of large renal tumors in kidneys with abundant perirenal fat. The platform is composed by mini-instruments with the peculiarity of a 2.9-mm shaft that is mounted on a handle and a jaw that are comparable in size and performance to those of conventional instruments, increasing the ergonomy and the confidence perceived by the surgeon. Allowing for inclusion criteria, nine consecutive patients were enrolled in our prospective study and underwent percutaneously assisted "two-ports" radical nephrectomy. Preliminary data showed that the novel platform allowed us to perform a safe and effective procedure with acceptable perioperative outcomes and apparent improvements in cosmesis. Larger sample size and comparative studies are needed to confirm these findings.

  13. Past, present and future of urological robotic surgery

    PubMed Central

    Kumar, Ramesh; Menon, Mani

    2016-01-01

    The first urologic robotic program in the world was built at the Vattikuti Urology Institute, Henry Ford Hospital Detroit, Michigan, in 2000 under the vision of surgical innovator, Dr. Mani Menon for the radical prostatectomy. The robot-assisted radical prostatectomy continues being modified with techniques to improve perioperative and surgical outcomes. The application of robotic surgical technique has since been expanded to the bladder and upper urinary tract surgery. The evolution of surgical technique and its expansion of application will continue to improve quality, outcome parameters and experience for the patients. PMID:26981588

  14. Safety and Cost Considerations during the Introduction Period of Laparoscopic Radical Hysterectomy

    PubMed Central

    Decruze, B.; Macdonald, R.; Kirwan, J.

    2017-01-01

    Objective. To compare the safety, efficacy, and direct cost during the introduction of laparoscopic radical hysterectomy within an enhanced recovery pathway. Methods. A 1 : 1 single centre retrospective case control study of 36 propensity matched pairs of patients receiving open or laparoscopic surgery for early cervical cancer. Results. There were no significant differences in the baseline characteristics of the two cohorts. Open surgery cohort had significantly higher intraoperative blood loss (189 versus 934 mL) and longer postoperative hospital stay (2.3 versus 4.1 days). Although no significant difference in the intraoperative or postoperative complications was found more urinary tract injuries were recorded in the laparoscopic cohort. Laparoscopic surgery had significantly longer duration (206 versus 159 minutes), lower lymph node harvest (12.6 versus 16.9), and slower bladder function recovery. The median direct hospital cost was £4850 for laparoscopic radical hysterectomy and £4400 for open surgery. Conclusions. Laparoscopic radical hysterectomy can be safely introduced in an enhanced recovery environment without significant increase in perioperative morbidity. The 10% higher direct hospital cost is not statistically significant and is expected to even out when indirect costs are included. PMID:28167964

  15. [Comparison of robotic surgery documentary in gynecological cancer].

    PubMed

    Vargas-Hernández, Víctor Manuel

    2012-01-01

    Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.

  16. Laser tumor treatment in oral and maxillofacial surgery

    NASA Astrophysics Data System (ADS)

    Neukam, F. W.; Stelzle, F.

    Cancer treatment is an integral part of oral and maxillofacial surgery. Oral cancer in particular is a highly prevalent neoplasm. Standard treatment for most of the tumors is radical surgery combined with stage-based neo-/adjuvant therapy. Laser surgery has become a reliable treatment option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. However, laser surgery has some major drawbacks: In contrast to conventional incisions with scalpels, the surgeon gets no feedback during laser ablation. There is no depth sensation and no tissue specificity with a laser incision, increasing the risk of iatrogenic damage to nerves and major blood vessels. Future prospects may solve these problems by means of an optical feedback mechanism that provides a tissue-specific laser ablation. First attempts have been made to perform remote optical tissue differentiation. Additionally, real time optical tumor detection during laser surgery would allow for a very precise and straight forward cancer resection, enhancing organ preservation and hence the quality of life for patients with cancer in the head and neck region.

  17. High resolution far-infrared Fourier transform spectroscopy of radicals at the AILES beamline of SOLEIL synchrotron facility.

    PubMed

    Martin-Drumel, M A; Pirali, O; Balcon, D; Bréchignac, Ph; Roy, P; Vervloet, M

    2011-11-01

    Experimental far-infrared (FIR) spectroscopy of transient species (unstable molecules, free radicals, and ions) has been limited so far in both emission and absorption (mainly by the low probability of spontaneous emission in that spectral range and the low brightness of continuum sources used for absorption measurements, respectively). Nevertheless, the FIR spectral range recently became of high astrophysical relevance thanks to several new observational platforms (HERSCHEL, ALMA...) dedicated to the study of this region suitable for the detection of the emission from cold objects of the interstellar medium. In order to complete the experimental dataset concerning transient species, three discharge experiments dedicated to the recording of high resolution FIR spectra of radicals have been developed at the Advanced Infrared Line Exploited for Spectroscopy (AILES) which extracts the bright FIR synchrotron continuum of the synchrotron facility SOLEIL. These experiments make use of a high resolution (R = 0.001 cm(-1)) Bruker IFS125 Fourier transform (FT) spectrometer. An emission setup (allowing to record spectra of radicals excited at high rotational and vibrational temperatures) and two absorption setups (exploiting the bright synchrotron source at the highest resolution available on the FT) are alternatively connected to the FT. The advantages and limitations of these techniques are discussed on the basis of the recent results obtained on OH and CH radicals. These results constitute the first FIR spectra of radicals using synchrotron radiation, and the first FIR spectrum of a C-bearing radical using FT-spectroscopy.

  18. The Radical Axis: A Motion Study

    ERIC Educational Resources Information Center

    McGivney, Ray; McKim, Jim

    2006-01-01

    Interesting problems sometimes have surprising sources. In this paper we take an innocent looking problem from a calculus book and rediscover the radical axis of classical geometry. For intersecting circles the radical axis is the line through the two points of intersection. For nonintersecting, nonconcentric circles, the radical axis still…

  19. Free-radical chemistry of sulfite.

    PubMed Central

    Neta, P; Huie, R E

    1985-01-01

    The free-radical chemistry of sulfite oxidation is reviewed. Chemical transformations of organic and biological molecules induced by sulfite oxidation are summarized. The kinetics of the free-radical oxidations of sulfite are discussed, as are the kinetics of the reactions of the sulfite-derived radicals SO3 and the peroxy derivative SO5 with organic compounds. PMID:3830699

  20. REACTIONS OF FREE RADICALS CONTAINING NITROGEN.

    DTIC Science & Technology

    deduced. The reactions of methyl and ethyl radicals with a variety of amino compounds were studied. The reactions of difluoroamino radicals in the...Hydrazines, Anilines and Cyanides were pyrolysed and the heats of formation of the resultant radicals and the strengths of the bonds formed by them

  1. Similar Treatment Outcomes for Radical Cystectomy and Radical Radiotherapy in Invasive Bladder Cancer Treated at a United Kingdom Specialist Treatment Center

    SciTech Connect

    Kotwal, Sanjeev; Choudhury, Ananya; Johnston, Colin; Paul, Alan B.; Whelan, Peter; Kiltie, Anne E.

    2008-02-01

    Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age of radiotherapy patients but not the cystectomy patients was higher than in the 1996-2000 cohort (78.4 years vs. 75.3 years for radiotherapy and 67.9 years vs. 68.2 years for surgery). Conclusions: Although the patients undergoing radical cystectomy were significantly younger than the radiotherapy patients, treatment modality did not influence survival. Bladder cancer patients are an increasingly elderly group. Radical radiotherapy is a viable treatment option for these patients, with the advantage of organ preservation.

  2. [What is the role of elective surgery in diverticular sigmoiditis?].

    PubMed

    Le Néel, J C; Guiberteau, B; Borde, L; Sartre, J Y; Bourseau, J C

    1992-01-01

    From 1981 to 1991 inclusive, 188 operations were carried out for diverticular sigmoiditis. One hundred and thirty-nine patients were operated in emergency for acute complications (123) or fistulae (16), and another 49 had surgery scheduled outside acute crisis periods. Mortality and morbidity respectively are 16.5 and 31% in the first group, against 0 and 12% in the second one. Similarly, the stay in hospital varies from 13 days for scheduled surgery to 23 days for emergent surgery, the latter also requiring to account for risks and for the duration of a second operation that is far from exceptional (40%). Considering the severity of some evolutive complications, the authors advocate early radical surgery for symptomatic diverticular sigmoiditis, after the second crisis or as soon as the first one if it has been severe, and in young subjects and patients at risks.

  3. Nephrocutaneous fistula as the initial manifestation of asymptomatic nephrolithiasis: A call for radical management

    PubMed Central

    Tanwar, Raman; Rathore, Kirti Vijay; Rohilla, Mahesh Kumar

    2015-01-01

    Renal stones are a common affliction presenting in an acute setting. We report a case of asymptomatic renal stone in an elderly gentleman presenting initially as a discharging lumbar sinus managed by subcapsular nephrectomy and radical excision of the fistula tract. Nephrocutaneous fistula is most commonly associated with tuberculosis, xanthogranulomatous pyelonephritis, and rarely with complicated calyceal stones, and its occurrence with asymptomatic pelvic stones is rare. We present the points in favor of radical open surgery in the management of such patients. PMID:25657555

  4. Robotic-Assisted Radical Prostatectomy after the First Decade: Surgical Evolution or New Paradigm

    PubMed Central

    Skarecky, Douglas W.

    2013-01-01

    Early studies indicate that robotic-assisted radical prostatectomy (RARP) has promising short-term outcomes; however, RARP is beyond its infancy, and the long-term report cards are now beginning. The important paradigm shift introduced by RARP is the reevaluation of the entire open radical prostatectomy experience in surgical technique by minimizing blood loss and complications, maximizing cancer free outcomes, and a renewed assault in preserving quality of life outcomes by many novel mechanisms. RARP provides a new technical “canvas” for surgical masters to create upon, and in ten years, has reinvigorated a 100-year-old “gold standard” surgery. PMID:23691367

  5. Mutagenicity of Oxygen Free Radicals

    NASA Astrophysics Data System (ADS)

    Moody, Carmella S.; Hassan, Hosni M.

    1982-05-01

    Paraquat 1,1'-dimethyl-4,4'-bipyridinium dichloride) was used as an intracellular generator of oxygen free radicals and was found to be highly mutagenic for Salmonella typhimurium. It caused both base-pair substitution and frameshift mutations. Paraquat was much more toxic and mutagenic in a simple nutritionally restricted medium than in a rich complex medium. The mutagenicity of paraquat was dependent upon the presence of a supply of both electrons and oxygen. Cells containing high levels of superoxide dismutase (superoxide:superoxide oxidoreductase, EC 1.15.1.1) were more resistant to the toxicity and the mutagenicity of paraquat than were cells containing normal levels of this enzyme. The mutagenicity of paraquat thus appears to be due to its ability to exacerbate the intracellular production of superoxide radicals.

  6. Highly durable photochromic radical complexes having no steric protections of radicals.

    PubMed

    Kobayashi, Yoichi; Mishima, Yasuhiro; Mutoh, Katsuya; Abe, Jiro

    2017-04-21

    Steric protection groups are usually necessary for stable radicals. However, here, we developed novel photochromic radical complexes which generate sterically unprotected imidazolyl and phenoxyl radicals upon UV light irradiation based on the phenoxyl-imidazolyl radical complex (PIC) framework. These photochromic compounds show excellent durability against repeated irradiation of intense nanosecond laser pulses even in polar protic solvents, such as ethanol.

  7. Geoscientists and the Radical Middle

    NASA Astrophysics Data System (ADS)

    Tinker, S. W.

    2015-12-01

    Addressing the great challenges facing society requires industry, government, and academia to work together. I call this overlap space, where compromises are made and real solutions determined, the Radical Middle. Radical because it can appear at times as if the loudest and most publicly influential voices lie outside of the actual solution space, content to provoke but not problem-solve. One key area where geoscientists can play a lead role in the Radical Middle is in the overlap between energy, the environment, and the economy. Globally, fossil fuels still represent 85% of the aggregate energy mix. As existing conventional oil and natural-gas reservoir production continues to slowly decline, unconventional reservoirs, led today by shale and other more expensive resources, will represent a growing part of the oil and gas production mix. Many of these unconventional reservoirs require hydraulic fracturing. The positive economic impact of hydraulic fracturing and associated natural gas and oil production on the United States economy is well documented and undeniable. Yet there are environmental concerns about fracking, and some states and nations have imposed moratoria. This energy-environment-economy space is ideal for leadership from the geosciences. Another such overlap space is the potential for geoscience leadership in relations with China, whose economy and global presence continue to expand. Although China is building major hydropower and natural-gas power plants, as well as nuclear reactors, coal is still king—with the associated environmental impacts. Carbon sequestration—onshore in brine and to enhance oil recovery, as well as offshore—could prove viable. It is vital that educated and objective geoscientists from industry, government, and academia leave their corners and work together in the Radical Middle to educate the public and develop and deliver balanced, economically sensible energy and environmental strategies.

  8. Radical Islam in East Africa

    DTIC Science & Technology

    2009-01-01

    track may not be feasible because of lack of political will on either side, but an effort should be made to detach the moderate (or less radical...Director, Sub-Saharan African Orientation Course, U.S. Air Force Special Operations School, February 15, 2008. 12 Among those arrested were the party’s...Sudan is the Tijaniyya Niassiyya, which has grown rapidly since 1950.7 The Sudanese Niassiyya is a millennial movement that preaches the imminence

  9. HPLC analysis of vitamin E isoforms in human epidermis: correlation with minimal erythema dose and free radical scavenging activity.

    PubMed

    Fuchs, Jürgen; Weber, Stefan; Podda, Maurizio; Groth, Norbert; Herrling, Thomas; Packer, Lester; Kaufmann, Roland

    2003-02-01

    The content and composition of different vitamin E isoforms was analyzed in normal human skin. Interestingly the epidermis contained 1% alpha-tocotrienol, 3% gamma-tocotrienol, 87% alpha-tocopherol, and 9% gamma-tocopherol. Although the levels of tocotrienol in human epidermis appear to be considerably lower than reported in the hairless mouse, the presence of significant amounts of tocotrienol levels leads to speculation about the physiological function of tocotrienols in skin. Besides antioxidant activity and photoprotection, tocotrienols may have skin barrier and growth-modulating properties. A good correlation was found for epidermal alpha-tocopherol (r = 0.7909, p <.0003), gamma-tocopherol (r = 0.556, p <.025), and the total vitamin E content (r = 0.831, p <.0001) with the free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging in epidermis, as assessed by electron paramagnetic resonance (EPR) spectroscopy. In human epidermis, alpha-tocopherol is quantitatively the most important vitamin E isoform present and comprises the bulk of first line free radical defense in the lipid compartment. Epidermal tocotrienol levels were not correlated with DPPH scavenging activity. The minimal erythema dose (MED), an individual measure for sun sensitivity and a crude indicator for skin cancer susceptibility, did not correlate with the epidermal content of the vitamin E isoforms. Hence it is concluded that vitamin E alone is not a determinant of individual photosensitivity in humans.

  10. Colorectal cancer liver metastases: laparoscopic and open radiofrequency-assisted surgery

    PubMed Central

    Vavra, Petr; Nowakova, Jana; Ostruszka, Petr; Jurcikova, Jana; Martinek, Lubomir; Penhaker, Marek; Ihnat, Peter; Habib, Nagy; Zonca, Pavel

    2015-01-01

    Introduction The liver is the most common site of colorectal metastases (colorectal liver metastases – CLM). Surgical treatment in combination with oncological therapy is the only potentially curative method. Unfortunately, only 10–25% of patients are suitable for surgery. Traditionally, open liver resection (OLR) is usually performed. However, laparoscopic liver resection (LLR) has become popular worldwide in the last two decades. Aim To evaluate the effectiveness and benefits of radiofrequency minor LLR of CLM in comparison with OLR. Material and methods The indication for surgery was CLM and the possibility to perform minor laparoscopic or OLR not exceeding two hepatic segments according to Couinaud's classification. Results Sixty-six minor liver resections for CLM were performed. Twenty-five (37.9%) patients underwent a laparoscopic approach and 41 (62.1%) patients underwent OLR. The mean operative time was 166.4 min for LLR and 166.8 min for OLR. Average blood loss was 132.3 ±218.0 ml during LLR and 149.5 ±277.5 ml during OLR. Length of hospital stay was 8.4 ±2.0 days for LLR and 10.5 ±5.8 days for OLR. All resections were R0. There was no case of mortality. Postoperative complications were recognized in 9 (13.6%) patients: 8 in the group of OLR patients and 1 in the LLR group. The median survival time for LLR was 70.5 months and for OLR 61.9 months. The 5-year overall survival rate was higher for LLR vs. OLR – 82.1% vs. 69.8%. The average length of disease-free interval after LLR was greater (52.2 months) in comparison with OLR (49.4%). The 5-year disease-free interval was 63.2% for LLR and 58% for OLR. Conclusions Outcomes and oncological radicality of minor laparoscopic liver resections of CLM are comparable to outcomes of OLR. PMID:26240620

  11. Radical scavengers from heavy hydrocarbons

    SciTech Connect

    Kubo, Junichi

    1996-10-01

    The hydrogen-donating properties of some hydrocarbons form the basis for processes such as coal liquefaction and heavy oil upgrading. However, these hydrocarbons have seldom been used for other purposes, because their potential applications have not been well recognized. Research has indicated that these hydrogen-donating hydrocarbons can be used in important reactions as radical scavengers and have properties particular to those of pure hydrocarbons without functional groups containing heteroatoms. Over years of study researchers have found that pure hydrocarbons with radical-scavenging effects nearly as high as those in conventional hindered phenolic antioxidants can be produced from petroleum, and these hydrogen-donating hydrocarbons exhibit such effects even in oxidative atmospheres (i.e., they function as antioxidants). He has also shown that these mixtures have some properties particular to pure hydrocarbons without functional groups containing heteroatoms, and they`ve seen that a mechanism based on the steric effects appears when these hydrocarbons are used in heavy oil hydroprocessing. Hydrogen-donating hydrocarbons should be a viable resource in many applications. In this article, he presents radical-scavenging abilities, characteristics as pure hydrocarbons, and applications on the basis of the studies.

  12. Renal parenchymal histopathology predicts life-threatening chronic kidney disease as a result of radical nephrectomy.

    PubMed

    Sejima, Takehiro; Honda, Masashi; Takenaka, Atsushi

    2015-01-01

    The preoperative prediction of post-radical nephrectomy renal insufficiency plays an important role in the decision-making process regarding renal surgery options. Furthermore, the prediction of both postoperative renal insufficiency and postoperative cardiovascular disease occurrence, which is suggested to be an adverse consequence caused by renal insufficiency, contributes to the preoperative policy decision as well as the precise informed consent for a renal cell carcinoma patient. Preoperative nomograms for the prediction of post-radical nephrectomy renal insufficiency, calculated using patient backgrounds, are advocated. The use of these nomograms together with other types of nomograms predicting oncological outcome is beneficial. Post-radical nephrectomy attending physicians can predict renal insufficiency based on the normal renal parenchymal pathology in addition to preoperative patient characteristics. It is suggested that a high level of global glomerulosclerosis in nephrectomized normal renal parenchyma is closely associated with severe renal insufficiency. Some studies showed that post-radical nephrectomy severe renal insufficiency might have an association with increased mortality as a result of cardiovascular disease. Therefore, such pathophysiology should be recognized as life-threatening, surgically-related chronic kidney disease. On the contrary, the investigation of the prediction of mild post-radical nephrectomy renal insufficiency, which is not related to adverse consequences in the postoperative long-term period, is also promising because the prediction of mild renal insufficiency might be the basis for the substitution of radical nephrectomy for nephron-sparing surgery in technically difficult or compromised cases. The deterioration of quality of life caused by post-radical nephrectomy renal insufficiency should be investigated in conjunction with life-threatening matters.

  13. Free-radical-mediated DNA binding.

    PubMed Central

    O'Brien, P J

    1985-01-01

    Free-radical metabolites can be generated metabolically by a one-electron reductase-catalyzed reaction or a "peroxidase" catalyzed oxidation or by photoactivation of a wide variety of aromatic xenobiotics. Radicals may also be generated during lipid peroxidation. Some radicals can react with DNA or bind covalently or noncovalently as a dismutation product or as a dimer, trimer or polymeric product. Modification to the DNA can result in single-strand breaks, loss of template activity, and crosslinking. The binding can prevent enzymic digestion. In some cases, the radicals react with oxygen, resulting before conversion to DNA reactive oxygen species. Most radicals probably do not interact with DNA. PMID:3007090

  14. 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.

  15. [Minimal-invasive surgery for lung cancer - strategies and limits].

    PubMed

    Schneiter, D; Weder, W

    2012-07-01

    Minimal invasive surgical procedures, also known as keyhole surgery, have gained in importance in the last years and have become the standard of care in experienced hands for most surgical procedures. Despite initial concerns with respect to the radicalness of the approach it is nowadays also established in oncologic surgery. Minimal invasive procedures aim at minimizing the operative trauma and associated inflammatory reactions to achieve faster convalescence after surgery. In addition to obvious cosmetic advantages minimal invasive surgery has been shown to be associated with fewer postoperative pain and shorter postoperative rehabilitation and faster reintegration into everyday as well as working life. With 15% of all cancer diagnoses and 29% of all cancer-associated causes of death, lung cancer is the most frequent malignancy in the general public and hence the treatment of lung cancer is a main focus of thoracic surgery. Within the scope of modern multimodal treatment concepts radical surgical resection of lung cancer is essential and the main pillar of curative treatment. In early stage lung cancer the current standard of care is a thoracoscopic lobectomy with mediastinal lymphadenectomy. The expertise of specialized centers allows for curative minimal-invasive treatment in a large number of patients, particularly of patients of advanced age or with limited pulmonary function.

  16. Periscopic Spine Surgery

    DTIC Science & Technology

    2005-01-01

    AD Award Number: W81XWH-04-1-0078 TITLE: Periscopic Spine Surgery PRINCIPAL INVESTIGATOR: Kevin R. Cleary, Ph.D. CONTRACTING ORGANIZATION: Georgetown...2005 Annual (22 Dec 2003 - 21 Dec 2004) 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Periscopic Spine Surgery W81XWH-04-1-0078 6. AUTHOR(S) Kevin R. Cleary... Surgery -specific image acquisition, processing, and display are needed. The two- dimensional (2D) static images typically used today are not sufficient

  17. Oxidative stress, free radicals and protein peroxides.

    PubMed

    Gebicki, Janusz M

    2016-04-01

    Primary free radicals generated under oxidative stress in cells and tissues produce a cascade of reactive secondary radicals, which attack biomolecules with efficiency determined by the reaction rate constants and target concentration. Proteins are prominent targets because they constitute the bulk of the organic content of cells and tissues and react readily with many of the secondary radicals. The reactions commonly lead to the formation of carbon-centered radicals, which generally convert in vivo to peroxyl radicals and finally to semistable hydroperoxides. All of these intermediates can initiate biological damage. This article outlines the advantages of the application of ionizing radiations to studies of radicals, with particular reference to the generation of desired radicals, studies of the kinetics of their reactions and correlating the results with events in biological systems. In one such application, formation of protein hydroperoxides in irradiated cells was inhibited by the intracellular ascorbate and glutathione.

  18. 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.

  19. Surgery: a risky business.

    PubMed

    Vats, Amit; Nagpal, Kamal; Moorthy, Krishna

    2009-10-01

    The advancement of surgical technology has made surgery an increasingly suitable management option for an increasing number of medical conditions. Yet there is also a growing concern about the number of patients coming to harm as a result of surgery. Studies show that this harm can be prevented by better teamwork and communication in operating theatres. This article discusses the extent of adverse events in surgery and how effective teamwork and communication can improve patient safety. It also highlights the role checklists and briefing in improving teamwork and reducing human error in surgery.

  20. Complications of Strabismus Surgery

    PubMed Central

    Olitsky, Scott E.; Coats, David K.

    2015-01-01

    All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen. PMID:26180463

  1. 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 - ...

  2. Differential steric effects in Cl reactions with aligned CHD3(v1 = 1) by the R(0) and Q(1) transitions. I. Attacking the excited C-H bond

    NASA Astrophysics Data System (ADS)

    Wang, Fengyan; Liu, Kopin

    2016-10-01

    When a CHD3 molecule is pumped to the C-H stretching-excited state by absorbing a linearly polarized infrared (IR) photon via the R(0) branch of the v1 = 1←0 transition, the rotational angular momentum j of the prepared state |" separators=" jK > = |" separators=" 10 > preferentially lies in a plane perpendicular to the IR polarization axis ɛIR. By way of contrast, when the Q(1) branch is used, the state of |" separators=" jK > = |" separators=" 1 ± 1 > is prepared with j aligned along the direction of ɛIR. Reported here is a detailed study of the title reaction by actively controlling the collision geometries under these two IR-excitation schemes at collision energy Ec = 8.6 kcal mol-1, using a crossed molecular beam, product imaging approach. We found that under the R(0) excitation, the polarization-dependent differential cross sections for the HCl(v = 0) + CD3(00) channel can largely be understood by invoking dual reaction mechanisms. The forward-scattered products are most likely mediated by a time-delayed resonance mechanism—as the formation of the HCl(v = 1) + CD3(00) channel, whereas the backward/sideways scattered products are governed by a direct abstraction mechanism. Compared to the previous results at lower Ec of 3.8 kcal mol-1, the sighting of opening-up the attack angle at the transition state of the direct pathway is proposed. Results under the Q(1) excitation are, however, perplexing and bear no obvious correlation to the corresponding ones for the R(0) excitation, defying simple intuitive interpretation. Possible reasons are put forward, which call for theoretical investigations for deeper insights. The results on the alternative isotope channel, DCl + CHD2, will be reported in the following paper.

  3. Doxorubicin-induced dilated cardiomyopathy for modified radical mastectomy: A case managed under cervical epidural anaesthesia

    PubMed Central

    Jain, Anuj; Kishore, Kamal

    2013-01-01

    Doxorubicin (Dox) is an antineoplastic agent used in a wide variety of malignancies. Its use is limited because of a cumulative, dose-dependent irreversible cardiomyopathy. We report a case of Dox induced cardiomyopathy, posted for modified radical mastectomy. The patient had poor LV function along with moderate pulmonary hypertension. Regional anaesthesia was planned as the risk associated with general anaesthesia was more. A cervical epidural was placed and a block adequate for surgery could be achived. The haemodynamic parameters as measured by esophageal doppler showed a stable trend. The surgery could be managed well under cervical epidural and also provided a good postoperative pain relief. PMID:23825820

  4. Avoiding and managing vascular injury during robotic-assisted radical prostatectomy

    PubMed Central

    Nunez Bragayrac, Luciano A.; Machuca, Victor; Garza Cortes, Roberto; Azhar, Raed A.

    2015-01-01

    There has been an increase in the number of urologic procedures performed robotically assisted; this is the case for radical prostatectomy. Currently, in the USA, 67% of prostatectomies are performed robotically assisted. With this increase in robotic urologic surgery it is clear that there are more surgeons in their learning curve, where most of the complications occur. Among the complications that can occur are vascular injuries. These can occur in the initial stages of surgery, such as in accessing the abdominal cavity, as well as in the intraoperative or postoperative setting. We present the most common vascular injuries in robot-assisted radical prostatectomy, as well as their management and prevention. We believe that it is of vital importance to be able to recognize these injuries so that they can be prevented. PMID:25642293

  5. Avoiding and managing vascular injury during robotic-assisted radical prostatectomy.

    PubMed

    Sotelo, René; Nunez Bragayrac, Luciano A; Machuca, Victor; Garza Cortes, Roberto; Azhar, Raed A

    2015-02-01

    There has been an increase in the number of urologic procedures performed robotically assisted; this is the case for radical prostatectomy. Currently, in the USA, 67% of prostatectomies are performed robotically assisted. With this increase in robotic urologic surgery it is clear that there are more surgeons in their learning curve, where most of the complications occur. Among the complications that can occur are vascular injuries. These can occur in the initial stages of surgery, such as in accessing the abdominal cavity, as well as in the intraoperative or postoperative setting. We present the most common vascular injuries in robot-assisted radical prostatectomy, as well as their management and prevention. We believe that it is of vital importance to be able to recognize these injuries so that they can be prevented.

  6. Laser spectroscopy of hydrocarbon radicals

    SciTech Connect

    Chen, P.

    1993-12-01

    The author reports the application of supersonic jet flash pyrolysis to the specific preparation of a range of organic radicals, biradicals, and carbenes in a skimmed molecular beam. Each species was produced cleanly and specifically, with little or no secondary reactions by the thermal dissociation of appropriately designed and synthesized organic precursors. Photoelectron spectra of the three isomeric C{sub 3}H{sub 2} carbenes, ortho-benzyne, and the {alpha},3-dehydrotoluene biradical, were used to establish adiabatic ionization potentials for use in thermochemical determinations.

  7. Aromatic-radical oxidation chemistry

    SciTech Connect

    Glassman, I.; Brezinsky, K.

    1993-12-01

    The research effort has focussed on discovering an explanation for the anomalously high CO{sub 2} concentrations observed early in the reaction sequence of the oxidation of cyclopentadiene. To explain this observation, a number of plausible mechanisms have been developed which now await experimental verification. One experimental technique for verifying mechanisms is to probe the reacting system by perturbing the radical concentrations. Two forms of chemical perturbation of the oxidation of cyclopentadiene were begun during this past year--the addition of NO{sub 2} and CO to the reacting mixture.

  8. Iron and iron derived radicals

    SciTech Connect

    Borg, D.C.; Schaich, K.M.

    1987-04-01

    We have discussed some reactions of iron and iron-derived oxygen radicals that may be important in the production or treatment of tissue injury. Our conclusions challenge, to some extent, the usual lines of thought in this field of research. Insofar as they are born out by subsequent developments, the lessons they teach are two: Think fastexclamation Think smallexclamation In other words, think of the many fast reactions that can rapidly alter the production and fate of highly reactive intermediates, and when considering the impact of competitive reactions on such species, think how they affect the microenvironment (on the molecular scale) ''seen'' by each reactive molecule. 21 refs., 3 figs., 1 tab.

  9. [Robotic surgery in gynecology].

    PubMed

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  10. Penile enlargement surgery.

    PubMed

    Alter, G J

    1998-06-01

    Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.

  11. 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

  12. Orbital endoscopic surgery.

    PubMed

    Prabhakaran, Venkatesh C; Selva, Dinesh

    2008-01-01

    Minimally invasive "keyhole" surgery performed using endoscopic visualization is increasing in popularity and is being used by almost all surgical subspecialties. Within ophthalmology, however, endoscopic surgery is not commonly performed and there is little literature on the use of the endoscope in orbital surgery. Transorbital use of the endoscope can greatly aid in visualizing orbital roof lesions and minimizing the need for bone removal. The endoscope is also useful during decompression procedures and as a teaching aid to train orbital surgeons. In this article, we review the history of endoscopic orbital surgery and provide an overview of the technique and describe situations where the endoscope can act as a useful adjunct to orbital surgery.

  13. Minimally invasive valve surgery.

    PubMed

    Woo, Y Joseph; Seeburger, Joerg; Mohr, Friedrich W

    2007-01-01

    As alternatives to standard sternotomy, surgeons have developed innovative, minimally invasive approaches to conducting valve surgery. Through very small skin incisions and partial upper sternal division for aortic valve surgery and right minithoracotomy for mitral surgery, surgeons have become adept at performing complex valve procedures. Beyond cosmetic appeal, apparent benefits range from decreased pain and bleeding to improved respiratory function and recovery time. The large retrospective studies and few small prospective randomized studies are herein briefly summarized. The focus is then directed toward describing specific intraoperative technical details in current clinical use, covering anesthetic preparation, incision, mediastinal access, cardiovascular cannulation, valve exposure, and valve reconstruction. Finally, unique situations such as pulmonic valve surgery, reoperations, beating heart surgery, and robotics are discussed.

  14. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    PubMed Central

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  15. Transperitoneal Robot-Assisted Radical Prostatectomy Should Be Considered in Prostate Cancer Patients with Pelvic Kidneys

    PubMed Central

    Plagakis, Sophie; Foreman, Darren; Sutherland, Peter

    2016-01-01

    Abstract We highlight two cases of transperitoneal robot-assisted radical prostatectomy (RARP) in patients with pelvic kidneys because of congenital development and renal transplant. These uncommon cases present a challenge to the surgeon contemplating surgery because of access and anomalous vascular and ureteral anatomy. We describe the technical considerations that are paramount in effectively completing transperitoneal RARP, and believe it should be considered as a treatment option in men with pelvic kidneys. PMID:27579412

  16. Evaluation of quality of life after radical prostatectomy-experience in Serbia.

    PubMed

    Dragićević, Svetomir M; Krejović-Marić, Snežana P; Hasani, Bajram H; Soldatović, Ivan A; Bojić, Svetlana D; Canović, Predrag

    2012-08-01

    The aim of this study was to compare health related quality of life (QoL) of patients with prostate cancer, who had undergone radical prostatectomy (RP), with patients who were carefully monitored. This prospective study included 56 patients who had undergone the radical prostatectomy (RP) and 48 non-operated patients (watchful waiting, WW). All patients filled EPIC questionnaire at baseline, 1th, 3rd, 6th and 12th month. At baseline, mean scores were similar in both groups, but one month after the surgery in RP group, patients had statistically significant lower score of urinary incontinency, urinary function and sexual function compared with WW patients. These scores were significantly higher in the 3rd, 6th and 12th month in operated patients, but there was no improvement in the WW group. Radical prostatectomy does not significantly improve quality of life. Prostatectomized patients had worse scores on the QoL scale, with exception of the urinary disturbance dimension.

  17. [Aesthetic surgery and history].

    PubMed

    Glicenstein, J

    2003-10-01

    The history of aesthetic surgery is linked to that of the 20th century. The first operations allowed by the progress of anesthesia and asepsis are the correction of "prominent ears" by Ely then rhinoplasty with endonasal incision by Roe. Considered by some as a precursor and a quack by others, C.C. Miller was the first surgeon to specialize and write books on the subject. Before world war I, aesthetic surgery was seldom practiced and publications were few. The war was at the origin of several units of maxillo-facial surgery created for the huge number of casualties with face trauma due to trench warfare. Many of those who will become great names in plastic surgery operated in these units: Blair, Davis, Léon Dufourmentel, Virenque, Morestin and Gillies. After the war, American surgeons were regrouped in scientific societies. Plastic surgery was privileged and aesthetic surgery was lifted for "quacks". In France, several surgeons such as Suzanne Noël, Passot, Bourguet, Dartigues showed an important creativity and described several techniques that inspired recent ones. The Dujarier case discredited French aesthetic surgery but did not stop the creation of the first French Society of Plastic Surgery in 1930. World war II led to new orientations. In England, the East Grinstead center with Gillies and McIndoe during and after the war was at the origin of many vocations. After the war, many national and international societies of plastic surgery started to appear. The French Society of Plastic Surgery was born in 1952.

  18. Gamma knife surgery for craniopharyngioma.

    PubMed

    Prasad, D; Steiner, M; Steiner, L

    1995-01-01

    We present our results of Gamma Knife surgery for craniopharyngioma in nine patients. The current status of surgery, radiation therapy, intracavitary instillation of radionucleides and Gamma Knife surgery in the management of craniopharyngiomas is discussed.

  19. Intracranial Hypertension: Medication and Surgery

    MedlinePlus

    ... Intracraneal en Espanol. STORE Shop the IHRF Store Medication and Surgery Medication and Surgery Both drugs and surgery are used ... to treat the headache that accompanies chronic IH. Medications for chronic headache like tricyclic anti-depressants, beta- ...

  20. Surgery for Stress Urinary Incontinence

    MedlinePlus

    ... Events Advocacy For Patients About ACOG Surgery for Stress Urinary Incontinence Home For Patients Search FAQs Surgery ... Incontinence FAQ166, July 2014 PDF Format Surgery for Stress Urinary Incontinence Special Procedures What is stress urinary ...

  1. 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 ...

  2. Preparing for Breast Reconstruction Surgery

    MedlinePlus

    ... Cancer 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 ...

  3. Surgical site infections in breast surgery: case-control study.

    PubMed

    Vilar-Compte, Diana; Jacquemin, Benedicte; Robles-Vidal, Carlos; Volkow, Patricia

    2004-03-01

    The purpose of this study was to estimate the frequency of surgical site infections (SSIs) and identify associated risk factors for each type of breast surgery at a cancer hospital. We used a nested case-control design. Between February 1, 2000 and July 31, 2000, all breast surgeries performed were recorded on a daily basis. After hospital discharge, we evaluated patients simultaneously with surgeons three times a week for 30 days or longer. The odds ratio (OR) was estimated using logistic regression analysis. The study followed 280 patients (298 wounds). Altogether, 77 SSIs were detected, for an overall SSI rate of 25.8% (77/298). For excisions, conservative surgery, and radical mastectomies the SSI rates were 1.4%, 18.0%, and 38.3%, respectively. Excisions were excluded ( n = 68) for risk factor analysis. After multivariate analysis, risk factors associated with SSIs were obesity [OR 2.5, 95% confidence interval (CI) 1.2-4.3], concomitant chemotherapy and radiation (OR 2.3, 95% CI 1.2-4.3), radical surgery (OR 3.1, 95% CI 1.1-8.6), insertion of a second drain during the late postoperative period (OR 3.7, 95% CI 1.8-7.8), and drainage duration > or = 19 days (OR 2.9, 95% CI 1.5-5.6). The bacteria most frequently isolated were Pseudomonas aeruginosa ( n = 18 ), Serratia sp. ( n = 18), Staphylococcus aureus ( n = 10), and Staphylococcus epidermidis ( n = 10). Poor compliance with infection control practices and wound management was detected throughout the study period. The overall frequency of SSIs for mastectomies was higher than the reported rates, which was principally related to the more radical surgery required for advanced-stage disease, preoperative irradiation, and inadequate wound and drain care.

  4. Free radicals and the pH of topical glaucoma medications: a lifetime of ocular chemical injury?

    PubMed Central

    Lockington, D; Macdonald, E C A; Stewart, P; Young, D; Caslake, M; Ramaesh, K

    2012-01-01

    Introduction Preservatives in ophthalmic preparations are known to cause ocular surface damage. Excipients can also contribute to oxidative stress in the compromised ocular surface. We evaluated commonly used topical glaucoma medications to ascertain pH levels and the intrinsic presence of free radicals. Methods Samples of 27 topical glaucoma preparations were analysed for total free radical presence using a Randox Kit for total antioxidant status. Analytical grade indicator paper was used to ascertain pH levels. Results Free radical concentrations for these 27 glaucoma preparations ranged from 0 to 4.54 mmol/l, with a median value of 0.66 mmol/l (mean value of 0.662 mmol/l, SD 0.839). Levels of pH ranged from 4.0 to 7.4, with a median value of 6.5 (mean 6.252, SD 0.826). There was no evidence of a direct correlation between these two variables (r=0.232, P=0.275). Conclusion This study is the first to document the range of pH and concentrations of free radicals intrinsically present in commonly used glaucoma medications. Long-term exposure to preservatives, free radicals, and pH levels could all contribute to ocular surface damage. The effect of excipients could be responsible for patient intolerance when changing products in the compromised ocular surface. PMID:22388593

  5. Analysing the outcome of surgery for chronic Achilles tendinopathy over the last 50 years

    PubMed Central

    Khan, Wasim S; Malvankar, Seema; Bhamra, Jagmeet S; Pengas, Ioannis

    2015-01-01

    AIM: To determine an association between when the study was performed, the robustness of the study and the outcomes for insertional and non-insertional Achilles tendinopathy surgery. METHODS: We performed a systematic review in accordance with the PRISMA guidelines to assess the methodology of studies investigating the outcome of surgery in chronic Achilles tendinopathy over the last 50 years to identify any trends that would account for the variable results. The Coleman Methodology Scores were correlated with the reported percentage success rates and with the publication year to determine any trends using Pearson’s correlation. RESULTS: We identified 62 studies published between 1964 and 2014 reporting on a total of 2923 surgically treated Achilles tendinopathies. The average follow-up time was 40 mo (range 5-204 mo), and the mean reported success rate was 83.5% (range 36%-100%). The Coleman Methodology Scores were highly reproducible (r = 0.99, P < 0.01), with a mean of 40.1 (SD 18.9, range 2-79). We found a negative correlation between reported success rate and overall methodology scores (r = -0.40, P < 0.001), and a positive correlation between year of publication and overall methodology scores (r = 0.46, P < 0.001). CONCLUSION: We conclude that although the success rate of surgery for chronic Acilles tendinopathy described in the literature has fallen over the last 50 years, this is probably due to a more rigorous methodology of the studies. PMID:26191496

  6. Impact of trainee involvement with robotic-assisted radical prostatectomy.

    PubMed

    Thomas, Anil A; Derboghossians, Armen; Chang, Allen; Karia, Rajiv; Finley, David S; Slezak, Jeff; Jacobsen, Steven J; Chien, Gary W

    2013-09-01

    Robotic-assisted surgery has been rapidly adopted within urology practice. As a result, academic centers are challenged with the burden of how to effectively train residents and fellows to perform robotic-assisted surgery without compromising outcomes. We evaluated the perioperative outcomes of trainee involvement with robotic-assisted radical prostatectomy (RARP) within our healthcare organization. We retrospectively reviewed RARP cases performed at our institution between September 2008 and December 2010 using a single da Vinci robotic platform. Trainees consisted of urology residents and fellows who operated with staff surgeons on select operating days, whereas two staff surgeon teams performed RARP on alternate days. We compared clinicopathologic variables including operating time, estimated blood loss, surgical margin rates, and complication rates between the trainee and staff-only surgeon groups. Overall, 1,019 RARP surgeries were performed within the study period and trainees participated in 162 cases (16 %). Clinical characteristics were similar between men undergoing surgery with a trainee and those without. Positive surgical margin rates were lower for patients with pT2 disease for cases with trainee involvement (11 vs. 19 %, p = 0.02), although overall margin rates and margin rates for patients with pT3 disease were similar between the groups (p = 0.34). Surgical cases involving trainees were longer (241 vs. 200 min, p < 0.001) and resulted in higher estimated blood loss (190 vs. 120 mL, p < 0.001) than the two staff surgeon cases. However, transfusion rates as well as intraoperative and postoperative complication rates did not differ significantly between groups. In conclusion, surgical margin rates were lower in teaching cases for patients with pT2 disease. Importantly, trainee involvement in RARP is safe, with similar perioperative outcomes to staff-only surgical cases. This information may be useful for training and surgical planning.

  7. The tyrosyl free radical in ribonucleotide reductase.

    PubMed Central

    Gräslund, A; Sahlin, M; Sjöberg, B M

    1985-01-01

    The enzyme, ribonucleotide reductase, catalyses the formation of deoxyribonucleotides from ribonucleotides, a reaction essential for DNA synthesis in all living cells. The Escherichia coli ribonucleotide reductase, which is the prototype of all known eukaryotic and virus-coded enzymes, consists of two nonidentical subunits, proteins B1 and B2. The B2 subunit contains an antiferromagnetically coupled pair of ferric ions and a stable tyrosyl free radical. EPR studies show that the tyrosyl radical, formed by loss of ferric ions and a stable tyrosyl free radical. EPR studies show that the tyrosyl radical, formed by loss of an electron, has its unpaired spin density delocalized in the aromatic ring of tyrosine. Effects of iron-radical interaction indicate a relatively close proximity between the iron center and the radical. The EPR signal of the radical can be studied directly in frozen packed cells of E. coli or mammalian origin, if the cells are made to overproduce ribonucleotide reductase. The hypothetic role of the tyrosyl free radical in the enzymatic reaction is not yet elucidated, except in the reaction with the inhibiting substrate analogue 2'-azido-CDP. In this case, the normal tyrosyl radical is destroyed with concomitant appearance of a 2'-azido-CDP-localized radical intermediate. Attempts at spin trapping of radical reaction intermediates have turned out negative. In E. coli the activity of ribonucleotide reductase may be regulated by enzymatic activities that interconvert a nonradical containing form and the fully active protein B2. In synchronized mammalian cells, however, the cell cycle variation of ribonucleotide reductase, studied by EPR, was shown to be due to de novo protein synthesis. Inhibitors of ribonucleotide reductase are of medical interest because of their ability to control DNA synthesis. One example is hydroxyurea, used in cancer therapy, which selectively destroys the tyrosyl free radical. PMID:3007085

  8. Quantitative determination of atmospheric hydroperoxyl radical

    DOEpatents

    Springston, Stephen R.; Lloyd, Judith; Zheng, Jun

    2007-10-23

    A method for the quantitative determination of atmospheric hydroperoxyl radical comprising: (a) contacting a liquid phase atmospheric sample with a chemiluminescent compound which luminesces on contact with hydroperoxyl radical; (b) determining luminescence intensity from the liquid phase atmospheric sample; and (c) comparing said luminescence intensity from the liquid phase atmospheric sample to a standard luminescence intensity for hydroperoxyl radical. An apparatus for automating the method is also included.

  9. Bioinspired terpene synthesis: a radical approach.

    PubMed

    Justicia, José; Álvarez de Cienfuegos, Luis; Campaña, Araceli G; Miguel, Delia; Jakoby, Verena; Gansäuer, Andreas; Cuerva, Juan M

    2011-07-01

    This tutorial review highlights the development of radical-based bioinspired synthesis of terpenes from the initial proposal to the development of modern catalytic methods for performing such processes. The power of the radical approach is demonstrated by the straightforward syntheses of many natural products from readily available starting materials. The efficiency of these processes nicely complements the described cationic polyolefin cyclisations and even suggests that modern radical methods provide means to improve upon nature's synthetic pathways.

  10. Dietary intake, neutrophil fatty acid profile, serum antioxidant vitamins and oxygen radical absorbance capacity in patients with ulcerative colitis.

    PubMed

    Kawakami, Yuko; Okada, Hiroyuki; Murakami, Yasuko; Kawakami, Takayo; Ueda, Yukiko; Kunii, Daisuke; Sakamoto, Yachiyo; Shiratori, Yasushi; Okita, Misako

    2007-04-01

    Nutrition may play an important role in the pathogenesis and treatment of ulcerative colitis. Several studies suggest an association between dietary factors and the onset of ulcerative colitis; however, only few studies have examined the relationship between dietary intake and relapse of ulcerative colitis. The aim of this study was to assess the dietary intake and antioxidative capacity of ulcerative colitis patients and to elucidate the efficacy of dietary therapy for ulcerative colitis. Dietary intake, fatty acid composition of phospholipids in plasma and neutrophils, serum fat-soluble vitamin levels, and oxygen radical absorbance capacity were analyzed in 29 ulcerative colitis patients (7 males and 22 females), who were treated at the Department of Gastroenterology, Okayama University Hospital. Total fat intake, fat energy ratio and linoleic acid intake were significantly lower, while protein and carbohydrate intakes were significantly higher, in the patients than age- and sex-matched controls. In the neutrophil phospholipids of ulcerative colitis patients, significantly higher levels of linoleic aicd and arachidonic acid and a lower level of eicosapentaenoic acid were observed. The concentrations of serum retinol and beta-carotene but not alpha-tocopherol were significantly lower and serum oxygen radical absorbance capacity was also lower than in the controls. Significant correlations between serum oxygen radical absorbance capacity and retinol (r = 0.567, p = 0.0031), alpha-tocopherol (r = 0.560, p = 0.0036) and beta-carotene (r = 0.440, p = 0.0279) concentrations were observed in the ulcerative colitis patients. A diet restricting the intake of linoleic acid and supplemented with eicosapentaenoic acid and antioxidative vitamins may be recommendable for the nutritional management of ulcerative colitis patients.

  11. Prostatic surgery associated acute kidney injury

    PubMed Central

    Costalonga, Elerson Carlos; Costa e Silva, Verônica Torres; Caires, Renato; Hung, James; Yu, Luis; Burdmann, Emmanuel A

    2014-01-01

    Acute kidney injury (AKI) is associated with extended hospital stays, high risks of in-hospital and long-term mortality, and increased risk of incident and progressive chronic kidney disease. Patients with urological diseases are a high-risk group for AKI owing to the coexistence of obstructive uropathy, older age, and preexistent chronic kidney disease. Nonetheless, precise data on the incidence and outcomes of postoperative AKI in urological procedures are lacking. Benign prostatic hyperplasia and prostate cancer are common diagnoses in older men and are frequently treated with surgical procedures. Whereas severe AKI after prostate surgery in general appears to be unusual, AKI associated with transurethral resection of the prostate (TURP) syndrome and with rhabdomyolysis (RM) after radical prostatectomy have been frequently described. The purpose of this review is to discuss the current knowledge regarding the epidemiology, risk factors, outcomes, prevention, and treatment of AKI associated with prostatic surgery. The mechanisms of TURP syndrome and RM following prostatic surgeries will be emphasized. PMID:25374813

  12. Changing Trends in Gastric Cancer Surgery

    PubMed Central

    Özer, İlter; Bostancı, Erdal Birol; Ulaş, Murat; Özoğul, Yusuf; Akoğlu, Musa

    2017-01-01

    Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with lymph node dissection. The extent of lymphadenectomy still remains controversial. Eastern surgeons have performed D2 or more extended lymphadenectomy while their Western colleagues have performed more limited lymph node dissection. However, the trend has been changing in favour of D2 lymph node dissection in both hemispheres. Currently, D2 is the recommended type of lymphadenectomy in experienced centres in the west. In Japan, D2 lymph node dissection is the standard surgical approach. More extensive lymphadenectomy than D2 has not been found to be associated with improved survival and generally is not performed. Bursectomy and splenectomy are additional controversial issues in surgical performance, and trends regarding them will be discussed. The performance of bursectomy is controversial and there is no clear evidence of its clinical benefit. However, a trend toward better survival in patients with serosal invasion has been reported. Routine splenectomy as a part of lymph node dissection has largely been abandoned, although splenectomy is recommended in selected cases. Minimally invasive surgery has gained wide popularity and indications for minimally invasive procedures have been expanding due to increasing experience and improving technology. Neoadjuvant therapy has been shown to have beneficial effects and seems necessary to provide a survival benefit. Diagnostic laparoscopy should be kept in mind prior to treatment. PMID:28251018

  13. [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.

  14. Anti-reflux surgery - children

    MedlinePlus

    ... reflux disease. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, ... surgery - children - discharge Anti-reflux surgery - discharge ...

  15. Formation of free radicals during phacoemulsification.

    PubMed

    Holst, A; Rolfsen, W; Svensson, B; Ollinger, K; Lundgren, B

    1993-04-01

    During phacoemulsification cavitation bubbles are formed. These bubbles are believed to be one source of damage to corneal endothelium seen after phacoemulsification. Free radicals are induced whenever cavitation bubbles implode. The aim of this study was to confirm the initiation of free radicals by phacoemulsification and to correlate the power of ultrasound in the phacoemulsification process to the amount of free radicals formed, using both in vitro and in vivo techniques. The formation of free radicals was determined by adding luminol to a buffer and measuring the chemoluminescence in vitro and in rabbit eyes (Lumacounter 2080 or a single-photon-counting apparatus) during phacoemulsification. The data obtained show that free radicals are formed during phacoemulsification and that the amount of free radicals correlates with the power of ultrasound. Furthermore, the radical formation could be inhibited by the radical scavengers SOD, Healon and Healon GV. These results were achieved both in vitro in the test tube and in vivo in rabbit eyes. By showing that the addition of SOD to the irrigation buffer during phacoemulsification decreases the corneal endothelial cell damage, we show that free radicals could have a role in postoperative complications seen clinically.

  16. Dynamics of Radical-Mediated Enzyme Catalyses

    NASA Astrophysics Data System (ADS)

    Warncke, Kurt

    1997-11-01

    An emergent class of enzymes harnesses the extreme reactivity of electron-deficient free radical species to perform some of the most difficult reactions in biology. The regio- and stereo-selectivity achieved by these enzymes defies long-held ideas that radical reactions are non-specific. The common primary step in these catalyses is metal- or metallocenter-assisted generation of an electron-deficient organic "initiator radical". The initiator radical abstracts a hydrogen atom from the substrate, opening a new reaction channel for rearrangement to the product. Our aim is to elucidate the detailed molecular mechanisms of the radical pair separation and radical rearrangement steps. Radical pair separation and substrate radical rearrangement are tracked by using time-resolved (10-7 to 10-3 s) techniques of pulsed-electron paramagnetic resonance spectroscopy (FT-EPR, ESEEM). Synchronous time-evolution of the reactions is attained by triggering with a visible laser pulse. Transient non-Boltzmann population of the states of the spin-coupled systems, and resultant electron spin polarization, facilitates study at or near room temperature under conditions where the enzymes are operative. The systems examined include ethanolamine deaminase, a vitamin B12 coenzyme-dependent enzyme, ribonucleotide reductase and photosynthetic reaction centers. The electronic and nuclear structural and kinetic information obtained from the pulsed-EPR studies is used to address how the initiator radicals are stabilized against deleterious recombination with the metal, and to distinguish the participation of concerted versus sequential rearrangement pathways.

  17. Physical activity and cognitive function in bariatric surgery candidates.

    PubMed

    Galioto, Rachel; King, Wendy C; Bond, Dale S; Spitznagel, Mary Beth; Strain, Gladys; Devlin, Michael; Cohen, Ronald; Crosby, Ross D; Mitchell, James E; Gunstad, John

    2014-12-01

    Cognitive impairment is common in severe obesity. Lack of physical activity is a likely contributor to impairment in this population, as many obese persons are inactive and physical activity has been positively and independently associated with cognitive function in healthy and medically-ill samples. This study investigated whether physical activity, measured by self-report of aerobic physical activity in 85 bariatric surgery candidates, was associated with cognitive function. A subset of 31 participants also completed objective activity monitoring. Steps/d and high-cadence min/week, representative of ambulatory moderate to vigorous physical activity (MVPA), were calculated. Approximately one quarter of participants self-reported at least 30 min/d of aerobic MVPA, at least 5 d/week. Median steps/d was 7949 (IQR = 4572) and median MVPA min/week was 105 (IQR = 123). Cognitive deficits were found in 32% of participants (29% memory, 10% executive function, 13% language, 10% attention). Controlling for demographic and medical factors, self-reported aerobic physical activity was weakly correlated with lower attention (r = -0.21, p = 0.04) and executive function (r = -0.27, p < 0.01) and both self-reported aerobic physical activity and objectively-determined MVPA min/week were negatively correlated with memory (r = -0.20, p = 0.04; r = -0.46; p = 0.02, respectively). No other correlations between physical activity measures and cognitive function were significant. Contrary to expectations, greater levels of physical activity were not associated with better cognitive functioning. Such findings encourage future studies to clarify the association among cognitive function and physical activity in obese persons.

  18. Surgical skills for laparoscopic resection of the bursa omentalis and lymph node scavenging with radical gastrectomy

    PubMed Central

    ZOU, LIAO-NAN; HE, YAO-BIN; LI, HONG-MING; DIAO, DE-CHANG; MO, DE-LONG; WANG, WEI; WAN, JIN

    2015-01-01

    The aim of the present study was to inquire into the feasibility, surgical skills required and short-term effect of a laparoscopic resection of the bursa omentalis and lymph node scavenging with radical gastrectomy. In this study, the clinical data of 18 patients who received a laparoscopic resection of the bursa omentalis with radical gastrectomy in the Department of Gastrointestinal Surgery, Guangdong Province Hospital of Traditional Chinese Medicine (Guangzhou, Guangdong, China) during the period between January 2012 and January 2014. A retrospective analysis was performed and the surgical duration, bursa omentalis resection time, amount of bleeding during the surgery, post-operative complications associated with the surgery, length of hospital stay, number of lymph nodes scavenged and short-term follow-up results were assessed. The results indicated that all of these 18 patients successfully received a resection of the bursa omentalis and no one required conversion to open surgery. The mean surgical duration was 289.3±30.3 min, the bursa omentalis resection time was 46.1±18.6 min and the amount of bleeding was recorded as 35.5±6.5 ml in these patients. No patients suffered from post-operative complications, such as pancreatic fistulae, anastomotic fistulae, intestinal obstructions or succumbing to the surgery, and no patients succumbed within a 6-month follow-up period. In conclusion, for advanced gastric carcinoma, laparoscopic resection of the bursa omentalis and lymph node scavenging with radical gastrectomy is feasible. In addition to meeting the requirement that the operator should be skilled and experienced in open bursa omentalis resection, and have well-knit basic skills in using a laparoscope, attention must also be paid to the construction of the surgical team. PMID:26170983

  19. Is laparoscopic colorectal cancer surgery equal to open surgery? An evidence based perspective

    PubMed Central

    Künzli, Beat M; Friess, Helmut; Shrikhande, Shailesh V

    2010-01-01

    Laparoscopic colorectal surgery (LCS) is an evolving subject. Recent studies show that LCS can not only offer safe surgery but evidence is growing that this new technique can be superior to classical open procedures. Fewer perioperative complications and faster postoperative recovery are regularly mentioned when studies of LCS are presented. Even though the learning curve of LCS is frequently debated when limitations of laparoscopic surgeries are reviewed, studies show that in experienced hands LCS can be a safe procedure for colorectal cancer treatment. The learning curve however, is associated with high conversion rates and economical aspects such as higher costs and prolonged hospital stay. Nevertheless, laparoscopic colorectal cancer surgery (LCCR) offers several advantages such as less co-morbidity and less postoperative pain in comparison with open procedures. Furthermore, the good exposure of the pelvic cavity by laparoscopy and the magnification of anatomical structures seem to facilitate pelvic dissection laparoscopically. Moreover, recent studies describe no difference in safety and oncological radicalness in LCCR compared to the open total mesorectal excision (TME). The oncological adequacy of LCCR still remains unproven today, because long-term results do not yet exist. To date, only a few studies have described the results of laparoscopic TME combined with preoperative adjuvant treatment for colorectal cancer. The aim of this review is to examine the various areas of development and controversy of LCCR in comparison to the conventional open approach. PMID:21160858

  20. Translating weight loss into agency: Men's experiences 5 years after bariatric surgery

    PubMed Central

    Natvik, Eli; Gjengedal, Eva; Moltu, Christian; Råheim, Målfrid

    2015-01-01

    Fewer men than women with severe obesity undergo bariatric surgery for weight loss, and knowledge about men's situation after surgery, beyond medical status, is lacking. Our aim was to explore men's experiences with life after bariatric surgery from a long-term perspective. We conducted in-depth interviews with 13 men, aged 28–60 years, between 5 and 7 years after surgery. The analysis was inspired by Giorgi's phenomenological method. We found that agency was pivotal for how the men understood themselves and their lives after surgery. Weight loss meant regaining opportunities for living and acting in unrestricted and independent daily lives, yet surgery remained a radical treatment with complex consequences. Turning to surgery had involved conceptualizing their own body size as illness, which the men had resisted doing for years. After surgery, the rapid and major weight loss and the feelings of being exhausted, weak, and helpless were intertwined. The profound intensity of the weight loss process took the men by surprise. Embodying weight loss and change involved an inevitable renegotiating of experiences connected to the large body. Having bariatric surgery was a long-term process that seemed unfinished 5 years after surgery. Restrictions and insecurity connected to health and illness persist, despite successful weight loss and embodied change. Bariatric surgery initiated a complex and long-lasting life-changing process, involving both increased capacity for agency and illness-like experiences. PMID:26066518

  1. Surgery induced immunosuppression.

    PubMed

    Hogan, Brian V; Peter, Mark B; Shenoy, Hrishikesh G; Horgan, Kieran; Hughes, Thomas A

    2011-02-01

    Surgery and anaesthesia result in a variety of metabolic and endocrine responses, which result in a generalised state of immunosuppression in the immediate post-operative period. Surgery induced immunosuppression has been implicated in the development of post-operative septic complications and tumour metastasis formation. In addition the effectiveness of many treatments in the adjuvant setting is dependent on a functioning immune system. By understanding the mechanisms contributing to surgery-induced immunosuppression, surgeons may undertake strategies to minimise its effect and reduce potential short-term and long-term consequences to patients.

  2. Safe Surgery Trainer

    DTIC Science & Technology

    2014-08-15

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period July 1, 2014 to July 31, 2014 Submitted: 15 August...DATE 15 AUG 2014 2. REPORT TYPE 3. DATES COVERED 01-07-2014 to 31-07-2014 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b... Surgery Trainer ONR N00014-14-C-0066 1 July 2014 to 31 July 2014 Unclassified 15 August 2014 Unclassified Use or disclosure of the data contained

  3. Transoral robotic thyroid surgery

    PubMed Central

    Clark, James H.; Kim, Hoon Yub

    2015-01-01

    There is currently significant demand for minimally invasive thyroid surgery; however the majority of proposed surgical approaches necessitate a compromise between minimal tissue dissection with a visible cervical scar or extensive tissue dissection with a remote, hidden scar. The development of transoral endoscopic thyroid surgery however provides an approach which is truly minimally invasive, as it conceals the incision within the oral cavity without significantly increasing the amount of required dissection. The transoral endoscopic approach however presents multiple technical challenges, which could be overcome with the incorporation of a robotic operating system. This manuscript summarizes the literature on the feasibility and current clinical experience with transoral robotic thyroid surgery. PMID:26425456

  4. Standing equine sinus surgery.

    PubMed

    Barakzai, Safia Z; Dixon, Padraic M

    2014-04-01

    Trephination of the equine sinuses is a common surgical procedure in sedated standing horses. Standing sinus flap surgery has become increasingly popular in equine referral hospitals and offers several advantages over sinusotomy performed under general anesthesia, including reduced patient-associated risks and costs; less intraoperative hemorrhage, allowing better visualization of the operative site; and allows surgeons to take their time. Other minimally invasive surgical procedures include sinoscopic surgery, balloon sinuplasty, and transnasal laser sinonasal fenestration. Despite the procedure used, appropriate indications for surgery, good patient selection, and familiarity with regional anatomy and surgical techniques are imperative for good results.

  5. Safe Surgery Trainer

    DTIC Science & Technology

    2015-02-20

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period Jan 1, 2014 to Jan 31, 2014 Submitted: 20 February...control number. 1. REPORT DATE FEB 2015 2. REPORT TYPE 3. DATES COVERED 00-01-2015 to 00-01-2015 4. TITLE AND SUBTITLE Safe Surgery Trainer...Progress Report – ONR Safe Surgery Trainer ONR N00014-14-C-0066 Unclassified Unclassified Use or disclosure of the data contained on this page is

  6. Safe Surgery Trainer

    DTIC Science & Technology

    2015-06-15

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period May, 2015 to May 31, 2015 Submitted: 15 June 2015...15 JUN 2015 2. REPORT TYPE 3. DATES COVERED 00-05-2015 to 31-05-2015 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b...ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Progress Report – ONR Safe Surgery

  7. Safe Surgery Trainer

    DTIC Science & Technology

    2015-03-15

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period Feb 1, 2014 to Feb 28, 2014 Submitted: 15 March 2015...DATE MAR 2015 2. REPORT TYPE 3. DATES COVERED 01-02-2014 to 28-02-2014 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b...COVERED 01-02-2014 to 28-02-2014 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  8. Safe Surgery Trainer

    DTIC Science & Technology

    2015-05-15

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period Mar 1, 2014 to Mar 31, 2014 Submitted: 15 May 2015...15 MAY 2015 2. REPORT TYPE 3. DATES COVERED 01-03-2014 to 31-03-2014 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b... Surgery Trainer ONR N00014-14-C-0066 Unclassified Unclassified Use or disclosure of the data contained on this page is subject to the restriction on

  9. Safe Surgery Trainer

    DTIC Science & Technology

    2015-04-15

    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period Mar 1, 2014 to Mar 31, 2014 Submitted: 15 April 2015...DATE 15 APR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b... Surgery Trainer ONR N00014-14-C-0066 Unclassified Unclassified Use or disclosure of the data contained on this page is subject to the restriction

  10. Should the Prevalence of Incidental Thyroid Cancer Determine the Extent of Surgery in Multinodular Goiter?

    PubMed Central

    2016-01-01

    Background The most appropriate surgical procedure for multinodular goiter (MNG) remains under debate. Incidental thyroid carcinoma (ITC) is often identified on histopathological examination after thyroidectomy performed for presumed benign MNG. Aim of the study The aim of the study was to determine the value of radical surgery for MNG patients considering the prevalence of ITC diagnosed postoperatively. Materials and Methods We conducted retrospective analysis of the medical records of 2,306 patients surgically treated for MNG between 2008 and 2013 at one center. None of the patients presented with any suspicion of malignancy, history of familial thyroid cancer, multiple endocrine neoplasia syndrome or previous head or neck radiation exposure. Results Among the 2,306 MNG patients, ITC was detected in 49 (2.12%) (44 women and 5 men, with average ages of 52.2 (21–79) and 55.6 (52–62), respectively). Papillary thyroid carcinoma was significantly more frequently observed than other types of ITC (p<0.00001). Among the MNG patients, 866 (37.5%) underwent total/near total surgery, 464 (20.1%) received subtotal thyroidectomy, and 701 (30.3%) received the Dunhill operation. The remaining 275 (11.9%) patients underwent a less radical procedure and were classified as "others." Among the 49 (100%) patients with ITC, 28 (57.1%) underwent radical surgery. Another 21 (42.9%) patients required completion surgery due to an insufficient primary surgical procedure. A total of 21 (2.42%) patients in the total/near total surgery group were diagnosed with ITC, as well as 16 (2.48%) in the subtotal thyroidectomy group and 12 (1.71%) in the Dunhill operation group; 21 (100%), 4 (25%) and 3 (25%) of these patients, respectively, underwent radical surgery; thus, 0 (0%), 12 (75%) and 9 (75%) required completion surgery. The prevalence rates of ITC were comparable between the radical and subtotal surgery groups (2.42% and 3.44%, respectively, p = 0.4046), and the prevalence was higher in

  11. The controversy surrounding penile rehabilitation after radical prostatectomy

    PubMed Central

    Clavell-Hernández, Jonathan

    2017-01-01

    Radical prostatectomy (RP) techniques have been refined in the last few decades. Despite nerve-sparing surgery, erectile dysfunction (ED) still seems to be affecting more than half of patients undergoing RP. Penile rehabilitation consists of understanding the mechanisms that affect erectile function (EF) and utilizing pharmacologic agents, devices or interventions to promote male sexual function before and after any insult to the penile erectile physiologic axis. There currently is a limited amount of clinical trials that assess treatments with the goal of recovering post-prostatectomy EF. The goal of this article is to assess a contemporary series of trials that study penile rehabilitation. Although the current evidence lacks to prove its irrefutable effectiveness, advancements in research and technology forecast a promising future in penile rehabilitation management. PMID:28217445

  12. Phase transition and conduction mechanism in Pb2Na0.8R0.2Nb4.8Fe0.2O15 material (R=rare earth)

    NASA Astrophysics Data System (ADS)

    Bouziane, M.; Taibi, M.; Boukhari, A.

    2013-11-01

    Electrical properties of Pb2Na0.8Eu0.2Nb4.8Fe0.2O15 tungsten bronze compound were investigated. Ferroelectric phase transition of diffuse type is observed at 395 °C. Conductivity study as a function of temperature (RT-600 °C) and at three different frequencies (10, 100 and 1000 kHz) suggests the existence of dominant ionic conduction. The rise of ac conductivity on increasing temperature supports the NTCR (negative temperature coefficient of resistance) behaviour of the material. The activation energies have been evaluated from ac conductivity using Arrhenius equation and discussed. Different conduction mechanisms were identified. For comparison, the conducting properties of Pb2Na0.8R0.2Nb4.8Fe0.2O15 (R=Dy, Nd, La) were also investigated.

  13. Concurrent magnetic and structural reconstructions at the interface of (111)-oriented L a0.7S r0.3Mn O3/LaFe O3

    NASA Astrophysics Data System (ADS)

    Hallsteinsen, I.; Moreau, M.; Grutter, A.; Nord, M.; Vullum, P.-E.; Gilbert, D. A.; Bolstad, T.; Grepstad, J. K.; Holmestad, R.; Selbach, S. M.; N'Diaye, A. T.; Kirby, B. J.; Arenholz, E.; Tybell, T.

    2016-11-01

    We observe an induced switchable magnetic moment of 1.6 ±0.40 μB/Fe for the nominally antiferromagnetic LaFe O3 extending two to four interface layers into the non-charge transfer system L a0.7S r0.3Mn O3/LaFe O3/SrTi O3(111 ) . Simultaneously a mismatch of oxygen octahedra rotations at the interface implies an atomic reconstruction of reduced symmetry at the interface, reaching two to five layers into LaFe O3 . Density functional theory of a structure with atomic reconstruction and different correlation strength shows a ferrimagnetic state with a net Fe moment at the interface. Together these results suggest that engineered oxygen octahedra rotations, affecting the local symmetry, affect electron correlations and can be used to promote magnetic properties.

  14. Measurement of the ratio of inclusive jet cross sections using the anti-kT algorithm with radius parameters R=0.5 and 0.7 in pp collisions ats=7TeV

    DOE PAGES

    Chatrchyan, S.; Khachatryan, V.; Sirunyan, A. M.; ...

    2014-10-16

    Measurements of the inclusive jet cross section with the anti-kT clustering algorithm are presented for two radius parameters, R = 0.5 and 0.7. They are based on data from LHC proton-proton collisions at √s = 7  TeV corresponding to an integrated luminosity of 5.0  fb⁻¹ collected with the CMS detector in 2011. The ratio of these two measurements is obtained as a function of the rapidity and transverse momentum of the jets. Significant discrepancies are found comparing the data to leading-order simulations and to fixed-order calculations at next-to-leading order, corrected for nonperturbative effects, whereas simulations with next-to-leading-order matrix elements matched to partonmore » showers describe the data best.« less

  15. Kinetics Studies of Radical-Radical Reactions: The NO2 + N2H3 System

    DTIC Science & Technology

    2013-10-01

    investigating the kinetics of this elementary reaction . 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES...Viewgraph 3. DATES COVERED (From - To) September 2013- October 2013 4. TITLE AND SUBTITLE Kinetics Studies of Radical-Radical Reactions (I): The NO2...characteristics in relevant operating environments. Here we report theoretical results obtained on the prototypical radical- radical reaction : NO2 + N2H3

  16. Students' Ideas and Radical Constructivism

    NASA Astrophysics Data System (ADS)

    Sánchez Gómez, Pedro J.

    2016-08-01

    In this article, I study, from the point of view of the analytic philosophy of mind, the compatibility of students' ideas studies (SIS) with radical constructivism (RC). I demonstrate that RC is based on a psychology of narrow mental states; that is, the idea that the mental content of an individual can be fully characterised without any reference external to her or him. I show that this fact imposes some severe restrictions to SIS to be incorporated into RC. In particular, I argue that only qualitative studies can comply with the requirement of narrowness. Nevertheless, I propose that quantitative works can be employed as sources of types in order to study token actual students. I use this type-token dichotomy to put forward an outline of a theory of the relation between school contents and mental contents. In this view, token mental contents regarding a given topic can be defined, and probed, only by resorting to typical school contents.

  17. Peroxy radical measurements with NCAR's chemical amplifier

    NASA Technical Reports Server (NTRS)

    Cantrell, Christopher; Shetter, Richard; Calvert, Jack G.

    1994-01-01

    The present NCAR instrument for HO2/RO2 measurements has been described previously. It is based on the reactions involving HO2, RO2, and HO radicals with CO and NO. Since (HO2) + (RO2) + (HO) is much greater than (HO) for most atmospheres, it is useful as a peroxy radical detector. Operation of the instrument depends on the creation of a chemical chain reaction which is initiated as HO2 and RO2 radicals in ambient air encounter added NO gas; this forms an NO2 molecule and an HO or RO radical: HO2(RO2) + NO yields HO(RO) + NO2. RO radicals react relatively efficiently with O2 to form an HO2 radical, and subsequently an HO-radical, by reaction with NO. CO gas added to the reaction chamber during part of the operating cycle, recycles the HO to HO2; HO + CO (+O2) yields HO2 + CO2. The reaction sequence may form several hundred NO2 molecules per HO2 (RO2) originally present, before chain termination occurs. The added CO is replaced by N2 addition periodically so that the chain reaction is suppressed, and a 'blank' signal resulting from NO2, O3 and possibly other NO2-forming species (non-chain processes) in ambient air is recorded. The difference between the signal with and without CO is proportional to the peroxy radical concentration. The NO2 produced is monitored using a sensitive luminol chemiluminescence detector system. In the NCAR instrument the length of the amplification chain is determined using a stable source of HO2 radicals (H2O2 thermal decomposition); the ratio of the signal seen with CO present to that with N2 present gives the sensitivity of the instrument to HO2 (molecules of NO2 formed/peroxy radical). The instrument is automated to carry out in hourly repeated cycles: (1) chain length determination; (2) NO2 calibration; and (3) linearity check on the response of signals. One minute averages of signals are normally recorded. The sensitivity of the instrument to detect peroxy radicals is in the pptv range. The present instrument has operated

  18. Fourier Transform Infrared Spectroscopy of Radicals

    NASA Astrophysics Data System (ADS)

    Rohrs, Henry William

    Radicals occur in many areas of chemistry as they are intermediates in reactions. They arise in combustion processes and several atmospheric phenomena and they have been located in interstellar space. In order to elucidate these areas of chemistry it is important to understand radicals. This is no easy task as these species are short -lived. This work focuses on determining the structure and bonding of these species using experimental measurements. Since it is specifically aimed at gas phase radicals, spectroscopy is the tool of choice for probing the radicals. This work developed a general technique for taking the rotation-vibration spectra of jet-cooled radicals. The work was based in the infrared since the desired structural information can be obtained in this region of the spectrum. The jet-cooling simplifies the enormous task of spectral assignment. A BOMEM FTIR was optically coupled to a supersonic expansion of radicals streaming from a homemade silicon carbide pyrolysis nozzle. This nozzle was heated to wall temperatures of 1500 K. A suitable organic precursor was entrained in an inert carrier gas, usually helium. Conditions were adjusted such that this precursor was nearly completely decomposed to produce high number densities of the radical of choice. The gas flows were adjusted such that the time for recombination and other radical destroying reactions were minimized. The first radical species observed was nitric oxide, NO, made from the pyrolysis of alkyl nitrites. Spectra with rotational temperatures from 20 K to 80 K were observed. This proved the viability of the method. It also demonstrated that fluid dynamics modeling and a separate photoionization mass spectrometry experiment would be invaluable aids in maximizing radical concentrations since the best chance of recording the spectra is when the most radicals are present.

  19. Surgery for Cervical Cancer

    MedlinePlus

    ... of watery brown discharge for a few weeks. Laser surgery A focused laser beam, directed through the vagina, is used to ... cervix. This is done using a surgical or laser knife (cold knife cone biopsy) or using a ...

  20. 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 – ...

  1. Brain surgery - discharge

    MedlinePlus

    ... to take these medicines. If you had a brain aneurysm , you may also have other symptoms or problems. ... chap 28. Read More Acoustic neuroma Brain abscess Brain aneurysm repair Brain surgery Brain tumor - children Brain tumor - ...

  2. Preparing for Surgery

    MedlinePlus

    ... for you before, during, and after your operation. Nurses will assist your doctor during surgery, perform special ... you are stable. As soon as possible, your nurses will have you move around as much as ...

  3. Hemostasis and Hepatic Surgery.

    PubMed

    Eeson, Gareth; Karanicolas, Paul J

    2016-04-01

    Operative blood loss is a major source of morbidity and even mortality for patients undergoing hepatic resection. This review discusses strategies to minimize blood loss and the utilization of allogeneic blood transfusion pertaining to oncologic hepatic surgery.

  4. Cataract surgery - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100079.htm Cataract surgery - series—Normal anatomy To use the sharing ... lens of an eye is normally clear. A cataract is when the lens becomes cloudy as you ...

  5. Carotid artery surgery - discharge

    MedlinePlus

    ... removed. The skin incision was closed with surgical tape. During your surgery, your heart and brain activity ... get home. It is ok if the surgical tape on your incision gets wet. DO NOT soak, ...

  6. Oophorectomy (Ovary Removal Surgery)

    MedlinePlus

    ... also be robotically assisted in certain cases. During robotic surgery, the surgeon watches a 3-D monitor ... Whether your oophorectomy is an open, laparoscopic or robotic procedure depends on your situation. Laparoscopic or robotic ...

  7. Hemorrhoid surgery - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100026.htm Hemorrhoid surgery - series—Normal anatomy To use the sharing ... empties stool from the body through the anus. Hemorrhoids are "cushions" of tissue filled with blood vessels ...

  8. American Board of Surgery

    MedlinePlus

    ... representatives from five major regional vascular surgery societies. Mar. 27, 2017 ABS Seeks New Executive Director The ... in Philadelphia. Applications are due by May 1. Mar. 10, 2017 E-News - Winter 2017 The latest ...

  9. Carotid artery surgery - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100124.htm Carotid artery surgery - series—Normal anatomy To use the sharing ... out of 4 Overview There are four carotid arteries, with a pair located on each side of ...

  10. Deep breathing after surgery

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000440.htm Deep breathing after surgery To use the sharing features on ... way to do so is by doing deep breathing exercises. Deep breathing keeps your lungs well-inflated ...

  11. 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 ...

  12. Types of Heart Surgery

    MedlinePlus

    ... conditions that make open-heart surgery very risky. Arrhythmia Treatment An arrhythmia (ah-RITH-me-ah) is a problem with ... rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, ...

  13. Blood donation before surgery

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000367.htm Blood donation before surgery To use the sharing features ... vessels. Several sources of blood are described here. Blood From the Public (Volunteer Blood Donation) The most ...

  14. Surgery for Pancreatic Cancer

    MedlinePlus

    ... but the goal is not to try to cure the cancer. Staging laparoscopy To determine which type of surgery ... the planned operation would be very unlikely to cure the cancer and could still lead to major side effects. ...

  15. Septoplasty and Turbinate Surgery

    MedlinePlus

    ... nose. Surgery on the septum can lead to stretching or injury to these nerves. This can lead ... a painless procedure that is performed in our office. A small endoscope is used to visualize the ...

  16. Breast augmentation surgery

    MedlinePlus

    ... the shape of your breasts. Talk with a plastic surgeon if you are considering breast augmentation. Discuss ... mammograms or breast x-rays before surgery. The plastic surgeon will do a routine breast exam. Several ...

  17. Heart bypass surgery - discharge

    MedlinePlus

    ... Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest . 2012;141(2 ... surgery Heart failure - overview High blood cholesterol levels Smoking - ...

  18. Cosmetic surgery: medicolegal considerations

    PubMed Central

    Piras, Mauro; Delbon, Paola; Conti, Adelaide; Capasso, Emanuele; Niola, Massimo; Bin, Paola

    2016-01-01

    Abstract Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery. PMID:28352816

  19. 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: ...

  20. 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

  1. 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. Review Date 10/ ...

  2. Anesthesia for bench surgery.

    PubMed

    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.

  3. Heart bypass surgery - slideshow

    MedlinePlus

    ... 24/2016 Updated by: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences ... reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. ...

  4. Orthognathic Surgery: General Considerations

    PubMed Central

    Khechoyan, David Y.

    2013-01-01

    Orthognathic surgery is a unique endeavor in facial surgery: a patient's appearance and occlusal function can be improved significantly, impacting the patient's sense of self and well-being. Successful outcomes in modern orthognathic surgery rely on close collaboration between the surgeon and the orthodontist across all stages of treatment, from preoperative planning to finalization of occlusion. Virtual computer planning promotes a more accurate analysis of dentofacial deformity and preoperative planning. It is also an invaluable aid in providing comprehensive patient education. In this article, the author describes the general surgical principles that underlie orthognathic surgery, highlighting the sequence of treatment, preoperative analysis of dentofacial deformity, surgical execution of the treatment plan, and possible complications. PMID:24872758

  5. Hydroxyl radical reaction with trans-resveratrol: initial carbon radical adduct formation followed by rearrangement to phenoxyl radical.

    PubMed

    Li, Dan-Dan; Han, Rui-Min; Liang, Ran; Chen, Chang-Hui; Lai, Wenzhen; Zhang, Jian-Ping; Skibsted, Leif H

    2012-06-21

    In the reaction between trans-resveratrol (resveratrol) and the hydroxyl radical, kinetic product control leads to a short-lived hydroxyl radical adduct with an absorption maximum at 420 nm and a lifetime of 0.21 ± 0.01 μs (anaerobic acetonitrile at 25 °C) as shown by laser flash photolysis using N-hydroxypyridine-2(1H)-thione (N-HPT) as a "photo-Fenton" reagent. The transient spectra of the radical adduct are in agreement with density functional theory (DFT) calculations showing an absorption maximum at 442 or 422 nm for C2 and C6 hydroxyl adducts, respectively, and showing the lowest energy for the transition state leading to the C2 adduct compared to other radical products. From this initial product, the relative long-lived 4'-phenoxyl radical of resveratrol (τ = 9.9 ± 0.9 μs) with an absorption maximum at 390 nm is formed in a process with a time constant (τ = 0.21 ± 0.01 μs) similar to the decay constant for the C2 hydroxyl adduct (or a C2/C6 hydroxyl adduct mixture) and in agreement with thermodynamics identifying this product as the most stable resveratrol radical. The hydroxyl radical adduct to phenoxyl radical conversion with concomitant water dissociation has a rate constant of 5 × 10(6) s(-1) and may occur by intramolecular hydrogen atom transfer or by stepwise proton-assisted electron transfer. Photolysis of N-HPT also leads to a thiyl radical which adds to resveratrol in a parallel reaction forming a sulfur radical adduct with a lifetime of 0.28 ± 0.04 μs and an absorption maximum at 483 nm.

  6. Robotic-assisted laparoscopic radical prostatectomy: initial 15 cases in Japan.

    PubMed

    Yoshioka, K; Hatano, T; Nakagami, Y; Ozu, C; Horiguchi, Y; Yonou, H; Tachibana, M; Coughlin, G; Patel, V R

    2008-07-01

    Recently, we have introduced robotic-assisted laparoscopic radical prostatectomy (RALP) in Japan. This article describes the details of a training program to shorten the learning curve in the absence of an urologist with expertise in robotic surgery. Five months after a 2-day training course of robotic surgery, RALP was first performed in Japan, and a total of 15 cases were performed in the subsequent 4 months. Our training program consisted of: (1) image training using surgical operation videos, (2) dry lab training using a sham pelvic cavity model, and (3) intraoperative mentoring. The operative procedure was divided into five consecutive stages, and time required to complete each stage was recorded. Robotic radical prostatectomy was completed in all patients without conversion to open surgery, except for the first patient in whom a restriction to a 2-h operation had been imposed by the ethics committee. The mean console time and the mean intraoperative blood loss (including urine) reduced from 264.2 min and 459.4 ml, respectively, in the first 11 cases, to 151 min and 133.3 ml, respectively, in the last three cases. With direct intraoperative guidance by the mentor during cases 13 and 14, the operation time was reduced at all five stages of the operative procedure. Our training program proved remarkably effective in reducing the learning curve of RALP in Japan, where there is no person with expertise in robotic surgery.

  7. Fluorescent imaging of cancerous tissues for targeted surgery

    PubMed Central

    Bu, Lihong; Shen, Baozhong; Cheng, Zhen

    2014-01-01

    To maximize tumor excision and minimize collateral damage is the primary goal of cancer surgery. Emerging molecular imaging techniques have to “image-guided surgery” developing into “molecular imaging-guided surgery”, which is termed “targeted surgery” in this review. Consequently, the precision of surgery can be advanced from tissue-scale to molecule-scale, enabling “targeted surgery” to be a component of “targeted therapy”. Evidence from numerous experimental and clinical studies has demonstrated significant benefits of fluorescent imaging in targeted surgery with preoperative molecular diagnostic screening. Fluorescent imaging can help to improve intraoperative staging and enable more radical cytoreduction, detect obscure tumor lesions in special organs, highlight tumor margins, better map lymph node metastases, and identify important normal structures intraoperatively. Though limited tissue penetration of fluorescent imaging and tumor heterogeneity are two major hurdles for current targeted surgery, multimodality imaging and multiplex imaging may provide potential solutions to overcome these issues, respectively. Moreover, though many fluorescent imaging techniques and probes have been investigated, targeted surgery remains at a proof-of-principle stage. The impact of fluorescent imaging on cancer surgery will likely be realized through persistent interdisciplinary amalgamation of research in diverse fields. PMID:25064553

  8. Bariatric surgery outcomes.

    PubMed

    Dumon, Kristoffel R; Murayama, Kenric M

    2011-12-01

    Obesity is associated with an increased risk of death, and morbid obesity carries a significant risk of life-threatening complications such as heart disease, diabetes, and high blood pressure. Bariatric surgery is recognized as the only effective treatment of morbid obesity. The estimated number of bariatric operations performed in the United States in 2008 was more than 13 times the number performed in 1992. Despite this increase, only 1% of the eligible morbidly obese population are currently treated with bariatric surgery.

  9. Neurological surgery planning system

    NASA Astrophysics Data System (ADS)

    Jiang, Charlie Z. W.; Zamorano, Lucia J.; Kadi, A. Majeed

    1993-09-01

    The computer-assisted neurological surgery planning system (NSPS), developed by the Neurological Surgery Department, Wayne State University, Detroit, MI, is designed to offer neurosurgeons a safe and accurate method to approach intracranial lesions. Software consisting of the most advanced technologies in computer vision, computer graphics, and stereotactic numeric analysis forms the kernel of the system. Our paper discusses the functionalities and background theories used in NSPS.

  10. Refining Patient Selection for Neoadjuvant Chemotherapy before Radical Cystectomy

    PubMed Central

    Culp, Stephen H.; Dickstein, Rian J.; Grossman, H. Barton; Pretzsch, Shanna M.; Porten, Sima; Daneshmand, Siamak; Cai, Jie; Groshen, Susan; Siefker-Radtke, Arlene; Millikan, Randall E.; Czerniak, Bogdan; Navai, Neema; Wszolek, Matthew F.; Kamat, Ashish M.; Dinney, Colin P. N.

    2014-01-01

    Purpose We evaluated the survival of patients with muscle invasive bladder cancer undergoing radical cystectomy without neoadjuvant chemotherapy to confirm the utility of existing clinical tools to identify low risk patients who could be treated with radical cystectomy alone and a high risk group most likely to benefit from neoadjuvant chemotherapy. Materials and Methods We identified patients with muscle invasive bladder cancer who underwent radical cystectomy without neoadjuvant chemotherapy at our institution between 2000 and 2010. Patients were considered high risk based on the clinical presence of hydroureteronephrosis, cT3b-T4a disease, and/or histological evidence of lymphovascular invasion, micropapillary or neuroendocrine features on transurethral resection. We evaluated survival (disease specific, progression-free and overall) and rate of pathological up staging. An independent cohort of patients from another institution was used to confirm our findings. Results We identified 98 high risk and 199 low risk patients eligible for analysis. High risk patients exhibited decreased 5-year overall survival (47.0% vs 64.8%) and decreased disease specific (64.3% vs 83.5%) and progression-free (62.0% vs 84.1%) survival probabilities compared to low risk patients (p <0.001). Survival outcomes were confirmed in the validation subset. On final pathology 49.2% of low risk patients had disease up staged. Conclusions The 5-year disease specific survival of low risk patients was greater than 80%, supporting the distinction of high risk and low risk muscle invasive bladder cancer. The presence of high risk features identifies patients with a poor prognosis who are most likely to benefit from neoadjuvant chemotherapy, while many of those with low risk disease can undergo surgery up front with good expectations and avoid chemotherapy associated toxicity. PMID:23911605

  11. Photobiomodulation in laser surgery

    NASA Astrophysics Data System (ADS)

    Liu, Timon Cheng-Yi; Rong, Dong-Liang; Huang, Jin; Deng, Xiao-Yuan; Liu, Song-Hao

    2006-01-01

    Laser surgery provides good exposure with clear operating fields and satisfactory preliminary functional results. In contrast to conventional excision, it was found that matrix metalloproteinases and the tissue inhibitors of metalloproteinases -1 mRNA expression is higher, myofibroblasts appeared and disappeared slower in laser excision wounds. It has been suggested that the better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes to recover vocal cord for early glottic tumors and better. In this paper, the role of photobiomodulation in laser surgery will be discussed by the cultured monolayer normal human skin fibroblast model of the photobiomodulation of marginal irradiation of high intensity laser beam, the photobiomodulation related to the irradiated tissue, the biological information model of photobiomodulation and the animal models of laser surgery. Although high intensity laser beam is so intense that it destroys the irradiated cells or tissue, its marginal irradiation intensity is so low that there is photobiomodulation on non-damage cells to modulate the regeneration of partly damaged tissue so that the surgery of laser of different parameters results in different post-surgical recovery. It was concluded that photobiomodulation might play an important role in the long-term effects of laser surgery, which might be used to design laser surgery.

  12. Surgery for childhood epilepsy

    PubMed Central

    Jayalakshmi, Sita; Panigrahi, Manas; Nanda, Subrat Kumar; Vadapalli, Rammohan

    2014-01-01

    Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In about 15% of these patients, the seizures are not adequately controlled with antiepileptic drugs; such patients are potential candidates for surgical treatment and the major proportion is in the pediatric group (18 years old or less). Epilepsy surgery in children who have been carefully chosen can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two-thirds of children with intractable seizures. Advances in structural and functional neuroimaging, neurosurgery, and neuroanaesthesia have improved the outcomes of surgery for children with intractable epilepsy. Early surgery improves the quality of life and cognitive and developmental outcome and allows the child to lead a normal life. Surgically remediable epilepsies should be identified early and include temporal lobe epilepsy with hippocampal sclerosis, lesional temporal and extratemporal epilepsy, hemispherical epilepsy, and gelastic epilepsy with hypothalamic hamartoma. These syndromes have both acquired and congenital etiologies and can be treated by resective or disconnective surgery. Palliative procedures are performed in children with diffuse and multifocal epilepsies who are not candidates for resective surgery. The palliative procedures include corpus callosotomy and vagal nerve stimulation while deep brain stimulation in epilepsy is still under evaluation. For children with “surgically remediable epilepsy,” surgery should be offered as a procedure of choice rather than as a treatment of last resort. PMID:24791093

  13. 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

  14. Cardioprotection during cardiac surgery

    PubMed Central

    Hausenloy, Derek J.; Boston-Griffiths, Edney; Yellon, Derek M.

    2012-01-01

    Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. For a large number of patients with CHD, coronary artery bypass graft (CABG) surgery remains the preferred strategy for coronary revascularization. Over the last 10 years, the number of high-risk patients undergoing CABG surgery has increased significantly, resulting in worse clinical outcomes in this patient group. This appears to be related to the ageing population, increased co-morbidities (such as diabetes, obesity, hypertension, stroke), concomitant valve disease, and advances in percutaneous coronary intervention which have resulted in patients with more complex coronary artery disease undergoing surgery. These high-risk patients are more susceptible to peri-operative myocardial injury and infarction (PMI), a major cause of which is acute global ischaemia/reperfusion injury arising from inadequate myocardial protection during CABG surgery. Therefore, novel therapeutic strategies are required to protect the heart in this high-risk patient group. In this article, we review the aetiology of PMI during CABG surgery, its diagnosis and clinical significance, and the endogenous and pharmacological therapeutic strategies available for preventing it. By improving cardioprotection during CABG surgery, we may be able to reduce PMI, preserve left ventricular systolic function, and reduce morbidity and mortality in these high-risk patients with CHD. PMID:22440888

  15. [Prostatectomy-pros and cons on open surgery/laparoscopic surgery/robot-assisted surgery].

    PubMed

    Abe, Mitsuhiro; Kawano, Yoshiyuki; Kameyama, Shuji

    2011-12-01

    We have 3 options when perfoming prostatectomy for the treatment of localized prostate cancer. Those are retropubic radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted laparoscopic radical prostatectomy. We compared the characteristics and results of these techniques. Robot-assisted laparoscopic radical prostatectomy could be superior to the others in many ways. However, it would be very difficult to adopt it in Japan because it would pose economical difficulties. The administrative assistance in the insurance systems requireds much more than we have.

  16. Alex Bloom, Pioneer of Radical State Education

    ERIC Educational Resources Information Center

    Fielding, Michael

    2005-01-01

    Alex Bloom is one of the greatest figures of radical state education in England. His approach to "personalised learning" and the development of a negotiated curriculum was immeasurably more profound and more inspiring than anything to emerge thus far from the current DfES. His approach to student voice was much more radical than anything…

  17. Ideals Adrift: An Educational Approach to Radicalization

    ERIC Educational Resources Information Center

    van San, Marion; Sieckelinck, Stijn; de Winter, Micha

    2013-01-01

    These days, the radicalization of young people is above all viewed as a security risk. Almost all research into this phenomenon has been carried out from a legal, criminological or socio-psychological perspective with a focus on detecting and containing the risks posed by radicalization. In the light of the political developments since September…

  18. THE RADICAL OF A JORDAN ALGEBRA

    PubMed Central

    McCrimmon, Kevin

    1969-01-01

    In this paper we define a Jacobson radical for Jordan algebras analogous to that for associative algebras and show that it enjoys many of the properties of the associative radical. We then relate the corresponding notion of “semisimplicity” to the previously defined notion of “nondegeneracy” (Jacobson, N., these Proceedings, 55, 243-251 (1966)). PMID:16591736

  19. Modified Pfannenstiel approach for radical retropubic prostatectomy.

    PubMed

    Manoharan, M; Gomez, Pablo; Sved, Paul; Soloway, Mark S

    2004-08-01

    Radical retropubic prostatectomy is traditionally performed using a vertical midline incision and occasionally using a transverse Pfannenstiel incision. We describe a technique for performing radical retropubic prostatectomy using a modified Pfannenstiel approach. This involves a Y incision of the rectus sheath, instead of a pure transverse incision, and provides both excellent exposure and better cosmetic results.

  20. Victimology: A Consideration of the Radical Critique.

    ERIC Educational Resources Information Center

    Friedrichs, David O.

    1983-01-01

    Discusses the emergence of a new radical model in criminology and a new subdisciplinary area of concern, victimology, with roots in Marx and Engels' original formulations. Argues that the radical understanding of victimization provides an important corrective to mainstream approaches and broadens the focus of the concept of victimization. (JAC)

  1. Free Radical Mechanisms in Autoxidation Processes.

    ERIC Educational Resources Information Center

    Simic, Michael G.

    1981-01-01

    Discusses the use of steady-state radiation chemistry and pulse radiolysis for the generation of initial free radicals and formation of peroxy radicals in the autoxidation process. Provides information regarding the autoxidation process. Defines autoxidation reactions and antioxidant action. (CS)

  2. Organic chemistry: A radical step forward

    NASA Astrophysics Data System (ADS)

    Zhang, Wenhao; Li, Ang

    2017-02-01

    Free radicals are notorious for unselective coupling reactions; however, the coupling of free radicals generated from acyl tellurides has now been shown to form C-C bonds with remarkable fidelity, which enables easy one-step assembly of densely oxygenated natural product motifs.

  3. Radical Behaviorism and Buddhism: Complementarities and Conflicts

    ERIC Educational Resources Information Center

    Diller, James W.; Lattal, Kennon A.

    2008-01-01

    Comparisons have been made between Buddhism and the philosophy of science in general, but there have been only a few attempts to draw comparisons directly with the philosophy of radical behaviorism. The present review therefore considers heretofore unconsidered points of comparison between Buddhism and radical behaviorism in terms of their…

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

    PubMed

    Olejek, A

    2006-01-01

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

  5. Measurement of atmospheric radicals by chemical amplification

    NASA Astrophysics Data System (ADS)

    Arias, Maria Corina

    1998-11-01

    In this work, atmospheric radicals were measured using the chemical amplification technique. To calibrate the chemical amplifier, an UV water photolysis radical source was built and tested. This source proved to be reliable and portable, and capable of delivering radical concentrations within the range of values found in the troposphere. We tested the performance of our instrument at the Peroxy Radical InterComparison Exercise II (PRICE II). In this intercomparison seven chemical amplifiers participated measuring several HO2 and CH3O2 concentrations. Results from this campaign indicate that all of the chemical amplifiers are equally capable of measuring HO2 and CH3O2 radicals from two different radical sources (ICG-HO2 source and UEA- CH3O2 source). The average response towards the ICG and UEA sources were 70% and 45%, respectively. Losses in the delivery system are thought to be responsible for these low responses. Radical measurements were taken at 4 contrasting sites: Atlantic '96 (clean continental), SONTOS '92 and '93 (rural), Calabozo '93 (tropical clean continental), and Pacific '93 (predominantly urban), where maximum ROx concentrations ranged from 17 to 52 pptv. These values are consistent with those found in the literature for similar regions. The measured radical concentrations reflect the interaction between the main production and loss processes at the different sites, as for example ozone photolysis and HNO3 formation. At Calabozo, the combination of moderate O3, low NOx and small Zenith angles resulted in the highest ROx measured. At the Pacific '93 site, O3 is higher, but NOx concentrations are also very high, enhancing the radical loss processes, and explaining the moderate radical concentrations observed. At Atlantic '96 the very low NOx concentration might account for the radical concentrations observed, even in the presence of low O3 concentrations. At SONTOS, the highest ozone concentrations were observed, so we would expect the radical

  6. Laparoscopic Surgery - What Is It?

    MedlinePlus

    ... Surgery - What is it? Laparoscopic Surgery - What is it? Laparoscopic Surgery - What is it? | ASCRS WHAT IS LAPAROSCOPIC SURGERY? Laparoscopic or “minimally ... information about the management of the conditions addressed. It should be recognized that these brochures should not ...

  7. Progressive Paraparesis after CABG Surgery

    PubMed Central

    Shadvar, Kamran; Eslampoor, Yashar

    2013-01-01

    CABG is one of the most common cardiac surgeries all over the world. Similar to other surgeries, it may be associated with some undesirable complications including neurologic complications which might cause morbidity and mortality after surgery. We will describe a case of Progressive Paraparesis after CABG Surgery and review its etiology, diagnosis and management. PMID:24251008

  8. Synchrotron threshold photoelectron photoion coincidence spectroscopy of radicals produced in a pyrolysis source: The methyl radical

    NASA Astrophysics Data System (ADS)

    Zhu, Yupeng; Wu, Xiangkun; Tang, Xiaofeng; Wen, Zuoying; Liu, Fuyi; Zhou, Xiaoguo; Zhang, Weijun

    2016-11-01

    We present here a flash pyrolysis source coupled with a threshold photoelectron photoion coincidence (TPEPICO) spectrometer and vacuum ultraviolet synchrotron radiation to investigate the spectroscopy and photochemistry of free radicals. The radicals are produced from pyrolysis in a heated silicon carbide tube, and the TPEPICO scheme provides a strategy to obtain pure spectra of the radicals without contamination from other byproducts. As a representative example, the methyl radical was studied, and its threshold photoelectron spectrum shows a series of umbrella vibrational transitions. The adiabatic ionization energy of the methyl radical was determined to be 9.84 ± 0.01 eV.

  9. Polymers based on stable phenoxyl radicals for the use in organic radical batteries.

    PubMed

    Jähnert, Thomas; Häupler, Bernhard; Janoschka, Tobias; Hager, Martin D; Schubert, Ulrich S

    2014-05-01

    Polymers with pendant phenoxyl radicals are synthesized and the electrochemical properties are investigated in detail. The monomers are polymerized using ring-opening metathesis polymerization (ROMP) or free-radical polymerization methods. The monomers and polymers, respectively, are oxidized to the radical either before or after the polymerization. These phenoxyl radicals containing polymers reveal a reversible redox behavior at a potential of -0.6 V (vs Ag/AgCl). Such materials can be used as anode-active material in organic radical batteries (ORBs).

  10. Comparison of postoperative acute kidney injury between ileal conduit and neobladder urinary diversions after radical cystectomy

    PubMed Central

    Joung, Kyoung-Woon; Kong, Yu-Gyeong; Yoon, Syn-Hae; Kim, Yeon Ju; Hwang, Jai-Hyun; Hong, Bumsik; Kim, Young-Kug

    2016-01-01

    Abstract Ileal conduit and neobladder urinary diversions are frequently performed after radical cystectomy. However, complications after radical cystectomy may be different according to the type of urinary diversion. Acute kidney injury (AKI) is a common complication after surgery and increases costs, morbidity, and mortality of hospitalized patients. This study was performed to compare the incidence of postoperative AKI between ileal conduit and neobladder urinary diversions after radical cystectomy. All consecutive patients who underwent radical cystectomy in 2004 to 2014 in a single tertiary care center were identified. The patients were divided into the ileal conduit and ileal neobladder groups. Preoperative variables, including demographics, cancer-related data and laboratory values, as well as intraoperative data and postoperative outcomes, including AKI, intensive care unit admission rate, and the duration of hospital stay, were evaluated between the groups. Postoperative AKI was defined according to the Kidney Disease: Improving Global Outcome criteria. Propensity score matching analysis was performed to reduce the influence of possible confounding variables and adjust for intergroup differences. After performing 1:1 propensity score matching, the ileal conduit and ileal neobladder groups each included 101 patients. The overall incidence of AKI after radical cystectomy was 30.7% (62 out of 202) and the incidences did not significantly differ between the groups (27 [26.7%], ileal conduit group vs 35 [34.7%], ileal neobladder group, P = 0.268). Intraoperative data, intensive care unit admission rate, and the duration of hospital stay were not significantly different between the groups. Postoperative AKI did not significantly differ between ileal conduit and neobladder urinary diversions after radical cystectomy. This finding provides additional information useful for appropriate selection of the urinary diversion type in conjunction with radical cystectomy

  11. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection

    PubMed Central

    Cueto Ladrón de Guevara, Antonio; Puche, Jose L.; Ruiz Zafra, Javier; de Miguel-Pérez, Diego; Ramos, Abel Sánchez-Palencia; Giraldo-Ospina, Carlos Fernando; Navajas Gómez, Juan A.; Delgado-Rodriguez, Miguel; Lorente, Jose A.; Serrano, María Jose

    2016-01-01

    Background Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC) stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs) is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC. Patients and Methods 56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR) expression. Results 51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1%) (p = 0.035). The mean number of CTCs was 3.16 per 10 ml (range 0–84) preoperatively and 0.66 (range 0–3) in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018) and a shorter disease free survival (DFS) (p = .008). In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50–21.946, p = 0.010) and N status (HR = 0.296, 95% CI: 0.091–0.961, p = 0.043) were independent prognostic factors for DFS. Conclusion CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence. PMID:26913536

  12. Characteristics of Radical Reactions, Spin Rules, and a Suggestion for the Consistent Use of a Dot on Radical Species

    ERIC Educational Resources Information Center

    Wojnarovits, Laszlo

    2011-01-01

    In many chemical reactions, reactive radicals have been shown to be transient intermediates. The free radical character of a chemical species is often, but not always, indicated by adding a superscript dot to the chemical formula. A consistent use of this radical symbol on all species that have radical character is suggested. Free radicals have a…

  13. Radical cation cyclization of 1,5-hexadiene to cyclohexene via the cyclohexane-2,5-diyl radical cation intermediate

    SciTech Connect

    Guo, Q.X.; Qin, X.Z.; Wang, J.T.; Williams, F.

    1988-03-16

    The classical example of a neutral carbon-centered radical cyclization reaction is the regioselective 1,5-ring closure (exocyclization) of the 5-hexenyl radical to the cyclopentylcarbinyl radical. Here the authors report the title reaction, a comparable addition process whereby an ..cap alpha.., omega-diene radical cation reacts by endocyclization and hydrogen shift(s) to produce a cycloolefin radical cation.

  14. [New aspects in hernia surgery].

    PubMed

    Lammers, B J; Goretzki, P E; Otto, T

    2005-07-01

    In the last 10 years in Germany we have seen a lot of hernia repairs using mesh.Meta-analysis shows the advantages of using meshes in hernia surgery; recurrence rates in inguinal hernia surgery are less than 3% in studies. There is some discussion about minimally invasive surgery in Germany.In incisional hernia surgery there is no discussion about using meshes. The role of minimally invasive surgery has not yet been defined.

  15. Halogenated silanes, radicals, and cations

    NASA Astrophysics Data System (ADS)

    Wang, Liming; He, Yi-Liang

    2008-09-01

    Quantum chemistry study has been carried out on the structure and energetics of halogenated silanes, radicals, and cations (SiHxXy0,+1, X = F, Cl, Br; x + y = 1-4). The geometries are optimized at B3LYP/6-31+G(2df,p) level. The adiabatic ionization energiess (IEas), relative energetics of cations, proton affinities (PAs) of silanes, and the enthalpies of formation are predicted using G3(CC) model chemistry. Non-classical ion complex structures are found for hydrogenated cations and transition states connecting classical and non-classical structures are also located. The most stable cations for silylene and silyl radicals have their classical divalent and trivalent structures, and those for silanes have non-classical structures except for SiH3Br+ and SiH2Br2+. The non-classical structures for halosilane cations imply difficulty in experimentally measurement of the adiabatic ionization energies using photoionization or photoelectron studies. For SiH3X, SiH2X2, and SiHX3, the G3(CC) adiabatic IEas to classical ionic structures closest to their neutrals agree better with the photoelectron spectroscopic measurements. The transition states between classical and non-classical structures also hamper the photoionization determination of the appearance energies for silylene cations from silanes. The G3(CC) results for SiHx0,+1 agree excellently with the photoionization mass spectrometric study, and the results for fluorinated and chlorinated species also agree with the previous theoretical predictions at correlation levels from BAC-MP4 to CCSD(T)/CBS. The predicted enthalpy differences between SiH2Cl+, SiHCl2+, and SiCl3+ are also in accordance with previous kinetics study. The G3(CC) results show large discrepancies to the collision-induced charge transfer and/or dissociation reactions involving SiFx+ and SiClx+ ions, for which the G3(CC) enthalpies of formation are also significantly differed from the previous theoretical predictions, especially on SiFx+ (x = 2-4). The G3

  16. [High-tech methods in pediatric surgery].

    PubMed

    Kirgizov, I V; Seniakovich, V M; Shishkin, I A

    2011-01-01

    Scientific and technical progress resulting in the introduction of high technologies in medicine radically changed the concept of surgical treatment of children. It is currently based on low-traumatic and minimally invasive methods for surgical intervention. High-tech surgical interventions implies the availability of modern sophisticated equipment and adequate anesthesiological support with comprehensive intraoperative monitoring all vitally important parameters. In the postoperative period, part of the patients need adequate (sometimes long-term) parenteral feeding with the application of long-term Broviak catheters and Space B-Braun systems. The use of this equipment in our Centre makes possible surgical treatment of children at a qualitatively new (low-traumatic and minimally invasive) level and reduce the duration of surgery by 50% compared with traditional methods.

  17. Organ preservation surgery for laryngeal cancer

    PubMed Central

    Chawla, Sharad; Carney, Andrew Simon

    2009-01-01

    The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented. PMID:19442314

  18. General surgery, translational lymphology and lymphatic surgery.

    PubMed

    Campisi, C; Witte, M H; Fulcheri, E; Campisi, C; Bellini, C; Villa, G; Campisi, C; Santi, P L; Parodi, A; Murdaca, G; Puppo, F; Boccardo, F

    2011-12-01

    A wide clinical experience in General Surgery has brought about a remarkable knowledge about lymphatic disorders both primary and secondary ones. Diagnostic and histopathological studies of lymphatic diseases allowed to better understand etiological aspects and pathophysiological mechanisms responsible of complex clinical features correlated to lymphatic dysfunctions. Translational lymphologic basic and clinical researches permitted to improve therapeutical approaches both from the medical and surgical point of view. Thus, strategies of treatment were proposed to prevent lymphatic injuries, to avoid lymphatic complications and to treat lymphatic diseases early in order to be able even to cure these pathologies.

  19. Robot-assisted versus other types of radical prostatectomy: population-based safety and cost comparison in Japan, 2012-2013.

    PubMed

    Sugihara, Toru; Yasunaga, Hideo; Horiguchi, Hiromasa; Matsui, Hiroki; Fujimura, Tetsuya; Nishimatsu, Hiroaki; Fukuhara, Hiroshi; Kume, Haruki; Changhong, Yu; Kattan, Michael W; Fushimi, Kiyohide; Homma, Yukio

    2014-11-01

    In 2012, Japanese national insurance started covering robot-assisted surgery. We carried out a population-based comparison between robot-assisted and three other types of radical prostatectomy to evaluate the safety of robot-assisted prostatectomy during its initial year. We abstracted data for 7202 open, 2483 laparoscopic, 1181 minimal incision endoscopic, and 2126 robot-assisted radical prostatectomies for oncological stage T3 or less from the Diagnosis Procedure Combination database (April 2012-March 2013). Complication rate, transfusion rate, anesthesia time, postoperative length of stay, and cost were evaluated by pairwise one-to-one propensity-score matching and multivariable analyses with covariants of age, comorbidity, oncological stage, hospital volume, and hospital academic status. The proportion of robot-assisted radical prostatectomies dramatically increased from 8.6% to 24.1% during the first year. Compared with open, laparoscopic, and minimal incision endoscopic surgery, robot-assisted surgery was generally associated with a significantly lower complication rate (odds ratios, 0.25, 0.20, 0.33, respectively), autologous transfusion rate (0.04, 0.31, 0.10), homologous transfusion rate (0.16, 0.48, 0.14), lower cost excluding operation (differences, -5.1%, -1.8% [not significant], -10.8%) and shorter postoperative length of stay (-9.1%, +0.9% [not significant], -18.5%, respectively). However, robot-assisted surgery also resulted in a + 42.6% increase in anesthesia time and +52.4% increase in total cost compared with open surgery (all P < 0.05). Introduction of robotic surgery led to a dynamic change in prostate cancer surgery. Even in its initial year, robot-assisted radical prostatectomy was carried out with several favorable safety aspects compared to the conventional surgeries despite its having the longest anesthesia time and the highest cost.

  20. Joint Manipulation Under Anesthesia for Arthrofibrosis After Hallux Valgus Surgery.

    PubMed

    Feuerstein, Catherine; Weil, Lowell; Weil, Lowell Scott; Klein, Erin E; Argerakis, Nicholas; Fleischer, Adam E

    2016-01-01

    Arthrofibrosis is a known complication of hallux valgus surgery. Joint manipulation under anesthesia has been studied for adhesive capsulitis of the shoulder; however, a paucity of published data exists on the use of this modality in the foot and ankle. The purpose of the present study was to investigate the outcomes of first metatarsophalangeal joint manipulation for arthrofibrosis that occurred as a complication of bunion surgery. The study population consisted of patients attending a single foot and ankle specialty clinic who were evaluated for arthrofibrosis after bunion surgery. Patients who underwent joint manipulation under anesthesia were asked to complete a research visit in which a clinical examination was performed and the presence and severity of joint pain were assessed. A total of 38 patients (34 females, 4 males, 53 feet), with a mean age of 55.7 ± 11.8 (range 30 to 83) years, agreed to participate. The mean follow-up period was 6.5 ± 3.4 (range 1 to 17) years. The visual analog scale scores improved significantly from baseline to the final follow-up visit (baseline 6.5 ± 1.5, range 2 to 10; final follow-up visit 2.3 ± 1.5, range 0 to 6; p < .001). Furthermore, joint motion had increased significantly (p < .001) for both dorsiflexion and plantarflexion at the final follow-up examination. The final range of motion (dorsiflexion, r = -0.431, p = .002; plantarflexion, r = -0.494, p < .001) correlated highly with patient self-reported pain in the first metatarsophalangeal joint. Our findings suggest that joint manipulation could be a useful modality for increasing first metatarsophalangeal joint mobility and alleviating pain in patients who experience arthrofibrosis after surgical correction of hallux valgus.

  1. Longterm quality of life after oncologic surgery and microvascular free flap reconstruction in patients with oral squamous cell carcinoma

    PubMed Central

    Raschke, Gregor-Franziskus; Guentsch, Arndt; Roshanghias, Korosh; Eichmann, Francy; Schultze-Mosgau, Stefan

    2016-01-01

    Background Quality of life (QoL) has become increasingly important in cancer treatment. It refers to the patient’s perception of the effects of the disease and therapy, and their impact on daily functioning and general feeling of well being. Material and Methods n this prospective study, a total of 100 patients treated at our institution, completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and the specific EORTC QLQ-H&N35 module. The questionnaires were distributed to the patients between 12 and 60 months postoperatively. Results Global QoL score was 58.3 and mean score for functioning scale was 76.7. Fatigue (28.7 ± 26.1), followed by financial problems (27.7 ± 33.5), insomnia (26.7 ± 34.5) and pain (26.3 ± 29.9) had highest symptom score on QLQ-C30. Fatigue (r=-0.488), insomnia (r=-0.416) and pain (r =-0.448) showed highest value for significantly negative correlation to global QoL. In the H&N35 module, restriction of mouth opening (43.3 ± 38.6), dry mouth (40.7 ± 36.9), sticky saliva (37.3 ± 37.1) and eating in public (33.8 ± 31.9) were the four worst symptoms. Swallowing problem (r=-0.438), eating in public (r=-0.420) and persistent severe speech (r=-0.398) ranked as the three worst symptoms with highest value for significantly negative correlation to global QoL. Conclusions Longterm QoL after oncologic surgery and microvascular free flap reconstruction in patients with oral cancer is satisfactory. Measuring QoL should be considered as part of the evaluation of cancer treatment. Key words:Longterm quality of life, oral cancer, oncologic surgery, microvascular free flap reconstruction. PMID:27031070

  2. Erectile preservation following radical prostatectomy

    PubMed Central

    Segal, Robert; Burnett, Arthur L.

    2011-01-01

    Prostate cancer is the most common cancer among men, representing approximately 25% of all new cancer diagnoses in the USA. For clinically localized prostate cancer, the gold standard for therapy remains radical prostatectomy. One of the main adverse effects of this procedure is erectile dysfunction, which can have a significant impact on the patient’s quality of life. There are several mechanisms of erectile dysfunction postprostatectomy, including arteriogenic, venogenic and neurogenic types, as well as the potentially heightened risk of postprostatectomy patients to develop Peyronie’s disease. The purpose of this review is to explain the various treatment options available, including phosphodiesterase type 5 inhibitors, intracavernosal injections, intraurethral alprostadil suppositories, vacuum erection devices, and penile prostheses. The role of these therapies in an erectile-dysfunction-treatment function, as well as in penile rehabilitation, will be discussed. Finally, a review of research on novel therapies will also be presented. A comprehensive literature review was performed using the PubMed database. Articles were chosen based on topical relevance and assessed for methodology and major findings. There are data to support the use of each of the therapeutic options in both treatment and rehabilitative roles. More study is needed, however, specifically in regard to penile rehabilitation, to confirm its benefits, as well as to determine optimal rehabilitation protocols. PMID:21789097

  3. Erectile preservation following radical prostatectomy.

    PubMed

    Segal, Robert; Burnett, Arthur L

    2011-02-01

    Prostate cancer is the most common cancer among men, representing approximately 25% of all new cancer diagnoses in the USA. For clinically localized prostate cancer, the gold standard for therapy remains radical prostatectomy. One of the main adverse effects of this procedure is erectile dysfunction, which can have a significant impact on the patient's quality of life. There are several mechanisms of erectile dysfunction postprostatectomy, including arteriogenic, venogenic and neurogenic types, as well as the potentially heightened risk of postprostatectomy patients to develop Peyronie's disease. The purpose of this review is to explain the various treatment options available, including phosphodiesterase type 5 inhibitors, intracavernosal injections, intraurethral alprostadil suppositories, vacuum erection devices, and penile prostheses. The role of these therapies in an erectile-dysfunction-treatment function, as well as in penile rehabilitation, will be discussed. Finally, a review of research on novel therapies will also be presented. A comprehensive literature review was performed using the PubMed database. Articles were chosen based on topical relevance and assessed for methodology and major findings. There are data to support the use of each of the therapeutic options in both treatment and rehabilitative roles. More study is needed, however, specifically in regard to penile rehabilitation, to confirm its benefits, as well as to determine optimal rehabilitation protocols.

  4. Kinetics of Propargyl Radical Dissociation.

    PubMed

    Klippenstein, Stephen J; Miller, James A; Jasper, Ahren W

    2015-07-16

    Due to the prominent role of the propargyl radical for hydrocarbon growth within combustion environments, it is important to understand the kinetics of its formation and loss. The ab initio transition state theory-based master equation method is used to obtain theoretical kinetic predictions for the temperature and pressure dependence of the thermal decomposition of propargyl, which may be its primary loss channel under some conditions. The potential energy surface for the decomposition of propargyl is first mapped at a high level of theory with a combination of coupled cluster and multireference perturbation calculations. Variational transition state theory is then used to predict the microcanonical rate coefficients, which are subsequently implemented within the multiple-well multiple-channel master equation. A variety of energy transfer parameters are considered, and the sensitivity of the thermal rate predictions to these parameters is explored. The predictions for the thermal decomposition rate coefficient are found to be in good agreement with the limited experimental data. Modified Arrhenius representations of the rate constants are reported for utility in combustion modeling.

  5. Consciousness: the radical plasticity thesis.

    PubMed

    Cleeremans, Axel

    2008-01-01

    In this chapter, I sketch a conceptual framework which takes it as a starting point that conscious and unconscious cognition are rooted in the same set of interacting learning mechanisms and representational systems. On this view, the extent to which a representation is conscious depends in a graded manner on properties such as its stability in time or its strength. Crucially, these properties are accrued as a result of learning, which is in turn viewed as a mandatory process that always accompanies information processing. From this perspective, consciousness is best characterized as involving (1) a graded continuum defined over "quality of representation", such that availability to consciousness and to cognitive control correlates with quality, and (2) the implication of systems of metarepresentations. A first implication of these ideas is that the main function of consciousness is to make flexible, adaptive control over behavior possible. A second, much more speculative implication, is that we learn to be conscious. This I call the "radical plasticity thesis"--the hypothesis that consciousness emerges in systems capable not only of learning about their environment, but also about their own internal representations of it.

  6. Robotic surgery in gynecology.

    PubMed

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes

    2016-01-01

    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  7. 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.

  8. Robotic surgery in gynecology

    PubMed Central

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes

    2016-01-01

    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the “patient cart,” an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the “patient cart” provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology. PMID:27990092

  9. Percutaneous forefoot surgery.

    PubMed

    Bauer, T

    2014-02-01

    Percutaneous methods can be used to perform many surgical procedures on the soft tissues and bones of the forefoot, thereby providing treatment options for all the disorders and deformities seen at this site. Theoretical advantages of percutaneous surgery include lower morbidity rates and faster recovery with immediate weight bearing. Disadvantages are the requirement for specific equipment, specific requirements for post-operative management, and lengthy learning curve. At present, percutaneous hallux valgus correction is mainly achieved with chevron osteotomy of the first metatarsal, for which internal fixation and a minimally invasive approach (2 cm incision) seem reliable and reproducible. This procedure is currently the focus of research and evaluation. Percutaneous surgery for hallux rigidus is simple and provides similar outcomes to those of open surgery. Lateral metatarsal malalignment and toe deformities are good indications for percutaneous treatment, which produces results similar to those of conventional surgery with lower morbidity rates. Finally, fifth ray abnormalities are currently the ideal indication for percutaneous surgery, given the simplicity of the procedure and post-operative course, high reliability, and very low rate of iatrogenic complications. The most commonly performed percutaneous techniques are described herein, with their current indications, main outcomes, and recent developments.

  10. Cardiac surgery 2015 reviewed.

    PubMed

    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria

    2016-10-01

    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  11. 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.

  12. Involvement of free radicals in breast cancer.

    PubMed

    Ríos-Arrabal, Sandra; Artacho-Cordón, Francisco; León, Josefa; Román-Marinetto, Elisa; Del Mar Salinas-Asensio, María; Calvente, Irene; Núñez, Maria Isabel

    2013-08-27

    Researchers have recently shown an increased interest in free radicals and their role in the tumor microenvironment. Free radicals are molecules with high instability and reactivity due to the presence of an odd number of electrons in the outermost orbit of their atoms. Free radicals include reactive oxygen and nitrogen species, which are key players in the initiation and progression of tumor cells and enhance their metastatic potential. In fact, they are now considered a hallmark of cancer. However, both reactive species may contribute to improve the outcomes of radiotherapy in cancer patients. Besides, high levels of reactive oxygen species may be indicators of genotoxic damage in non-irradiated normal tissues. The purpose of this article is to review recent research on free radicals and carcinogenesis in order to understand the pathways that contribute to tumor malignancy. This review outlines the involvement of free radicals in relevant cellular events, including their effects on genetic instability through (growth factors and tumor suppressor genes, their enhancement of mitogenic signals, and their participation in cell remodeling, proliferation, senescence, apoptosis, and autophagy processes; the possible relationship between free radicals and inflammation is also explored. This knowledge is crucial for evaluating the relevance of free radicals as therapeutic targets in cancer.

  13. Magnetic fields, radicals and cellular activity.

    PubMed

    Montoya, Ryan D

    2017-01-01

    Some effects of low-intensity magnetic fields on the concentration of radicals and their influence on cellular functions are reviewed. These fields have been implicated as a potential modulator of radical recombination rates. Experimental evidence has revealed a tight coupling between cellular function and radical pair chemistry from signaling pathways to damaging oxidative processes. The effects of externally applied magnetic fields on biological systems have been extensively studied, and the observed effects lack sufficient mechanistic understanding. Radical pair chemistry offers a reasonable explanation for some of the molecular effects of low-intensity magnetic fields, and changes in radical concentrations have been observed to modulate specific cellular functions. Applied external magnetic fields have been shown to induce observable cellular changes such as both inhibiting and accelerating cell growth. These and other mechanisms, such as cell membrane potential modulation, are of great interest in cancer research due to the variations between healthy and deleterious cells. Radical concentrations demonstrate similar variations and are indicative of a possible causal relationship. Radicals, therefore, present a possible mechanism for the modulation of cellular functions such as growth or regression by means of applied external magnetic fields.

  14. Vitamin a deficiency after gastric bypass surgery: an underreported postoperative complication.

    PubMed

    Zalesin, Kerstyn C; Miller, Wendy M; Franklin, Barry; Mudugal, Dharani; Rao Buragadda, Avdesh; Boura, Judith; Nori-Janosz, Katherine; Chengelis, David L; Krause, Kevin R; McCullough, Peter A

    2011-01-01

    Introduction. Few data are available on vitamin A deficiency in the gastric bypass population. Methods. We performed a retrospective chart review of gastric bypass patients (n = 69, 74% female). The relationship between serum vitamin A concentration and markers of protein metabolism at 6-weeks and 1-year post-operative were assessed. Results. The average weight loss at 6-weeks and 1-year following surgery was 20.1 ± 9.1 kg and 44.1 ± 17.1 kg, respectively. At 6 weeks and 1 year after surgery, 35% and 18% of patients were vitamin A deficient, (<325 mcg/L). Similarly, 34% and 19% had low pre-albumin levels (<18 mg/dL), at these time intervals. Vitamin A directly correlated with pre-albumin levels at 6 weeks (r = 0.67, P < 0.001) and 1-year (r = 0.67,  P < 0.0001). There was no correlation between the roux limb length measurement and pre-albumin or vitamin A serum concentrations at these post-operative follow-ups. Vitamin A levels and markers of liver function testing were also unrelated. Conclusion. Vitamin A deficiency is common after bariatric surgery and is associated with a low serum concentration of pre-albumin. This fat-soluble vitamin should be measured in patients who have undergone gastric bypass surgery and deficiency should be suspected in those with evidence of protein-calorie malnutrition.

  15. Outcomes of surgery among the Medicare aged: mortality after surgery.

    PubMed

    Lubitz, J; Riley, G; Newton, M

    1985-01-01

    This study examines post-surgical mortality, up to 1 year after surgery, for eight common operations among aged Medicare enrollees. The operations with the highest mortality in the 1.5 months after surgery were femur fracture reduction, hip arthroplasty (other, i.e., not total replacement), and coronary artery bypass. Mortality was still above average for femur fracture reduction, hip arthroplasty (other), and transurethral prostatectomy 1 year after surgery. The highest mortality rates following surgery were for people 85 years of age or over. This raises the following question: Should certain elective surgery be performed at younger ages if it appears that surgery may eventually be needed?

  16. Pathways of arachidonic acid peroxyl radical reactions and product formation with guanine radicals.

    PubMed

    Crean, Conor; Geacintov, Nicholas E; Shafirovich, Vladimir

    2008-02-01

    Peroxyl radicals were derived from the one-electron oxidation of polyunsaturated fatty acids by sulfate radicals that were generated by the photodissociation of peroxodisulfate anions in air-equilibrated aqueous solutions. Reactions of these peroxyl and neutral guanine radicals, also generated by oxidation with sulfate radicals, were investigated by laser kinetic spectroscopy, and the guanine oxidation products were identified by HPLC and mass spectrometry methods. Sulfate radicals rapidly oxidize arachidonic (ArAc), linoleic (LnAc), and palmitoleic (PmAc) acids with similar rate constants, (2-4) x 10 (9) M (-1) s (-1). The C-centered radicals derived from the oxidation of ArAc and LnAc include nonconjugated Rn(.) ( approximately 80%) and conjugated bis-allylic Rba(.) ( approximately 20%) radicals. The latter were detectable in the absence of oxygen by their prominent, narrow absorption band at 280 nm. The Rn(.) radicals of ArAc (containing three bis-allylic sites) transform to the Rba(.) radicals via an intramolecular H-atom abstraction [rate constant (7.5 +/- 0.7) x 10 (4) s (-1)]. In contrast, the Rn(.) radicals of LnAc that contain only one bis-allylic site do not transform intramolecularly to the Rba(.) radicals. In the case of PmAc, which contains only one double bond, the Rba(.) radicals are not observed. The Rn(.) radicals of PmAc rapidly combine with oxygen with a rate constant of (3.8 +/- 0.4) x 10(9) M(-1) s(-1). The Rba(.) radicals of ArAc are less reactive and react with oxygen with a rate constant of (2.2 +/- 0.2) x 10 (8) M (-1) s (-1). The ArAc peroxyl radicals formed spontaneously eliminate superoxide radical anions [rate constant = (3.4 +/- 0.3) x 10 (4) M (-1) s (-1)]. The stable oxidative lesions derived from the 2',3',5'-tri- O-acetylguanosine or 2',3',5'-tri- O-acetyl-8-oxo-7,8-dihydroguanosine radicals and their subsequent reactions with ArAc peroxyl radicals were also investigated. The major products found were the 2,5-diamino-4 H

  17. Transumbilical Surgery for Duodenal Stenosis in a Child with Situs Inversus: The First Report

    PubMed Central

    Ueno, Yu; Mukai, Wataru; Imaji, Reisuke; Akiyama, Takashi

    2017-01-01

    Background. Situs inversus is a rare congenital anomaly with a reported incidence of only 1 in 5,000 to 10,000 live births. Congenital duodenal stenosis complicated with situs inversus is an even rarer entity. Case Presentation. A 1-year-old girl with situs inversus who had undergone a hemi-Fontan procedure against a single ventricle in our hospital was referred to our department for vomiting and failure to thrive. An upper gastrointestinal contrast study and endoscopy revealed duodenal stenosis. A transumbilical radical operation as a minimally invasive surgery was successfully performed. After the surgery, she stopped vomiting, and the postoperative course was uneventful with good cosmetic results. Conclusions. To our knowledge, this is the first report of transumbilical surgery for congenital duodenal stenosis with situs inversus as minimally invasive surgery. Transumbilical surgery to situs inversus patient can be performed safely and lead to good cosmetic outcome. PMID:28386502

  18. [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.

  19. 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

  20. Ethics in global surgery.

    PubMed

    Wall, Anji E

    2014-07-01

    Global surgery, while historically a small niche, is becoming a larger part of the global health enterprise. This article discusses the burden of global surgery, emphasizing the importance of addressing surgical needs in low- and middle-income countries. It describes the barriers to surgical care in the developing world, the ethical challenges that these barriers create, and strategies to overcome these barriers. It emphasizes the crucial role of preparation for global surgical interventions as a way to maximize benefits as well as minimize harms and ethical challenges. It ends with the cautionary statement that preparation does not eliminate ethical problems, so surgical volunteers must be prepared not only for the technical challenges of global surgery but also for the ethical challenges.

  1. [Antimicrobial prophylaxis in surgery].

    PubMed

    Cisneros, José Miguel; Rodríguez-Baño, Jesús; Mensa, José; Trilla, Antoni; Cainzos, Miguel

    2002-01-01

    Antimicrobial prophylaxis in surgery refers to a very brief course of an antimicrobial agent initiated just before the start of the procedure. The efficacy of antimicrobials to prevent postoperative infection at the site of surgery (incisional superficial, incisional deep, or organ/space infection) has been demonstrated for many surgical procedures. Nevertheless, the majority of studies centering on the quality of preoperative prophylaxis have found that a high percentage of the antimicrobials used are inappropriate for this purpose. This work discusses the scientific basis for antimicrobial prophylaxis, provides general recommendations for its correct use and specific recommendations for various types of surgery. The guidelines for surgical antimicrobial prophylaxis are based on results from well-designed studies, whenever possible. These guidelines are focussed on reducing the incidence of infection at the surgical site while minimizing the contribution of preoperative administration of antimicrobials to the development of bacterial resistance.

  2. Robotic aortic surgery.

    PubMed

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean

    2011-01-01

    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  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. Canted magnetic ground state of quarter-doped manganites R 0.75Ca0.25MnO3 (R  =  Y, Tb, Dy, Ho, and Er).

    PubMed

    Sinclair, R; Cao, H B; Garlea, V O; Lee, M; Choi, E S; Dun, Z L; Dong, S; Dagotto, E; Zhou, H D

    2017-02-15

    Polycrystalline samples of the quarter-doped manganites R 0.75Ca0.25MnO3 (R  =  Y, Tb, Dy, Ho, and Er) were studied by x-ray diffraction and AC/DC susceptibility measurements. All five samples are orthorhombic and exhibit similar magnetic properties: enhanced ferromagnetism below T 1 (∼80 K) and a spin glass (SG) state below T SG (∼30 K). With increasing R (3+) ionic size, both T 1 and T SG generally increase. The single crystal neutron diffraction results on Tb0.75Ca0.25MnO3 revealed that the SG state is mainly composed of a short-range ordered version of a novel canted (i.e. noncollinear) antiferromagnetic spin state. Furthermore, calculations based on the double exchange model for quarter-doped manganites reveal that this new magnetic phase provides a transition state between the ferromagnetic state and the theoretically predicted spin-orthogonal stripe phase.

  5. Canted magnetic ground state of quarter-doped manganites R 0.75Ca0.25MnO3 (R  =  Y, Tb, Dy, Ho, and Er)

    NASA Astrophysics Data System (ADS)

    Sinclair, R.; Cao, H. B.; Garlea, V. O.; Lee, M.; Choi, E. S.; Dun, Z. L.; Dong, S.; Dagotto, E.; Zhou, H. D.

    2017-02-01

    Polycrystalline samples of the quarter-doped manganites R 0.75Ca0.25MnO3 (R  =  Y, Tb, Dy, Ho, and Er) were studied by x-ray diffraction and AC/DC susceptibility measurements. All five samples are orthorhombic and exhibit similar magnetic properties: enhanced ferromagnetism below T 1 (∼80 K) and a spin glass (SG) state below T SG (∼30 K). With increasing R 3+ ionic size, both T 1 and T SG generally increase. The single crystal neutron diffraction results on Tb0.75Ca0.25MnO3 revealed that the SG state is mainly composed of a short-range ordered version of a novel canted (i.e. noncollinear) antiferromagnetic spin state. Furthermore, calculations based on the double exchange model for quarter-doped manganites reveal that this new magnetic phase provides a transition state between the ferromagnetic state and the theoretically predicted spin-orthogonal stripe phase.

  6. Expanding Radical SAM Chemistry by Using Radical Addition Reactions and SAM Analogues.

    PubMed

    Ji, Xinjian; Li, Yongzhen; Xie, Liqi; Lu, Haojie; Ding, Wei; Zhang, Qi

    2016-09-19

    Radical S-adenosyl-l-methionine (SAM) enzymes utilize a [4Fe-4S] cluster to bind SAM and reductively cleave its carbon-sulfur bond to produce a highly reactive 5'-deoxyadenosyl (dAdo) radical. In almost all cases, the dAdo radical abstracts a hydrogen atom from the substrates or from enzymes, thereby initiating a highly diverse array of reactions. Herein, we report a change of the dAdo radical-based chemistry from hydrogen abstraction to radical addition in the reaction of the radical SAM enzyme NosL. This change was achieved by using a substrate analogue containing an olefin moiety. We also showed that two SAM analogues containing different nucleoside functionalities initiate the radical-based reactions with high efficiencies. The radical adduct with the olefin produced in the reaction was found to undergo two divergent reactions, and the mechanistic insights into this process were investigated in detail. Our study demonstrates a promising strategy in expanding radical SAM chemistry, providing an effective way to access nucleoside-containing compounds by using radical SAM-dependent reactions.

  7. Competition of charge- versus radical-directed fragmentation of gas-phase protonated cysteine sulfinyl radicals.

    PubMed

    Love, Chasity B; Tan, Lei; Francisco, Joseph S; Xia, Yu

    2013-04-24

    The fragmentation behavior of various cysteine sulfinyl ions (intact, N-acetylated, and O-methylated), new members of the gas-phase amino acid radical ion family, was investigated by low-energy collision-induced dissociation (CID). The dominant fragmentation channel for the protonated cysteine sulfinyl radicals ((SO•)Cys) was the radical-directed Cα-Cβ homolytic cleavage, resulting in the formation of glycyl radical ions and loss of CH2SO. This channel, however, was not observed for protonated N-acetylated cysteine sulfinyl radicals (Ac-(SO•)Cys); instead, charge-directed H2O loss followed immediately by SH loss prevailed. Counterintuitively, the H2O loss did not derive from the carboxyl group but involved the sulfinyl oxygen, a proton, and a Cβ hydrogen atom. Theoretical calculations suggested that N-acetylation significantly increases the barrier (~14 kcal mol(-1)) for the radical-directed fragmentation channel because of its reduced capability to stabilize the thus-formed glycyl radical ions via the captodative effect. N-Acetylation also assists in moving the proton to the sulfinyl site, which reduces the barrier for H2O loss. Our studies demonstrate that for cysteine sulfinyl radical ions, the stability of the product ions (glycyl radical ions) and the location of the charge (proton) can significantly modulate the competition between radical- and charge-directed fragmentation.

  8. Robotic Surgery for Thoracic Disease.

    PubMed

    Yamashita, Shin-Ichi; 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.

  9. Bariatric and metabolic surgery.

    PubMed

    Fried, M

    2013-09-01

    In the beginning of the 21st century obesity still represents health, social and economical threat for most of economically wealthy countries worldwide. Estimated direct costs for obesity and related comorbidities treatment exceed 5% of the total health care costs both in the US and in European Union. However, in addition there are obesity-related indirect costs linked to more frequent work sickness leave, higher unemployment rates and overall lower productivity of obese patients. Surgical treatment of obesity (bariatric surgery) is the most effective long-term treatment modality for those patients suffering from higher degrees of obesity. Bariatric surgery has not only positive effects on weight loss, but is also extremely effective in improving or resolving many of obesity-related comorbidities, which have evolved rapidly into the so-called metabolic surgery. T2DM may serve as excellent example of metabolic, obesity-related comorbidity which can be treated with bariatric-metabolic procedure even without direct relation to weight loss. In such cases bariatric surgery evolves into metabolic surgery. Thus metabolic operations (namely from the malabsorptive end) deeply influence hormonal secretion especially in the proximal part of small bowel, change parametres of entero-insular axis and have positive influence on insulin secretion, sensitivity and on the entire complex of glucose tolerance. Nowadays we can witness dramatic changes in perception of T2DM from bariatric surgeons, diabetologists, and many other medical specialists. T2DM has evolved from primarily medical disease into a condition where surgeons may play a more active role in the management of the diabetic patient. However, it has to be stressed that metabolic treatment of T2DM and other metabolic disorders need multidisciplinary approach and collaboration and that surgeon should play very important role as a multidisciplinary team member, however metabolic surgery should not yet be considered as stand

  10. Enzymatic vitreous surgery.

    PubMed

    Trese, M T

    2000-06-01

    Enzymatic manipulation of the vitreous and vitreoretinal juncture is currently in the process of being evaluated in many centers around the world. The goals of such manipulation are either to disinsert the posterior hyaloid from the retina surface in an atraumatic, very clean, cleavage plane or, at this point, to try to disinsert the peripheral vitreous from the neurosensory retina. In addition, enzymatic manipulation of the central vitreous in terms of liquefaction has also been evaluated. Although this is certainly the beginning of this type of vitreal surgery, adjuvant or alternative, it does appear to be a new and exciting area of vitreoretinal surgery.

  11. Avian Soft Tissue Surgery.

    PubMed

    Guzman, David Sanchez-Migallon

    2016-01-01

    Basic surgical instrumentation for avian soft tissue surgery includes soft tissue retractors, microsurgical instrumentation, surgical loupes, and head-mounted lights. Hemostasis is fundamental during the surgical procedures. The indications, approach, and complications associated with soft tissue surgeries of the integumentary (digit constriction repair, feather cyst excision, cranial wound repair, sternal wound repair, uropygial gland excision), gastrointestinal (ingluviotomy, crop biopsy, crop burn repair, celiotomy, coelomic hernia and pseudohernia repair, proventriculotomy, ventriculotomy, enterotomy, intestinal resection and anastomosis, cloacoplasty, cloacopexy), respiratory (rhinolith removal, sinusotomy, tracheotomy, tracheal resection and anastomosis, tracheostomy, pneumonectomy) and reproductive (ovocentesis, ovariectomy, salpingohysterectomy, cesarean section, orchidectomy, vasectomy, phallectomy) systems are reviewed.

  12. Robotic retroauricular thyroid surgery

    PubMed Central

    Alabbas, Haytham; Bu Ali, Daniah

    2016-01-01

    Surgery is the gold standard treatment for patients with thyroid cancer or nodules suspicious for cancer. Open conventional approach is the standard surgical approach. However, a visible neck incision could be a concern for most young female patients, especially for patients with a history of healing with keloid or hypertrophic scars. Robotic remote access approaches have evolved into a safe and feasible approach in selected patients, providing a hidden scar with good patient satisfaction. This review will focus on the performance and safety of robotic retroauricular thyroid surgery. PMID:28149806

  13. 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.

  14. Standing equine dental surgery.

    PubMed

    Menzies, Robert A; Easley, Jack

    2014-04-01

    Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, and revisits the AO pinless external fixator for fractures of the body of the mandible.

  15. [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

  16. Comparison of laparoscopic vs. open surgery for rectal cancer

    PubMed Central

    Ding, Zihai; Wang, Zheng; Huang, Shijie; Zhong, Shizhen; Lin, Jianhua

    2017-01-01

    This study was conducted to evaluate the safety of laparoscopic radical resection for rectal cancer. A total of 64 cases of rectal cancer patients undergoing radical surgery between January, 1998 and March, 2010 were collected. The patients were divided into the laparoscopic rectal surgery group (LS group, n=31) and the open surgery group (OS group, n=33). Operation time, postoperative recovery, complications and tumor-free survival rate were compared between the two groups. The inclusion criteria were as follows: Standard Karnofsky score >70 prior to surgery, definitive pathological diagnosis and complete clinical data. The exclusion criteria were concomitant tumors affecting survival. With the Dixon operation, the LS group had a longer operation time compared with the OS group (271.2±56.2 vs. 216.0±62.7 min, respectively; P=0.036), and an earlier time of oral intake (3.0±0.9 vs. 4.7±1.0 days, respectively; P=0.000). There were no significant differences between the LS and OS groups in terms of intraoperative blood loss, number of lymph nodes retrieved, duration of postoperative hyperthermia and hospitalization time (P>0.05). With the Miles operation, there were no obvious differences between the LS and OS groups regarding operation time, intraoperative blood loss, number of lymph nodes retrieved, time of oral intake, duration of postoperative hyperthermia and hospitalization time (P>0.05). Furthermore, there were no significant differences between the LS and OS groups with the Dixon or Miles operation in terms of 3-year tumor-free survival rate (P>0.05). Thus, laparoscopic surgery appears to be a safe and feasible option for the treatment of rectal cancer. PMID:28357087

  17. Robotic technology in surgery: current status in 2008.

    PubMed

    Murphy, Declan G; Hall, Rohan; Tong, Raymond; Goel, Rajiv; Costello, Anthony J

    2008-12-01

    There is increasing patient and surgeon interest in robotic-assisted surgery, particularly with the proliferation of da Vinci surgical systems (Intuitive Surgical, Sunnyvale, CA, USA) throughout the world. There is much debate over the usefulness and cost-effectiveness of these systems. The currently available robotic surgical technology is described. Published data relating to the da Vinci system are reviewed and the current status of surgical robotics within Australia and New Zealand is assessed. The first da Vinci system in Australia and New Zealand was installed in 2003. Four systems had been installed by 2006 and seven systems are currently in use. Most of these are based in private hospitals. Technical advantages of this system include 3-D vision, enhanced dexterity and improved ergonomics when compared with standard laparoscopic surgery. Most procedures currently carried out are urological, with cardiac, gynaecological and general surgeons also using this system. The number of patients undergoing robotic-assisted surgery in Australia and New Zealand has increased fivefold in the past 4 years. The most common procedure carried out is robotic-assisted laparoscopic radical prostatectomy. Published data suggest that robotic-assisted surgery is feasible and safe although the installation and recurring costs remain high. There is increasing acceptance of robotic-assisted surgery, especially for urological procedures. The da Vinci surgical system is becoming more widely available in Australia and New Zealand. Other surgical specialties will probably use this technology. Significant costs are associated with robotic technology and it is not yet widely available to public patients.

  18. Fast beam studies of free radical photodissociation

    SciTech Connect

    Neumark, D.M.

    1993-12-01

    The authors have developed a novel technique for studying the photodissociation spectroscopy and dynamics of free radicals. In these experiments, radicals are generated by laser photodetachment of a fast (6-8 keV) mass-selected negative ion beam. The resulting radicals are photodissociated with a second laser, and the photofragments are collected and detected with high efficiency using a microchannel plate detector. The overall process is: ABC{sup -} {yields} ABC + e{sup -} {yields} A + BC, AB + C. Two types of fragment detection schemes are used. To map out the photodissociation cross-section of the radical, the photodissociation laser is scanned and the total photofragment yield is measured as a function of wavelength. In other experiments, the photodissociation frequency is fixed and the photofragment masses, kinetic energy release, and scattering angle is determined for each photodissociation event.

  19. RADICALLY CONTESTED ASSERTIONS IN ECOSYSTEM MANAGEMENT

    EPA Science Inventory

    Ecosystem management is a magnet for controversy, in part because some of its formulations rest on questionable assertions that are radically contested. These assertions are important to understanding much of the conflict surrounding ecosystem management and, therrefore, deserve...

  20. Magnetic Trapping of Cold Methyl Radicals

    NASA Astrophysics Data System (ADS)

    Liu, Yang; Vashishta, Manish; Djuricanin, Pavle; Zhou, Sida; Zhong, Wei; Mittertreiner, Tony; Carty, David; Momose, Takamasa

    2017-03-01

    We have demonstrated that a supersonic beam of methyl radicals (CH3 ) in the ground rotational state of both para and ortho species has been slowed down to standstill with a magnetic molecular decelerator, and successfully captured spatially in an anti-Helmholtz magnetic trap for >1 s . The trapped CH3 radicals have a mean translational temperature of about 200 mK with an estimated density of >5.0 ×1 07 cm-3 . The methyl radical is an ideal system for the study of cold molecules not only because of its high reactivities at low temperatures, but also because further cooling below 1 mK is plausible via sympathetic cooling with ultracold atoms. The demonstrated trapping capability of methyl radicals opens up various possibilities for realizing ultracold ensembles of molecules towards Bose-Einstein condensation of polyatomic molecules and investigations of reactions governed by quantum statistics.

  1. Psychopathology according to behaviorism: a radical restatement.

    PubMed

    Pérez-Alvarez, Marino

    2004-11-01

    This article is a radical restatement of the predominant psychopathology, which is characterized by nosological systems and by its approach towards a neurobiological conception of the so-called mental disorders. The "radical" sense of this restatement is that of radical behaviorism itself. As readers will recall, "radical" applied to behaviorism means total (not ignoring anything that interests psychology), pragmatic (referring to the practical sense of knowledge), and it also derives from the Latin word for "root" (and thus implies change beginning at a system's roots or getting to the root of things, in this case, of psychological disorders). Based on this, I introduce the Aristotelian distinction of material and form, which, besides being behaviorist avant la lettre, is used here as a critical instrument to unmask the hoax of psychopathology as it is presented. The implications of this restatement are discussed, some of them already prepared for clinical practice.

  2. Soft tissue sarcomas of the extremities: survival and patterns of failure with conservative surgery and postoperative irradiation compared to surgery alone

    SciTech Connect

    Leibel, S.A.; Tranbaugh, R.F.; Wara, W.M.; Beckstead, J.H.; Bovill, E.G.; Phillips, T.L.

    1982-09-15

    Between 1960 and 1978, 81 patients received their primary treatment for localized soft tissue sarcomas of the extremities, buttock and shoulder at the University of California, San Francisco. Initial treatment consisted of surgery alone in 47 patients, planned conservative surgery followed by radiation therapy in 29 patients, and irradiation alone in five patients. The two- and five-year determinate survival for all cases was 86% and 73%, respectively. The local control rate achieved with surgery alone was related to the extent of surgery. Eighty-seven percent (14/16) of the patients undergoing amputation were locally controlled. Seventy-two percent (8/11) were treated with wide en bloc resection and had local tumor control while only 30% (6/20) having simple excision were controlled. The local control rate with surgery and postoperative irradiation was 90% (26/29). No patients treated with irradiation therapy alone were controlled. This review suggests that local tumor control achieved with limb preserving conservative surgery and postoperative irradiation is superior to limited surgery alone. The survival and patterns of failure of patients undergoing radical surgery is comparable to combined treatment with the risk-benefit ratio favoring the latter. (JMT)

  3. Effectiveness of Surgical Release in Patients With Neglected Congenital Muscular Torticollis According to Age at the Time of Surgery

    PubMed Central

    Min, Kyung-Jay; Ahn, Ah-Reum; Park, Eun-Ji

    2016-01-01

    Objective To identify the correlation between change in spinal deformities after surgical release and age at the time of surgery, and the effectiveness of surgical release in patients with neglected congenital muscular torticollis (CMT). Methods This was a retrospective study of 46 subjects with neglected CMT who had undergone surgical release at age ≥5 years at a tertiary medical center between January 2009 and January 2014. Spinal deformities were measured on anteroposterior plain radiographs of the cervical and whole spine, both preoperatively and postoperatively, to assess 3 parameters: cervicomandibular angle (CMA), lateral shift (LS), and Cobb angle (CA). We analyzed the change in spinal deformities after surgical release in consideration of age at the time of surgery. Results The median age at the time of surgery was 12.87 years. All 3 parameters showed significant improvement after surgical release (median values, pre- to post-surgery: CMA, 12.13° to 4.02°; LS, 18.13 mm to 13.55 mm; CA, 6.10° to 4.80°; all p<0.05). There was no significant correlation between age at the time of surgery and change in CMA (R=0.145, p=0.341) and LS (R=0.103, p=0.608). However, CA showed significant improvement with increasing age (R=0.150, p=0.046). Conclusion We assessed the correlation between change in spinal deformities after surgical release and age at the time of surgery. We found that that surgical release is effective for spinal deformities, even in older patients. These findings enhance our understanding of the effectiveness and timing of surgical release in patients with neglected CMT. PMID:26949667

  4. "Fast track surgery" in the north-west of Italy: influence on the orientation of surgical practice.

    PubMed

    Pozzi, G; Falcone, A; Sabbatino, F; Solej, M; Nano, M

    2012-06-01

    Fast track surgery is a peri-operative management model, including different strategies to improve patients' convalescence, avoid metabolic alterations, reduce complications, and shorten hospital stay. Prerequisite is coordination between different practitioners (surgeon, anaesthetist, nurse, nutritionist, physiotherapist). The purpose of our investigation is to understand the level of fast track surgery application in Piedmont and to evidence analogies and differences among departments. We projected an investigation proposing, to every surgery department in Piedmont, a multiple-choice questionnaire evaluating the level of fast track surgery peri-operative interventions' application. Data analysis was conducted in two points of view: the transversal one with an overview of answer's percentages, the longitudinal one correlating data through Pearson's index (r). We collected answers by 78 % of balloted departments (38 on 49). Transversal analysis, including the evaluation of percentages of each question, shows that intra-operative period is the most influenced by fast track principles, and that only 12 departments of 38 apply complete protocols. Longitudinal analysis, estimating the whole of each department's answers, demonstrates the absence of statistical significance in the correlation between fast track surgery application and territorial (r = 0.18), economic (r = 0.31), or age (r = 0.06) variables. Influence of fast track surgery is significantly present in our territory, even though it is not fully concretized in protocols. The choice of fast track depends on the instruction, the environment and the sensibility of each surgeon. Knowledge of geographic distribution of departments applying this model can be useful to organize common protocols, starting from more experienced hospitals.

  5. Mechanism of disproportionation of ascorbate radicals

    SciTech Connect

    Bielski, B.H.J.; Allen, A.O.; Schwarz, H.A.

    1981-06-17

    Existing data on the kinetics of ascorbate radical decay, together with some new data on the effects of temperature, ionic strength, and presence of phosphate buffers, suggest a mechanism in which the ascorbate radical ion is in equilibrium with a dimer. This dimer reacts with hydrogen ion, or with other proton donors present including water and buffers (at rates depending upon their acid strengths), to form the disproportionation products ascorbate ion and dehydroascorbate acid.

  6. The stabilization energies of polyenyl radicals

    NASA Astrophysics Data System (ADS)

    Luo, Yu-Ran; Holmes, John L.

    1994-10-01

    The resonance stabilization energies, Es, of polyenyl radicals can be estimated by the equation Es( N)=-13.2+[3.95-15.8(2) -2/ n] kcal mol -1, where N is the number of C, C-π bonds in the polyenyl radicals. This correlation has been extended for predicting the weakest HC, CC and COH bond dissociation energies in vitamin A and similar compounds.

  7. Hydroxyl radical generation by red tide algae.

    PubMed

    Oda, T; Akaike, T; Sato, K; Ishimatsu, A; Takeshita, S; Muramatsu, T; Maeda, H

    1992-04-01

    The unicellular marine phytoplankton Chattonella marina is known to have toxic effects against various living marine organisms, especially fishes. However, details of the mechanism of the toxicity of this plankton remain obscure. Here we demonstrate the generation of superoxide and hydroxyl radicals from a red tide unicellular organism, C. marina, by using ESR spectroscopy with the spin traps 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) and N-t-butyl-alpha-phenylnitrone (PBN), and by using the luminol-enhanced chemiluminescence response. The spin-trapping assay revealed productions of spin adduct of superoxide anion (O2-) (DMPO-OOH) and that of hydroxyl radical (.OH) (DMPO-OH) in the algal suspension, which was not observed in the ultrasonic-ruptured suspension. The addition of superoxide dismutase (500 U/ml) almost completely inhibited the formation of both DMPO-OOH and DMPO-OH, and carbon-centered radicals were generated with the disappearance of DMPO-OH after addition of 5% dimethyl sulfoxide (Me2SO) and 5% ethanol. Furthermore, the generation of methyl and methoxyl radicals, which are thought to be produced by the reaction of hydroxyl radical and Me2SO under aerobic condition, was identified using spin trapping with a combination of PBN and Me2SO. Luminol-enhanced chemiluminescence assay also supported the above observations. These results clearly indicate that C. marina generates and releases the superoxide radical followed by the production of hydroxyl radical to the surrounding environment. The velocity of superoxide generation by C. marina was about 100 times faster than that by mammalian phagocytes per cell basis. The generation of oxygen radical is suggested to be a pathogenic principle in the toxication of red tide to susceptible aquaculture fishes and may be directly correlated with the coastal pollution by red tide.

  8. Radicals: Reactive Intermediates with Translational Potential

    PubMed Central

    2016-01-01

    This Perspective illustrates the defining characteristics of free radical chemistry, beginning with its rich and storied history. Studies from our laboratory are discussed along with recent developments emanating from others in this burgeoning area. The practicality and chemoselectivity of radical reactions enable rapid access to molecules of relevance to drug discovery, agrochemistry, material science, and other disciplines. Thus, these reactive intermediates possess inherent translational potential, as they can be widely used to expedite scientific endeavors for the betterment of humankind. PMID:27631602

  9. Laser Studies of Gas Phase Radical Reactions.

    DTIC Science & Technology

    1989-01-01

    Acremonium chrysogenum , was prepared according to the published procedure [6]. This fungal enzyme had a specific activity of 0.023 IUmg1, and was estimated to...Dist-lbitionj Avdielbiity Codes jAvail atidjor Dist 6a A-I . p -1- Laser Studies of Gas Phase Radical Reactions G. Hancock Physical Chemistry...some additional experiments concerning the formation of carbene radicals in liquid phase enzyme cleavage studies are described. Keywords Laser

  10. Radical behaviorism and buddhism: complementarities and conflicts.

    PubMed

    Diller, James W; Lattal, Kennon A

    2008-01-01

    Comparisons have been made between Buddhism and the philosophy of science in general, but there have been only a few attempts to draw comparisons directly with the philosophy of radical behaviorism. The present review therefore considers heretofore unconsidered points of comparison between Buddhism and radical behaviorism in terms of their respective goals, conceptualization of human beings, and the outcomes of following either philosophy. From these comparisons it is concluded that the commonalities discerned between these two philosophies may enhance both philosophical systems.

  11. Derivation of hydroperoxyl radical (HO2) levels at an urban site via measurement of pernitric acid (HO2NO2) by iodide chemical ionization mass spectrometry (I(-)-CIMS).

    PubMed

    Chen, Dexian; Huey, L Gregory; Tanner, David J; Li, Jianfeng; Ng, Nga Lee; Wang, Yuhang

    2017-02-17

    Hydroperoxyl radical (HO2) is a key species to atmospheric chemistry. At warm temperatures, the hydroperoxyl radical (HO2) and NO2 come to a rapid steady state with pernitric acid (HO2NO2). This paper presents the derivation of HO2 from observations of HO2NO2 and NO2 in metropolitan Atlanta, US in winter 2014 and summer 2015. HO2 was observed to have a diurnal cycle with morning concentrations suppressed by high NO from the traffic. At night, derived HO2 levels were nonzero and exhibited correlations with O3 and NO3, consistent with previous studies that ozonolysis and oxidation by NO3 are sources of nighttime HO2. Measured and model calculated HO2 were in reasonable agreement: Without the constraint of measured HO2NO2 , the model reproduced HO2 with a model-to-observed ratio (M/O) 1.27 (r = 0.54) for winter, 2014, and 0.70 (r = 0.80) for summer, 2015. Adding measured HO2NO2 as a constraint, the model predicted HO2 with M/O = 1.13 ((r = 0.77) for winter 2014, and 0.90 ((r = 0.97) for summer 2015. These results demonstrate the feasibility of deriving HO2 from HO2NO2 measurements in warm regions where HO2NO2 has a short lifetime.

  12. Whodunit? Ghost surgery and ethical billing.

    PubMed

    Jones, James W; McCullough, Laurence B; Richman, Bruce W

    2005-12-01

    A senior vascular surgery resident started an autogenous radical-cephalic arteriovenous fistula procedure on a comatose patient in the surgical intensive care unit (SICU), expecting you to arrive momentarily. You were nevertheless unexpectedly detained establishing hemostasis in the main operating suite. You arrived in the SICU as the dressing was being applied. Fistula flows were excellent and there were no operative complications. The resident who began and finally completed the case was highly skilled and in the final month of his vascular training; you had supervised his satisfactory performance of many procedures like this one during the last 2 years. The patient's elderly wife had consented to the procedure, which she was told you would be directly supervising while the resident performed the surgery. When the operation was over you met with her to explain your emergency conflict and assure her that you checked the resident's work and found it entirely satisfactory. She accepted your explanation and was relieved that the operation went well. The patient's multiple comorbidities nevertheless necessitated an extended postoperative stay in the SICU, where you personally cared for him. The resident had dictated routinely that you attended the procedure, and your billing clerk had no reason to doubt the operative report's accuracy when she submitted your surgical fees to Medicare and the patient's private insurer, which paid to their contractual limits without challenge. On many occasions you have had your billings shorted by both. The resident since has graduated. What should you do?

  13. Mitral valve surgery - open

    MedlinePlus

    ... Saunders; 2012:chap 61. Otto CM, Bonow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Mitral Valve Prolapse Browse the Encyclopedia A.D. ...

  14. Aortic valve surgery - open

    MedlinePlus

    ... Saunders; 2012:chap 61. Otton CM, Bowow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  15. Mohs micrographic surgery

    MedlinePlus

    ... 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. Review Date 12/2/2014 Updated by: Richard J. Moskowitz, MD, dermatologist in private practice, Mineola, ...

  16. Minimally invasive valve surgery.

    PubMed

    Woo, Y Joseph

    2009-08-01

    Traditional cardiac valve replacement surgery is being rapidly supplanted by innovative, minimally invasive approaches toward the repair of these valves. Patients are experiencing benefits ranging from less bleeding and pain to faster recovery and greater satisfaction. These operations are proving to be safe, highly effective, and durable, and their use will likely continue to increase and become even more widely applicable.

  17. Paediatric surgery in Uganda.

    PubMed

    Sekabira, John

    2015-02-01

    The Hugh Greenwood Lecture acknowledges the extremely generous support from Mr Greenwood that has enabled the BAPS to establish funds to advance paediatric surgical training in developing countries. In this Inaugural Lecture, Dr. Sekabira, the first Hugh Greenwood Fellow, describes the influence that this has had on his career and reviews the state of paediatric surgery in Uganda.

  18. Heart bypass surgery

    MedlinePlus Videos and Cool Tools

    Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, a portion of the saphenous vein is ... used to bypass the blocked arteries in the heart. The venous graft is sewn to the aorta ...

  19. Periscopic Spine Surgery

    DTIC Science & Technology

    2008-06-01

    modulating shoulder impedance during physical therapy 4. Demonstrated image-guided spinal vertebroplasty in a phantom model using our open source...Image-Guided Vertebroplasty ...................................... 11 3.3.3 Accomplishment 3: Abdominal Phantom Evaluation...49 7.7 Enquobahrie 2007: The image-guided surgery … .............................................. 58 7.8 Lin 2008: Phantom

  20. 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

  1. Decreasing strabismus surgery

    PubMed Central

    Arora, A; Williams, B; Arora, A K; McNamara, R; Yates, J; Fielder, A

    2005-01-01

    Aim: To determine whether there has been a consistent change across countries and healthcare systems in the frequency of strabismus surgery in children over the past decade. Methods: Retrospective analysis of data on all strabismus surgery performed in NHS hospitals in England and Wales, on children aged 0–16 years between 1989 and 2000, and between 1994 and 2000 in Ontario (Canada) hospitals. These were compared with published data for Scotland, 1989–2000. Results: Between 1989 and 1999–2000 the number of strabismus procedures performed on children, 0–16 years, in England decreased by 41.2% from 15 083 to 8869. Combined medial rectus recession with lateral rectus resection decreased from 5538 to 3013 (45.6%) in the same period. Bimedial recessions increased from 489 to 762, oblique tenotomies from 43 to 121, and the use of adjustable sutures from 29 to 44, in 2000. In Ontario, operations for squint decreased from 2280 to 1685 (26.1%) among 0–16 year olds between 1994 and 2000. Conclusion: The clinical impression of decrease in the frequency of paediatric strabismus surgery is confirmed. In the authors’ opinion this cannot be fully explained by a decrease in births or by the method of healthcare funding. Two factors that might have contributed are better conservative strabismus management and increased subspecialisation that has improved the quality of surgery and the need for re-operation. This finding has a significant impact upon surgical services and also on the training of ophthalmologists. PMID:15774914

  2. Cavus Foot Surgery

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... related problems. What are the goals of cavus foot surgery? The ... reduce other injuries such as repeated ankle sprains and broken bones. ...

  3. Hair transplantation surgery

    PubMed Central

    Khanna, Manoj

    2008-01-01

    Techniques in hair transplantation have evolved recently which make results look more natural. Hair restoration is one of the most exciting and innovative surgical fields in aesthetic surgery today. A precise appreciation of anatomy has allowed the use of follicular unit grafts. With better methods of harvesting and implantation, hair transplantation results represent a blend of art and science. PMID:20174544

  4. [Drainage in thyroid surgery].

    PubMed

    Ardito, G; Revelli, L; Guidi, M L; Murazio, M; Lucci, C; Modugno, P; Di Giovanni, V

    1999-01-01

    Bleeding represents a rare complication of thyroid surgery but when it occurs it may be life-threatening. To prevent this complication drainage is widely used. However no study has demonstrated the drains' value and recent reports have questioned its benefits. Therefore we have analyzed our experience of a 10 year-period in which 1.217 thyroidectomies were performed by the same surgical team and prophylactic routine drainage was always adopted. In 13 patients (1.06%) a benign hematoma occurred with spontaneous remission. In 6 patients the bleeding was severe and compressive hematoma occurred; it required surgical re-exploration. Such a complication is unusual in the neck surgery (0.49% in the authors' series) performed by experienced surgeons and when life-threatening hematomas do occur they depend on various uncontrolled factors and drainage is often not helpful. Otherwise a meticulous haemostatic technique is necessary and patients should be observed very closely during the few first hours following surgery on the thyroid gland. Therefore on the basis of the analysis of their series, although it is not always possible to prove the benefit of the drainage, the authors suggest its indication in the neck surgery, as in other fields with dead space, to remove blood and secretions reducing postoperative complications. They have never observed wound infections and patients were discharged within 72 hours.

  5. Intrauterine surgery in myelomeningocele.

    PubMed

    Bruner, Joseph P

    2007-12-01

    Intrauterine surgery for repair of fetal myelomeningocele has been performed since 1994. Open repair through a hysterotomy has been performed since 1997. Although much has been published about diagnosis, counseling, case selection, pre-, intra-, and postoperative management, delivery and long-term sequelae for both mother and baby, and associated ethical issues, several questions have yet to be openly discussed in a public forum.

  6. Anti-reflux surgery

    MedlinePlus

    ... much stomach acid is coming back into your esophagus). Upper endoscopy. Almost all people who have this anti-reflux surgery have already had this test. If you have not had this test, ... of the esophagus. Always tell your provider if: You could be ...

  7. [Cutaneous surgery workshop].

    PubMed

    Purim, Kátia Sheylla Malta

    2010-08-01

    The training of physician request knowledge, skills and attitudes for the effective exercise of professional practice. The training of basic surgical techniques, used in outpatient procedures, will prepare students to work in different scenarios. This work presents a proposal for teaching through workshops for cutaneous surgery in an experimental model.

  8. Surgery with cooperative robots.

    PubMed

    Lehman, Amy C; Berg, Kyle A; Dumpert, Jason; Wood, Nathan A; Visty, Abigail Q; Rentschler, Mark E; Platt, Stephen R; Farritor, Shane M; Oleynikov, Dmitry

    2008-03-01

    Advances in endoscopic techniques for abdominal procedures continue to reduce the invasiveness of surgery. Gaining access to the peritoneal cavity through small incisions prompted the first significant shift in general surgery. The complete elimination of external incisions through natural orifice access is potentially the next step in reducing patient trauma. While minimally invasive techniques offer significant patient advantages, the procedures are surgically challenging. Robotic surgical systems are being developed that address the visualization and manipulation limitations, but many of these systems remain constrained by the entry incisions. Alternatively, miniature in vivo robots are being developed that are completely inserted into the peritoneal cavity for laparoscopic and natural orifice procedures. These robots can provide vision and task assistance without the constraints of the entry incision, and can reduce the number of incisions required for laparoscopic procedures. In this study, a series of minimally invasive animal-model surgeries were performed using multiple miniature in vivo robots in cooperation with existing laparoscopy and endoscopy tools as well as the da Vinci Surgical System. These procedures demonstrate that miniature in vivo robots can address the visualization constraints of minimally invasive surgery by providing video feedback and task assistance from arbitrary orientations within the peritoneal cavity.

  9. Inactivation of Bacillus atrophaeus by OH radicals

    NASA Astrophysics Data System (ADS)

    Ono, Ryo; Yonetamari, Kenta; Tokumitsu, Yusuke; Yonemori, Seiya; Yasuda, Hachiro; Mizuno, Akira

    2016-08-01

    The inactivation of Bacillus atrophaeus by OH radicals is measured. This study aims to evaluate the bactericidal effects of OH radicals produced by atmospheric-pressure nonthermal plasma widely used for plasma medicine; however, in this study, OH radicals are produced by vacuum ultraviolet (VUV) photolysis of water vapor instead of plasma to allow the production of OH radicals with almost no other reactive species. A 172 nm VUV light from a Xe2 excimer lamp irradiates a He-H2O mixture flowing in a quartz tube to photodissociate H2O to produce OH, H, O, HO2, H2O2, and O3. The produced reactive oxygen species (ROS) flow out of the quartz tube nozzle to the bacteria on an agar plate and cause inactivation. The inactivation by OH radicals among the six ROS is observed by properly setting the experimental conditions with the help of simulations calculating the ROS densities. A 30 s treatment with approximately 0.1 ppm OH radicals causes visible inactivation.

  10. Hydroxyl radical oxidation of feruloylated arabinoxylan.

    PubMed

    Bagdi, Attila; Tömösközi, Sándor; Nyström, Laura

    2016-11-05

    Feruloylated arabinoxylan (AX) has a unique capacity to form covalent gels in the presence of certain oxidizing agents. The present study demonstrates that hydroxyl radical oxidation does not provoke ferulic acid dimerization and thus oxidative gelation. We studied the hydroxyl radical mediated oxidation of an alkali-extracted AX preparation (purity: 92g/100g dry matter) that showed gel-forming capability upon peroxidase/hydrogen peroxide treatment. Hydroxyl radicals were produced with ascorbate-driven Fenton reaction and the radical formation was monitored with electron paramagnetic resonance, using a POBN/EtOH spin trapping system. Oxidation was carried out at different catalytic concentrations of iron (50 and 100μM) and at different temperatures (20°C, 50°C, and 80°C). It was demonstrated that hydroxyl radical oxidation does not provoke gel formation, but viscosity decrease in AX solution, which suggests polymer degradation. Furthermore, it was demonstrated that hydroxyl radical formation in AX solution can be initiated merely by increasing temperature.

  11. Hydroxyl radical scavengers inhibit lymphocyte mitogenesis.

    PubMed Central

    Novogrodsky, A; Ravid, A; Rubin, A L; Stenzel, K H

    1982-01-01

    Agents that are known to be scavengers of hydroxyl radicals inhibit lymphocyte mitogenesis induced by phorbol myristate acetate (PMA) to a greater extent than they inhibit mitogenesis induced by concanavalin A or phytohemagglutinin. These agents include dimethyl sulfoxide, benzoate, thiourea, dimethylurea, tetramethylurea, L-tryptophan, mannitol, and several other alcohols. Their inhibitory effect is not associated with cytotoxicity. The hydroxyl radical scavengers do not inhibit PMA-dependent amino acid transport in T cells or PMA-induced superoxide production by monocytes. Thus, they do not inhibit the primary interaction of PMA with responding cells. Treatment of peripheral blood mononuclear cells with PMA increased cellular guanylate cyclase in most experiments, and dimethyl sulfoxide tended to inhibit this increase. In addition to inhibition of PMA-induced mitogenesis, hydroxyl radical scavengers markedly inhibited the activity of lymphocyte activating factor (interleukin 1). The differential inhibition of lymphocyte mitogenesis induced by different mitogens appears to be related to the differential macrophage requirements of the mitogens. The data suggest that hydroxyl radicals may be involved in mediating the triggering signal for lymphocyte activation. Some of the hydroxyl radical scavengers are inducers of cellular differentiation,. nd it is possible that their differentiating activity is related to their ability to scavenge free radicals. PMID:6122209

  12. [Minilaparoscopic surgery : alternative or supplement to single-port surgery?].

    PubMed

    Brinkmann, L; Lorenz, D

    2011-05-01

    In recent years scarless surgery (axillo-bilateral-breast aproach [ABBA], natural orifice transluminal endoscopic surgery [NOTES], single-port surgery) has gained importance in order to improve postoperative outcome in laparoscopic surgery. As part of this effort minilaparoscopic surgery might be a suitable alternative concerning cosmetic outcome without implementing a completely new technique. Due to the definition minilaparoscopic surgery is based on instruments which reduce the total length of trocar incisions to less than 2.5 cm. Nevertheless the total number of incisions is similar to conventional laparoscopic techniques. Most recent indications for minilaparoscopic surgery are cholecystectomy, appendectomy, hernia and colorectal surgery. This article describes the technical aspects and feasibility of minilaparoscopic cholecystectomy and transabdominal preperitoneal hernia repair (TAPP).While the trocar positions remain in the original setting the laparoscopic surgeon benefits from experience gained in conventional laparoscopic surgery. Although the cosmetic outcome is not comparable to single-port surgery, in the author's opinion minilaparoscopic surgery is a useful alternative in scarless surgery due to the fact that it is easy to adapt without establishing a completely new technique.

  13. Radicalization and Radical Catalysis of Biomass Sugars: Insights from First-principles Studies

    PubMed Central

    Yang, Gang; Zhu, Chang; Zou, Xianli; Zhou, Lijun

    2016-01-01

    Ab initio and density functional calculations are conducted to investigate the radicalization processes and radical catalysis of biomass sugars. Structural alterations due to radicalization generally focus on the radicalized sites, and radicalization affects H-bonds in D-fructofuranose more than in D-glucopyranose, potentially with outcome of new H-bonds. Performances of different functionals and basis sets are evaluated for all radicalization processes, and enthalpy changes and Gibbs free energies for these processes are presented with high accuracy, which can be referenced for subsequent experimental and theoretical studies. It shows that radicalization can be utilized for direct transformation of biomass sugars, and for each sugar, C rather than O sites are always preferred for radicalization, thus suggesting the possibility to activate C-H bonds of biomass sugars. Radical catalysis is further combined with Brønsted acids, and it clearly states that functionalization fundamentally regulates the catalytic effects of biomass sugars. In presence of explicit water molecules, functionalization significantly affects the activation barriers and reaction energies of protonation rather than dehydration steps. Tertiary butyl and phenyl groups with large steric hindrances or hydroxyl and amino groups resulting in high stabilities for protonation products drive the protonation steps to occur facilely at ambient conditions. PMID:27405843

  14. Radicalization and Radical Catalysis of Biomass Sugars: Insights from First-principles Studies

    NASA Astrophysics Data System (ADS)

    Yang, Gang; Zhu, Chang; Zou, Xianli; Zhou, Lijun

    2016-07-01

    Ab initio and density functional calculations are conducted to investigate the radicalization processes and radical catalysis of biomass sugars. Structural alterations due to radicalization generally focus on the radicalized sites, and radicalization affects H-bonds in D-fructofuranose more than in D-glucopyranose, potentially with outcome of new H-bonds. Performances of different functionals and basis sets are evaluated for all radicalization processes, and enthalpy changes and Gibbs free energies for these processes are presented with high accuracy, which can be referenced for subsequent experimental and theoretical studies. It shows that radicalization can be utilized for direct transformation of biomass sugars, and for each sugar, C rather than O sites are always preferred for radicalization, thus suggesting the possibility to activate C-H bonds of biomass sugars. Radical catalysis is further combined with Brønsted acids, and it clearly states that functionalization fundamentally regulates the catalytic effects of biomass sugars. In presence of explicit water molecules, functionalization significantly affects the activation barriers and reaction energies of protonation rather than dehydration steps. Tertiary butyl and phenyl groups with large steric hindrances or hydroxyl and amino groups resulting in high stabilities for protonation products drive the protonation steps to occur facilely at ambient conditions.

  15. [Aesthetic surgery, the liability].

    PubMed

    Branchet, F

    2003-10-01

    Which are the specific risks for the plastic surgeons in aesthetic surgery? There are several: first of all, patients consult by desire and not because of health problems; it is often during difficult moments in their life (job loss.). Moreover, the surgeon must give the most complete information to the patient: he must describe the surgery, the risks (even the most exceptional ones). The surgeons have to "use the best practices": what does it mean? This sentence deals with the idea that the surgeons must have all the necessary skills to perform an aesthetic surgery and to ensure the cares after the operation (experience, diploma, staff, equipment.). They do not have to guarantee a result. As they do not operate in a hurry, they must renounce to a surgery if there is a doubt concerning the risk or the result the patient is waiting for. For years we have been observing that the requests for getting compensations have been left to drift for a lot of reasons (deception with the result, youth not found again.). The capacity to discover the real reasons of an aesthetic surgery, the listening, the courage to refuse to operate if the patient expects too much. depends on the surgeon (and insurer) future quiet. Despite all these precautions, we can notice that each surgeon is involved one time in a 4-years period: he will waste his time (forensic examinations.). As a conclusion, we can say that the respect of the rules of ethics is the key to battle against the increase of files in proceedings.

  16. Advances in mucogingival surgery.

    PubMed

    Prato, G P

    2000-01-01

    The term Mucogingival Surgery was proposed by Friedman in 1957 to indicate any surgery "designed to preserve attached gingiva, to remove frena or muscle attachment, and to increase the depth of the vestibule". The aim of this type of surgery was to maintain an adequate amount of attached gingiva and to prevent continuous loss of attachment. This philosophy was supported by many horizontal observations in humans that confirmed the need for a certain band of attached gingiva to maintain periodontal tissue in a healthy state. Subsequently, clinical and experimental studies by Wennström and Lindhe (1983) demonstrated that as long as plaque buildup is kept under careful control there is no minimum width of keratinised gingiva necessary to prevent the development of periodontal disease. These observations reduce the importance of Mucogingival Surgery. Surgical techniques are used mostly to solve aesthetic problems, since the term "Periodontal Plastic Surgery" has been suggested to indicate surgical procedures performed to correct or eliminate anatomical, developmental or traumatic deformities of the gingiva or alveolar mucosa. More recently the Consensus Report of the American Academy of Periodontology (1996) defines Mucogingival Therapy as "non surgical and surgical correction of the defects in morphology, position and/or amount of soft tissue and underlying bone". This assigns importance to non-surgical therapy and to the bone condition because of its influence on the morphology of the defects. In this respect the Mucogingival Therapy includes: Root coverage procedures, Gingival augmentation, Augmentation of the edentulous ridge, Removing of the aberrant frenulum, Prevention of ridge collapse associated with tooth extraction, Crown lengthening, Teeth that are not likely to erupt, Loss of interdental papilla which presents an aesthetic and/or phonetic problem.

  17. Direct Administration of Nerve-Specific Contrast to Improve Nerve Sparing Radical Prostatectomy

    PubMed Central

    Barth, Connor W.; Gibbs, Summer L.

    2017-01-01

    Nerve damage remains a major morbidity following nerve sparing radical prostatectomy, significantly affecting quality of life post-surgery. Nerve-specific fluorescence guided surgery offers a potential solution by enhancing nerve visualization intraoperatively. However, the prostate is highly innervated and only the cavernous nerve structures require preservation to maintain continence and potency. Systemic administration of a nerve-specific fluorophore would lower nerve signal to background ratio (SBR) in vital nerve structures, making them difficult to distinguish from all nervous tissue in the pelvic region. A direct administration methodology to enable selective nerve highlighting for enhanced nerve SBR in a specific nerve structure has been developed herein. The direct administration methodology demonstrated equivalent nerve-specific contrast to systemic administration at optimal exposure times. However, the direct administration methodology provided a brighter fluorescent nerve signal, facilitating nerve-specific fluorescence imaging at video rate, which was not possible following systemic administration. Additionally, the direct administration methodology required a significantly lower fluorophore dose than systemic administration, that when scaled to a human dose falls within the microdosing range. Furthermore, a dual fluorophore tissue staining method was developed that alleviates fluorescence background signal from adipose tissue accumulation using a spectrally distinct adipose tissue specific fluorophore. These results validate the use of the direct administration methodology for specific nerve visualization with fluorescence image-guided surgery, which would improve vital nerve structure identification and visualization during nerve sparing radical prostatectomy. PMID:28255352

  18. Orthotopic urinary diversion after radical cystectomy in treatment of muscle invasive bladder cancer.

    PubMed

    Jovan, Hadži-Djokić; Vladan, Andrejević; Tomislav, Pejčić; Miodrag, Aćimović; Uroš, Babić; Miodrag, Stanić; Zoran, Džamić

    2014-01-01

    Surgical treatment of invasive carcinoma of the bladder in males includes total cystectomy removal of the prostate, seminal vesicles, and the distal parts of the urethers and the pelvic lymph node dissection as well. At this moment it is not possible to recommend a particular type of urinary diversion, but today in clinical practice commonly used derivative are ileal orthotopic neobladder as the continent one and ileal conduit as non-continent urinary diversion. Continent urinary diversion after radical cystectomy are the result of the application of technological innovation in surgery, but also knowledge, imagination and skill of well trained urologist. This type of operation significantly improves the quality of life in patients who underwent radical cystectomy, and the proposal is to operate whenever there is a possibility for this type of procedure. Also it is very important, during surgery to respect oncological principles, of complete removal of tumorous tissue and that the functional principle of ensur- ing that the patients have daytime and also nighttime continence later on after the surgery.

  19. Direct Administration of Nerve-Specific Contrast to Improve Nerve Sparing Radical Prostatectomy.

    PubMed

    Barth, Connor W; Gibbs, Summer L

    2017-01-01

    Nerve damage remains a major morbidity following nerve sparing radical prostatectomy, significantly affecting quality of life post-surgery. Nerve-specific fluorescence guided surgery offers a potential solution by enhancing nerve visualization intraoperatively. However, the prostate is highly innervated and only the cavernous nerve structures require preservation to maintain continence and potency. Systemic administration of a nerve-specific fluorophore would lower nerve signal to background ratio (SBR) in vital nerve structures, making them difficult to distinguish from all nervous tissue in the pelvic region. A direct administration methodology to enable selective nerve highlighting for enhanced nerve SBR in a specific nerve structure has been developed herein. The direct administration methodology demonstrated equivalent nerve-specific contrast to systemic administration at optimal exposure times. However, the direct administration methodology provided a brighter fluorescent nerve signal, facilitating nerve-specific fluorescence imaging at video rate, which was not possible following systemic administration. Additionally, the direct administration methodology required a significantly lower fluorophore dose than systemic administration, that when scaled to a human dose falls within the microdosing range. Furthermore, a dual fluorophore tissue staining method was developed that alleviates fluorescence background signal from adipose tissue accumulation using a spectrally distinct adipose tissue specific fluorophore. These results validate the use of the direct administration methodology for specific nerve visualization with fluorescence image-guided surgery, which would improve vital nerve structure identification and visualization during nerve sparing radical prostatectomy.

  20. Anaesthesia for robotic gynaecological surgery.

    PubMed

    Gupta, K; Mehta, Y; Sarin Jolly, A; Khanna, S

    2012-07-01

    Robotic surgery is gaining widespread popularity due to advantages such as reduced blood loss, reduced postoperative pain, shorter hospital stay and better visualisation of fine structures. Robots are being used in urological, cardiac, thoracic, orthopaedic, gynaecological and general surgery. Robotic surgery received US Food and Drug Administration approval for use in gynaecological surgery in 2005. The various gynaecological robotic operations being performed are myomectomy, total and supracervical hysterectomy, ovarian cystectomy, sacral colpopexy, tubal reanastomosis, lymph node dissection, surgery of retroperitoneal ectopic pregnancy, Moskowitz procedure and endometriosis surgery. The anaesthetic considerations include difficult access to the patient intraoperatively, steep Trendelenburg position, long surgical duration and the impact of pneumoperitoneum. We highlight the complications encountered in these surgeries and methods to prevent these complications. Robotic gynaecological surgery can be safely performed after considering the physiological effects of the steep Trendelenburg position and of pneumoperitoneum. The benefits of the surgical procedure should be weighed against the risks in patients with underlying cardiorespiratory problems.