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Sample records for relaxing incision knife

  1. Diamond knife.

    PubMed

    Rowsey, J J; Balyeat, H D; Yeisley, K P

    1982-04-01

    We present a new diamond knife which allows for reasonably precise incisions in cornea or sclera. The knife may be ultrasonically cleaned and is sharper than any metal knife whose edge we have examined to date by scanning electron microscopy. The edge is approximately 0.1 micron in width, compared to 1-5 micron width edges of most metal knives. We feel that this prototype will allow investigators to recommend special modifications to the manufacturer of their own choice. PMID:6285246

  2. Endoscopy-Assisted Single-Incision Technique to Harvest the Conchal Cartilage and Temporal Fascia Simultaneously by Using Phaco Slit Knife.

    PubMed

    Ugurlu, Alper Mete; Ersozlu, Tolga; Basat, Salih Onur; Ceran, Fatih

    2015-11-01

    Conchal cartilage and temporal fascia grafts are useful materials for secondary rhinoplasty cases. Generally, surgeons require to access autologous grafts fast and effortlessly. Harvesting 2 different types of graft, such as cartilage and fascia, however, are associated with limitations, such as additional surgery time, extra incisions, and postoperative additional distortions at the graft-host interface. The authors evolved a modified single incision that would harvest conchal cartilage and temporal fascia simultaneously by using 4 mm endoscope and 3 mm angled phaco slit knife.

  3. Dosimetric comparison between cone/Iris-based and InCise MLC-based CyberKnife plans for single and multiple brain metastases.

    PubMed

    Jang, Si Young; Lalonde, Ron; Ozhasoglu, Cihat; Burton, Steven; Heron, Dwight; Huq, M Saiful

    2016-01-01

    We performed an evaluation of the CyberKnife InCise MLC by comparing plan qualities for single and multiple brain lesions generated using the first version of InCise MLC, fixed cone, and Iris collimators. We also investigated differences in delivery efficiency among the three collimators. Twenty-four patients with single or multiple brain mets treated previously in our clinic on a CyberKnife M6 using cone/Iris collimators were selected for this study. Treatment plans were generated for all lesions using the InCise MLC. Number of monitor units, delivery time, target coverage, conformity index, and dose falloff were compared between MLC- and clinical cone/Iris-based plans. Statistical analysis was performed using the non-parametric Wilcoxon-Mann-Whitney signed-rank test. The planning accuracy of the MLC-based plans was validated using chamber and film measurements. The InCise MLC-based plans achieved mean dose and target coverage comparable to the cone/Iris-based plans. Although the conformity indices of the MLC-based plans were slightly higher than those of the cone/Iris-based plans, beam delivery time for the MLC-based plans was shorter by 30% ~ 40%. For smaller targets or cases with OARs located close to or abutting target volumes, MLC-based plans provided inferior dose conformity compared to cone/Iris-based plans. The QA results of MLC-based plans were within 5% absolute dose difference with over 90% gamma passing rate using 2%/2 mm gamma criteria. The first version of InCise MLC could be a useful delivery modality, especially for clinical situations for which delivery time is a limiting factor or for multitarget cases. PMID:27685124

  4. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

    PubMed Central

    Hirnschall, Nino; Wiesinger, Jörg; Draschl, Petra; Findl, Oliver

    2015-01-01

    Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs) during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany) was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany), ORA (Ocular Response Analyzer, Reichert Ophthalmic Instruments, USA), and autorefraction (Autorefractometer RM 8800 Topcon) were performed postoperatively. Results. Mean age of the study population (n = 74) was 73.5 years (±9.3; range: 53 to 90) and mean corneal astigmatism preoperatively was −1.82 D (±0.59; 1.00 to 4.50). Mean corneal astigmatism was reduced to 1.14 D (±0.67; 0.11 to 3.89) 4 months postoperatively. A partial least squares regression showed that a high eccentricity of the cornea, a large deviation between keratometry and topography, and a high preoperative astigmatism resulted in a larger postoperative error concerning astigmatism. Conclusions. PCRI causes a reduction of preoperative astigmatism, though the prediction is difficult but several factors were found to be a relevant source of error. PMID:26199739

  5. Dosimetric and radiobiological comparison of CyberKnife M6™ InCise multileaf collimator over IRIS™ variable collimator in prostate stereotactic body radiation therapy.

    PubMed

    Kathriarachchi, Vindu; Shang, Charles; Evans, Grant; Leventouri, Theodora; Kalantzis, Georgios

    2016-01-01

    The impetus behind our study was to establish a quantitative comparison between the IRIS collimator and the InCise multileaf collimator (MLC) (Accuray Inc. Synnyvale, CA) for prostate stereotactic body radiation therapy (SBRT). Treatment plans for ten prostate cancer patients were performed on MultiPlan™ 5.1.2 treatment planning system utilizing MLC and IRIS for 36.25 Gy in five fractions. To reduce the magnitude of variations between cases, the planning tumor volume (PTV) was defined and outlined for treating prostate gland only, assuming no seminal vesicle or ex-capsule involvement. Evaluation indices of each plan include PTV coverage, conformity index (CI), Paddick's new CI, homogeneity index, and gradient index. Organ at risk (OAR) dose sparing was analyzed by the bladder wall Dmax and V37Gy, rectum Dmax and V36Gy. The radiobiological response was evaluated by tumor control probability and normal tissue complication probability based on equivalent uniform dose. The dose delivery efficiency was evaluated on the basis of planned monitor units (MUs) and the reported treatment time per fraction. Statistical significance was tested using the Wilcoxon signed rank test. The studies indicated that CyberKnife M6™ IRIS and InCise™ MLC produce equivalent SBRT prostate treatment plans in terms of dosimetry, radiobiology, and OAR sparing, except that the MLC plans offer improvement of the dose fall-off gradient by 29% over IRIS. The main advantage of replacing the IRIS collimator with MLC is the improved efficiency, determined from the reduction of MUs by 42%, and a 36% faster delivery time. PMID:27217626

  6. Dosimetric and radiobiological comparison of CyberKnife M6™ InCise multileaf collimator over IRIS™ variable collimator in prostate stereotactic body radiation therapy

    PubMed Central

    Kathriarachchi, Vindu; Shang, Charles; Evans, Grant; Leventouri, Theodora; Kalantzis, Georgios

    2016-01-01

    The impetus behind our study was to establish a quantitative comparison between the IRIS collimator and the InCise multileaf collimator (MLC) (Accuray Inc. Synnyvale, CA) for prostate stereotactic body radiation therapy (SBRT). Treatment plans for ten prostate cancer patients were performed on MultiPlan™ 5.1.2 treatment planning system utilizing MLC and IRIS for 36.25 Gy in five fractions. To reduce the magnitude of variations between cases, the planning tumor volume (PTV) was defined and outlined for treating prostate gland only, assuming no seminal vesicle or ex-capsule involvement. Evaluation indices of each plan include PTV coverage, conformity index (CI), Paddick's new CI, homogeneity index, and gradient index. Organ at risk (OAR) dose sparing was analyzed by the bladder wall Dmax and V37Gy, rectum Dmax and V36Gy. The radiobiological response was evaluated by tumor control probability and normal tissue complication probability based on equivalent uniform dose. The dose delivery efficiency was evaluated on the basis of planned monitor units (MUs) and the reported treatment time per fraction. Statistical significance was tested using the Wilcoxon signed rank test. The studies indicated that CyberKnife M6™ IRIS and InCise™ MLC produce equivalent SBRT prostate treatment plans in terms of dosimetry, radiobiology, and OAR sparing, except that the MLC plans offer improvement of the dose fall-off gradient by 29% over IRIS. The main advantage of replacing the IRIS collimator with MLC is the improved efficiency, determined from the reduction of MUs by 42%, and a 36% faster delivery time. PMID:27217626

  7. A Hot Knife Through Ice-Cream: Earthflow Response to Channel Incision (Or Channel Response to Earthflows?), Eel River Canyon, California

    NASA Astrophysics Data System (ADS)

    Mackey, B. H.; Roering, J. J.; McKean, J. A.

    2007-12-01

    Abundant glacier-like earthflow features are recognized as a primary erosional process in the highly erodable Franciscan Melange of the Eel River Basin, CA. Despite their prominence in this "melting ice-cream" topography, many questions regarding their effects on the long term sediment flux from this rapidly eroding basin remain unresolved. For example, does an earthflow's basal shear zone propagate vertically downwards with vertical river incision? What controls the upslope and lateral extent of individual earthflows? How does the erosive power of a river influence the rate of earthflow movement, or conversely do earthflow toe deposits regulate the rate of river incision? Here we present preliminary findings derived from study of 200km2 of lidar data (1m resolution) covering hillslopes adjacent to 30km of the Eel River. Lidar allows detailed analysis of the interaction between earthflows and the drainage network, and we document how inferred changes in local base level are propagated throughout adjacent hillslopes via earthflow movement. The most active earthflows (determined by field surveying and analysis of aerial photos rectified using lidar- generated digital topography) coincide with locally steep sections of channel, while downstream of the most active flows we frequently observe less-active or dormant earthflows. This observation supports the idea that the locations of the most active earthflows coincide with headward propagating knickpoints in the channel. The rate of earthflow movement appears to slow when an earthflow exhausts the upslope area of easily mobilized sediment. Earthflow toes can protrude directly into the channel, causing the channel to narrow and steepen, and even undercut the opposite bank. Large resistant boulders (>2m diameter) transported by the earthflow accumulate in the streambed and appear to both act as a check on further channel incision and earthflow movement. In contrast, areas adjacent to active earthflows exhibit smooth

  8. Use of Sato's curved laryngoscope and an insulated-tip knife for endoscopic incisional therapy of esophageal web

    PubMed Central

    Ohtaka, Masahiko; Kobayashi, Shouji; Yoshida, Takashi; Yamaguchi, Tatsuya; Uetake, Tomoyosi; Sato, Tadashi; Hayashi, Akira; Kanai, Mari; Yamamoto, Takanori; Hatsushika, Kyosuke; Masuyama, Keisuke; Enomoto, Nobuyuki

    2015-01-01

    We experienced two cases of esophageal web accompanying severe stricture that were treated by endoscopic incisions with an insulated-tip knife (IT-knife). With attention paid to the mucosa at the stricture, the lesion was incised with an IT-knife without complications. Sato's curved laryngoscope was used even in cervical esophageal lesions and an excellent field was secured. PMID:25131450

  9. Use of a Toric Intraocular Lens and a Limbal-Relaxing Incision for the Management of Astigmatism in Combined Glaucoma and Cataract Surgery

    PubMed Central

    Gibbons, Allister

    2016-01-01

    Purpose We report the surgical management of a patient with glaucoma undergoing cataract surgery with high preexisting astigmatism. A combination of techniques was employed for her astigmatism management. Methods A 76-year-old female with 5.5 dpt of corneal astigmatism underwent surgery in her left eye consisting of one-site trabeculectomy, phacoemulsification, toric intraocular lens implantation and a single inferior limbal-relaxing incision. Results Intraocular pressure control was achieved with no medication at 11 mm Hg; before the filtering procedure, the pressure was 16 mm Hg on two topical drugs. Astigmatism was reduced to 0.75 dpt, and both corrected and uncorrected visual acuity improved. Conclusions Astigmatism management can have a good outcome in combined procedures. We encourage surgeons to address astigmatism in the preoperative planning of patients undergoing glaucoma surgery associated with phacoemulsification. PMID:27293408

  10. Bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes versus cold-knife transurethral incision for the treatment of posterior urethral stricture: a prospective, randomized study

    PubMed Central

    Cai, Wansong; Chen, Zhiyuan; Wen, Liping; Jiang, Xiangxin; Liu, Xiuheng

    2016-01-01

    OBJECTIVE: Evaluate the efficiency and safety of bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes for the treatment of posterior urethral stricture. Compare the outcomes following bipolar plasma vaporization with conventional cold-knife urethrotomy. METHODS: A randomized trial was performed to compare patient outcomes from the bipolar and cold-knife groups. All patients were assessed at 6 and 12 months postoperatively via urethrography and uroflowmetry. At the end of the first postoperative year, ureteroscopy was performed to evaluate the efficacy of the procedure. The mean follow-up time was 13.9 months (range: 12 to 21 months). If re-stenosis was not identified by both urethrography and ureteroscopy, the procedure was considered “successful”. RESULTS: Fifty-three male patients with posterior urethral strictures were selected and randomly divided into two groups: bipolar group (n=27) or cold-knife group (n=26). Patients in the bipolar group experienced a shorter operative time compared to the cold-knife group (23.45±7.64 hours vs 33.45±5.45 hours, respectively). The 12-month postoperative Qmax was faster in the bipolar group than in the cold-knife group (15.54±2.78 ml/sec vs 18.25±2.12 ml/sec, respectively). In the bipolar group, the recurrence-free rate was 81.5% at a mean follow-up time of 13.9 months. In the cold-knife group, the recurrence-free rate was 53.8%. CONCLUSIONS: The application of bipolar plasma-cutting and plasma-loop electrodes for the management of urethral stricture disease is a safe and reliable method that minimizes the morbidity of urethral stricture resection. The advantages include a lower recurrence rate and shorter operative time compared to the cold-knife technique. PMID:26872076

  11. Gamma Knife

    MedlinePlus

    ... results are sent to the Gamma Knife®'s planning computer system. Together, physicians ( radiation oncologists and neurosurgeons) and medical physicists delineate targets and normal anatomical structures. They use a planning computer program to determine the exact spatial relationship between ...

  12. Stereotactic radiosurgery - Gamma Knife

    MedlinePlus

    ... Gamma Knife; Gamma Knife radiosurgery; Non-invasive neurosugery; Epilepsy - Gamma Knife ... problems ( arteriovenous malformation , arteriovenous fistula ) Some types of epilepsy Trigeminal neuralgia (severe nerve pain of the face) ...

  13. Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism

    PubMed Central

    Lee, Jeihoon; Lee, Hun; Kang, David Sung Yong; Choi, Jin Young; Kim, Eung Kweon

    2016-01-01

    Purpose To compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes. Materials and Methods The medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed. For subgroup analysis, the two groups were subdivided according to preoperative astigmatic severity [moderate, 2.00 to <3.00 diopters (D); high, 3.00–4.00 D]. Visual and astigmatic outcomes were compared 6 months postoperatively. Results The uncorrected distance visual acuity was at least 20/25 in 100% and 98% of the toric and LRI group eyes, respectively. The toric group had lower mean residual cylindrical error (-0.67±0.39 D vs. -1.14±0.56 D; p<0.001) and greater mean cylindrical error change (2.17±0.56 D vs. 1.63±0.72 D; p<0.001) than the LRI group, regardless of the preoperative astigmatic severity. The mean correction index (1.10±0.16 vs. 0.72±0.24; p<0.001) and success index (0.24±0.14 vs. 0.42±0.21; p<0.001) also differed significantly between the groups. Conclusion Both surgical techniques considerably reduced astigmatism and had comparable visual outcomes. However, toric foldable iris-fixated pIOL implantation was more reliable for correcting moderate-to-high astigmatism in myopic eyes. PMID:27593877

  14. Cold knife cone biopsy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003910.htm Cold knife cone biopsy To use the sharing features on this page, please enable JavaScript. A cold knife cone biopsy (conization) is surgery to remove ...

  15. Incising Tibet

    NASA Astrophysics Data System (ADS)

    Yang, R.; Herman, F.; Fellin, M. G.; Willett, S.; Wang, W.

    2014-12-01

    Convergence between India and Eurasia has produced the Tibetan Plateau, which stands 5 km high over a region of 3 million km2,since collision at ~50 Ma. A key region for understanding the mechanisms and timing of uplift is the SE margin, where major rivers have incised the plateau margin, permitting the use of thermochronometry to time incision. Here we present new (U-Th)/He ages including 17 ages on apatite and 23 on zircon and 12 apatite fission track ages on the southeastern margins of the Plateau to explore rates and timing of incision. All three thermochronometric systems on the Salween suggest a regional change in the last 8 Myr and exhibit progressive younging over ~ 150 km upstream. Apatite (U-Th)/He ages of valley bottom samples from the Mekong become younger upstream whereas apatite fission-track and zircon (U-Th)/He ages show a large scatter from ~ 5 Ma to ~160 Ma, depending on the distance above the thalweg. Similarly, upstream samples north of 290N on the Yangtze yield much younger ages than downstream samples. Inversion of combined thermochronometers reveals a northward propagation of the highest rates of incision along the Salween and Mekong since 8 Ma. These results, together with analysis of river profiles, are best explained by a scenario of plateau incision that occurred in southeastern Tibet before or coeval at 8 Ma. We infer that the southeastern plateau margin was deformed under a complex context with both lateral expansion of the plateau margin and oblique indenting of the India plate localizing shortening and high uplift rates at the corner of the indenter.

  16. The Shoemaker's Knife

    ERIC Educational Resources Information Center

    Thomson, Ian

    2010-01-01

    Archimedes, the famous Greek mathematician, lived from 287 BCE until approximately 212 BCE. He thought that the figure of two semi-circles on a straight line enclosed by a larger semi-circle resembled a shoemaker's knife. Archimedes called this figure an "arbelos" since arbelos is the Greek word for a shoemaker's knife. The author describes the…

  17. The plasma scalpel: a new thermal knife.

    PubMed

    Glover, J L; Bendick, P J; Link, W J; Plunkett, R J

    1982-01-01

    A new thermal knife, the plasma scalpel, capable of simultaneous division of tissue and coagulation of blood vessels, is described. A high temperature argon gas plasma (unrelated to blood plasma) is created by passing the gas through a direct current arc, ionizing the gas and elevating its temperature to 3000 degrees C. A small plasma cutting jet is formed by a nozzle at the tip of the handpiece. Liver resections and muscle transections performed in a canine model, and full thickness burn excisions in a pig skin model showed effective division of tissue and significantly less blood loss when compared to the steel scalpel. Wound healing studies of histologic comparisons and wound breaking strength were performed for steel, plasma, laser, and electrosurgical scalped incisions in the skin of mice and rats. All thermal knife wounds showed localized tissue damage at the edges of the incision, but the events of healing began at the same time. Compared to the steel scalpel, there was a three to six day delay in the onset of healing, but healing occurred in the normal fashion and all thermal knife wounds reached the same healed breaking strength as the steel scalpel wounds. Clinically, the plasma scalped has been used for 138 procedures in 96 patients. The majority of cases have been transection of muscle, hepatic resection or debridement, or soft tissue debridement. Muscle transection data for the plasma scalped compared to the electrosurgical scalpel has shown virtually no blood loss with a shorter time to hemostasis for the plasma scalpel. The plasma scalpel has proved to be an effective thermal knife, capable of simultaneous division and coagulation. Further development work and proof of its efficacy in the clinical setting are necessary to establish the plasma scalpel and adequately demonstrate its proper role in surgery.

  18. Dynamic gamma knife radiosurgery

    NASA Astrophysics Data System (ADS)

    Luan, Shuang; Swanson, Nathan; Chen, Zhe; Ma, Lijun

    2009-03-01

    Gamma knife has been the treatment of choice for various brain tumors and functional disorders. Current gamma knife radiosurgery is planned in a 'ball-packing' approach and delivered in a 'step-and-shoot' manner, i.e. it aims to 'pack' the different sized spherical high-dose volumes (called 'shots') into a tumor volume. We have developed a dynamic scheme for gamma knife radiosurgery based on the concept of 'dose-painting' to take advantage of the new robotic patient positioning system on the latest Gamma Knife C™ and Perfexion™ units. In our scheme, the spherical high dose volume created by the gamma knife unit will be viewed as a 3D spherical 'paintbrush', and treatment planning reduces to finding the best route of this 'paintbrush' to 'paint' a 3D tumor volume. Under our dose-painting concept, gamma knife radiosurgery becomes dynamic, where the patient moves continuously under the robotic positioning system. We have implemented a fully automatic dynamic gamma knife radiosurgery treatment planning system, where the inverse planning problem is solved as a traveling salesman problem combined with constrained least-square optimizations. We have also carried out experimental studies of dynamic gamma knife radiosurgery and showed the following. (1) Dynamic gamma knife radiosurgery is ideally suited for fully automatic inverse planning, where high quality radiosurgery plans can be obtained in minutes of computation. (2) Dynamic radiosurgery plans are more conformal than step-and-shoot plans and can maintain a steep dose gradient (around 13% per mm) between the target tumor volume and the surrounding critical structures. (3) It is possible to prescribe multiple isodose lines with dynamic gamma knife radiosurgery, so that the treatment can cover the periphery of the target volume while escalating the dose for high tumor burden regions. (4) With dynamic gamma knife radiosurgery, one can obtain a family of plans representing a tradeoff between the delivery time and the

  19. The Knife Machine. Module 15.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This module on the knife machine, one in a series dealing with industrial sewing machines, their attachments, and operation, covers one topic: performing special operations on the knife machine (a single needle or multi-needle machine which sews and cuts at the same time). These components are provided: an introduction, directions, an objective,…

  20. Stereotactic radiosurgery - CyberKnife

    MedlinePlus

    ... slides into a machine that delivers radiation. A robotic arm controlled by a computer moves around you. ... Accuray Incorporated. CyberKnife robotic radiosurgery system patient brochure. 2012. ... Accessed ...

  1. Changing the gamma knife.

    PubMed

    Ganz, Jeremy C

    2014-01-01

    The first Gamma Knife used helmets containing collimators of different diameters that increase the flexibility of the treatment. Changing these helmets was time-consuming and tedious. The original model that was introduced into the United States was the U model where the patient was inserted into the machine inward and upward, using hydraulics. A new simpler machine was devised called the B model where the patient simply moved in and out, but there was still the problem of changing helmets. Then, the C model was introduced, with a robot called the automatic positioning system that permitted the patient’s position to be moved automatically. However, the helmets still had to be changed when collimators of different sizes were required. Finally, an entirely redesigned model called Perfexion was introduced where there were no helmets and the patient once placed in the machine would be treated completely following a single pressure on a button. PMID:25376576

  2. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife

    PubMed Central

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook

    2016-01-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  3. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife.

    PubMed

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook; Lee, Soo Teik

    2016-07-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture.

  4. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife.

    PubMed

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook; Lee, Soo Teik

    2016-07-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  5. The inverted Batman incision: a new incision in transcolumellar incision for open rhinoplasty.

    PubMed

    Nakanishi, Yuji; Nagasao, Tomohisa; Shimizu, Yusuke; Miyamoto, Junpei; Fukuta, Keizo; Kishi, Kazuo

    2013-12-01

    Columellar and nostril shapes often present irregularity after transcolumellar incision for open rhinoplasty, because of the contracture of the incised wound. The present study introduces a new technique to prevent this complication, and verifies its efficacy in improving cosmetic appearance. In our new method, a zig-zag incision with three small triangular flaps is made on the columella and in the pericolumellar regions of the bilateral nostril rims. Since the shape of the incision resembles the contour of an inverted "batman", we term our new method the "Inverted Batman" incision. To verify the effectiveness of the Inverted Batman incision, aesthetic evaluation was conducted for 21 patients operated on using the conventional transcolumellar incision (Conventional Group) and 19 patients operated on using the Inverted Batman incision (Inverted Batman Group). The evaluation was performed by three plastic surgeons, using a four-grade scale to assess three separate items: symmetry of bilateral soft triangles, symmetry of bilateral margins of the columella, and evenness of the columellar surface. The scores of the two groups for these three items were compared using a non-parametric test (Mann-Whitney U-test). With all three items, the Inverted Batman group patients present higher scores than Conventional Group patients. The Inverted Batman incision is effective in preserving the correct anatomical structure of the columella, soft triangle, and nostril rims. Hence, we recommend the Inverted Batman incision as a useful technique for open rhinoplasty.

  6. Biomechanics of knife stab attacks.

    PubMed

    Chadwick, E K; Nicol, A C; Lane, J V; Gray, T G

    1999-10-25

    Equipment, materials and methods for the measurement of the biomechanical parameters governing knife stab attacks have been developed and data have been presented that are relevant to the improvement of standards for the testing of stab-resistant materials. A six-camera Vicon motion analysis system was used to measure velocity, and derive energy and momentum during the approach phase of the attack and a specially developed force-measuring knife was used to measure three-dimensional forces and torque during the impact phase. The body segments associated with the knife were modelled as a series of rigid segments: trunk, upper arm, forearm and hand. The velocities of these segments, together with knowledge of the mass distribution from biomechanical tables, allowed the calculation of the individual segment energy and momentum values. The instrumented knife measured four components of load: axial force (along the length of the blade), cutting force (parallel to the breadth of the blade), lateral force (across the blade) and torque (twisting action) using foil strain gauges. Twenty volunteers were asked to stab a target with near maximal effort. Three styles of stab were used: a short thrust forward, a horizontal style sweep around the body and an overhand stab. These styles were chosen based on reported incidents, providing more realistic data than had previously existed. The 95th percentile values for axial force and energy were 1885 N and 69 J, respectively. The ability of current test methods to reproduce the mechanical parameters measured in human stab attacks has been assessed. It was found that current test methods could reproduce the range of energy and force values measured in the human stab attacks, although the simulation was not accurate in some respects. Non-axial force and torque values were also found to be significant in the human tests, but these are not reproduced in the standard mechanical tests.

  7. Channel incision and water quality

    NASA Astrophysics Data System (ADS)

    Shields, F. D.

    2009-12-01

    Watershed development often triggers channel incision that leads to radical changes in channel morphology. Although morphologic evolution due to channel incision has been documented and modeled by others, ecological effects, particularly water quality effects, are less well understood. Furthermore, environmental regulatory frameworks for streams frequently focus on stream water quality and underemphasize hydrologic and geomorphic issues. Discharge, basic physical parameters, solids, nutrients (nitrogen and phosphorus), chlorophyll and bacteria were monitored for five years at two sites along a stream in a mixed cover watershed characterized by rapid incision of the entire channel network. Concurrent data were collected from two sites on a nearby stream draining a watershed of similar size and cultivation intensity, but without widespread incision. Data sets describing physical aquatic habitat and fish fauna of each stream were available from other studies. The second stream was impacted by watershed urbanization, but was not incised, so normal channel-floodplain interaction maintained a buffer zone of floodplain wetlands between the study reach and the urban development upstream. The incised stream had mean channel depth and width that were 1.8 and 3.5 times as large as for the nonincised stream, and was characterized by flashier hydrology. The median rise rate for the incised stream was 6.4 times as great as for the nonincised stream. Correlation analyses showed that hydrologic perturbations were associated with water quality degradation, and the incised stream had levels of turbidity and solids that were two to three times higher than the nonincised, urbanizing stream. Total phosphorus, total Kjeldahl N, and chlorophyll a concentrations were significantly higher in the incised stream, while nitrate was significantly greater in the nonincised, urbanizing stream (p < 0.02). Physical aquatic habitat and fish populations in the nonincised urbanizing stream were

  8. Peripheral doses in CyberKnife radiosurgery

    SciTech Connect

    Petti, Paula L.; Chuang, Cynthia F.; Smith, Vernon; Larson, David A.

    2006-06-15

    The purpose of this work is to measure the dose outside the treatment field for conformal CyberKnife treatments, to compare the results to those obtained for similar treatments delivered with gamma knife or intensity-modulated radiation therapy (IMRT), and to investigate the sources of peripheral dose in CyberKnife radiosurgery. CyberKnife treatment plans were developed for two hypothetical lesions in an anthropomorphic phantom, one in the thorax and another in the brain, and measurements were made with LiF thermoluminescent dosimeters (TLD-100 capsules) placed within the phantom at various depths and distances from the irradiated volume. For the brain lesion, gamma knife and 6-MV IMRT treatment plans were also developed, and peripheral doses were measured at the same locations as for the CyberKnife plan. The relative contribution to the CyberKnife peripheral dose from inferior- or superior-oblique beams entering or exiting through the body, internally scattered radiation, and leakage radiation was assessed through additional experiments using the single-isocenter option of the CyberKnife treatment-planning program with different size collimators. CyberKnife peripheral doses (in cGy) ranged from 0.16 to 0.041 % ({+-}0.003%) of the delivered number of monitor units (MU) at distances between 18 and 71 cm from the field edge. These values are two to five times larger than those measured for the comparable gamma knife brain treatment, and up to a factor of four times larger those measured in the IMRT experiment. Our results indicate that the CyberKnife peripheral dose is due largely to leakage radiation, however at distances less than 40 cm from the field edge, entrance, or exit dose from inferior- or superior-oblique beams can also contribute significantly. For distances larger than 40 cm from the field edge, the CyberKnife peripheral dose is directly related to the number of MU delivered, since leakage radiation is the dominant component.

  9. A sharp knife for high temperatures

    NASA Technical Reports Server (NTRS)

    Heisman, R. M.; Iceland, W. F.

    1978-01-01

    Electrically heated nickel-chrome-steel alloy knife may be used to cut heat resistant plastic felt and similar materials with relative ease. Blade made of commercially available alloy RA 330 retains edge at temperatures as high as 927 C.

  10. Gamma Knife Radiosurgery for Acromegaly

    PubMed Central

    Rolston, John D.; Blevins, Lewis S.

    2012-01-01

    Acromegaly is debilitating disease occasionally refractory to surgical and medical treatment. Stereotactic radiosurgery, and in particular Gamma Knife surgery (GKS), has proven to be an effective noninvasive adjunct to traditional treatments, leading to disease remission in a substantial proportion of patients. Such remission holds the promise of eliminating the need for expensive medications, along with side effects, as well as sparing patients the damaging sequelae of uncontrolled acromegaly. Numerous studies of radiosurgical treatments for acromegaly have been carried out. These illustrate an overall remission rate over 40%. Morbidity from radiosurgery is infrequent but can include cranial nerve palsies and hypopituitarism. Overall, stereotactic radiosurgery is a promising therapy for patients with acromegaly and deserves further study to refine its role in the treatment of affected patients. PMID:22518132

  11. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic...

  12. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic...

  13. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic...

  14. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic...

  15. 21 CFR 886.4230 - Ophthalmic knife test drum.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ophthalmic knife test drum. 886.4230 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4230 Ophthalmic knife test drum. (a) Identification. An ophthalmic knife test drum is a device intended to test the keenness of ophthalmic...

  16. SIMPLIFIED LAPAROSCOPIC CHOLECYSTECTOMY WITH TWO INCISIONS

    PubMed Central

    ABAID, Rafael Antoniazzi; CECCONELLO, Ivan; ZILBERSTEIN, Bruno

    2014-01-01

    Background Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. Aim To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. Technique In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. Conclusion Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result. PMID:25004296

  17. Hillslope-derived blocks retard river incision

    NASA Astrophysics Data System (ADS)

    Shobe, Charles M.; Tucker, Gregory E.; Anderson, Robert S.

    2016-05-01

    The most common detachment-limited river incision models ignore the effects of sediment on fluvial erosion, yet steep reaches of mountain rivers often host clusters of large (>1 m) blocks. We argue that this distribution of blocks is a manifestation of an autogenic negative feedback in which fast vertical river incision steepens adjacent hillslopes, which deliver blocks to the channel. Blocks inhibit incision by shielding the bed and enhancing form drag. We explore this feedback with a 1-D channel-reach model in which block delivery by hillslopes depends on the river incision rate. Results indicate that incision-dependent block delivery can explain the block distribution in Boulder Creek, Colorado. The proposed negative feedback may significantly slow knickpoint retreat, channel adjustment, and landscape response compared to rates predicted by current theory. The influence of hillslope-derived blocks may complicate efforts to extract base level histories from river profiles.

  18. Gamma Knife Radiosurgery for Choroidal Hemangioma

    SciTech Connect

    Kim, Yun Taek; Kang, Se Woong; Lee, Jung-Il

    2011-12-01

    Purpose: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Methods and Materials: Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm{sup 3} (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). Results: The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p = .018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Conclusion: Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.

  19. Relaxation System

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Environ Corporation's relaxation system is built around a body lounge, a kind of super easy chair that incorporates sensory devices. Computer controlled enclosure provides filtered ionized air to create a feeling of invigoration, enhanced by mood changing aromas. Occupant is also surrounded by multidimensional audio and the lighting is programmed to change colors, patterns, and intensity periodically. These and other sensory stimulators are designed to provide an environment in which the learning process is stimulated, because research has proven that while an individual is in a deep state of relaxation, the mind is more receptive to new information.

  20. Knife River Indian Villages National Historic Site: Teacher's Guide.

    ERIC Educational Resources Information Center

    National Park Service (Dept. of Interior), Washington, DC. National Register of Historic Places.

    This guide provides history and social studies teachers, at all grade levels, with information and activities about the American Indians of the Northern Plains who lived in the area of the Knife River where it enters the Missouri River. Located in what is now North Dakota, this area is the Knife River Indian Villages National Historic Site. The…

  1. [LASER CONISATION VS. COLD KNIFE CONISATION FOR CIN].

    PubMed

    Karagyozov, I

    2016-01-01

    For the period of 5 years (2008-2012) at the outpatient department and the operation theater of Tokuda hospital 280 conisations were done--135 lasers and 145 cold knifes. Indications for the operation were common, with no specific choice for the aim of comparison. All patients had proven colposcopic or histologic dysplasia of the cervix. The operations were performed 2 or 3 days after menstruation. Laser conisations received local anesthesia and were not hospitalized. Cold knife conisations were done at the operation theater under regional anesthesia, they attended the hospital for 24 hours, had vaginal tapenade and urethral catheter. Indications for the operation were as follows: CIN I-14 laser and 38 cold knife conisations; CIN II-30 laser and 28 cold knife conisations; CIN III--CIS-73 laser and 74 cold knife conisations. The follow up is: 2 months after the operation-colposcopy and every 3 months afterwards--PAP smear and colposcopy for 1 year. PMID:27514128

  2. Clear Corneal Incision in Cataract Surgery

    PubMed Central

    Al Mahmood, Ammar M.; Al-Swailem, Samar A.; Behrens, Ashley

    2014-01-01

    Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature. PMID:24669142

  3. Low-power holmium:YAG laser urethrotomy for urethral stricture disease: comparison of outcomes with the cold-knife technique.

    PubMed

    Atak, Mustafa; Tokgöz, Hüsnü; Akduman, Bülent; Erol, Bülent; Dönmez, Ibrahim; Hancı, Volkan; Türksoy, Ozlem; Mungan, Necmettin Aydın

    2011-11-01

    In this prospective randomized clinical trial, we aimed to evaluate the safety and efficacy of endourethrotomy with holmium:yttrium-aluminium-garnet (HO:YAG) laser and compare the outcomes with the conventional cold-knife urethrotomy. Fifty-one male patients with single, iatrogenic, annular strictures of the urethra were randomly divided into two groups; 21 patients who underwent direct-vision endoscopic urethrotomy with Ho:YAG laser (15 W; 1,200-1,400 mJ; 8-12 Hz) at 12 o'clock position (laser group) and 30 patients who underwent direct-vision endoscopic urethrotomy with cold-knife incision at 12 o'clock position (cold-knife group). The results obtained were analyzed and compared at 3 months, 6 months, 9 months, and 12 months postoperatively by clinical evaluation, uroflowmetry, and retrograde urethrographies. Variables were compared among groups using Fisher's exact and Mann Whitney U tests. There were no differences between two groups in terms of patient age, preoperative Qmax value, stricture location, and length. Operative time was shorter in laser group (16.4 ± 8.04 minutes) when compared with cold-knife group (23.8 ± 5.47 minutes) (p<0.001). Recurrence-free rate at 3 months was similar between two groups (p=0.122). However, recurrence-free rates at 6 months, 9 months, and 12 months were significantly higher in laser group when compared with cold-knife group (p values were 0.045, 0.027, and 0.04, respectively). No intra- or postoperative complications were encountered. Use of Ho:YAG laser in the management of urethral stricture disease is a safe and effective method. In addition, it provides shorter operative time and lower recurrence rate when compared with the conventional technique.

  4. Knife and impact cutting of lamb bone.

    PubMed

    King, M J

    1999-05-01

    The forces and hence fracture energies required to cut bone are presented in this paper and the merits of cutting with a high speed blade are considered. A plain knife blade was used to cut cancellous and compact lamb bone using three different methods. A microtome was used to produce a range of cut thicknesses which enabled the fracture energy to be separated into friction, surface fracture and plastic deformation energies. A tensile test machine was used to produce thicker off-cuts so that the energy required to cut through full sections of bone could be determined. A high speed rail gun was used to cut at speeds up to 130 m/s. The energy required to cut bone did not change with blade speed. However, the energies measured during the cutting varied over a wide range. In situations in which the surface of the cut bone exhibited a very uneven surface high energy was required, whereas when the resulting cut surface was planar the cutting energy was low. A light weight blade which impacts the bone at high speed will transmit a small impulse to the carcass which may be absorbed without transmitting strain to the muscle/connective tissue. This may allow the development of a high speed knife which will cut bone without excessively damaging the meat surrounding the cut. PMID:22062140

  5. A nurse clinician's approach to knife crime prevention.

    PubMed

    England, Rachel; Jackson, Rob

    This article outlines a new and creative contribution to knife crime prevention by an emergency nurse clinician and an initial evaluation of its effectiveness. The 'knife crime prevention programme' is delivered to young people aged 11-16 years by one of the authors, Rob Jackson, an emergency nurse clinician at Liverpool University Hospital; the aim is to educate young people about the medical consequences of knife injury. A group of 140 students and 17 teachers responded to a questionnaire evaluating the effectiveness of the session delivered to four schools in Liverpool. Students and teachers positively rated the session, with the combination of the nurse clinician's knowledge and expertise and photographs and depictions of knife crime as a unique and impacting approach to knife crime prevention. It is suggested that the nurse clinician and other experienced health professionals have an important contribution to make in preventive approaches to knife crime. Further evaluation of the knife crime prevention programme will be conducted by the authors.

  6. [Bumping into a knife--exculpatory statement or (tragic) accident?].

    PubMed

    Wilke, Nadine; Püschel, Klaus

    2011-01-01

    Assessing stab wounds is a common task in forensic medicine. Quite often an accused claims that the victim bumped into the knife. Taking into account all the facts ascertained in the investigations conducted, such a statement can be rapidly disproved in most cases. The present case of a 14-year-old boy fatally wounded by his mother with a kitchen knife examines the aspect of walking into a knife. It is an example that this statement cannot always be regarded as implausible and that every single case has to be reconstructed in detail on the basis of all the investigation results. PMID:22039697

  7. Single incision endoscopic surgery for lumbar hernia.

    PubMed

    Kawaguchi, Masahiko; Ishikawa, Norihiko; Shimizu, Satsuki; Shin, Hisato; Matsunoki, Aika; Watanabe, Go

    2011-01-01

    Single Incision Endoscopic Surgery (SIES) has emerged as a less invasive surgery among laparoscopic surgeries, and this approach for incisional hernia was reported recently. This is the first report of SIES for an incisional lumbar hernia. A 66-year-old Japanese woman was referred to our institution because of a left flank hernia that developed after left iliac crest bone harvesting. A 20-mm incision was created on the left side of the umbilicus and all three trocars (12, 5, and 5 mm) were inserted into the incision. The hernial defect was 14 × 9 cm and was repaired with intraperitoneal onlay mesh and a prosthetic graft. The postoperative course was uneventful. SIES for lumbar hernia offers a safe and effective outcome equivalent compared to laparoscopic surgery. In addition, SIES is less invasive and has a cosmetic benefit.

  8. Minimally Invasive Cardiovascular Surgery: Incisions and Approaches

    PubMed Central

    Langer, Nathaniel B.; Argenziano, Michael

    2016-01-01

    Throughout the modern era of cardiac surgery, most operations have been performed via median sternotomy with cardiopulmonary bypass. This paradigm is changing, however, as cardiovascular surgery is increasingly adopting minimally invasive techniques. Advances in patient evaluation, instrumentation, and operative technique have allowed surgeons to perform a wide variety of complex operations through smaller incisions and, in some cases, without cardiopulmonary bypass. With patients desiring less invasive operations and the literature supporting decreased blood loss, shorter hospital length of stay, improved postoperative pain, and better cosmesis, minimally invasive cardiac surgery should be widely practiced. Here, we review the incisions and approaches currently used in minimally invasive cardiovascular surgery. PMID:27127555

  9. How Sharp Does a "Knife Edge" Have to Be?

    ERIC Educational Resources Information Center

    Dietz, Eric R.; Gash, Philip W.

    1994-01-01

    Describes an experiment designed to help understand the effect of the curvature of the laboratory equipment support (cylindrical rod instead of knife-edge) on the frequency of oscillation of pendula. (ZWH)

  10. Gamma knife radiosurgery for clinically persistent acromegaly.

    PubMed

    Liu, Xiaomin; Kano, Hideyuki; Kondziolka, Douglas; Park, Kyung-Jae; Iyer, Aditya; Niranjan, Ajay; Flickinger, John C; Lunsford, L Dade

    2012-08-01

    Gamma knife radiosurgery (GKRS) is an important additional strategy for unresected clinically active pituitary adenomas. Radiosurgery for acromegaly aims to achieve tumor growth control and endocrine remission, potentially obviating the need for lifetime medication suppression therapy. Forty patients with clinically active acromegaly underwent GKRS between 1988 and 2009. Thirty-four patients had undergone prior surgical resection. The median follow-up interval was 72 months (range 24-145). Endocrine remission was defined as growth hormones (GH) level <2.5 ng/ml and a normal insulin-like growth factor 1 (IGF-1) level (age and sex adjusted) off growth hormone inhibiting drugs for at least 3 months. Endocrine control was defined as normal GH and IGF-1 levels on suppression medication. Endocrine remission was achieved in 19 (47.5 %) patients and endocrine control in four additional (10.0 %) patients. Patients with lower IGF-1 level and with tumors that were less invasive of the cavernous sinus before GKRS were associated with better GH remission rates. Imaging-defined local tumor control was achieved in 39 (97.5 %) patients (27 had tumor regression). One patient with delayed tumor progression underwent a second GKRS procedure. Three other patients had repeat GKRS because of persistently elevated and clinically symptomatic GH and IGF-1 levels. Sixteen (40.0 %) patients eventually developed a new pituitary axis deficiency at a median onset of 36 months after radiosurgery. No patient developed new visual dysfunction. Gamma knife radiosurgery, which is most often applied in clinically symptomatic acromegaly persistent after initial microsurgery, was most effective when the tumor was less invasive of the cavernous sinus and when patients had lower IGF-1 levels before GKRS. Almost one half of the patients no longer required long term medication suppression.

  11. Single-Incision Laparoscopic Total Colectomy

    PubMed Central

    Ojo, Oluwatosin J.; Carne, David; Guyton, Daniel

    2012-01-01

    Background and Objectives: To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy. Methods: A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed. Results: Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications. Conclusions: Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy. PMID:22906326

  12. The transareolar incision for breast augmentation revisited.

    PubMed

    Kompatscher, Peter; Schuler, Christine; Beer, Gertrude M

    2004-01-01

    Of the various possible incisions for breast augmentation, the transareolar access has gained only limited popularity. The potential side effects of this incision are said to be altered nipple sensation, impaired lactation, an increased rate of infections with capsular fibrosis, well visible scar formation with hypopigmentation, and the need for an additional access in case a breast ptosis correction should prove necessary at a later date. The purpose of this retrospective study was to judge advantages and limitations of transareolar breast augmentation, and to verify whether the reluctant attitude toward this surgical approach is justified. A sample of 18 patients with a transareolar, retropectoral breast augmentation was selected for a retrospective evaluation. The suitability of the technique in general was examined together with early postoperative complications, sensory changes, and late complications on the basis of an evaluation system for cosmetic surgical results. The study showed that only women with an areolar diameter of 3.5 cm or more without pronounced breast ptosis were suitable for the transareolar access. No early infections were noted. The rate of capsular fibrosis was 11%. Two years after breast augmentation, 16 women (89%) judged their breast sensation to be normal, but objective assessment showed that mean pressure and vibration sensation were moderately compromised in all parts of the breast. The scars were of good quality, with very little hypopigmentation. With appropriate patient selection, respecting the advantages and limitations, the transareolar incision has its definite place among the different incisions for breast augmentation. PMID:15164231

  13. Butylcyanoacrylate tissue adhesive for columellar incision closure.

    PubMed

    Ozturan, O; Miman, M C; Aktas, D; Oncel, S

    2001-07-01

    Cosmetic outcome of the columellar incision closure in external rhinoplasty patients has been a subject of discussion. This study was conducted to assess whether tissue adhesives provide an alternative option for sutureless closure of columellar skin incisions for cases utilizing open technique rhinoplastic surgery. One hundred and one patients undergoing external rhinoplasty were randomized to either topical application of butylcyanoacrylate or polypropylene sutures for columellar skin closure. The majority of tension on the wound edges was taken up using 5-0 chromic catgut. Cosmetic outcomes were evaluated by two otolaryngologists independently using visual analogue and Hollander wound evaluation scales in a blinded manner. There was no statistically significant difference in cosmesis between the surgeons' evaluation scores for either type or repair of the columellar incision. Since the tissue adhesive forms its own protective barrier, post-operative care is simplified. Closure with adhesives eliminates the need for post-operative suture removal requiring an extra visit that should lead to more efficient use of physician and patient time. Butylcyanoacrylate performs cosmetically as well as standard suture closure of columellar skin incision used for external rhinoplasty.

  14. Breathing and Relaxation

    MedlinePlus

    ... Top Doctors in the Nation Departments & Divisions Home Health Insights Stress & Relaxation Breathing and Relaxation Breathing and Relaxation Make ... Management Assess Your Stress Coping Strategies Identifying ... & Programs Health Insights Doctors & Departments Research & Science Education & Training Make ...

  15. Relaxation Assessment with Varied Structured Milieu (RELAX).

    ERIC Educational Resources Information Center

    Cassel, Russell N.; Cassel, Susie L.

    1983-01-01

    Describes Relaxation Assessment with Varied Structured Milieu (RELAX), a clinical program designed to assess the degree to which an individual is able to demonstrate self-control for overall general relaxation. The program is designed for use with the Cassel Biosensors biofeedback equipment. (JAC)

  16. Drainage basins and channel incision on Mars

    PubMed Central

    Aharonson, Oded; Zuber, Maria T.; Rothman, Daniel H.; Schorghofer, Norbert; Whipple, Kelin X.

    2002-01-01

    Measurements acquired by the Mars Orbiter Laser Altimeter on board the Mars Global Surveyor indicate that large drainage systems on Mars have geomorphic characteristics inconsistent with prolonged erosion by surface runoff. We find the topography has not evolved to an expected equilibrium terrain form, even in areas where runoff incision has been previously interpreted. By analogy with terrestrial examples, groundwater sapping may have played an important role in the incision. Longitudinally flat floor segments may provide a direct indication of lithologic layers in the bedrock, altering subsurface hydrology. However, it is unlikely that floor levels are entirely due to inherited structures due to their planar cross-cutting relations. These conclusions are based on previously unavailable observations, including extensive piece-wise linear longitudinal profiles, frequent knickpoints, hanging valleys, and small basin concavity exponents. PMID:16578863

  17. CyberKnife radiosurgery for spinal neoplasms.

    PubMed

    Gerszten, Peter C; Burton, Steven A; Ozhasoglu, Cihat

    2007-01-01

    The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited by the availability of effective target immobilization and localization technologies. Conventional external beam radiotherapy lacks the precision to allow delivery of large doses of radiation near radiosensitive structures such as the spinal cord. The CyberKnife (Accuray Inc., Sunnyvale, Calif., USA) is an imageguided frameless stereotactic radiosurgery system that allows for the radiosurgical treatment of spinal lesions. The system utilizes the coupling of an orthogonal pair of X-ray cameras to a dynamically manipulated robot-mounted lightweight linear accelerator which has 6 d.f. that guides the therapy beam to the intended target without the use of frame-based fixation. Realtime imaging tracking allows for patient movement tracking with 1mm spatial accuracy. Cervical spine lesions are located and tracked relative to skull bony landmarks; lower spinal lesions are tracked relative to percutaneously placed gold fiducial bone markers. Spinal stereotactic radiosurgery using a frameless image-guided system is now both feasible and safe. The major potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with rapid recovery and good symptomatic response. This technique offers a successful therapeutic modality for the treatment of a variety of spinal lesions as a primary treatment or for lesions not amenable to open surgical techniques, in medically inoperable patients, lesions located in previously irradiated sites, or as an adjunct to surgery.

  18. Neck incision planning for total laryngectomy: A finite element analysis.

    PubMed

    Feng, Allen L; Clark, James H; Agrawal, Nishant; Moussa, Walied; Richmon, Jeremy D

    2015-11-26

    Post-operative complications can be attributed to technical aspects of surgery, yet no studies have investigated the mechanics behind commonly used incisions for total laryngopharyngectomies (TLP). This procedure, seen in head and neck cancer patients, necessitates free tissue transfer to construct a neo-pharynx, creating an inherently greater risk of complications. We sought to investigate the impact of neck incision location on these post-operative complications for TLP using finite element analysis (FEA). A nonlinear hyperelastic 2-D finite element model was used to evaluate the stress and strain along the incision line of two separate neck incision models commonly used for TLP: low-neck apron (LNA) incisions that incorporate the patient׳s tracheostoma and mid-neck apron (MNA) incisions that do not communicate with the tracheostoma. A constant displacement was applied to the incision to simulate normal neck extension experienced during the post-operative phase. Each neck incision was also modeled at varying strain energy densities to simulate various stages of wound healing. For a constant displacement of 40mm, the principal von Mises stress of the LNA incision varied between 5.87 and 6.41MPa, depending on the hyperelastic properties of the healing incision. This stress was concentrated at the junction of the incision and the fixed tracheostomal edge. The MNA model demonstrated a principal von Mises stress that varied between 0.558 and 0.711MPa and was concentrated along the midline of the neck incision. MNA incisions for TL patients result in principal von Mises stresses which are up to 11 times lower than those seen in LNA incisions. These results coincided with clinical observations from a concurrent study that showed a decrease in rate of wound dehiscence for patients undergoing TLP with an MNA incision.

  19. Leiomyomatous hamartoma of the incisive papilla.

    PubMed

    Corrêa, L; Lotufo, M; Martins, M T; Sugaya, N; de Sousa, S C

    2001-01-01

    A case of unusual hamartoma in a six-year-old otherwise healthy Brazilian girl is reported, with emphasis on histological and immunohistochemical features. A mass observed in the incisive papilla was detected whose appearance was similar to congenital epulis or fibroma. Histological findings showed interlacing fascicles of large spindle cells resembling smooth muscle cells. Immunohistochemical staining for desmin and for smooth-muscle actin was positive. The histological diagnosis was leiomyomatous hamartoma, based on clinical and microscopic observations.

  20. Development of an air knife to remove seed coat fragments during lint cleaning

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An air knife is a tool commonly used to blow off debris in a manufacturing line. The knife may also be used to break the attachment force between a lint cleaner saw and a seed coat fragment (SCF) with attached fiber, and remove them. Work continued on evaluating an auxiliary air knife mounted on t...

  1. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction.

    PubMed

    Djordjevic, Miroslav L; Kojovic, Vladimir

    2013-05-01

    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14-82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting.

  2. Repeat Gamma Knife Radiosurgery for Trigeminal Neuralgia

    SciTech Connect

    Aubuchon, Adam C.; Chan, Michael D.; Lovato, James F.; Balamucki, Christopher J.; Ellis, Thomas L.; Tatter, Stephen B.; McMullen, Kevin P.; Munley, Michael T.; Deguzman, Allan F.; Ekstrand, Kenneth E.; Bourland, J. Daniel; Shaw, Edward G.

    2011-11-15

    Purpose: Repeat gamma knife stereotactic radiosurgery (GKRS) for recurrent or persistent trigeminal neuralgia induces an additional response but at the expense of an increased incidence of facial numbness. The present series summarized the results of a repeat treatment series at Wake Forest University Baptist Medical Center, including a multivariate analysis of the data to identify the prognostic factors for treatment success and toxicity. Methods and Materials: Between January 1999 and December 2007, 37 patients underwent a second GKRS application because of treatment failure after a first GKRS treatment. The mean initial dose in the series was 87.3 Gy (range, 80-90). The mean retreatment dose was 84.4 Gy (range, 60-90). The dosimetric variables recorded included the dorsal root entry zone dose, pons surface dose, and dose to the distal nerve. Results: Of the 37 patients, 81% achieved a >50% pain relief response to repeat GKRS, and 57% experienced some form of trigeminal dysfunction after repeat GKRS. Two patients (5%) experienced clinically significant toxicity: one with bothersome numbness and one with corneal dryness requiring tarsorraphy. A dorsal root entry zone dose at repeat treatment of >26.6 Gy predicted for treatment success (61% vs. 32%, p = .0716). A cumulative dorsal root entry zone dose of >84.3 Gy (72% vs. 44%, p = .091) and a cumulative pons surface dose of >108.5 Gy (78% vs. 44%, p = .018) predicted for post-GKRS numbness. The presence of any post-GKRS numbness predicted for a >50% decrease in pain intensity (100% vs. 60%, p = .0015). Conclusion: Repeat GKRS is a viable treatment option for recurrent trigeminal neuralgia, although the patient assumes a greater risk of nerve dysfunction to achieve maximal pain relief.

  3. [Treatment of choroid melanoma by Gamma-Knife radiosurgery].

    PubMed

    Devin, F; Regis, J; Berros, P; Manera, L; Porcheron, D; Sedan, R; Peragut, J C; Saracco, J B

    1996-01-01

    Conservative treatment of uveal melanomas by Gamma Knife Radiosurgery is based on the use of cross fire technique with 201 Cobalt60 sources. A following of 13 months is available for the first case operated by Gamma-Knife Surgery in France. Technical baselines and one year preliminary results are reported. The diagnosis of uveal melanoma T3NOMO was established by converging results of clinical examination, angiography and echography. The definition of the target was based on stereotactic MRT examination. We delivered a dose of 50 Gys to the marginal isodose (50%). Today, one year after treatment the tumor decreased, the visual function was preserved. There were no side effect or complication.

  4. Effect of location of opening incision on astigmatic correction after small-incision lenticule extraction

    PubMed Central

    Chan, Tommy C. Y.; Ng, Alex LK; Cheng, George P. M.; Wang, Zheng; Woo, Victor C. P.; Jhanji, Vishal

    2016-01-01

    We compared the visual and refractive outcomes between 2 different incisional sites in small incision lenticule extraction (SMILE) for low myopic astigmatism. This was a contralateral eye study. Consecutive cases that underwent bilateral SMILE surgery were included. Procedures for both eyes were identical apart from the location of opening incision. The incision was set on the temporal side for the right eye (Group 1), while a superior incision was set for the left eye (Group 2). Twenty-nine patients with a mean age of 35.0 ± 9.6 years were included. Preoperative visual and refractive parameters were comparable between the 2 groups (p > 0.250). At 3 months, the logMAR uncorrected distance visual acuity was 0.074 ± 0.090 in Group 1 and 0.084 ± 0.130 in Group 2 (p = 0.861). No difference was found in the postoperative manifest spherical equivalent (p = 0.501) and manifest cylinder (p = 0.178) between the 2 groups. The efficacy index was 0.85 ± 0.16 in Group 1 and 0.85 ± 0.20 in Group 2 (p = 0.828). Astigmatic correction was not significantly affected by the location of opening incisions using vector analysis. Our study did not find significant differences in visual and refractive outcomes with temporal or superior opening incision during SMILE surgery. PMID:27775085

  5. Feasibility of identification of gamma knife planning strategies by identification of pareto optimal gamma knife plans.

    PubMed

    Giller, C A

    2011-12-01

    The use of conformity indices to optimize Gamma Knife planning is common, but does not address important tradeoffs between dose to tumor and normal tissue. Pareto analysis has been used for this purpose in other applications, but not for Gamma Knife (GK) planning. The goal of this work is to use computer models to show that Pareto analysis may be feasible for GK planning to identify dosimetric tradeoffs. We define a GK plan A to be Pareto dominant to B if the prescription isodose volume of A covers more tumor but not more normal tissue than B, or if A covers less normal tissue but not less tumor than B. A plan is Pareto optimal if it is not dominated by any other plan. Two different Pareto optimal plans represent different tradeoffs between dose to tumor and normal tissue, because neither plan dominates the other. 'GK simulator' software calculated dose distributions for GK plans, and was called repetitively by a genetic algorithm to calculate Pareto dominant plans. Three irregular tumor shapes were tested in 17 trials using various combinations of shots. The mean number of Pareto dominant plans/trial was 59 ± 17 (sd). Different planning strategies were identified by large differences in shot positions, and 70 of the 153 coordinate plots (46%) showed differences of 5mm or more. The Pareto dominant plans dominated other nearby plans. Pareto dominant plans represent different dosimetric tradeoffs and can be systematically calculated using genetic algorithms. Automatic identification of non-intuitive planning strategies may be feasible with these methods.

  6. Transanal polypectomy using single incision laparoscopic instruments

    PubMed Central

    Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C

    2011-01-01

    Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible. PMID:21528096

  7. Transanal polypectomy using single incision laparoscopic instruments.

    PubMed

    Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C

    2011-04-27

    Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible.

  8. Minimal inframammary incision for breast augmentation

    PubMed Central

    Fanous, Nabil; Tawilé, Caroline; Brousseau, Valérie J

    2008-01-01

    The inframammary approach in breast augmentation, still the most popular technique among plastic surgeons, has always been hampered by the undesirable appearance of its scar. The present paper describes a modified approach to inframammary augmentation with saline-filled prostheses. This approach uses a very short incision, thus resulting in a much less noticeable scar. The surgical technique is easy to learn, simple to execute, does not necessitate any special equipment and gives consistent results. Decreasing the scar length to an absolute minimum ensures higher patient and surgeon satisfaction. PMID:19554159

  9. PROSPECTIVE COMPARATIVE STUDY BETWEEN PROXIMAL TRANSVERSE INCISION AND THE CONVENTIONAL LONGITUDINAL INCISIONS FOR CARPAL TUNNEL RELEASE

    PubMed Central

    Teixeira Alves, Marcelo de Pinho

    2015-01-01

    Carpal tunnel syndrome (CTS) is a pathological condition frequently seen in orthopedic consultation offices. It is most common compressive neuropathy and also the one most often treated surgically. CTS is usually diagnosed clinically, through the clinical history, physical examination (Tinel, Phalen and Durkan tests) and complementary examinations, and more specifically, nerve conduction studies. Ultrasound scans and magnetic resonance imaging may also be used. Conservative treatment is reserved for patients presenting with mild symptoms, with little incapacitation, who show good response to non-steroidal or steroidal anti-inflammatory drugs, physiotherapy and lifestyle changes. Surgical treatment is more frequent, and a variety of techniques are used. The goal of the surgery is to decompress the carpal tunnel and, by sectioning the transverse carpal ligament, release the median nerve. The aim of this paper was to compare surgical treatment of CTS by means of a transverse mini-incision made proximally to the carpal canal, with the classic longitudinal incision over the carpal canal. The mini-incision technique was shown to be less invasive and equally effective for treating CTS, with less morbidity than with the classic longitudinal incision. PMID:27022592

  10. 40. Main fuses and knife switch for power to the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. Main fuses and knife switch for power to the bridge, located in the control house. This is one of two located at either end of the main electrical panel (photograph 41). Facing east. - Henry Ford Bridge, Spanning Cerritos Channel, Los Angeles-Long Beach Harbor, Los Angeles, Los Angeles County, CA

  11. "Fist, Stick, Knife, Gun": Getting Real in Upward Bound.

    ERIC Educational Resources Information Center

    Pace, Barbara G.; Adkins, Theresa A.

    2002-01-01

    Describes how a teacher found literature for Upward Bound students. Presents Geoffrey Canada's "Fist, Stick, Knife, Gun: A Personal History of Violence in America" as a nonfiction work to provide clarity and connections that might not have been available in a fictional work, yet it had elements of literary fiction that made the text engaging. (SG)

  12. The Shoemaker's Knife--An Approach of the Polya Type.

    ERIC Educational Resources Information Center

    Libeskind, Shlomo; Lott, Johnny W.

    1984-01-01

    Archimedes' shoemaker's knife problem is interesting in its own right and also allows the demonstration of heuristic teaching ideas and a different method of doing a routine construction. The focus in the article is on the thought processes involved and questions asked when attempting proofs with the problem. (MNS)

  13. Optical Image Acquisition by Vibrating KNIFE Edge Techniques

    NASA Astrophysics Data System (ADS)

    Samson, Scott A.

    Traditional optical microscopes have inherent limitations in their attainable resolution. These shortcomings are a result of non-propagating evanescent waves being created by the small details in the specimen to be imaged. These problems are circumvented in the Near-field Scanning Optical Microscope (NSOM). Previous NSOMs use physical apertures to sample the optical field created by the specimen. By scanning a sub-wavelength-sized aperture past the specimen, very minute details may be imaged. In this thesis, a new method for obtaining images of various objects is studied. The method is a derivative of scanned knife edge techniques commonly used in optical laboratories. The general setup consists of illuminating a vibrating optically-opaque knife edge placed in close proximity to the object. By detecting only the time-varying optical power and utilizing various signal processing techniques, including computer-subtraction, beat frequency detection, and tomographic reconstruction, two-dimensional images of the object may be formed. In essence, a sampler similar to the aperture NSOMs is created. Mathematics, computer simulations, and low-resolution experiments are used to verify the thesis. Various aspects associated with improving the resolution with regards to NSOM are discussed, both theoretically and practically. The vibrating knife edge as a high- resolution sampler is compared to the physically -small NSOM aperture. Finally, future uses of the vibrating knife edge techniques and further research are introduced. Applicable references and computer programs are listed in appendices.

  14. Optical Coherence Tomography of Clear Corneal Incisions for Cataract Surgery

    PubMed Central

    Schallhorn, Julie M.; Tang, Maolong; Li, Yan; Song, Jonathan C.; Huang, David

    2008-01-01

    Purpose To study the architecture of clear corneal incisions for phacoemulsification cataract surgery using optical coherence tomography (OCT). Setting University-based cornea practice. Methods A prospective study of twenty eyes of twenty patients one month after cataract surgery performed by two experienced surgeons. Temporal clear corneal single-plane incisions were made with 3-mm metal keratomes; five of the twenty eyes received sutures for wound closure. Each eye was scanned before and 1 month after surgery with a prototype high-speed anterior segment OCT system (Carl Zeiss Meditec Inc.). The OCT scans were repeated 3 times during the same visit. The length of the corneal incision, thickness of the cornea, and position of the incision (distance from the external wound edge to the scleral spur) were measured using a computer caliper. The angle of the incision relative to the corneal surface was then calculated. Results The mean corneal incision length was 1.81±0.27mm, the mean corneal thickness at the incision was 747±67µm, and the mean distance between the incision and the scleral spur was 1.46±0.24mm. The average angle of the incision was 26.8±5.5°. The measurements were repeatable to within 0.072mm (pooled standard deviation) for the incision length, 11µm for the corneal thickness, and 0.042mm for the position of the incision. There was no statistically significant difference in any of the parameters between eyes with sutures and those without. Conclusions OCT provides an excellent way to evaluate corneal incisions in cataract surgery postoperatively. Measurements of wound dimensions using OCT are highly repeatable. PMID:18721720

  15. Two-Step Incision for Periarterial Sympathectomy of the Hand

    PubMed Central

    Jeon, Seung Bae; Ahn, Yong Su; Choi, Matthew Seung Suk

    2015-01-01

    Background Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. Methods A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. Results The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). Conclusions Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures. PMID:26618125

  16. Knife mill operating factors effect on switchgrass particle size distributions

    SciTech Connect

    Bitra, V.S.P.; Womac, A.R.; Yang, Y.T.; Igathinathane, C.; Miu, P.I; Chevanan, Nehru; Sokhansanj, Shahabaddine

    2009-06-01

    Biomass particle size impacts handling, storage, conversion, and dust control systems. Switchgrass (Panicum virgatum L.) particle size distributions created by a knife mill were determined for integral classifying screen sizes from 12.7 to 50.8 mm, operating speeds from 250 to 500 rpm, and mass input rates from 2 to 11 kg/min. Particle distributions were classified with standardized sieves for forage analysis that included horizontal sieving motion with machined-aluminum sieves of thickness proportional to sieve opening dimensions. Then, a wide range of analytical descriptors were examined to mathematically represent the range of particle sizes in the distributions. Correlation coefficient of geometric mean length with knife mill screen size, feed rate, and speed were 0.872, 0.349, and 0.037, respectively. Hence, knife mill screen size largely determined particle size of switchgrass chop. Feed rate had an unexpected influence on particle size, though to a lesser degree than screen size. The Rosin Rammler function fit the chopped switchgrass size distribution data with an R2 > 0.982. Mass relative span was greater than 1, which indicated a wide distribution of particle sizes. Uniformity coefficient was more than 4.0, which indicated a large assortment of particles and also represented a well-graded particle size distribution. Knife mill chopping of switchgrass produced strongly fine skewed mesokurtic particles with 12.7 25.4 mm screens and fine skewed mesokurtic particles with 50.8 mm screen. Results of this extensive analysis of particle sizes can be applied to selection of knife mill operating parameters to produce a particular size of switchgrass chop, and will serve as a guide for relations among the various analytic descriptors of biomass particle distributions.

  17. Knife mill operating factors effect on switchgrass particle size distributions.

    PubMed

    Bitra, Venkata S P; Womac, Alvin R; Yang, Yuechuan T; Igathinathane, C; Miu, Petre I; Chevanan, Nehru; Sokhansanj, Shahab

    2009-11-01

    Biomass particle size impacts handling, storage, conversion, and dust control systems. Switchgrass (Panicum virgatum L.) particle size distributions created by a knife mill were determined for integral classifying screen sizes from 12.7 to 50.8 mm, operating speeds from 250 to 500 rpm, and mass input rates from 2 to 11 kg/min. Particle distributions were classified with standardized sieves for forage analysis that included horizontal sieving motion with machined-aluminum sieves of thickness proportional to sieve opening dimensions. Then, a wide range of analytical descriptors were examined to mathematically represent the range of particle sizes in the distributions. Correlation coefficient of geometric mean length with knife mill screen size, feed rate, and speed were 0.872, 0.349, and 0.037, respectively. Hence, knife mill screen size largely determined particle size of switchgrass chop. Feed rate had an unexpected influence on particle size, though to a lesser degree than screen size. The Rosin-Rammler function fit the chopped switchgrass size distribution data with an R(2)>0.982. Mass relative span was greater than 1, which indicated a wide distribution of particle sizes. Uniformity coefficient was more than 4.0, which indicated a large assortment of particles and also represented a well-graded particle size distribution. Knife mill chopping of switchgrass produced 'strongly fine skewed mesokurtic' particles with 12.7-25.4 mm screens and 'fine skewed mesokurtic' particles with 50.8 mm screen. Results of this extensive analysis of particle sizes can be applied to selection of knife mill operating parameters to produce a particular size of switchgrass chop, and will serve as a guide for relations among the various analytic descriptors of biomass particle distributions.

  18. Strong alkalinization of Chara cell surface in the area of cell wall incision as an early event in mechanoperception.

    PubMed

    Bulychev, Alexander A; Alova, Anna V; Bibikova, Tatiana N

    2013-11-01

    Mechanical wounding of cell walls occurring in plants under the impact of pathogens or herbivores can be mimicked by cell wall incision with a glass micropipette. Measurements of pH at the surface of Chara corallina internodes following microperforation of cell wall revealed a rapid (10-30s) localized alkalinization of the apoplast after a lag period of 10-20s. The pH increase induced by incision could be as large as 3 pH units and relaxed slowly, with a halftime up to 20min. The axial pH profile around the incision zone was bell-shaped and localized to a small area, extending over a distance of about 100μm. The pH response was suppressed by lowering cell turgor upon the replacement of artificial pond water (APW) with APW containing 50mM sorbitol. Stretching of the plasma membrane during its impression into the cell wall defect is likely to activate the Ca(2+) channels, as evidenced from sensitivity of the incision-induced alkalinization to the external calcium concentration and to the addition of Ca(2+)-channel blockers, such as La(3+), Gd(3+), and Zn(2+). The maximal pH values attained at the incision site (~10.0) were close to pH in light-dependent alkaline zones of Chara cells. The involvement of cytoskeleton in the origin of alkaline patch was documented by observations that the incision-induced pH transients were suppressed by the inhibitors of microtubules (oryzalin and taxol) and, to a lesser extent, by the actin inhibitor (cytochalasin B). The results indicate that the localized increase in apoplastic pH is an early event in mechanoperception and depends on light, cytoskeleton, and intracellular calcium.

  19. Strong alkalinization of Chara cell surface in the area of cell wall incision as an early event in mechanoperception.

    PubMed

    Bulychev, Alexander A; Alova, Anna V; Bibikova, Tatiana N

    2013-11-01

    Mechanical wounding of cell walls occurring in plants under the impact of pathogens or herbivores can be mimicked by cell wall incision with a glass micropipette. Measurements of pH at the surface of Chara corallina internodes following microperforation of cell wall revealed a rapid (10-30s) localized alkalinization of the apoplast after a lag period of 10-20s. The pH increase induced by incision could be as large as 3 pH units and relaxed slowly, with a halftime up to 20min. The axial pH profile around the incision zone was bell-shaped and localized to a small area, extending over a distance of about 100μm. The pH response was suppressed by lowering cell turgor upon the replacement of artificial pond water (APW) with APW containing 50mM sorbitol. Stretching of the plasma membrane during its impression into the cell wall defect is likely to activate the Ca(2+) channels, as evidenced from sensitivity of the incision-induced alkalinization to the external calcium concentration and to the addition of Ca(2+)-channel blockers, such as La(3+), Gd(3+), and Zn(2+). The maximal pH values attained at the incision site (~10.0) were close to pH in light-dependent alkaline zones of Chara cells. The involvement of cytoskeleton in the origin of alkaline patch was documented by observations that the incision-induced pH transients were suppressed by the inhibitors of microtubules (oryzalin and taxol) and, to a lesser extent, by the actin inhibitor (cytochalasin B). The results indicate that the localized increase in apoplastic pH is an early event in mechanoperception and depends on light, cytoskeleton, and intracellular calcium. PMID:23850637

  20. Laparoscopic vs mini-incision open appendectomy

    PubMed Central

    Çiftçi, Fatih

    2015-01-01

    AIM: To compare laparoscopic vs mini-incision open appendectomy in light of recent data at our centre. METHODS: The data of patients who underwent appendectomy between January 2011 and June 2013 were collected. The data included patients’ demographic data, procedure time, length of hospital stay, the need for pain medicine, postoperative visual analog scale of pain, and morbidities. Pregnant women and patients with previous lower abdominal surgery were excluded. Patients with surgery converted from laparoscopic appendectomy (LA) to mini-incision open appendectomy (MOA) were excluded. Patients were divided into two groups: LA and MOA done by the same surgeon. The patients were randomized into MOA and LA groups a computer-generated number. The diagnosis of acute appendicitis was made by the surgeon with physical examination, laboratory values, and radiological tests (abdominal ultrasound or computed tomography). All operations were performed with general anaesthesia. The postoperative vision analog scale score was recorded at postoperative hours 1, 6, 12, and 24. Patients were discharged when they tolerated normal food and passed gas and were followed up every week for three weeks as outpatients. RESULTS: Of the 243 patients, 121 (49.9%) underwent MOA, while 122 (50.1%) had laparoscopic appendectomy. There were no significant differences in operation time between the two groups (P = 0.844), whereas the visual analog scale of pain was significantly higher in the open appendectomy group at the 1st hour (P = 0.001), 6th hour (P = 0.001), and 12th hour (P = 0.027). The need for analgesic medication was significantly higher in the MOA group (P = 0.001). There were no differences between the two groups in terms of morbidity rate (P = 0.599). The rate of total complications was similar between the two groups (6.5% in LA vs 7.4% in OA, P = 0.599). All wound infections were treated non-surgically. Six out of seven patients with pelvic abscess were successfully treated with

  1. Comparison of O-Type HybridKnife to Conventional Knife in Endoscopic Submucosal Dissection for Gastric Mucosal Lesions

    PubMed Central

    Huang, Rui; Yan, Honglin; Ren, Gui; Pan, Yanglin; Zhang, Linhui; Liu, Zhiguo; Guo, Xuegang; Wu, Kaichun

    2016-01-01

    Abstract Endoscopic submucosal dissection (ESD) has been accepted as a minimal invasive alternative to surgery for localized superficial gastrointestinal neoplasms recently. However, the procedure remains to be technically challenging and time consuming. A new dissecting knife with partially insulated tip has been recently developed with built-in injection capability. The purpose of this study was to investigate whether the efficiency of ESD procedure could be improved with this new device. A total of 78 patients, who underwent ESD with gastric mucosal lesions including flat type polyps, adenoma or early gastric cancer, were randomly assigned to either ESD with O-type HybridKnife or conventional ESD knives without waterjet. Procedure time and related factors of ESD were analyzed. ESD procedure time was 43.0 (interquartile range, IQR 27.0–60.0) minutes in HybridKnife group compared to 60.5 (IQR 44.0–86.3) minutes in the control group (P = 0.001). There was no difference in the clinical outcome and the adverse event rate. The former demonstrated more favorable results in lesions ≤4 cm of specimen size (P ≤ 0.0001) and when located in the distal stomach (P = 0.001), also in lesions with fibrosis (P = 0.008). Multivariate regression analysis showed that O-type Knife (P ≤ 0.0001), specimen size (P ≤ 0.0001), and fibrosis (P ≤ 0.0001) were independent predictors of procedure time. The O-type HybridKnife yielded faster procedure time compared to the conventional knives in gastric ESD with a similar safety profile. PMID:27043675

  2. Detrital Zircon Record of Colorado River Incision

    NASA Astrophysics Data System (ADS)

    Kimbrough, D.; Grove, M.; Gehrels, G.; Dorsey, R.; House, K. P.; Howard, K.; Pearthree, P. A.; Spencer, J. E.; Mahoney, B.

    2007-05-01

    The Colorado River is a large, youthful, unequilibrated continental drainage system the base-level for which was established rather abruptly between 5 and 6 million years ago in conjunction with Gulf of California rifting and establishment of the modern river course through the western Grand Canyon and lower Colorado river region. New laser ablation ICPMS detrital zircon U-Pb analyses (~3000) from ~40 samples provide insight into details relating to the cause, timing and consequences of river inception. These samples encompass (1) the modern Colorado River delta, (2) major tributaries including the Green, "Grand", San Juan, Little Colorado and Gila rivers (3) late Miocene to Pliocene sediments along the lower Colorado (4) late Miocene to Pleistocene deltaic and fluvial sediments of the Imperial and Palm Spring Groups in the western Salton Trough, and (5) late Miocene- early Pliocene Bidahochi Formation of eastern Arizona. Data from the western Salton Trough and modern delta yield strata yield remarkably homogeneous age distributions that indicate there was little evolution in Colorado River sediment composition since 5.3 Ma. Detrital zircon is dominated by a mix of local southwest US cratonal basement (1.7 and 1.4 Ga) plus reworked supracrustal sequences of the Colorado Plateau that provide Neoproterozoic, 1.1 Ga, and early Paleozoic zircons. A relative paucity of Grenville-age grains in the earliest part of the delta sequence may reflect an early stage of the modern river prior to deep incision through Colorado Plateau erg deposits. The strong homogeneity of the detrital zircon record from late Miocene to the present is consistent with the `lake spillover model' for inception and integration of the modern Colorado River drainage. Abrupt integration of the lower Colorado River after 5.6 Ma is clearly recorded by detrital zircon ages from the laucustrine Bouse Formation and Bullhead alluvium aggradational package. Fluvial-laucustrine deposits of the Bidahochi

  3. Wound Hypoxia in Deep Tissue after Incision in the Rats

    PubMed Central

    Kang, Sinyoung; Lee, Dongchul; Theusch, Brett E.; Arpey, Christopher J.; Brennan, Timothy J.

    2013-01-01

    Our previous studies using rat models of incisional pain have demonstrated that tissue lactate levels increase and pH decreases for several days after incision, suggesting the presence of an ischemic-like condition. The purpose of this study was to evaluate the time course and the extent of tissue hypoxia that develops in incised muscle and skin. We directly measured oxygen tension at several time points after incisions of the gastrocnemius muscle, the paraspinal skin, and the plantar hindpaw in anesthetized rats using an oxygen-sensitive microelectrode. In vivo hypoxia of the incised tissues was also evaluated immunohistochemically using a hypoxia marker pimonidazole hydrochloride. To minimized inter-subject variability, unincised contralateral tissues were used as a control. Tissue oxygen tension was decreased in both skeletal muscle and skin compared to control, for several days after incision: when measured directly, oxygen tension decreased immediately and remained low for several days after incisions. Pimonidazole immunostaining revealed hypoxic areas in incised muscle and skin for several days. By postoperative day 10, tissue oxygen tension recovered to that of control tissue. These results support the evidence that a hypoxic condition is present in deep tissue after incisions and that an ischemic-like mechanism may contribute to postoperative pain. PMID:23926943

  4. First Canadian experience with robotic single-incision pyeloplasty: Comparison with multi-incision technique

    PubMed Central

    Law, Jeffrey; Rowe, Neal; Archambault, Jason; Nastis, Sofia; Sener, Alp; Luke, Patrick P.

    2016-01-01

    Introduction: We compared the outcomes of single-incision, robot-assisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system. Methods: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA). Results: Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups. Conclusions: Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated. PMID:27217850

  5. An oscillating cryo-knife reduces cutting-induced deformation of vitreous ultrathin sections.

    PubMed

    Al-Amoudi, A; Dubochet, J; Gnaegi, H; Lüthi, W; Studer, D

    2003-10-01

    A new oscillating cryo-knife for producing uncompressed vitreous sections is introduced. The knife is a modified cryo diamond knife that is driven by a piezo translator. Optimal setting for the oscillation was found to be in the inaudible frequency range of 20-25 kHz. Yeast cells and polystyrene spheres were used as model systems to describe compression in the vitreous sections. We found that compression could be reduced by a factor of about 2 when the knife was oscillating. When the oscillator was turned off, sections were compressed by 40-45%. However, only 15-25% compression was obtained when the knife was oscillating. In some cases completely uncompressed sections of yeast cells were produced. It was also found that the amount of compression depends on the specimen itself and on its embedding medium. With the results shown here, we demonstrate that the oscillating knife can produce high-quality vitreous sections with minimum cutting artefacts.

  6. Incision into the eastern Andean Plateau during Pliocene cooling.

    PubMed

    Lease, Richard O; Ehlers, Todd A

    2013-08-16

    Canyon incision into mountain topography is commonly used as a proxy for surface uplift driven by tectonic or geodynamic processes, but climatic changes can also instigate incision. The ~1250-kilometer (km)-long eastern margin of the Andean Plateau hosts a series of 1.5- to 2.5-km-deep canyons that cross major deformation zones. Using (U-Th)/He thermochronology, we document a transition from Miocene faulting to Pliocene canyon incision across the northeastern plateau margin. Regionally, widespread Pliocene incision into the eastern plateau margin is concurrent with a shift in global climate from early Pliocene warmth to late Pliocene cooling. Enhanced moisture transport onto the Andean Plateau driven by sea surface temperature changes during cooling is the likely pacemaker for canyon incision. PMID:23950534

  7. A noninvasive eye fixation monitoring system for CyberKnife radiotherapy of choroidal and orbital tumors

    SciTech Connect

    Daftari, I. K.; Petti, P. L.; Larson, D. A.; O'Brien, J. M.; Phillips, T. L.

    2009-03-15

    A new noninvasive monitoring system for fixing the eye has been developed to treat orbital and choroidal tumors with CyberKnife-based radiotherapy. This device monitors the eye during CT/MRI scanning and during treatment. The results of this study demonstrate the feasibility of the fixation light system for CyberKnife-based treatments of orbital and choroidal tumors and supports the idea that larger choroidal melanomas and choroidal metastases could be treated with CyberKnife without implanting fiducial markers.

  8. Influence of Incision Location on Transmitter Loss, Healing, Incision Lengths, Suture Retention, and Growth of Juvenile Chinook Salmon

    SciTech Connect

    Panther, Jennifer L.; Brown, Richard S.; Gaulke, Greggory L.; Woodley, Christa M.; Deters, Katherine A.

    2010-05-11

    In this study, conducted by Pacific Northwest National Laboratory for the U.S. Army Corps of Engineers, Portland District, we measured differences in survival and growth, incision openness, transmitter loss, wound healing, and erythema among abdominal incisions on the linea alba, lateral and parallel to the linea alba (muscle-cutting), and following the underlying muscle fibers (muscle-sparing). A total of 936 juvenile Chinook salmon were implanted with both Juvenile Salmon Acoustic Tracking System transmitters (0.43 g dry) and passive integrated transponder tags. Fish were held at 12°C (n = 468) or 20°C (n = 468) and examined once weekly over 98 days. We found survival and growth did not differ among incision groups or between temperature treatment groups. Incisions on the linea alba had less openness than muscle-cutting and muscle-sparing incisions during the first 14 days when fish were held at 12°C or 20°C. Transmitter loss was not different among incision locations by day 28 when fish were held at 12°C or 20°C. However, incisions on the linea alba had greater transmitter loss than muscle-cutting and muscle-sparing incisions by day 98 at 12°C. Results for wound closure and erythema differed among temperature groups. Results from our study will be used to improve fish-tagging procedures for future studies using acoustic or radio transmitters.

  9. Quantitative measurement of CyberKnife robotic arm steering.

    PubMed

    Wong, K H; Dieterich, S; Tang, J; Cleary, K

    2007-12-01

    Respiratory motion is a significant and challenging problem for radiation medicine. Without adequate compensation for respiratory motion, it is impossible to deliver highly conformal doses to tumors in the thorax and abdomen. The CyberKnife frameless stereotactic radiosurgery system with Synchrony provides respiratory motion adaptation by monitoring skin motion and dynamically steering the beam to follow the moving tumor. This study quantitatively evaluated this beam steering technology using optical tracking of both the linear accelerator and a ball-cube target. Respiratory motion of the target was simulated using a robotic motion platform and movement patterns recorded from previous CyberKnife patients. Our results show that Synchrony respiratory tracking can achieve sub-millimeter precision when following a moving object. PMID:17994788

  10. A knife-edge array field emission cathode

    SciTech Connect

    Lee, B.

    1994-08-01

    many cathode applications require a new type of cathode that is able to produce short pulsed electron beams at high emission current. Gated field emitter arrays of micrometer size are recognized as candidates to meet this need and have become the research focus of vacuum microelectronics. Existing fabrication methods produce emitters that are limited either in frequency response or in current emission. One reason is that the structure of these emitters are not sufficiently optimized. In this study, the author investigated the factors that affect the performance of field emitters. An optimum emitter structure, the knife-edge field emitter array, was developed from the analysis. Large field enhancement factor, large effective emission area, and small emitter capacitance are the advantages of the structure. The author next explored various options of fabricating the knife-edge emitter structure. He proposed a unique thin film process procedure and developed the fabrication techniques to build the emitters on (110) silicon wafers. Data from the initial cathode tests showed very low onset voltages and Fowler-Nordheim type emission. Emission simulation based on the fabricated emitter structure indicated that the knife-edge emitter arrays have the potential to produce high performance in modulation frequency and current emission. Several fabrication issues that await further development are discussed and possible solutions are suggested.

  11. Post-Last Glacial Maximum fluvial incision and sediment generation in the unglaciated Waipaoa catchment, North Island, New Zealand

    NASA Astrophysics Data System (ADS)

    Marden, M.; Betts, H.; Palmer, A.; Taylor, R..; Bilderback, E..; Litchfield, N.

    2014-06-01

    Small river systems contribute a significant component of sediment delivered to oceans, but the temporal evolution of fluvially eroded landscapes is needed. A sequence of postglacial terraces in the unglaciated Waipaoa River catchment provides the opportunity to document fluvial incision and sediment flux on an ~ 2000-year timescale since the Last Glacial Maximum (LGM), which has previously only been undertaken for the entire post-LGM period. This study also calculates sediment mass, where previously sediment volume was calculated. Using a 15-m DEM, field mapping and surveying, and tephrochronology, we calculate rates of fluvial incision and sediment volumes excavated during successive age-constrained, postglacial, incision events and correlate these with a framework of inferred climatic events established for New Zealand. We identify seven periods of terrace formation each succeeded by a period of fluvial incision, six in total. Although the magnitude of the response during each incision event and thus the sediment volumes generated varied through time and across subcatchments draining two contrasting lithological terrains, we conclude that incision events were essentially synchronous, at least within the timeframe constrained by the ca. 2000 year interval between successive eruptive airfall events. Slope relaxation processes were simultaneous with incision thereby indicating that both processes were likely climate driven. We identify a period of accelerated fluvial incision ~ 7 mm y- 1 commencing before ca. 14.0 cal. ka BP (during the early postglacial period) and ceasing ca. 7.9 cal. ka BP toward the end of the Early Holocene Warming period. The magnitude of this incision response was significantly higher in subcatchments draining highly erodible lithologies in the higher uplifting parts of the catchment when river bedload was at over capacity. In contrast, within the remainder of subcatchments draining the more resistant lithologies and in areas of lower uplift

  12. Direct measures of mechanical energy for knife mill size reduction

    SciTech Connect

    Bitra, V.S.P.; Womac, A.R.; Igathinathane, C.; Miu, P.I; Yang, Y.T.; Smith, D.R.; Chevanan, Nehru; Sokhansanj, Shahabaddine

    2009-08-01

    Lengthy straw/stalk of biomass may not be directly fed into grinders such as hammer mills and disc refiners. Hence, biomass needs to be preprocessed using coarse grinders like a knife mill to allow for efficient feeding in refiner mills without bridging and choking. Size reduction mechanical energy was directly measured for switchgrass (Panicum virgatum L.), wheat straw (Triticum aestivum L.), and corn stover (Zea mays L.) in an instrumented knife mill. Direct power inputs were determined for different knife mill screen openings from 12.7 to 50.8 mm, rotor speeds between 250 and 500 rpm, and mass feed rates from 1 to 11 kg/min. Overall accuracy of power measurement was calculated to be 0.003 kW. Total specific energy (kWh/Mg) was defined as size reduction energy to operate mill with biomass. Effective specific energy was defined as the energy that can be assumed to reach the biomass. The difference is parasitic or no-load energy of mill. Total specific energy for switchgrass, wheat straw, and corn stover chopping increased with knife mill speed, whereas, effective specific energy decreased marginally for switchgrass and increased for wheat straw and corn stover. Total and effective specific energy decreased with an increase in screen size for all the crops studied. Total specific energy decreased with increase in mass feed rate, but effective specific energy increased for switchgrass and wheat straw, and decreased for corn stover at increased feed rate. For knife mill screen size of 25.4 mm and optimum speed of 250 rpm, optimum feed rates were 7.6, 5.8, and 4.5 kg/min for switchgrass, wheat straw, and corn stover, respectively, and the corresponding total specific energies were 7.57, 10.53, and 8.87 kWh/Mg and effective specific energies were 1.27, 1.50, and 0.24 kWh/Mg for switchgrass, wheat straw, and corn stover, respectively. Energy utilization ratios were calculated as 16.8%, 14.3%, and 2.8% for switchgrass, wheat straw, and corn stover, respectively. These

  13. Accessing the Orbital Roof via an Eyelid Incision

    PubMed Central

    Ohjimi, Hiroyuki; Taniguchi, Yasushi; Tanahashi, Shinji; Era, Kozo; Fukushima, Takeo

    2000-01-01

    This article outlines a new surgical technique for accessing the orbital roof: the transpalpebral approach. It involves making an incision on the double fold of the upper eyelid, then dissecting the orbital septum and the orbicular muscle of the eye. This exposes the orbital roof and enables the surgeon to approach without a coronal incision of the scalp; the direct eyelid incision provides adequate workspace. We use this approach in three orbital roof fractures and one orbital hemangioma. This orbital approach offers a simpler surgical technique, a less invasive one, and still provides excellent exposure of the superior orbital cavity. ImagesFigure 3Figure 4Figure 5 PMID:17171150

  14. Graded nonintersecting transverse incisions for correction of idiopathic astigmatism.

    PubMed

    Thornton, S P; Sanders, D R

    1987-01-01

    We present the results of a consecutive series of graded transverse (T) incisions for correcting idiopathic astigmatism evaluated by vector analysis, a method not previously used to report T-incision results. In fact, no clinical studies on the results of the T-incision method have been reported. For comparison with conventional reporting methods, the results of graded T incisions on a series of eyes were evaluated, using both vector analysis and simplified analytic procedures. Sixty eyes were evaluated following surgery based on the Thornton guide for astigmatism correction. The mean preoperative cylinder in the series was 1.5 diopters (D) (SD = 0.43, range 1.00 D to 2.25 D); mean postoperative cylinder was 0.4 D (SD = 0.61, range 0 to 3.75 D). The mean decrease of 1.1 D was statistically significant. The results show that it is possible to quantify astigmatism correction using vector analysis. PMID:3559948

  15. Removing seed coat fragments with a lint cleaner grid bar air knife

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Seed coat fragments (SCF) in ginned lint cause spinning problems at the textile mill and undesirable defects in finished goods. Work continued on developing an air knife that may help remove SCF from ginned lint. The air knife is mounted on the 1st lint cleaner grid bar of a saw-type lint cleaner,...

  16. Differential stream incision in the Oregon Coast Range

    SciTech Connect

    Personius, S.F. )

    1993-04-01

    Stream incision rates are used to determine rates and styles of late quaternary deformation of the Oregon Coast Range, in the forearc of the Cascadia subduction zone. Bedrock incision rates were obtained along westward-flowing streams, from the Umpqua river in a central western Oregon to the North Fork Nehalem River in northwestern Oregon. Incision measurements were restricted mostly to nontidal reaches that are more than 20--40 km inland from the coast, to exclude areas affected by eustatic changes in sea level. Most strath ages were determined indirectly by radiocarbon dating of detrital charcoal sampled from alluvium that overlies the straths. A few incision measurements were made on straths that underlie higher, less well preserved terrace remnants. The ages of some of these higher straths were determined by thermoluminescence (TL) dating. These ages are less constrained than those established with radiocarbon dating, but they appear to yield similar rates of incision. The difference in age between the overlying sediments and the age of strath abandonment is unknown, but several lines of evidence indicate that sediment mobilization and deposition most likely were concurrent with cutting of the strath. Numerous strath height measurements indicate that rates of incision are fairly uniform along many kilometers of individual Coast Range streams, regardless of the type of bedrock traversed. Such uniform incision rates do not support the landward tilting of the Coast Range as postulated by other studies. However, regional differences in incision apparent in northern Oregon may be explained by differential uplift caused by north-south compression in the overriding North American plate, or by changes in the geometry of the subducting Juan de Fuca plate.

  17. Relaxation selective pulses in fast relaxing systems.

    PubMed

    Lopez, Christopher J; Lu, Wei; Walls, Jamie D

    2014-05-01

    In this work, the selectivity or sharpness of the saturation profiles for relaxation selective pulses (R^rsps) that suppress magnetization possessing relaxation times of T2=T2(rsp) and T1=αT2 for α∈12,∞ was optimized. Along with sharpening the selectivity of the R^rsps, the selective saturation of these pulses was also optimized to be robust to both B0 and B1 inhomogeneities. Frequency-swept hyperbolic secant and adiabatic time-optimal saturation pulse inputs were found to work best in the optimizations, and the pulse lengths required to selectivity saturate the magnetization were always found to be less than the inversion recovery delay, T1ln(2). The selectivity of the optimized relaxation selective pulses was experimentally demonstrated in aqueous solutions with varying concentrations of the paramagnetic species, [Mn(+2)], and for use in solvent suppression. Finally, the "rotational" properties of spin relaxation were explored along with an analytical derivation of adiabatic time-optimal saturation pulses. PMID:24631803

  18. Water table fluctuations near an incised stream, Walnut Creek, Iowa

    USGS Publications Warehouse

    Schilling, K.E.; Zhang, Y.-K.; Drobney, P.

    2004-01-01

    Incised channels are common features in many agricultural watersheds, but the effects of channel incision on riparian water table conditions have been poorly documented. In this study, we evaluate the water table fluctuations in the floodplain near an incised stream (Walnut Creek, Iowa) and investigate the roles that channel incision and variable recharge play in modifying the water table configuration in the floodplain. Groundwater flows from higher landscape positions towards Walnut Creek under hydraulic gradients that were steepest near the upland/floodplain contact and in the near-stream riparian zone. Annually, water table fluctuations on the floodplain were greatest in wells located 30 m from the creek, midway between the creek and upland. Water levels monitored continuously during a runoff event indicated that bank storage was confined to a narrow zone adjacent to the channel. A steady-state, one-dimensional analytical model was developed to describe the shape of the water table surface near an incised stream and evaluate how variable groundwater recharge and channel bed lowering has affected the shape of the water table surface. Results from this study have implications for managing the riparian buffers of incised streams with successful establishment dependent upon matching buffer vegetation to riparian water table conditions. ?? 2003 Elsevier B.V. All rights reserved.

  19. Transfixion incision as an initial technique in nasal tip deprojection

    PubMed Central

    Solomon, Philip; Rival, Richard; Mabini, Aimee; Boyd, Jennifer

    2008-01-01

    BACKGROUND: The overprojected nasal tip presents a significant challenge to the surgeon performing rhinoplasty. Full transfixion incision as a means of dealing with this deformity has been studied only in combination with other surgical methods. OBJECTIVES: To determine whether transfixion incision alone would result in significant nasal tip deprojection, and if skin thickness had an effect on the extent of deprojection the procedure yielded. METHOD: Seventy-two consecutive patients with an aesthetic goal of nasal tip deprojection were enrolled. The sole surgical means of deprojection used was transfixion incision. Subjects were categorized as thin-, medium- or thick-skinned based on the surgeon’s analysis. These groups were compared in terms of their postprocedural nasal tip deprojection. RESULTS: Using transfixion incision as the sole means of correcting this deformity resulted in a mean nasal tip deprojection of 1.6 mm (ranging from 0 mm to 3 mm). Patients in the thin skin group had a mean deprojection of 2.12 mm. This was significantly greater than for both the medium- and thick-skinned groups. There was no significant difference between the medium- and thick-skinned groups. CONCLUSIONS: Surgeons may use skin thickness when planning interventions for correcting nasal tip overprojection. When used alone, transfixion incision resulted in tip deprojection comparable with that achieved when combined with other methods, particularly for thin-skinned patients. Surgeons can thus use a graduated approach in which transfixion incision, the least destructive method, is used before proceeding with other interventions. PMID:19949502

  20. Tensile Properties of the Murine Ventral Vertical Midline Incision

    PubMed Central

    Carlson, Mark A.; Chakkalakal, Dennis

    2011-01-01

    Background In clinical surgery, the vertical midline abdominal incision is popular but associated with healing failures. A murine model of the ventral vertical midline incision was developed in order to study the healing of this incision type. Methodology/Principal Findings The strength of the wild type murine ventral abdominal wall in the midline was contained within the dermis; the linea alba made a negligible contribution. Unwounded abdominal wall had a downward trend (nonsignificant) in maximal tension between 12 and 29 weeks of age. The incision attained 50% of its final strength by postoperative day 40. The maximal tension of the ventral vertical midline incision was nearly that of unwounded abdominal wall by postwounding day 60; there was no difference in unwounded vs. wounded maximal tension at postwounding day 120. Conclusions/Significance After 120 days of healing, the ventral vertical midline incision in the wild type mouse was not significantly different from age-matched nonwounded controls. About half of the final incisional strength was attained after 6 weeks of healing. The significance of this work was to establish the kinetics of wild type incisional healing in a model for which numerous genotypes and genetic tools would be available for subsequent study. PMID:21915298

  1. A geometric analysis of mastectomy incisions: Optimizing intraoperative breast volume

    PubMed Central

    Chopp, David; Rawlani, Vinay; Ellis, Marco; Johnson, Sarah A; Buck, Donald W; Khan, Seema; Bethke, Kevin; Hansen, Nora; Kim, John YS

    2011-01-01

    INTRODUCTION: The advent of acellular dermis-based tissue expander breast reconstruction has placed an increased emphasis on optimizing intraoperative volume. Because skin preservation is a critical determinant of intraoperative volume expansion, a mathematical model was developed to capture the influence of incision dimension on subsequent tissue expander volumes. METHODS: A mathematical equation was developed to calculate breast volume via integration of a geometrically modelled breast cross-section. The equation calculates volume changes associated with excised skin during the mastectomy incision by reducing the arc length of the cross-section. The degree of volume loss is subsequently calculated based on excision dimensions ranging from 35 mm to 60 mm. RESULTS: A quadratic relationship between breast volume and the vertical dimension of the mastectomy incision exists, such that incrementally larger incisions lead to a disproportionally greater amount of volume loss. The vertical dimension of the mastectomy incision – more so than the horizontal dimension – is of critical importance to maintain breast volume. Moreover, the predicted volume loss is more profound in smaller breasts and primarily occurs in areas that affect breast projection on ptosis. CONCLUSIONS: The present study is the first to model the relationship between the vertical dimensions of the mastectomy incision and subsequent volume loss. These geometric principles will aid in optimizing intra-operative volume expansion during expander-based breast reconstruction. PMID:22654531

  2. Geology of the Knife River area, North Dakota

    USGS Publications Warehouse

    Benson, William Edward

    1953-01-01

    The Knife River area, consisting of six 15-minute quadrangles, includes the lower half of the Knife River valley in west-central North Dakota. The area, in the center of the Williston Basin, is underlain by the Tongue River member of the Fort Union formation (Paleocene) and the Golden Valley formation (Eocene). The Tongue River includes beds equivalent to the Sentinel Butte shale; the Golden Valley formation, which receives its first detailed description in this report, consists of two members, a lower member of gray to white sandy kaolin clay and an upper member of cross-bedded micaceous sandstone. Pro-Tongue River rocks that crop out in southwestern North Dakota include the Ludlow member of the Fort Union formation, the Cannonball marine formation (Paleocene) and the Hell Creek, Fox Hills, and Pierre formations, all upper Cretaceous. Post-Golden Valley rocks include the White River formation (Oligocene) and gravels on an old planation surface that may be Miocene or Pliocent. Surficial deposits include glacial and fluvial deposits of Pleistocene age and alluvium, dune sand, residual silica, and landslide blocks of Recent age. Three ages of glacial deposits can be differentiated, largely on the basis of three fills, separated by unconformities, in the Knife River valley. All three are of Wisconsin age and probably represent the Iowan, Tazewell, and Mankato substages. Deposits of the Cary substage have not been identified either in the Knife River area or elsewhere in southern North Dakota. Iowan glacial deposits form the outermost drift border in North Dakota. Southwest of this border are a few scattered granite boulders that are residual from the erosion of either the White River formation or a pre-Wisconsin till. The Tazewell drift border cannot be followed in southern North Dakota. The Mankato drift border can be traced in a general way from the South Dakota State line northwest across the Missouri River and through the middle of the Knife River area. The major

  3. PRESAGE 3D dosimetry accurately measures Gamma Knife output factors

    NASA Astrophysics Data System (ADS)

    Klawikowski, Slade J.; Yang, James N.; Adamovics, John; Ibbott, Geoffrey S.

    2014-12-01

    Small-field output factor measurements are traditionally very difficult because of steep dose gradients, loss of lateral electronic equilibrium, and dose volume averaging in finitely sized detectors. Three-dimensional (3D) dosimetry is ideal for measuring small output factors and avoids many of these potential challenges of point and 2D detectors. PRESAGE 3D polymer dosimeters were used to measure the output factors for the 4 mm and 8 mm collimators of the Leksell Perfexion Gamma Knife radiosurgery treatment system. Discrepancies between the planned and measured distance between shot centers were also investigated. A Gamma Knife head frame was mounted onto an anthropomorphic head phantom. Special inserts were machined to hold 60 mm diameter, 70 mm tall cylindrical PRESAGE dosimeters. The phantom was irradiated with one 16 mm shot and either one 4 mm or one 8 mm shot, to a prescribed dose of either 3 Gy or 4 Gy to the 50% isodose line. The two shots were spaced between 30 mm and 60 mm apart and aligned along the central axis of the cylinder. The Presage dosimeters were measured using the DMOS-RPC optical CT scanning system. Five independent 4 mm output factor measurements fell within 2% of the manufacturer’s Monte Carlo simulation-derived nominal value, as did two independent 8 mm output factor measurements. The measured distances between shot centers varied by ±0.8 mm with respect to the planned shot displacements. On the basis of these results, we conclude that PRESAGE dosimetry is excellently suited to quantify the difficult-to-measure Gamma Knife output factors.

  4. A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization

    PubMed Central

    Gontijo de Deus, Kleber; Diogo Filho, Augusto; Cesar Santos, Paulo

    2016-01-01

    Objective Compare the evolution regarding the complications concerning two types of incision (conventional × mini-incision), for saphenectomy in patients that go under myocardial revascularization or otherwise known as coronary artery bypass surgery. Methods In January 2012 to August 2013, 66 patients were prospectively selected for coronary artery bypass with cardiopulmonary bypass surgery. These were divided into two groups: Conventional and Mini-Incision, with 33 patients in each group chosen in a random fashion and with knowledge of which technique to be used being presented only at the start of the surgery. In the conventional group, the patients received an incision to the lower member of 7–10 cm. The patients in the Mini-Incision group received an incision to the lower member of 3–4 cm, both performed without the use of any special material. Results The groups were similar in terms of clinical data and in the preoperative period. Males made up a greater part of the group with 63.7% and 81.9% in groups C and M, respectively. Among the complications analysed, edema (p = 0.011), hematoma (p = 0.020), dehiscence (p = 0.012) and infection (p = 0.012), were significantly greater in group C when compared to group M. When the matter comes to the variable in relation to the risk of Surgical Site Infections (SSI), no difference was found between the groups. Conclusion Coronary artery bypass surgery with mini-incision for saphenectomy, demonstrated a lower rate for preoperative complications when compared to saphenectomy under conventional incision procedures. PMID:27006766

  5. MCNP-based computational model for the Leksell Gamma Knife

    SciTech Connect

    Trnka, Jiri; Novotny, Josef Jr.; Kluson, Jaroslav

    2007-01-15

    We have focused on the usage of MCNP code for calculation of Gamma Knife radiation field parameters with a homogenous polystyrene phantom. We have investigated several parameters of the Leksell Gamma Knife radiation field and compared the results with other studies based on EGS4 and PENELOPE code as well as the Leksell Gamma Knife treatment planning system Leksell GammaPlan (LGP). The current model describes all 201 radiation beams together and simulates all the sources in the same time. Within each beam, it considers the technical construction of the source, the source holder, collimator system, the spherical phantom, and surrounding material. We have calculated output factors for various sizes of scoring volumes, relative dose distributions along basic planes including linear dose profiles, integral doses in various volumes, and differential dose volume histograms. All the parameters have been calculated for each collimator size and for the isocentric configuration of the phantom. We have found the calculated output factors to be in agreement with other authors' works except the case of 4 mm collimator size, where averaging over the scoring volume and statistical uncertainties strongly influences the calculated results. In general, all the results are dependent on the choice of the scoring volume. The calculated linear dose profiles and relative dose distributions also match independent studies and the Leksell GammaPlan, but care must be taken about the fluctuations within the plateau, which can influence the normalization, and accuracy in determining the isocenter position, which is important for comparing different dose profiles. The calculated differential dose volume histograms and integral doses have been compared with data provided by the Leksell GammaPlan. The dose volume histograms are in good agreement as well as integral doses calculated in small calculation matrix volumes. However, deviations in integral doses up to 50% can be observed for large

  6. Ultrasonic Incisions Produce Less Inflammatory Mediator Response during Early Healing than Electrosurgical Incisions

    PubMed Central

    Shack, Leslie A.; Kumar, Ranjit; Clymer, Jeffrey W.; Korvick, Donna L.; Burgess, Shane C.

    2013-01-01

    As the use of laparoscopic surgery has become more widespread in recent years, the need has increased for minimally-invasive surgical devices that effectively cut and coagulate tissue with reduced tissue trauma. Although electrosurgery (ES) has been used for many generations, newly-developed ultrasonic devices (HARMONIC® Blade, HB) have been shown at a macroscopic level to offer better coagulation with less thermally-induced tissue damage. We sought to understand the differences between ES and HB at a microscopic level by comparing mRNA transcript and protein responses at the 3-day timepoint to incisions made by the devices in subcutaneous fat tissue in a porcine model. Samples were also assessed via histological examination. ES-incised tissue had more than twice as many differentially-expressed genes as HB (2,548 vs 1,264 respectively), and more differentially-expressed proteins (508 vs 432) compared to control (untreated) tissue. Evaluation of molecular functions using Gene Ontology showed that gene expression changes for the energized devices reflected the start of wound healing, including immune response and inflammation, while protein expression showed a slightly earlier stage, with some remnants of hemostasis. For both transcripts and proteins, ES exhibited a greater response than HB, especially in inflammatory mediators. These findings were in qualitative agreement with histological results. This study has shown that transcriptomics and proteomics can monitor the wound healing response following surgery and can differentiate between surgical devices. In agreement with clinical observations, electrosurgery was shown to incur a greater inflammatory immune response than an ultrasonic device during initial iatrogenic wound healing. PMID:24058457

  7. Unusual clinical case: extraluminal manifestation of a tapeworm from the eviscerated midline incision in a post-surgery patient.

    PubMed

    Dural, Ahmet Cem; Celik, Muhammet Ferhat; Temizgonul, Baha; Unsal, Mustafa Gokhan; Akarsu, Cevher; Gonenc, Murat; Kalayci, Mustafa Uygar; Alis, Halil

    2015-04-01

    Taenia saginata infestation is one of the most common cestode infestations in humans, that may cause gastrointestinal tract related complications as a result of obstruction, perforation or anastomotic leakage. A 55-year-old male patient who was receiving palliative chemotherapy for stage IV gastric cancer was admitted to the emergency department for abdominal pain. A hollow viscus organ perforation was diagnosed and an emergency surgery was performed. On postoperative day 5, the patient's midline incision eviscerated and a moving taenia emerged, with abundant particulated fluid from the incision line. The patient was admitted for abdominal surgery due to suspected bowel perforation. During the abdominal exploration, a relaxed purse stitch of the feeding tube was observed and no other bowel perforations were seen. The patient underwent two planned surgery for abdominal cavity lavage after the removal of cestode. Unfortunately, the patient died sixteen days after his admission to the intensive care unit. This is the first case describing an extraluminal manifestation of a tapeworm in a midline incision from evisceration without intestinal perforation.

  8. Unusual clinical case: extraluminal manifestation of a tapeworm from the eviscerated midline incision in a post-surgery patient.

    PubMed

    Dural, Ahmet Cem; Celik, Muhammet Ferhat; Temizgonul, Baha; Unsal, Mustafa Gokhan; Akarsu, Cevher; Gonenc, Murat; Kalayci, Mustafa Uygar; Alis, Halil

    2015-04-01

    Taenia saginata infestation is one of the most common cestode infestations in humans, that may cause gastrointestinal tract related complications as a result of obstruction, perforation or anastomotic leakage. A 55-year-old male patient who was receiving palliative chemotherapy for stage IV gastric cancer was admitted to the emergency department for abdominal pain. A hollow viscus organ perforation was diagnosed and an emergency surgery was performed. On postoperative day 5, the patient's midline incision eviscerated and a moving taenia emerged, with abundant particulated fluid from the incision line. The patient was admitted for abdominal surgery due to suspected bowel perforation. During the abdominal exploration, a relaxed purse stitch of the feeding tube was observed and no other bowel perforations were seen. The patient underwent two planned surgery for abdominal cavity lavage after the removal of cestode. Unfortunately, the patient died sixteen days after his admission to the intensive care unit. This is the first case describing an extraluminal manifestation of a tapeworm in a midline incision from evisceration without intestinal perforation. PMID:25881535

  9. Dosimetrical evaluation of Leksell Gamma Knife 4C radiosurgery unit

    NASA Astrophysics Data System (ADS)

    Sajeev, Thomas; Mustafa, Mohamed M.; Supe, Sanjay S.

    2011-01-01

    A number of experiments was performed using standard protocols, in order to evaluate the dosimetric accuracy of Leksell Gamma Knife 4C unit. Verification of the beam alignment has been performed for all collimators using solid plastic head phantom and Gafchromic™ type MD-55 films. The study showed a good agreement of Leksell Gammaplan calculated dose profiles with experimentally determined profiles in all three axes. Isocentric accuracy is verified using a specially machined cylindrical aluminium film holder tool made with very narrow geometric tolerances aligned between trunnions of 4 mm collimator. Considering all uncertainties in all three dimensions, the estimated accuracy of the unit was 0.1 mm. Dose rate at the centre point of the unit has been determined according to the IAEA, TRS-398 protocol, using Unidose-E (PTW-Freiburg, Germany) with a 0.125 cc ion chamber, over a period of 6 years. The study showed that the Leksell Gamma Knife 4C unit is excellent radiosurgical equipment with high accuracy and precision, which makes it possible to deliver larger doses of radiation, within the limits defined by national and international guidelines, applicable for stereotactic radiosurgery procedures.

  10. Anterior capsulotomy with a pulsed-electron avalanche knife

    PubMed Central

    Palanker, Daniel; Nomoto, Hiroyuki; Huie, Philip; Vankov, Alexander; Chang, David F.

    2009-01-01

    PURPOSE To evaluate a new pulsed-electron avalanche knife (PEAK) design for creating a continuous curvilinear capsulorhexis (CCC) and compare the CCC with a mechanical capsulorhexis. SETTING Department of Ophthalmology, Stanford University, Stanford, California, USA. METHODS In this study, CCCs were created in freshly enucleated bovine eyes and in rabbit eyes in vivo. The cutting velocity was adjusted by controlling the burst repetition rate, voltage amplitude, and burst duration. Tissue samples were fixed and processed for histology and scanning electron microscopy (SEM) immediately after surgery. RESULTS The study included 50 bovine eyes and 10 rabbit eyes. By adjusting the electrosurgical waveforms, gas-bubble formation was minimized to permit good surgical visualization. The optimum voltage level was determined to be ±410 V with a burst duration of 20 μs. Burst repetition rate, continuously adjustable from 20 to 200 Hz with footpedal control, allowed the surgeon to vary linear cutting velocity up to 2.0 mm/second. Histology and SEM showed that the pulsed-electron avalanche knife produced sharp-edged capsule cutting without radial nicks or tears. CONCLUSIONS The pulsed-electron probe duplicated the surgical feel of a 25-gauge cystotome and created a histologically smooth capsule cut. PMID:20117716

  11. Lateral Erosion Encourages Vertical Incision in a Bimodal Alluvial River

    NASA Astrophysics Data System (ADS)

    Gran, K. B.

    2015-12-01

    Sand can have a strong impact on gravel transport, increasing gravel transport rates by orders of magnitude as sand content increases. Recent experimental work by others indicates that adding sand to an armored bed can even cause armor to break-up and mobilize. These two elements together help explain observations from a bimodal sand and gravel-bedded river, where lateral migration into sand-rich alluvium breaks up the armor layer, encouraging further incision into the bed. Detailed bedload measurements were coupled with surface and subsurface grain size analyses and cross-sectional surveys in a seasonally-incised channel carved into the upper alluvial fan of the Pasig-Potrero River at Mount Pinatubo, Philippines. Pinatubo erupted in 1991, filling valleys draining the flanks of the volcano with primarily sand-sized pyroclastic flow debris. Twenty years after the eruption, sand-rich sediment inputs are strongly seasonal, with most sediment input to the channel during the rainy season. During the dry season, flow condenses from a wide braided planform to a single-thread channel in most of the upper basin, extending several km onto the alluvial fan. This change in planform creates similar unit discharge ranges in summer and winter. Lower sediment loads in the dry season drive vertical incision until the bed is sufficiently armored. Incision proceeds downstream in a wave, with increasing sediment transport rates and decreasing grain size with distance downstream, eventually reaching a gravel-sand transition and return to a braided planform. Incision depths in the gravel-bedded section exceeded 3 meters in parts of a 4 km-long study reach, a depth too great to be explained by predictions from simple winnowing during incision. Instead, lateral migration into sand-rich alluvium provides sufficient fine sediment to break up the armor surface, allowing incision to start anew and increasing the total depth of the seasonally-incised valley. Lateral migration is recorded in a

  12. [Main relaxation techniques].

    PubMed

    Mateos Rodilla, Juana

    2002-11-01

    After having provided a detailed explanation on what relaxation consists of (see Rev. Rol Enf 2002; 25(9):582-586), the author presents a recap of the major known relaxation techniques including progressive muscular therapy, yoga stretching exercises, breathing techniques, therapeutic massages, meditation,... emphasizing the theoretical basis and practical experience as a function of each technique; each person ought to adopt those techniques which are most appropriate.

  13. Endoscopic treatment for pancreatic diseases: Needle-knife-guided cannulation via the minor papilla

    PubMed Central

    Wang, Wei; Gong, Biao; Jiang, Wei-Song; Liu, Lei; Bielike, Kouken; Xv, Bin; Wu, Yun-Lin

    2015-01-01

    AIM: To determine the efficacy and safety of meticulous cannulation by needle-knife. METHODS: Three needle-knife procedures were used to facilitate cannulation in cases when standard cannulation techniques failed. A total of 104 cannulations via the minor papilla attempted in 74 patients at our center between January 2008 and June 2014 were retrospectively reviewed. RESULTS: Standard methods were successful in 79 cannulations. Of the 25 cannulations that could not be performed by standard methods, 19 were performed by needle-knife, while 17 (89.5%) were successful. Needle-knife use improved the success rate of cannulation [76.0%, 79/104 vs 92.3%, (79 + 17)/104; P = 0.001]. When the 6 cases not appropriate for needle-knife cannulation were excluded, the success rate was improved further (80.6%, 79/98 vs 98.0%, 96/98; P = 0.000). There were no significant differences in the rates of post-endoscopic retrograde cholangiopancreatography adverse events between the group using standard methods alone and the group using needle-knife after failure of standard methods (4.7% vs 10.5%, P = 0.301). CONCLUSION: The needle-knife procedure may be an alternative method for improving the success rate of cannulation via the minor papilla, particularly when standard cannulation has failed. PMID:26019460

  14. Slide crown lengthening procedure using wide surface incisions and cyanoacrylate.

    PubMed

    Szymaitis, Dennis W

    2011-01-01

    This article introduces the slide crown lengthening procedure (SCLP), which incorporates surgical design features to overcome present crown lengthening procedure (CLP) shortcomings. The result is a 75% decrease in required surgery on adjacent teeth and a corresponding 75% reduction in surgical time. Other advantages include a reduction in surgical morbidity, improvement in terminal esthetics, and fewer teeth subject to papillae removal and apically repositioned gingiva. The 20 to 30 degree incision forming the slide is the pivotal feature; it allows effortless flap positioning. This incision angle enables wide surface incisions to adhere flaps together by producing stronger fibrin clots, decreasing tissue retraction angles, and reforming disrupted fibrin clots as incision sides slide while maintaining contact. This enhanced fibrin clot eliminates the need for sutures. The slide produced by the 20 to 30 degree incision functions for crown lengthening on all sites (facial, lingual, or palatal). This versatile surgical design introduces a new healing dimension that adapts to and provides benefits for other dental surgeries, such as gingival grafts, endodontic surgery, implants, and extractions.

  15. Episodic incision of the Colorado River in Glen Canyon, Utah

    USGS Publications Warehouse

    Garvin, C.D.; Hanks, T.C.; Finkel, R.C.; Heimsath, A.M.

    2005-01-01

    Incision rates of the Colorado River are integral to understanding the development of the Colorado Plateau. Here we calculate episodic incision rates of the Colorado River based on absolute ages of two levels of Quaternary deposits adjacent to Glen Canyon, Utah, along the north flank of Navajo Mountain. Minimum surface ages are determined by a combination of cosmogenic radionuclide surface exposure ages, uranium series and soil-development formation times. Bedrock incision rates of the Colorado River between c. 500 ka and c. 250 ka, and c. 250 ka to present are c. 0??4 m ka-1 and c. 0??7 m ka-1, respectively. These rates are more than double the rates reported in the Grand Canyon, suggesting that the Colorado River above Lees Ferry is out of equilibrium with the lower section of the river. We also determine incision rates of two tributaries to the Colorado River. Oak Creek and Bridge Creek flow off Navajo Mountain into Glen Canyon from the southeast. Oak Creek and Bridge Creek both have incision rates of c. 0??6 m ka-1 over the past c. 100 ka at points about 9 km away from the main stem of the Colorado River. Copyright ?? 2005 John Wiley & Sons, Ltd.

  16. Novel design and sensitivity analysis of displacement measurement system utilizing knife edge diffraction for nanopositioning stages.

    PubMed

    Lee, ChaBum; Lee, Sun-Kyu; Tarbutton, Joshua A

    2014-09-01

    This paper presents a novel design and sensitivity analysis of a knife edge-based optical displacement sensor that can be embedded with nanopositioning stages. The measurement system consists of a laser, two knife edge locations, two photodetectors, and axillary optics components in a simple configuration. The knife edge is installed on the stage parallel to its moving direction and two separated laser beams are incident on knife edges. While the stage is in motion, the direct transverse and diffracted light at each knife edge is superposed producing interference at the detector. The interference is measured with two photodetectors in a differential amplification configuration. The performance of the proposed sensor was mathematically modeled, and the effect of the optical and mechanical parameters, wavelength, beam diameter, distances from laser to knife edge to photodetector, and knife edge topography, on sensor outputs was investigated to obtain a novel analytical method to predict linearity and sensitivity. From the model, all parameters except for the beam diameter have a significant influence on measurement range and sensitivity of the proposed sensing system. To validate the model, two types of knife edges with different edge topography were used for the experiment. By utilizing a shorter wavelength, smaller sensor distance and higher edge quality increased measurement sensitivity can be obtained. The model was experimentally validated and the results showed a good agreement with the theoretically estimated results. This sensor is expected to be easily implemented into nanopositioning stage applications at a low cost and mathematical model introduced here can be used for design and performance estimation of the knife edge-based sensor as a tool. PMID:25273778

  17. Force modeling for incision surgery into tissue with haptic application

    NASA Astrophysics Data System (ADS)

    Kim, Pyunghwa; Kim, Soomin; Choi, Seung-Hyun; Oh, Jong-Seok; Choi, Seung-Bok

    2015-04-01

    This paper presents a novel force modeling for an incision surgery into tissue and its haptic application for a surgeon. During the robot-assisted incision surgery, it is highly urgent to develop the haptic system for realizing sense of touch in the surgical area because surgeons cannot sense sensations. To achieve this goal, the force modeling related to reaction force of biological tissue is proposed in the perspective on energy. The force model describes reaction force focused on the elastic feature of tissue during the incision surgery. Furthermore, the force is realized using calculated information from the model by haptic device using magnetorheological fluid (MRF). The performance of realized force that is controlled by PID controller with open loop control is evaluated.

  18. INVESTIGATION OF WASTE GLASS POURING PROCESS OVER A KNIFE EDGE

    SciTech Connect

    M.A. Ebadian, Ph.D.

    1999-01-01

    Vitrification is the process of capturing radioactive waste in glass. The Savannah River Site's (SRS) Defense Waste Processing Facility (DWPF) is one of the facilities using the vitrification technology to treat and immobilize radioactive waste. The objective of the project is to investigate the pouring behavior of molten glass over a pour spout knife edge. Experiments are run using simulant glass containing the same chemical formulation as the radioactive sludge glass, but without radioactive contaminants. The purpose of these tests is to obtain actual glass data that, when combined with previous cold data from other fluids, will provide an overall understanding of the physics of liquids flowing over a pour spout and knife edge, A specific objective is to verify computational fluid dynamics (CFD) models with a range of liquid data with particular emphasis on glass so as to provide confidence in use of these CFD models for designing a new improved pour spout for the DWPF melter. The work to be performed at FIU-HCET includes assembling the melting and pouring system that mimics the DWPF melter and determining the key parameters that may influence wicking. Information from the FIU-HCET melter tests will lead to better operating guidelines for the DWPF melter so as to avoid wicking. During FY98, a bench-scale melter complete with pour spout and a knife edge was designed and assembled at FIU-HCET. Initially, the system was tested with glycerine. Subsequently, glass provided by SRS was used for experimentation. Flow visualization tests were performed with the melter in FY98 to investigate the pouring behavior of molten glass over a pour spout model simulating a DWPF pour spout of the original design. Simulant glass containing the same chemical formulation as sludge glass but without radioactive contaminants was used in the tests. All the tasks and milestones mentioned in the PTP for the project were accomplished. The project completed its second year, and this document

  19. Influence on grip of knife handle surface characteristics and wearing protective gloves.

    PubMed

    Claudon, Laurent

    2006-11-01

    Ten subjects were asked to apply maximum torques on knife handles with either their bare hand or their hand wearing a Kevlar fibre protective glove. Four knife handles (2 roughnesses, 2 hardnesses) were tested. Surface electromyograms of 6 upper limb and shoulder muscles were recorded and subject opinions on both knife handle hardness and friction in the hand were also assessed. The results revealed the significant influence of wearing gloves (p<0.0001), knife type (p<0.0005) and handle hardness (p<0.005) on the applied torque. Wearing Kevlar fibre gloves greatly increased the torque independently of the other two parameters. Under the bare hand condition, a 90 degrees ShA slightly rough handle provided the greatest torque. Subject opinion agreed with the observed effects on recorded torque values except for the hardness factor, for which a preference for the 70 degrees ShA value over the 90 degrees ShA value emerged.

  20. Modeling of laser knife-edge and pinhole experiments

    SciTech Connect

    Auerbach, J M; Boley, C D; Estabrook, K G; Feit, M D; Rubenchik, A M

    1998-06-29

    We describe simulations of experiments involving laser illumination of a metallic knife edge in the Optical Sciences Laboratory (OSL) at LLNL, and pinhole closure in the Beamlet experiment at LLNL. The plasma evolution is modeled via LASNEX. In OSL, the calculated phases of a probe beam are found to exhibit the same behavior as in experiment but to be consistently larger. The motion of a given phase contour tends to decelerate at high intensities. At fixed intensity, the speed decreases with atomic mass. We then calculate the plasmas associated with 4-leaf pinholes on the Beamlet transport spatial filter. We employ a new propagation code to follow a realistic input beam through the entire spatial filter, including the plasmas. The detailed behavior of the output wavefronts is obtained. We show how closure depends on the orientation and material of the pinhole blades. As observed in experiment, a diamond orientation is preferable to a square orientation, and tantalum performs better than stainless

  1. Transorbital Stab Injury with Retained Knife: A Narrow Escape

    PubMed Central

    Alharthy, Abdulrehman; Aletreby, Waleed Tharwat; Huwait, Basim; Kulshrestha, Akhilesh

    2014-01-01

    Transorbital penetrating injuries are unusual but may cause severe brain damage if cranium is entered. These kinds of injuries are dangerous as the walls of orbit are very thin, hence easily broken by the otherwise innocent objects. Because of the very critical anatomical area involved, these injuries pose a serious challenge to the physicians who first receive them as well as the treating team. These may present as trivial trauma or may be occult and are often associated with serious complications and delayed sequel. Prompt evaluation by utilizing best diagnostic modality available and timely interference to remove them are the key aspects to avoid damage to vital organs surrounding the injury and to minimize the late complications. We report a case of transorbital assault with a 13 centimeter long knife which got broken from the handle and the blade was retained. The interesting aspect is that there was no neurological deficit on presentation or after removal. PMID:25328717

  2. [Gamma knife radiosurgery for temporal bone chondroblastoma: case report].

    PubMed

    Mizumatsu, Shinichiro; Sakai, Kyoji; Nishimura, Takushi; Goto, Masaki; Higashi, Toru; Takahashi, Kazuya; Shimizu, Yoji; Nakamura, Norio; Nakada, Michihiro

    2008-01-01

    A case with chondroblastoma arising from the right temporal bone was reported. A 52-year-old woman demonstrated residual tumor growth after surgical excision. The patient presented continuous right temporalgia and right facial twitch while opening her mouth. The tumor was an expansile mass (tumor volume: 12.8 cm3) and showed homogeneous hypo-intensity on T1 and T2-weighted images, but little contrast enhancement. The patient underwent gamma knife radiosurgery (GKR: marginal dose: 12 Gy, maximum dose: 24 Gy). One month later, her symptoms improved completely. The size of the tumor was reduced to 6.4 cm3 twenty months after GKR. The patient has been free of recurrence and side effects for four years since GKR. GKR may be useful to control residual chondroblastoma of the skull after surgery. PMID:18232323

  3. Gamma knife: an alternative treatment for acoustic neurinomas

    SciTech Connect

    Kamerer, D.B.; Lunsford, L.D.; Moller, M.

    1988-11-01

    Despite surgical advances and technologic means of better monitoring seventh and eighth nerve function intraoperatively, there remains a group of patients for whom alternative methods of treatment are desirable. These include the elderly, those with bilateral tumors or tumors in only hearing ears, individuals with medical contraindications to major surgery, and those who refuse surgical resection. The University of Pittsburgh became the fifth world center and the first in the United States to install the gamma knife for stereotactic radiosurgery. On the basis of the pioneering work done at the Karolinska Institute in Stockholm, acoustic tumor patients who fulfill the above criteria are being treated. A tumoricidal single treatment closed-skull radiation dose is given through 201 sharply focused cobalt 60 sources, minimizing the effects on surrounding brain or other tissues. Our early results are discussed and compared to those from more than 200 cases in Stockholm. Complications and expected long-term results are presented.

  4. Single-incision laparoscopic surgery for biliary tract disease

    PubMed Central

    Chuang, Shu-Hung; Lin, Chih-Sheng

    2016-01-01

    Single-incision laparoscopic surgery (SILS), or laparoendoscopic single-site surgery, has been employed in various fields to minimize traumatic effects over the last two decades. Single-incision laparoscopic cholecystectomy (SILC) has been the most frequently studied SILS to date. Hundreds of studies on SILC have failed to present conclusive results. Most randomized controlled trials (RCTs) have been small in scale and have been conducted under ideal operative conditions. The role of SILC in complicated scenarios remains uncertain. As common bile duct exploration (CBDE) methods have been used for more than one hundred years, laparoscopic CBDE (LCBDE) has emerged as an effective, demanding, and infrequent technique employed during the laparoscopic era. Likewise, laparoscopic biliary-enteric anastomosis is difficult to carry out, with only a few studies have been published on the approach. The application of SILS to CBDE and biliary-enteric anastomosis is extremely rare, and such innovative procedures are only carried out by a number of specialized groups across the globe. Herein we present a thorough and detailed analysis of SILC in terms of operative techniques, training and learning curves, safety and efficacy levels, recovery trends, and costs by reviewing RCTs conducted over the past three years and two recently updated meta-analyses. All existing literature on single-incision LCBDE and single-incision laparoscopic hepaticojejunostomy has been reviewed to describe these two demanding techniques. PMID:26811621

  5. Single-incision pediatric endosurgery in newborns and infants

    PubMed Central

    Kozlov, Yury; Novozhilov, Vladimir; Baradieva, Polina; Krasnov, Pavel; Kovalkov, Konstantin; Muensterer, Oliver J

    2015-01-01

    This study focuses on the successful application of single-incision pediatric endosurgery in the treatment of congenital anomalies and acquired diseases in neonates and infants. The purpose of this scientific review consists in highlighting the spectrum, indications, applicability, and effectiveness of single-port endosurgery in children during the first 3 postnatal months. PMID:26566478

  6. Late Quaternary rates of stream incision in Northeast Peloponnese, Greece

    NASA Astrophysics Data System (ADS)

    Karymbalis, Efthimios; Papanastassiou, Dimitrios; Gaki-Papanastassiou, Kalliopi; Ferentinou, Maria; Chalkias, Christos

    2016-09-01

    This study focuses on defining rates of fluvial incision for the last 580±5 kyr along valley systems of eight streams that drain the eastern part of the northern Peloponnese. The streams are developed on the uplifted block of the offshore-running Xylokastro normal fault, one of the main faults bounding the southern edge of the Gulf of Corinth half-graben, and have incised a set of ten uplifted marine terraces having an amphitheatric shape. These terraces range in age from 60±5 kyr to 580±5 kyr and have been mapped in detail and correlated with late Pleistocene oxygen-isotope stages of high sea-level stands by previous studies. The terraces were used in this paper as reference surfaces in order to define fluvial incision rates at the lower reaches of the studied streams. To evaluate incision rates, thirty-three topographic valley cross-sections were drawn using fieldwork measurements as well as using a highly accurate (2×2 cell size) Digital Elevation Model (DEM) at specific locations where streams cut down the inner edges of the marine terraces. For each cross-section the ratio of valley floor width to valley height (Vf) and long-term mean stream incision rates were estimated for the last 580±5 kyr, while rock uplift rates were estimated for the last 330±5 kyr. The geomorphic evolution of the valleys on the uplifted block of the Xylokastro fault has been mainly driven by the lithology of the bedrock, sea level fluctuations during the late Quaternary, and incision of the channels due to the tectonic uplift. Stream incision rates range from 0.10±0.1 mm/yr for the last 123±7 kyr to 1.14±0.1 mm/yr for the last 310±5 kyr and are gradually greater from east to west depending on the distance from the trace of the fault. Downcutting rates are comparable with the rock uplift rates, which range from 0.4±0.02 mm/yr to 1.49±0.12 mm/yr, over the last 330±5 kyr.

  7. The Hydrodynamics of Natural and Incised Mountain Meadows

    NASA Astrophysics Data System (ADS)

    Essaid, H.; Hill, B. R.

    2012-12-01

    Surface water and groundwater flow and storage in mountain meadows are important hydrologic components of watershed systems. Historical grazing and land development have caused channel incision and streambed lowering in a large fraction of Sierra Nevada meadows. This in turn, has resulted in lowering of groundwater tables and changes in the magnitude and timing of fluxes and storage changes in the meadows and watersheds. The hydrodynamics of mountain meadows under natural and incised conditions has been investigated using the U.S. Geological Survey (USGS) coupled surface water - groundwater flow model GSFLOW. Processes represented in this model include: daily rain, snowfall and snowmelt; streamflow, surface runoff, interflow and infiltration; near-surface soil-zone storage and evapotranspiration; and subsurface unsaturated zone and groundwater flow and evapotranspiration. The Sagehen Creek watershed, located on the east slope of the northern Sierra Nevada near Truckee, California, USA, was used as the basis for watershed topography, hydrography and soil properties. Depth-dependent bedrock hydraulic properties and meadow stratigraphy were varied in model simulations. The results from this coupled modeling approach illustrate the interdependence between bedrock and meadow hydrology, and between surface and groundwater flow through the meadow. Wet meadow conditions formed when the bedrock was sufficiently permeable and transmitted flows to the meadows at a rate that maintained high water tables. Meadows with lower permeability sediments sustained longer wet seasons and did not dry out as quickly. The net effect of stream incision on flow from the meadow to the stream was complex. Stream incision resulted in decreased overland flow and interflow, and increased groundwater discharge from the meadow to the stream. During the wet spring season when groundwater storage was being replenished (especially during wet years) surface runoff and interflow decreased with incision

  8. Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

    PubMed Central

    Choi, Jong-Woo; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan

    2016-01-01

    Backgrounds/Aims Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. Methods During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. Results The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. Conclusions The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously. PMID:27621750

  9. Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

    PubMed Central

    Choi, Jong-Woo; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan

    2016-01-01

    Backgrounds/Aims Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. Methods During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. Results The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. Conclusions The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously.

  10. Quaternary incised valleys in southern Brazil coastal zone

    NASA Astrophysics Data System (ADS)

    Weschenfelder, Jair; Baitelli, Ricardo; Corrêa, Iran C. S.; Bortolin, Eduardo C.; dos Santos, Cristiane B.

    2014-11-01

    High-resolution seismic records obtained in the Rio Grande do Sul coastal zone, southern Brazil, revealed that prominent valleys and channels developed in the area before the installation of actual coastal plain. Landwards, the paleoincisions can be linked with the present courses of the main river dissecting the area. Oceanwards, they can be linked with related features previously recognized in the continental shelf and slope by means of seismic and morphostructural studies. Based mainly on seismic, core data and geologic reasoning, it can be inferred that the coastal valleys were incised during forced regression events into the coastal prism deposited during previous sea level highstand events of the Quaternary. Seismic data has revealed paleovalleys up to 10 km wide and, in some places, infilled with up to 40 m thick of sediments. The results indicated two distinct periods of cut-and-fill events in the Patos Lagoon area. The filling of the younger incision system is mainly Holocene and its onset is related to the last main regressive event of the Pleistocene, when the sea level fell about 130 m below the actual position. The older incision and filling event is related to the previous regressive-transgressive events of the Middle and Late Pleistocene. The fluvial discharge fed delta systems on the shelf edge during the sea level lowstands. The subsequent transgressions drowned the incised drainage, infilling it and closing the inlets formerly connecting the coastal river to the ocean. The incised features may have played a significant role on the basin-margin architecture, facies distribution and accommodation space during the multitude of up and down sea level events of the Quaternary.

  11. Thoracoscopic surgery via a single-incision subxiphoid approach is associated with less postoperative pain than single-incision transthoracic or three-incision transthoracic approaches for spontaneous pneumothorax

    PubMed Central

    Wang, Bing-Yen; Chang, Yin-Chun; Chang, Yih-Chen; Wang, Kung-Min; Lin, Ching-Hsiung; Lin, Sheng-Hao

    2016-01-01

    Background Comparison of the degree of postoperative pain associated with different thoracoscopic surgical techniques for spontaneous pneumothorax has never reported. In this study we compared perioperative outcomes and degrees of postoperative pain associated with single-incision subxiphoid thoracoscopic surgery, single-incision transthoracic thoracoscopic surgery and three-incision transthoracic thoracoscopic surgery for spontaneous pneumothorax. Methods During the period August 2013 to September 2015, fifty-seven consecutive patients with spontaneous pneumothorax were treated via single-incision subxiphoid thoracoscopic surgery, single-incision transthoracic thoracoscopic surgery or three-incision transthoracic thoracoscopic surgery. Demographic data, operative time, operative blood loss, length of hospital stay, duration of chest tube drainage, postoperative complications, and numeric pain rating scale scores were collected from the medical records for analysis. Results Among the 57 patients, 14 received single-incision subxiphoid thoracoscopic surgery, 26 underwent single-incision transthoracic surgery and 17 received three-incision thoracoscopic surgery. In all patients, surgeries were completed without the need for conversion to open surgery. Patients who underwent the single-incision subxiphoid procedure had significantly lower 1-, 8-, 24- and 32-hour postoperative pain scale scores than patients who underwent the other two procedures. The average and maximum pain scale scores during the first 24 hours were lowest in the single-incision subxiphoid group (P<0.0001). Conclusions Single-incision subxiphoid thoracoscopic surgery is associated with significantly lower postoperative pain intensity than transthoracic approaches and therefore may provide an alternative surgical technique for patients with spontaneous pneumothorax. PMID:27014474

  12. Observation of Phase Objects by Using an X-ray Microscope with a Foucault Knife-Edge

    NASA Astrophysics Data System (ADS)

    Watanabe, N.; Sasaya, T.; Imai, Y.; Iwata, S.; Zama, K.; Aoki, S.

    2011-09-01

    An x-ray microscope with a zone plate was assembled at the synchrotron radiation source of BL3C, Photon Factory. A Foucault knife-edge was set at the back focal plate of the objective zone plate and phase retrieval was tested by scanning the knife-edge. A preliminary result shows that scanning the knife-edge during exposure was effective for phase retrieval. Phase-contrast tomography was investigated using differential projection images calculated from two Schlieren images with the oppositely oriented knife-edges. Fairly good reconstruction images of polystyrene beads and spores could be obtained.

  13. Observation of Phase Objects by Using an X-ray Microscope with a Foucault Knife-Edge

    SciTech Connect

    Watanabe, N.; Sasaya, T.; Imai, Y.; Iwata, S.; Zama, K.; Aoki, S.

    2011-09-09

    An x-ray microscope with a zone plate was assembled at the synchrotron radiation source of BL3C, Photon Factory. A Foucault knife-edge was set at the back focal plate of the objective zone plate and phase retrieval was tested by scanning the knife-edge. A preliminary result shows that scanning the knife-edge during exposure was effective for phase retrieval. Phase-contrast tomography was investigated using differential projection images calculated from two Schlieren images with the oppositely oriented knife-edges. Fairly good reconstruction images of polystyrene beads and spores could be obtained.

  14. Lifting incise drapes off the skin during wound closure can cause contamination.

    PubMed

    Makki, D; Probert, N; Gedela, V; Kustos, I; Thonse, R; Banim, R

    2015-05-01

    Incise drapes adhere well to skin and reduce bacterial migration into the wound. We took skin swabs before and after the application of incise drapes during 49 hip and knee arthroplasty procedures. Contamination was detected under incise drapes in four cases (8.1%) and consisted mainly of skin flora. We conclude that it is important to clean the skin again with antiseptics if the incise drape is removed by the surgeon. PMID:26292465

  15. What can we learn from fluvial incision in high mountains?

    NASA Astrophysics Data System (ADS)

    Fuchs, Margret; Gloaguen, Richard; Krbetschek, Matthias

    2013-04-01

    High and actively deforming mountain ranges attract the attention of geoscientists as they provide natural laboratories of fast evolving process-response systems. Tectonic compressional settings, often linked to perpendicular extension, control the topographic growth and hence, erosion, transport pathways and sedimentation. High altitude differences within short horizontal distances promote material re-organisation and high rates of surface processes. Furthermore, high mountains constitute orographic barriers that affect atmospheric circulations as well as host different climate regimes similar to those of widely separated latitudinal belts. Both cause a high sensitivity of surface processes to changes in climatic conditions. However, feedbacks between climatic and tectonic forcing are complex. Additionally, the dominance of one or the other varies in space and also over time, inheriting various traces of the paleo-morphodynamic conditions to the subsequent process regimes. To unravel the forces driving the evolution of relief in active mountains, numerous studies employ the drainage network of the corresponding mountains as a proxy of landscape evolution. Especially the rates of river incision provide a powerful tool to characterize the surface response and infer causes behind it. Several parameters of river incision are available to describe the fluvial incision at individual sites (e.g. terrace incision rates), along the river course (e.g. longitudinal river profiles, Hack index) and in its perpendicular dimension (e.g. valley cross sections, valley shape ratios). But they require careful interpretation. They are sensitive to both, climatic and tectonic forcing. Therefore, the synopsis of such indices for fluvial incision is essential to evaluate the role of climatic versus tectonic forcing. Here, we use the Panj river system, the major river draining the Pamir mountains of Central Asia, as an example. The Panj experiences high altitude changes of more than 4000

  16. Big Blocks and River Incision: A Numerical Modeling Perspective

    NASA Astrophysics Data System (ADS)

    Shobe, C. M.; Tucker, G. E.; Anderson, R. S.

    2015-12-01

    Sediment supply dynamics affect fluvial erosion in steep landscapes. Workers have explored the effects of changing sediment flux and uniform grain size on incision processes and distribution of alluvial cover. However, sediment supplied to real rivers is often highly heterogeneous in size, especially in rapidly eroding landscapes where supply processes may range from landslides to rockfall to moraine incision. We hypothesize that the pace of landscape evolution depends on the sediment size distribution supplied to rapidly eroding channels. Rivers that quickly cut steep-walled canyons may incite a negative feedback on incision by receiving an increased supply of large, immobile blocks from the canyon walls that shield significant portions of the bed from erosion. We use a 1-D numerical model that combines mass-flux continuum treatment of several grain size classes with tracking of discrete large blocks to explore fluvial response to changing grain size distribution. We compare simulations with and without a feedback between channel incision rate and the supply rate of large blocks from adjacent hillslopes. This reflects the hypothesis that slopes will be steeper and more prone to releasing large blocks when the channel at their base is eroding rapidly. Comparing model predictions with field observations shows that our models can successfully reproduce the distribution of blocks in natural channels. Results suggest that in landscapes with access to large blocks, fluvial incision may be slowed as increasing amounts of immobile material are supplied from adjacent hillslopes and canyon walls. This can act to stall knickpoint retreat in such rivers and slow the pace of landscape adjustment. The importance of channel armoring by blocks is governed by competition between two timescales: the time required for significant block cover to accumulate in the channel and the time required for blocks to abrade, fragment, or weather down to transportable sizes. Model results also

  17. Relaxation: mapping an uncharted world.

    PubMed

    Smith, J C; Amutio, A; Anderson, J P; Aria, L A

    1996-03-01

    Nine hundred and forty practitioners of massage, abbreviated progressive muscle relaxation (PMR), yoga stretching, breathing, imagery meditation, and various combination treatments described their technique experiences on an 82-item wordlist. Factor analysis yielded 10 interpretable relaxation categories: Joyful Affects and Appraisals (Joyful), Distant, Calm, Aware, Prayerful, Accepted, Untroubled, Limp, Silent, and Mystery The relaxation response and cognitive/somatic specificity models predict Calm and Limp, which account for only 5.5% of the variance of relaxation experience. Unlike much of previous relaxation research, we found important technique differences. PMR and massage are associated with Distant and Limp; yoga stretching, breathing, and meditation with Aware; meditation with Prayerful and all techniques except PMR with Joyful. Results are consistent with cognitive-behavioral relaxation theory and have implications for relaxation theory, treatment, training, assessment, and research. We close with a revised model of relaxation that posits three global dimensions; tension-relief, passive disengagement, and passive engagement.

  18. Hair Dye and Hair Relaxers

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women Hair Dye and Hair Relaxers Share Tweet Linkedin Pin it More sharing ... products. If you have a bad reaction to hair dyes and relaxers, you should: Stop using the ...

  19. Air kerma based dosimetry calibration for the Leksell Gamma Knife

    SciTech Connect

    Meltsner, Sheridan Griffin; DeWerd, Larry A.

    2009-02-15

    No accepted official protocol exists for the dosimetry of the Leksell Gamma Knife registered (GK) stereotactic radiosurgery device. Establishment of a dosimetry protocol has been complicated by the unique partial-hemisphere arrangement of 201 individual {sup 60}Co beams simultaneously focused on the treatment volume and by the rigid geometry of the GK unit itself. This article proposes an air kerma based dosimetry protocol using either an in-air or in-acrylic phantom measurement to determine the absorbed dose rate of fields of the 18 mm helmet of a GK unit. A small-volume air ionization chamber was used to make measurements at the physical isocenter of three GK units. The absorbed dose rate to water was determined using a modified version of the AAPM Task Group 21 protocol designed for use with {sup 60}Co-based teletherapy machines. This experimentally determined absorbed dose rate was compared to the treatment planning system (TPS) absorbed dose rate. The TPS used with the GK unit is Leksell GammaPlan. The TPS absorbed dose rate at the time of treatment is the absorbed dose rate determined by the physicist at the time of machine commissioning decay corrected to the treatment date. The TPS absorbed dose rate is defined as absorbed dose rate to water at the isocenter of a water phantom with a radius of 8 cm. Measurements were performed on model B and C Gamma Knife units. The absorbed dose rate to water for the 18 mm helmet determined using air-kerma based calculations is consistently between 1.5% and 2.9% higher than the absorbed dose rate provided by the TPS. These air kerma based measurements allow GK dosimetry to be performed with an established dosimetry protocol and without complications arising from the use of and possible variations in solid phantom material. Measurements were also made with the same ionization chamber in a spherical acrylic phantom for comparison. This methodology will allow further development of calibration methods appropriate for the

  20. Relaxation phenomena in disordered systems

    NASA Astrophysics Data System (ADS)

    Sciortino, F.; Tartaglia, P.

    1997-02-01

    In this article we discuss how the assumptions of self-similarity imposed on the distribution of independently relaxing modes, as well as on their amplitude and characteristic times, manifest in the global relaxation phenomena. We also review recent applications of such approach to the description of relaxation phenomena in microemulsions and molecular glasses.

  1. A Comparison of Relaxation Strategies.

    ERIC Educational Resources Information Center

    Matthews, Doris B.

    Some researchers argue that all relaxation techniques produce a single relaxation response while others support a specific-effects hypothesis which suggests that progressive relaxation affects the musculoskeletal system and that guided imagery affects cognitive changes. Autogenics is considered a technique which is both somatic and cognitive. This…

  2. Rehabilitation of anterior teeth with customised incisal guide table

    PubMed Central

    Mall, Priyanka; Singh, Kamleshwar; Rao, Jitendra; Kumar, Lakshya

    2013-01-01

    Restoration of anterior guidance is a major challenge to the clinician in planning of all restorative treatments. An accurate anterior guidance is important for proper function, aesthetics, comfort and phonetics. This article describes anterior rehabilitation of a patient who met with a road traffic accident and lost his anterior teeth. Anterior guidance developed in the provisional restorations was accurately recorded in the customised incisal guide table and permanent restorations were fabricated accordingly. PMID:23709546

  3. Hydraulic Implications of Different Megaflood Canyon Incision Models

    NASA Astrophysics Data System (ADS)

    Larsen, I. J.; Lamb, M. P.

    2015-12-01

    Deeply incised canyons are some of the most dramatic features of landscapes carved by megafloods. The geometry of these canyons may reveal information regarding flood magnitudes during the last ice age on Earth and the volume of water flowing on early Mars. Canyons on both planets have been alternatively modeled as 'channels', where the modern topography was completely inundated with water to the elevation of the canyon rims, or as 'valleys' that were progressively incised by lesser discharges. Here we combine numerical flood simulations and sediment transport mechanics to explore the hydraulic implications that result from modeling the canyons as 'channels' versus 'valleys'. Over 300 floods were simulated for Moses Coulee, a 60 km-long canyon in the Channeled Scablands of eastern Washington, USA, using a 2D, depth-averaged hydraulic model. We simulated floods with discharges ranging from 0.1 million m3 s-1 to 6 million m3 s-1 using both the modern landscape as a topographic boundary condition and synthetic topographies that restored the canyon floor to different elevations as guided by strath terraces. For each simulation we tracked whether shear stresses on the terrace treads exceeded thresholds for sliding of basalt columns. Simulations using the modern topography indicate shear stresses were sufficiently high to erode the terraces at discharges lower than bankfull, and surprisingly, shear stresses decrease with increasing discharge at some sites due to backwater dynamics, which constrains canyon formation to moderate discharges. Simulations performed on the synthetic topography suggest the canyon could have been incised progressively by floods smaller than those required to fill the canyon to bankfull stage. These results suggest the canyons can be viewed as valleys that incised progressively, as opposed to channels filled with water, which has implications for placing bounds on paleoflood hydraulic reconstruction on Earth and Mars.

  4. Single-Incision Laparoscopic Colon and Rectal Surgery

    PubMed Central

    Keller, Deborah S.; Haas, Eric M.

    2015-01-01

    Single-incision laparoscopic surgery (SILS) was introduced to further the enhanced outcomes of multiport laparoscopy. Multiple studies have demonstrated the safety and feasibility of SILS for both benign and malignant colorectal disease. SILS provides the potential for improved cosmesis, postoperative outcomes, and patient quality of life. However, widespread use has been limited by technical demands and lack of an evidence and competency-based curriculum. PMID:26491404

  5. Climate-Driven Bedrock Incision in an Active Mountain Belt

    NASA Astrophysics Data System (ADS)

    Hartshorn, Karen; Hovius, Niels; Dade, W. Brian; Slingerland, Rudy L.

    2002-09-01

    Measurements of fluvial bedrock incision were made with submillimeter precision in the East Central Range of Taiwan, where long-term exhumation rates and precipitation-driven river discharge are independently known. They indicate that valley lowering is driven by relatively frequent flows of moderate intensity, abrasion by suspended sediment is an important fluvial wear process, and channel bed geometry and the presence of widely spaced planes of weakness in the rock mass influence erosion rate and style.

  6. Progressive incision of the Channeled Scablands by outburst floods

    NASA Astrophysics Data System (ADS)

    Larsen, Isaac J.; Lamb, Michael P.

    2016-10-01

    The surfaces of Earth and Mars contain large bedrock canyons that were carved by catastrophic outburst floods. Reconstructing the magnitude of these canyon-forming floods is essential for understanding the ways in which floods modify planetary surfaces, the hydrology of early Mars and abrupt changes in climate. Flood discharges are often estimated by assuming that the floods filled the canyons to their brims with water; however, an alternative hypothesis is that canyon morphology adjusts during incision such that bed shear stresses exceed the threshold for erosion by a small amount. Here we show that accounting for erosion thresholds during canyon incision results in near-constant discharges that are five- to ten-fold smaller than full-to-the-brim estimates for Moses Coulee, a canyon in the Channeled Scablands, which was carved during the Pleistocene by the catastrophic Missoula floods in eastern Washington, USA. The predicted discharges are consistent with flow-depth indicators from gravel bars within the canyon. In contrast, under the assumption that floods filled canyons to their brims, a large and monotonic increase in flood discharge is predicted as the canyon was progressively incised, which is at odds with the discharges expected for floods originating from glacial lake outbursts. These findings suggest that flood-carved landscapes in fractured rock might evolve to a threshold state for bedrock erosion, thus implying much lower flood discharges than previously thought.

  7. Pleistocene drainage incision in the upper Mississippi Valley Driftless Area

    SciTech Connect

    Knox, J.C.

    1985-01-01

    The deep dissection of the Wisconsin Driftless Area and topographically similar, but glaciated areas in adjacent states is generally acknowledged to have occurred during the Pleistocene, but the precise chronology has been poorly understood. The distribution of pre-Illinoian glacial outwash gravels on uplands and valley side benches near the Mississippi River, on the western margin of the Wisconsin Driftless Area, indicates that the major incision (50-60 m) of drainage had occurred during the very early Pleistocene. Deposits in cut-off valley meanders, a common feature in the lower reaches of Driftless Area rivers, provide a basis for relative dating of the valley incision. The cut-offs appear to have evolved episodically when, at various times during the Pleistocene, glacial debris blocked the drainages of the Mississippi and Wisconsin Rivers causing massive alluviation of side valley tributaries. A radiocarbon date of 21,910 +/- 350 year B.P., representing a buried soil horizon at 22 m depth and about 9 m above the bedrock floor of a cut-off valley meander and 18 m above the bedrock floor of the adjacent present-day valley, supports stratigraphic interpretations that suggest modest valley incision into bedrock probably occurred during the Illinoian and may have also occurred during the early Wisconsinan.

  8. Nucleotide excision repair by dual incisions in plants

    PubMed Central

    Canturk, Fazile; Karaman, Muhammet; Selby, Christopher P.; Kemp, Michael G.; Kulaksiz-Erkmen, Gulnihal; Hu, Jinchuan; Li, Wentao; Lindsey-Boltz, Laura A.; Sancar, Aziz

    2016-01-01

    Plants use light for photosynthesis and for various signaling purposes. The UV wavelengths in sunlight also introduce DNA damage in the form of cyclobutane pyrimidine dimers (CPDs) and pyrimidine (6-4) pyrimidone photoproducts [(6-4)PPs] that must be repaired for the survival of the plant. Genome sequencing has revealed the presence of genes for both CPD and (6-4)PP photolyases, as well as genes for nucleotide excision repair in plants, such as Arabidopsis and rice. Plant photolyases have been purified, characterized, and have been shown to play an important role in plant survival. In contrast, even though nucleotide excision repair gene homologs have been found in plants, the mechanism of nucleotide excision repair has not been investigated. Here we used the in vivo excision repair assay developed in our laboratory to demonstrate that Arabidopsis removes CPDs and (6-4)PPs by a dual-incision mechanism that is essentially identical to the mechanism of dual incisions in humans and other eukaryotes, in which oligonucleotides with a mean length of 26–27 nucleotides are removed by incising ∼20 phosphodiester bonds 5′ and 5 phosphodiester bonds 3′ to the photoproduct. PMID:27071131

  9. Surgical robot for single-incision laparoscopic surgery.

    PubMed

    Choi, Hyundo; Kwak, Ho-Seong; Lim, Yo-An; Kim, Hyung-Joo

    2014-09-01

    This paper introduces a novel surgical robot for single-incision laparoscopic surgeries. The robot system includes the cone-type remote center-of-motion (RCM) mechanism and two articulated instruments having a flexible linkage-driven elbow. The RCM mechanism, which has two revolute joints and one prismatic joint, is designed to maintain a stationary point at the apex of the cone shape. By placing the stationary point on the incision area, the mechanism allows a surgical instrument to explore the abdominal area through a small incision point. The instruments have six articulated joints, including an elbow pitch joint, which make the triangulation position for the surgery possible inside of the abdominal area. The presented elbow pitch structure is similar to the slider-crank mechanism but the connecting rod is composed of a flexible leaf spring for high payload and small looseness error. We verified the payload of the robot is more than 10 N and described preliminary experiments on peg transfer and suture motion by using the proposed surgical robot. PMID:24835120

  10. Nucleotide excision repair by dual incisions in plants.

    PubMed

    Canturk, Fazile; Karaman, Muhammet; Selby, Christopher P; Kemp, Michael G; Kulaksiz-Erkmen, Gulnihal; Hu, Jinchuan; Li, Wentao; Lindsey-Boltz, Laura A; Sancar, Aziz

    2016-04-26

    Plants use light for photosynthesis and for various signaling purposes. The UV wavelengths in sunlight also introduce DNA damage in the form of cyclobutane pyrimidine dimers (CPDs) and pyrimidine (6-4) pyrimidone photoproducts [(6-4)PPs] that must be repaired for the survival of the plant. Genome sequencing has revealed the presence of genes for both CPD and (6-4)PP photolyases, as well as genes for nucleotide excision repair in plants, such as Arabidopsis and rice. Plant photolyases have been purified, characterized, and have been shown to play an important role in plant survival. In contrast, even though nucleotide excision repair gene homologs have been found in plants, the mechanism of nucleotide excision repair has not been investigated. Here we used the in vivo excision repair assay developed in our laboratory to demonstrate that Arabidopsis removes CPDs and (6-4)PPs by a dual-incision mechanism that is essentially identical to the mechanism of dual incisions in humans and other eukaryotes, in which oligonucleotides with a mean length of 26-27 nucleotides are removed by incising ∼20 phosphodiester bonds 5' and 5 phosphodiester bonds 3' to the photoproduct. PMID:27071131

  11. Bedrock incision by bedload: insights from direct numerical simulations

    NASA Astrophysics Data System (ADS)

    Aubert, Guilhem; Langlois, Vincent J.; Allemand, Pascal

    2016-04-01

    Bedload sediment transport is one of the main processes that contribute to bedrock incision in a river and is therefore one of the key control parameters in the evolution of mountainous landscapes. In recent years, many studies have addressed this issue through experimental setups, direct measurements in the field, or various analytical models. In this article, we present a new direct numerical approach: using the classical methods of discrete-element simulations applied to granular materials, we explicitly compute the trajectories of a number of pebbles entrained by a turbulent water stream over a rough solid surface. This method allows us to extract quantitatively the amount of energy that successive impacts of pebbles deliver to the bedrock, as a function of both the amount of sediment available and the Shields number. We show that we reproduce qualitatively the behaviour observed experimentally by Sklar and Dietrich (2001) and observe both a "tool effect" and a "cover effect". Converting the energy delivered to the bedrock into an average long-term incision rate of the river leads to predictions consistent with observations in the field. Finally, we reformulate the dependency of this incision rate with Shields number and sediment flux, and predict that the cover term should decay linearly at low sediment supply and exponentially at high sediment supply.

  12. Measurement of Gamma Knife registered helmet factors using MOSFETs

    SciTech Connect

    Kurjewicz, Laryssa; Berndt, Anita

    2007-03-15

    The relative dose rate for the different Gamma Knife registered helmets (4, 8, 14, and 18 mm) is characterized by their respective helmet factors. Since the plateau of the dose profile for the 4 mm helmet is at most 1 mm wide, detector choices are limited. Traditionally helmet factors have been measured using 1x1x1 mm{sup 3} thermoluminescent dosimeters (TLDs). However, these are time-consuming, cumbersome measurements. This article investigates the use of metal-oxide-semiconductor field effect transistors (MOSFETs) (active area of 0.2x0.2 mm{sup 2}) as a more accurate and convenient dosimeter. Their suitability for these measurements was confirmed by basic characterization measurements. Helmet factors were measured using both MOSFETs and the established TLD approach. A custom MOSFET cassette was designed in analogy to the Elekta TLD cassette (Elekta Instruments AB) for use with the Elekta dosimetry sphere. Although both dosimeters provided values within 3% of the manufacturer's suggestion, MOSFETs provided superior accuracy and precision, in a fraction of the time required for the TLD measurements. Thus, MOSFETs proved to be a reasonable alternative to TLDs for performing helmet factor measurements.

  13. Class characteristics of serrated knife stabs to cartilage.

    PubMed

    Pounder, Derrick J; Cormack, Lesley; Broadbent, Elizabeth; Millar, John

    2011-06-01

    A total of 136 stab wounds were made in cartilage with 8 serrated knives and 72 stabs with 4 nonserrated knives. The walls of the stab track were documented by photography, cast with dental impression material, and the casts photographed. Staining the translucent cartilage surface with blue or green food dye improved photography. Serrated blades produced striations on cartilage in all stabbings. Patterns of blade serration beyond the broad categories of coarse and fine were recognizable. The overall pattern of striations was "irregularly regular." The distance between the blade-spine wound end and the first serration striation is a class characteristic of the knife which produced the defect, as are distances to the subsequent serration striations, which become ever close together and eventually merge near the blade-edge wound end. Serrated knives may be ground (scalloped) on either the left side or the right side of the blade and this class characteristic is identifiable from the walls of the wound track, on which the scalloped blade surface produces broad ridges and narrow striation valleys, with a reverse image on the opposing wound wall. A drop point serrated blade consistently produced an additional oblique mark angled from the blade-spine wound end, accurately reflecting the shape of the blade tip, and representing a chatter mark.

  14. Gamma Knife radiosurgery for the treatment of cavernous sinus hemangiomas

    PubMed Central

    XU, QINGSHENG; SHEN, JIAN; FENG, YIPING; ZHAN, RENYA

    2016-01-01

    The present retrospective study aimed to analyze the outcome of patients with cavernous sinus hemangioma (CSH) treated with Gamma Knife radiosurgery (GKS). Between August 2011 and April 2014, 7 patients with CSHs underwent GKS. GKS was performed as the sole treatment option in 5 patients, whilst partial resection had been performed previously in 1 patient and biopsy had been performed in 1 patient. The mean volume of the tumors at the time of GKS was 12.5±10.2 cm3 (range, 5.3–33.2 cm3), and the median prescription of peripheral dose was 14.0 Gy (range, 10.0–15.0 Gy). The mean follow-up period was 20 months (range, 6–40 months). At the last follow-up, the lesion volume had decreased in all patients, and all cranial neuropathies observed prior to GKS had improved. There were no radiation-induced neuropathies or complications during the follow-up period. GKS appears to be an effective and safe treatment modality for the management of CSHs. PMID:26893777

  15. Recurrent Juvenile Nasopharyngeal Angiofibroma Treated with Gamma Knife Surgery

    PubMed Central

    Park, Chul-Kee; Paek, Sun Ha; Chung, Hyun-Tai; Jung, Hee-Won

    2006-01-01

    Radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of recurred JNA with gamma knife surgery (GKS). A 48-yr-old man was presented with right visual acuity deterioration and brain magnetic resonance images (MRI) disclosed a 3 cm-sized intraorbital mass in the right orbit. He underwent a right fronto-temporal craniotomy and the mass was subtotally removed to preserve visual function. Histological diagnosis confirmed JNA in typical nature. However, the vision gradually worsened to fail four years after operation. MRI then showed regrowth of the tumor occupying most of the right orbit. GKS was done for the recurred lesion. A dose of 17 Gy was delivered to the 50% isodose line of tumor margin. During the following four-year follow-up period, the mass disappeared almost completely without any complications. Usually JNA can be exclusively diagnosed by radiological study alone. So this report of successful treatment of JNA with GKS may provide an important clue for the novel indication of GKS. PMID:16891831

  16. Recurrent juvenile nasopharyngeal angiofibroma treated with gamma knife surgery.

    PubMed

    Park, Chul-Kee; Kim, Dong Gyu; Paek, Sun Ha; Chung, Hyun-Tai; Jung, Hee-Won

    2006-08-01

    Radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of recurred JNA with gamma knife surgery (GKS). A 48-yr-old man was presented with right visual acuity deterioration and brain magnetic resonance images (MRI) disclosed a 3 cm-sized intraorbital mass in the right orbit. He underwent a right fronto-temporal craniotomy and the mass was subtotally removed to preserve visual function. Histological diagnosis confirmed JNA in typical nature. However, the vision gradually worsened to fail four years after operation. MRI then showed regrowth of the tumor occupying most of the right orbit. GKS was done for the re-curred lesion. A dose of 17 Gy was delivered to the 50% isodose line of tumor mar-gin. During the following four-year follow-up period, the mass disappeared almost completely without any complications. Usually JNA can be exclusively diagnosed by radiological study alone. So this report of successful treatment of JNA with GKS may provide an important clue for the novel indication of GKS.

  17. Ruptured Pseudoaneurysm after Gamma Knife Surgery for Vestibular Schwannoma

    PubMed Central

    MURAKAMI, Mamoru; KAWARABUKI, Kentaro; INOUE, Yasuo; OHTA, Tsutomu

    2016-01-01

    Ruptured aneurysms of anterior inferior cerebellar artery (AICA) after radiotherapy for vestibular schwannoma (VS) are rare, and no definite treatment has been established for distal AICA pseudoaneurysms. We describe a 61-year-old man who underwent Gamma Knife surgery (GKS) for left VS. Follow-up magnetic resonance imaging (MRI) revealed partial regression of the tumor. Twelve years after GKS, he suffered from subarachnoid hemorrhage. Initial angiogram showed no vascular lesions; second left vertebral angiogram, 10 days after admission, demonstrated a pseudoaneurysm in the lateral pontine segment of the left AICA. The proximal portion of the AICA was occluded by a coil. Postoperative MRI revealed an infarction on the left side of the pons and brachium pontis. Although the patient suffered from mild postoperative cerebellar ataxia and facial and abducens nerve palsy, he was discharged 1 month postoperatively requiring no assistance with activities of daily living. Twelve months later, he recovered satisfactorily with a modified Rankin Scale grade of 1, and no recanalization of the aneurysm was found on MR angiography. Endovascular parent artery occlusion for ruptured aneurysms at distal AICA carries the risk of brain stem infarction, but should be considered when no other option is available such as after radiotherapy for VS. PMID:26667081

  18. Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy.

    PubMed

    Litta, Pietro; Saccardi, Carlo; Gizzo, Salvatore; Conte, Lorena; Ambrosi, Giulia; Sissi, Claudia; Palumbo, Manlio

    2015-08-01

    Electrical surgical devices may determine tissue damage through lateral thermal spread and activation of inflammatory processes. Several tissue effects are associated with the use of different surgical instruments. The aim of the present study was to compare tissue damage following the application of cold knife biopsy, bipolar electrocoagulation and the ultracision harmonic scalpel, through the analysis of inflammatory gene mediator expression. Three fragments of the round ligament (length 0.5 cm) were obtained from 22 females who had undergone total or subtotal laparoscopic hysterectomy using three different modes of resection: Cold knife biopsy, bipolar electrocoagulation and ultracision harmonic scalpel. The tissue fragments were examined by quantitative polymerase chain reaction (qPCR) analysis of selected cytokines. Gene expression analysis demonstrated large standard deviations due to individual variability among patients and indicated variability in the concentrations of cytokines in the three different samples. The quantity of cytokine mRNA in the cold knife biopsy samples was generally greater than those obtained by other techniques. Tumor necrosis factor-α expression was significantly higher in the sample obtained with the ultracision harmonic scalpel and bipolar electrocoagulation (P=0.033) when compared with cold knife biopsy. The inflammatory response was analyzed by the quantification of gene expression through the use of qPCR. The ultracision harmonic scalpel and bipolar electrocoagulation triggered the inflammatory cascade and resulted in an increased production of cytokines compared with cold knife biopsy.

  19. Management of Liver Cancer Argon-helium Knife Therapy with Functional Computer Tomography Perfusion Imaging.

    PubMed

    Wang, Hongbo; Shu, Shengjie; Li, Jinping; Jiang, Huijie

    2016-02-01

    The objective of this study was to observe the change in blood perfusion of liver cancer following argon-helium knife treatment with functional computer tomography perfusion imaging. Twenty-seven patients with primary liver cancer treated with argon-helium knife and were included in this study. Plain computer tomography (CT) and computer tomography perfusion (CTP) imaging were conducted in all patients before and after treatment. Perfusion parameters including blood flows, blood volume, hepatic artery perfusion fraction, hepatic artery perfusion, and hepatic portal venous perfusion were used for evaluating therapeutic effect. All parameters in liver cancer were significantly decreased after argon-helium knife treatment (p < 0.05 to all). Significant decrease in hepatic artery perfusion was also observed in pericancerous liver tissue, but other parameters kept constant. CT perfusion imaging is able to detect decrease in blood perfusion of liver cancer post-argon-helium knife therapy. Therefore, CTP imaging would play an important role for liver cancer management followed argon-helium knife therapy.

  20. Bedrock River Incision Following Aggradation: Observations from the Waipaoa River Regarding Tributary Response to Mainstem Incision and the Role of Paleotopography

    NASA Astrophysics Data System (ADS)

    Crosby, B. T.; Whipple, K. X.

    2005-12-01

    Following a period of valley-filling aggradation, the form and extent of subsequent alluvial and bedrock incision is governed by the pre-aggradation topography and the position of the channel at the time of incision. We present findings from an extensive along-stream survey of the Waihuka Stream, a tributary to the Waipaoa River on the North Island of New Zealand. Never glaciated, this basin aggraded 5 to 25 m of coarse alluvial sediment during the last glacial period, creating an extensive and distinctive valley-fill surface. ~18 ka, aggradation ceased and a subsequent pulse of fluvial incision abandoned the aggradational surface. At present, the river gorge is incised 25 to 60 m into alluvial fill and mudstone bedrock beneath the top of the aggradational surface. Using a laser range-finder and GPS-enabled GIS surveying tool, we surveyed ~17 km of the Waihuka Stream (4.8×106 m2 to 6.3×107 m2). We collected a longitudinal profile and the relative elevations of fill and strath surfaces exposed in channel banks. We also surveyed a total of ~9 km in 14 tributaries to the Waihuka. Drainage areas of tributaries ranged between 5×105 m2 and 9.9×106 m2. In the Waihuka, we find that the amount of bedrock incision depends on whether the incising channel locally lowered through alluvial fill to reoccupy the preaggradation channel or whether it locally had to cut an entirely new valley into bedrock. Reaches dominated by bedrock incision were observed where alluvial fan deposits laterally shifted the mainstem channel out of the paleovalley and against the opposite bedrock hillslope. The along-stream variation in bed erodability forced by whether the re-incising channel encountered bedrock or alluvium had a significant effect on the propagation of the incision signal into tributaries. Where the channel dominantly re-incised alluvial fill, tributaries have stepped but not dramatically over-steepened longitudinal profiles that appear to be adjusting to the new base-level. In

  1. Progressive muscle relaxation, yoga stretching, and ABC relaxation theory.

    PubMed

    Ghoncheh, Shahyad; Smith, Jonathan C

    2004-01-01

    This study compared the psychological effects of progressive muscle relaxation (PMR) and yoga stretching (hatha) exercises. Forty participants were randomly divided into two groups and taught PMR or yoga stretching exercises. Both groups practiced once a week for five weeks and were given the Smith Relaxation States Inventory before and after each session. As hypothesized, practitioners of PMR displayed higher levels of relaxation states (R-States) Physical Relaxation and Disengagement at Week 4 and higher levels of Mental Quiet and Joy as a posttraining aftereffect at Week 5. Contrary to what was hypothesized, groups did not display different levels of R-States Energized or Aware. Results suggest the value of supplementing traditional somatic conceptualizations of relaxation with the psychological approach embodied in ABC relaxation theory. Clinical and research implications are discussed.

  2. [Acupoint position and manipulation of needle knife treating shoulder bi syndrome].

    PubMed

    Zhao, Li; Guo, Changqing

    2016-03-01

    With Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) for instance, the three acupoints used to treat shoulder bi syndrome by needle knife, and through traceability and researching constant structure, the acupoint position, insertion trace, manipulation and clinical significance of needle knife medicine were discussed. Accurate position is one of the characteristics of acupoints selection of needle knife medicine. As for the acupoints selection method, the mean of body surface localization is always used. The phanerous or palpable bone processes, muscles and tendons are taken as positioning marks; pressing areas where appear sour, numb, or distensible and other sensations is considered as the principle of press positioning. So acupoints position method is the combination of observation and palpation. Different insertion methods can effectively relieve the accretive bursae synovialis, tendon, joint capsule and the compressed nerve, so that shoulder bi syndrome is relieved. PMID:27344840

  3. Influence of Incision Location on Transmitter Loss, Healing, Survival, Growth, and Suture Retention of Juvenile Chinook Salmon

    SciTech Connect

    Panther, Jennifer L.; Brown, Richard S.; Gaulke, Greg L.; Deters, Katherine A.; Woodley, Christa M.; Eppard, M. Brad

    2011-11-01

    Fisheries research involving surgical implantation of transmitters necessitates the use of methods that minimize transmitter loss and fish mortality and optimize healing of the incision. We evaluated the effects of three incision locations on transmitter loss, healing, survival, growth, and suture retention in juvenile Chinook salmon Oncorhynchus tshawytscha. The three incision locations were (1) on the linea alba (LA incision), (2) adjacent and parallel to the LA (muscle-cutting [MC] incision), and (3) extending from the LA towards the dorsum at a 45° angle, between the parallel lines of myomeres (muscle-sparing [MS] incision). A Juvenile Salmon Acoustic Telemetry System acoustic transmitter (0.44 g in air) and a passive integrated transponder tag (0.10 g in air) were implanted into each fish (total N = 936 fish). The fish were held at 12°C or 20°C and were examined weekly for 98 d. The progression of healing among incision locations and the variability in transmitter loss made it difficult to identify one incision location as the best choice. The LA incisions had a much smaller wound extent (area of visible subepidermal tissue) than MC and MS incisions during the first 28 d of the study. In both temperature treatments, apposition of incisions through day 14 was better for LA incisions than for MC and MS incisions. However, MC and MS incisions were less likely than LA incisions to reopen over time and thus were less likely to allow transmitter loss through the incision.

  4. A simple and effective procedure for treating burn contractures: releasing incision and quadra Z technique.

    PubMed

    Sen, Cenk; Karacalar, Ahmet; Agir, Hakan; Dinar, Serkan; Isil, Eda; Iscen, Deniz

    2007-03-01

    Burn contractures particularly involving the joints are challenging problems which might cause severe functional impairments. Many surgical techniques have been described for use, however, an ideal method yet to be found. Releasing incision is the most common and effective way to release the wide and severe contractures but it has some drawbacks. We propose a releasing incision technique combined with four Z plasty incisions to overcome the disadvantages of traditional releasing incision technique. We successfully used our releasing incision and quadra Z technique on seven consecutive patients with burn contractures between 2003 and 2005. We modified the classical releasing incision technique by adding four Z plasties; two of them with a common base on each corner of the incision line. In this technique, limitation of the webbing following the incision is made possible by the transposed flaps and unnecessary lateral extension of the incision and the defect was avoided, i.e. maximum release gain with minimal defect was provided. Satisfactory results were achieved in seven patients treated with this technique due to significant burn contractures between 2003 and 2005 with no significant complication. We propose this technique is suitable in all patients with severe burn contractures who require releasing incision and grafting.

  5. Comparison of two different labial salivary gland biopsy incision techniques: A randomized clinical trial

    PubMed Central

    Ati775 i?kler, Mert; Ergun, Sertan; Ofluo?lu, Duygu; Tanyeri775 i?, Hakk?

    2013-01-01

    Objectives: To compare the reliability of two different labial salivary gland biopsy (LSGB) incision techniques (vertical versus horizontal incision techniques) and to report the related complications and discomfort. Study Design: 163 patients who underwent LSGB were included in this study. Patients were randomly divided as vertical incision group (n=81) and horizontal incision group (n=82). Demographic and clinical information of each patient were recorded. A questionnaire was prepared and applied together with Visual Analog Scale (VAS) on the subjects verbally at the 7th day, postoperatively. Intraoperative, short- term and delayed complications were evaluated. Results: The mean age of patients (117 female, 46 male) was 47.3 years (range 19-79 years). Vertical incision technique was associated with less pain (p<0.001), less swelling (p<0.05), less scar formation (p<0.05) and less difficulty in eating (p<0.05) when compared with horizontal incision technique. No statistically significant differences were observed between the 2 groups in terms of hematoma, parasthesia and speech difficulty (p>0.05). Additionally, two subjects in the horizontal incision group revealed permanent paresthesia during the follow-up period of two years. Conclusions: This prospective study demonstrated that the subjects in the vertical incision group had less complication rates and discomfort after labial salivary gland procedure than those in the horizontal incision group. Key words:Salivary gland, biopsy, incision. PMID:23986021

  6. Adaptive hypofractionated gamma knife radiosurgery for a large brainstem metastasis

    PubMed Central

    Sinclair, Georges; Bartek, Jiri; Martin, Heather; Barsoum, Pierre; Dodoo, Ernest

    2016-01-01

    Background: To demonstrate how adaptive hypofractionated radiosurgery by gamma knife (GK) can be successfully utilized to treat a large brainstem metastasis - a novel approach to a challenging clinical situation. Case Description: A 42-year-old woman, diagnosed with metastatic nonsmall cell lung cancer in July 2011, initially treated with chemotherapy and tyrosine kinase inhibitors, developed multiple brain metastases March 2013, with subsequent whole brain radiotherapy, after which a magnetic resonance imaging (MRI) showed a significant volume regression of all brain metastases. A follow-up MRI in October 2013 revealed a growing brainstem lesion of 26 mm. Linear accelerator-based radiotherapy and microsurgery were judged contraindicated, why the decision was made to treat the patient with three separate radiosurgical sessions during the course of 1 week, with an 18% tumor volume reduction demonstrated after the last treatment. Follow-up MRI 2.5 months after her radiosurgical treatment showed a tumor volume reduction of 67% compared to the 1st day of treatment. Later on, the patient developed a radiation-induced perilesional edema although without major clinical implications. An MRI at 12 months and 18-fluoro-deoxyglucose positron emission tomography of the brain at 13 months showed decreased edema with no signs of tumor recurrence. Despite disease progression during the last months of her life, the patient's condition remained overall acceptable. Conclusion: GK-based stereotactic adaptive hypofractionation proved to be effective to achieve tumor control while limiting local adverse reactions. This surgical modality should be considered when managing larger brain lesions in critical areas. PMID:26958430

  7. Salvage Gamma Knife Stereotactic Radiosurgery for Surgically Refractory Trigeminal Neuralgia

    SciTech Connect

    Little, Andrew S.; Shetter, Andrew G. Shetter, Mary E.; Kakarla, Udaya K.; Rogers, C. Leland

    2009-06-01

    Purpose: To evaluate the clinical outcome of patients with surgically refractory trigeminal neuralgia (TN) treated with rescue gamma knife radiosurgery (GKRS). Methods and Materials: Seventy-nine patients with typical TN received salvage GKRS between 1997 and 2002 at the Barrow Neurological Institute (BNI). All patients had recurrent pain following at least one prior surgical intervention. Prior surgical interventions included percutaneous destructive procedures, microvascular decompression (MVD), or GKRS. Thirty-one (39%) had undergone at least two prior procedures. The most common salvage dose was 80 Gy, although 40-50 Gy was typical in patients who had received prior radiosurgery. Pain outcome was assessed using the BNI Pain Intensity Score, and quality of life was assessed using the Brief Pain Inventory. Results: Median follow-up after salvage GKRS was 5.3 years. Actuarial analysis demonstrated that at 5 years, 20% of patients were pain-free and 50% had pain relief. Pain recurred in patients who had an initial response to GKRS at a median of 1.1 years. Twenty-eight (41%) required a subsequent surgical procedure for recurrence. A multivariate Cox proportional hazards model suggested that the strongest predictor of GKRS failure was a history of prior MVD (p=0.029). There were no instances of serious morbidity or mortality. Ten percent of patients developed worsening facial numbness and 8% described their numbness as 'very bothersome.' Conclusions: GKRS salvage for refractory TN is well tolerated and results in long-term pain relief in approximately half the patients treated. Clinicians may reconsider using GKRS to salvage patients who have failed prior MVD.

  8. Gamma Knife Radiosurgery for Brain Metastases From Primary Breast Cancer

    SciTech Connect

    Kased, Norbert; Binder, Devin K.; McDermott, Michael W.; Nakamura, Jean L.; Huang, Kim; Berger, Mitchel S.; Wara, William M.; Sneed, Penny K.

    2009-11-15

    Purpose: The relative roles of stereotactic radiosurgery (SRS) vs. whole brain radiotherapy (WBRT) in the treatment of patients with brain metastases from breast cancer remain undefined. In this study, we reviewed our experience with these patients. Materials and Methods: We retrospectively reviewed all patients treated between 1991 and 2005 with Gamma Knife SRS for brain metastases from breast cancer. The actuarial survival and freedom from progression endpoints were calculated using the Kaplan-Meier method. Results: Between 1991 and 2005, 176 patients underwent SRS for brain metastases from breast cancer. The median survival time was 16.0 months for 95 newly diagnosed patients and 11.7 months for 81 patients with recurrent brain metastases. In the newly diagnosed patients, omission of upfront WBRT did not significantly affect the MST (p = .20), brain freedom from progression (p = .75), or freedom from new brain metastases (p = .83). Longer survival was associated with age <50 years, Karnofsky performance score >=70, primary tumor control, estrogen receptor positivity, and Her2/neu overexpression. No association was found between the number of treated brain metastases and the survival time. Conclusion: We have described prognostic factors for breast cancer patients treated with SRS for newly diagnosed or recurrent brain metastases. Most patient subsets had a median survival time of >=11 months. Unexpectedly, upfront WBRT did not appear to improve brain freedom from progression, and a larger number of brain metastases was not associated with a shorter survival time. Breast cancer might be distinct from other primary sites in terms of prognostic factors and the roles of WBRT and SRS for brain metastases.

  9. Gamma Knife Radiosurgery for the Treatment of Cystic Cerebral Metastases

    SciTech Connect

    Ebinu, Julius O.; Lwu, Shelly; Monsalves, Eric; Arayee, Mandana; Chung, Caroline; Laperriere, Normand J.; Kulkarni, Abhaya V.; Goetz, Pablo; Zadeh, Gelareh

    2013-03-01

    Purpose: To assess the role of Gamma Knife radiosurgery (GKRS) in the treatment of nonsurgical cystic brain metastasis, and to determine predictors of response to GKRS. Methods: We reviewed a prospectively maintained database of brain metastases patients treated at our institution between 2006 and 2010. All lesions with a cystic component were identified, and volumetric analysis was done to measure percentage of cystic volume on day of treatment and consecutive follow-up MRI scans. Clinical, radiologic, and dosimetry parameters were reviewed to establish the overall response of cystic metastases to GKRS as well as identify potential predictive factors of response. Results: A total of 111 lesions in 73 patients were analyzed; 57% of lesions received prior whole-brain radiation therapy (WBRT). Lung carcinoma was the primary cancer in 51% of patients, 10% breast, 10% colorectal, 4% melanoma, and 26% other. Fifty-seven percent of the patients were recursive partitioning analysis class 1, the remainder class 2. Mean target volume was 3.3 mL (range, 0.1-23 mL). Median prescription dose was 21 Gy (range, 15-24 Gy). Local control rates were 91%, 63%, and 37% at 6, 12, and 18 months, respectively. Local control was improved in lung primary and worse in patients with prior WBRT (univariate). Only lung primary predicted local control in multivariate analysis, whereas age and tumor volume did not. Lesions with a large cystic component did not show a poorer response compared with those with a small cystic component. Conclusions: This study supports the use of GKRS in the management of nonsurgical cystic metastases, despite a traditionally perceived poorer response. Our local control rates are comparable to a matched cohort of noncystic brain metastases, and therefore the presence of a large cystic component should not deter the use of GKRS. Predictors of response included tumor subtype. Prior WBRT decreased effectiveness of SRS for local control rates.

  10. Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma

    PubMed Central

    Larson, Erik W; Peterson, Halloran E; Lamoreaux, Wayne T; MacKay, Alexander R; Fairbanks, Robert K; Call, Jason A; Carlson, Jonathan D; Ling, Benjamin C; Demakas, John J; Cooke, Barton S; Lee, Christopher M

    2014-01-01

    Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM (rGBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery (GKRS) salvage therapy. Following a PubMed search for studies using GKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rGBM treatment. In this review, we compare Overall survival following diagnosis, Overall survival following salvage treatment, Progression-free survival, Time to recurrence, Local tumor control, and adverse radiation effects. This report discusses results for rGBM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates (from diagnosis, range: 16.7-33.2 mo; from salvage, range: 9-17.9 mo). Three studies identified median progression-free survival (range: 4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects (range: 0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rGBM patient. However, there needs to be a randomized clinical trial to test GKRS for rGBM before the possibility of selection bias can be dismissed. PMID:24829861

  11. Impact of channel incision on the hydraulics of flood flows: Examples from Polish Carpathian rivers

    NASA Astrophysics Data System (ADS)

    Wyżga, Bartłomiej; Zawiejska, Joanna; Radecki-Pawlik, Artur

    2016-11-01

    Channel deepening may result from channel incision or river metamorphosis changing a wide and shallow channel to a narrow and deep one. As only the first type of channel change leads to increased flow capacity of the channel, a lowering of water stage associated with a given discharge rather than a lowering of river bed should be used to identify channel incision. A lowering of minimum annual stage at gauging stations is typically used to assess the relative importance of channel incision along a river or within a particular region. Rivers of the Polish Carpathians incised by 0.5-3.8 m over the twentieth century, with the amount of incision being greater in their lower and middle courses than in the upper ones. Variability in the hydraulic importance of channel incision with increasing river size is analysed by comparing changes in the frequency of valley floor inundation at gauging stations located along the seventh-order Dunajec River. Despite a lower absolute amount of channel incision in the upper river course, here incision has increased channel conveyance and reduced the frequency of valley floor inundation considerably more than in the lower course. Hydraulic effects of channel incision depend also on lateral stability of an incising river. Low-energy rivers from the eastern part of the Polish Carpathians remained laterally stable during channel incision. This has resulted in substantial lowering of stages for low flood discharges and markedly smaller one for high-magnitude floods, whereas velocity of the flows conveyed over the highly elevated floodplains has decreased considerably. In high-energy rivers from the western part of the Polish Carpathians, alternation of incision and lateral channel migration has led to the formation of incised meander belts, with substantially lowered stages for all flood discharges and increased velocity of the flows conveyed over the newly-formed, low-lying floodplains.

  12. Single-incision laparoscopic surgery - current status and controversies

    PubMed Central

    Rao, Prashanth P; Rao, Pradeep P; Bhagwat, Sonali

    2011-01-01

    Scarless surgery is the Holy Grail of surgery and the very raison d’etre of Minimal Access Surgery was the reduction of scars and thereby pain and suffering of the patients. The work of Muhe and Mouret in the late 80s, paved the way for mainstream laparoscopic procedures and it rapidly became the method of choice for many intra-abdominal procedures. Single-incision laparoscopic surgery is a very exciting new modality in the field of minimal access surgery which works for further reducing the scars of standard laparoscopy and towards scarless surgery. Natural orifice translumenal endoscopic surgery (NOTES) was developed for scarless surgery, but did not gain popularity due to a variety of reasons. NOTES stands for natural orifice translumenal endoscopic surgery, a term coined by a consortium in 2005. NOTES remains a research technique with only a few clinical cases having been reported. The lack of success of NOTES seems to have spurred on the interest in single-incision laparoscopy as an eminently doable technique in the present with minimum visible scarring, rendering a ‘scarless’ effect. Laparo-endoscopic single-site surgery (LESS) is, a term coined by a multidisciplinary consortium in 2008 for single-incision laparoscopic surgery. These are complementary technologies with similar difficulties of access, lack of triangulation and inadequate instrumentation as of date. LESS seems to offer an advantage to surgeons with its familiar field of view and instruments similar to those used in conventional laparoscopy. LESS remains a evolving special technique used successfully in many a centre, but with a significant way to go before it becomes mainstream. It currently stands between standard laparoscopy and NOTES in the armamentarium of minimal access surgery. This article outlines the development of LESS giving an overview of all the techniques and devices available and likely to be available in the future. PMID:21197236

  13. Incisal edge reattachment: literature review and treatment perspectives.

    PubMed

    Murchison, D F; Worthington, R B

    1998-07-01

    Anterior crown fractures in children and adolescents are a common form of injury, affecting approximately 25% of that population. Common restorative treatments such as composite bonding, laminate veneers, or full-coverage restorations tend to sacrifice healthy tooth structure and challenge dentists to match the adjacent unrestored dentition. Incisal edge fragment reattachment, including the use of current bonding techniques, is a restorative treatment option that offers the advantages of simplicity, immediate esthetics, and conservatism in cases of dental trauma. This article presents a comprehensive literature review on this restorative technique. It also provides diagnostic and treatment algorithms to simplify and clarify the recommended diagnostic and clinical regimens. PMID:9780892

  14. [Death in a relaxation tank].

    PubMed

    Rupp, Wolf; Simon, Karl-Heinz; Bohnert, Michael

    2009-01-01

    Complete relaxation can be achieved by floating in a darkened, sound-proof relaxation tank filled with salinated water kept at body temperature. Under these conditions, meditation exercises up to self-hypnosis may lead to deep relaxation with physical and mental revitalization. A user manipulated his tank, presumably to completely cut off all optical and acoustic stimuli and accidentally also covered the ventilation hole. The man was found dead in his relaxation tank. The findings suggested lack of oxygen as the cause of death.

  15. Topological constraints on magnetic relaxation.

    PubMed

    Yeates, A R; Hornig, G; Wilmot-Smith, A L

    2010-08-20

    The final state of turbulent magnetic relaxation in a reversed field pinch is well explained by Taylor's hypothesis. However, recent resistive-magnetohydrodynamic simulations of the relaxation of braided solar coronal loops have led to relaxed fields far from the Taylor state, despite the conservation of helicity. We point out the existence of an additional topological invariant in any flux tube with a nonzero field: the topological degree of the field line mapping. We conjecture that this constrains the relaxation, explaining why only one of three example simulations reaches the Taylor state. PMID:20868104

  16. Relaxation Techniques for Trauma.

    PubMed

    Scotland-Coogan, Diane; Davis, Erin

    2016-01-01

    Physiological symptoms of posttraumatic stress disorder (PTSD) manifest as increased arousal and reactivity seen as anger outburst, irritability, reckless behavior with no concern for consequences, hypervigilance, sleep disturbance, and problems with focus (American Psychiatric Association, 2013 ). In seeking the most beneficial treatment for PTSD, consideration must be given to the anxiety response. Relaxation techniques are shown to help address the physiological manifestations of prolonged stress. The techniques addressed by the authors in this article include mindfulness, deep breathing, yoga, and meditation. By utilizing these techniques traditional therapies can be complemented. In addition, those who are averse to the traditional evidence-based practices or for those who have tried traditional therapies without success; these alternative interventions may assist in lessening physiological manifestations of PTSD. Future research studies assessing the benefits of these treatment modalities are warranted to provide empirical evidence to support the efficacy of these treatments. PMID:27119722

  17. Comet Bursting Through Relaxation

    NASA Astrophysics Data System (ADS)

    Jacobson, Seth A.; Scheeres, D. J.

    2012-10-01

    Comets may be excited and occupy non-principal axis (complex) rotation states for a large fraction of their lifetimes. Many comet nuclei have been identified or are suspected to occupy non-principal axis (complex) rotation [Belton 2005, etc.] as well as have evolving rotation rates [Belton 2011, etc.]. Comet orbits drive these rotation states through cycles of excitation due to surface jets and relaxation due to time variable internal stresses that dissipate energy in the anelastic comet interior. Furthermore, relaxation from complex rotation can increase the loads along the symmetry axis of prolate comets. These loads stretch the body along the symmetry axis and may be the cause of the characteristic ``bowling pin’’ shape and eventually may lead to failure. This is an alternative model for comet bursting. Each cycle deposits only a small amount of energy and stress along the axis, but this process is repeated every orbit during which jets are activated. Our model for the evolution of comet nuclei includes torques due to a number of discrete jets located on the surface based on Neishtadt et al. [2002]. The model also includes internal dissipation using an approach developed by Sharma et al. [2005] and Vokrouhlicky et al. [2009]. These equations are averaged over the instantaneous spin state and the heliocentric orbit so the long-term evolution of the comet can be determined. We determine that even after the inclusion of internal dissipation there still exist non-principal axis equilibrium states for certain jet geometries. For ranges of dissipation factors and jet geometries, prolate comets are found to occupy states that have time variable internal loads over long time periods. These periodic loadings along the symmetry axis may lead to ``necking’’ as the body extends along the axis to release the stress and eventually disruption.

  18. Sutureless cataract incision closure using laser-activated tissue glues

    NASA Astrophysics Data System (ADS)

    Eaton, Alexander M.; Bass, Lawrence S.; Libutti, Steven K.; Schubert, Herman D.; Treat, Michael R.

    1991-06-01

    With the advent of phacoemulsification and foldable intraocular lenses, there is renewed interest in sutureless cataract wound. We report the use of laser activated tissue glues for the closure of scleral tunnel cataract incisions. Two glue mixtures were tested in enucleated porcine eyes. Glue A was composed of hyaluronic acid, human albumin, and indocyanine green dye. Glue B contained hyaluronic acid, chondroitin sulfate, human albumin, and indocyanine green dye. A Spectra Physics diode laser (808 nm) with a power density of 7-1 1 watts/cm2 was used for glue activation. Wound bursting pressures, as determined by the presence of fluid at the wound margin, was significantly higher with both glue combinations than without the glue (Pincisions.

  19. Measuring the Longitudinal NMR Relaxation Rates of Fast Relaxing Nuclei Using a Signal Eliminating Relaxation Filter

    NASA Astrophysics Data System (ADS)

    Hansen, D. Flemming; Led, Jens J.

    2001-08-01

    A new experiment for selective determination of the relaxation rates of fast relaxing NMR signals is presented. The experiment is derived from the conventional inversion recovery experiment by substituting the 180° inversion pulse of this experiment with a signal eliminating relaxation filter (SERF) consisting of three 180° pulses separated by two variable delays, Δ1 and Δ2. The SERF experiment allows a selective suppression of signals with relaxation rates below a given limit while monitoring the relaxation of faster relaxing signals. The experiment was tested on a sample of 20% oxidized plastocyanin from Anabaena variabilis, where the fast exchange of an electron between the reduced (diamagnetic) and the oxidized (paramagnetic) form results in a series of average signals with widely different relaxation rates. To ensure an optimum extraction of information from the experimental data, the relaxation rates were obtained from the SERF experiment by a simultaneous analysis of all the FIDs of the experiment using a fast linear prediction model method developed previously. The reliability of the relaxation rates obtained from the SERF experiment was confirmed by a comparison of the rates with the corresponding rates obtained from a conventional inversion recovery experiment.

  20. Measuring the longitudinal NMR relaxation rates of fast relaxing nuclei using a signal eliminating relaxation filter.

    PubMed

    Hansen, D F; Led, J J

    2001-08-01

    A new experiment for selective determination of the relaxation rates of fast relaxing NMR signals is presented. The experiment is derived from the conventional inversion recovery experiment by substituting the 180 degrees inversion pulse of this experiment with a signal eliminating relaxation filter (SERF) consisting of three 180 degrees pulses separated by two variable delays, Delta1 and Delta2. The SERF experiment allows a selective suppression of signals with relaxation rates below a given limit while monitoring the relaxation of faster relaxing signals. The experiment was tested on a sample of 20% oxidized plastocyanin from Anabaena variabilis, where the fast exchange of an electron between the reduced (diamagnetic) and the oxidized (paramagnetic) form results in a series of average signals with widely different relaxation rates. To ensure an optimum extraction of information from the experimental data, the relaxation rates were obtained from the SERF experiment by a simultaneous analysis of all the FIDs of the experiment using a fast linear prediction model method developed previously. The reliability of the relaxation rates obtained from the SERF experiment was confirmed by a comparison of the rates with the corresponding rates obtained from a conventional inversion recovery experiment.

  1. Transurethral incision of prostate compared with transurethral resection of prostate in 132 matching cases.

    PubMed

    Orandi, A

    1987-10-01

    In a prospective project during a 2-year period 132 patients with bladder outlet obstruction who were candidates for transurethral incision of the prostate were managed alternately by transurethral incision and transurethral resection of the prostate. Both operations were compared in matched patients. The results and complications favored transurethral incision, although there was no statistical significance except for the high incidence of bladder neck contracture after transurethral resection (p equals 0.028). PMID:2443728

  2. Modified method for closure of transverse pyelotomy incision in Gil-Vernet pyelolithotomy operation.

    PubMed

    Shah, S R

    1999-06-01

    A technique is described for effective closure of the transverse pyelotomy incision used to initiate the Gil-Vernet extended pyelolithotomy operation. Long preplaced sutures of 5-0 Vicryl are made on the intact pelvis across the proposed incision line. After stone removal, the preplaced sutures are tied to approximate the edges of the pyelotomy incision. This simple method helps reduce the chance of pelvic tear, which is a common occurrence when the conventional method of closure is used. PMID:10458666

  3. Rapid incision of the Colorado River in Glen Canyon - insights from channel profiles, local incision rates, and modeling of lithologic controls

    USGS Publications Warehouse

    Cook, K.L.; Whipple, K.X.; Heimsath, A.M.; Hanks, T.C.

    2009-01-01

    The Colorado River system in southern Utah and northern Arizona is continuing to adjust to the baselevel fall responsible for the carving of the Grand Canyon. Estimates of bedrock incision rates in this area vary widely, hinting at the transient state of the Colorado and its tributaries. In conjunction with these data, we use longitudinal profiles of the Colorado and tributaries between Marble Canyon and Cataract Canyon to investigate the incision history of the Colorado in this region. We find that almost all of the tributaries in this region steepen as they enter the Colorado River. The consistent presence of oversteepened reaches with similar elevation drops in the lower section of these channels, and their coincidence within a corridor of high local relief along the Colorado, suggest that the tributaries are steepening in response to an episode of increased incision rate on the mainstem. This analysis makes testable predictions about spatial variations in incision rates; these predictions are consistent with existing rate estimates and can be used to guide further studies. We also present cosmogenic nuclide data from the Henry Mountains of southern Utah. We measured in situ 10Be concentrations on four gravel-covered strath surfaces elevated from 1 m to 110 m above Trachyte Creek. The surfaces yield exposure ages that range from approximately 2??5 ka to 267 ka and suggest incision rates that vary between 350 and 600 m/my. These incision rates are similar to other rates determined within the high-relief corridor. Available data thus support the interpretation that tributaries of the Colorado River upstream of the Grand Canyon are responding to a recent pulse of rapid incision on the Colorado. Numerical modeling of detachment-limited bedrock incision suggests that this incision pulse is likely related to the upstream-dipping lithologic boundary at the northern edge of the Kaibab upwarp. ?? 2009 John Wiley & Sons, Ltd.

  4. Thoracoscopic reoperation for recurrent pneumothorax after single-incision thoracoscopic surgery.

    PubMed

    Sano, Atsushi; Kawashima, Mitsuaki

    2015-11-01

    An 18-year-old male patient who had undergone single-incision thoracoscopic surgery for left spontaneous pneumothorax was diagnosed with bilateral recurrent pneumothorax. We performed thoracoscopic reoperation and observed adhesions between the previous incision and the left lung. A bulla that was thought to be the cause of the recurrent left pneumothorax was found on the mediastinal side of previously ligated lesions. Longer incisions during single-incision thoracoscopic surgery may be more likely to cause adhesions. Despite the restricted view during surgery, care must be taken to identify all bullae. Use of reinforcement techniques is also important to prevent recurrence.

  5. An episode of rapid bedrock channel incision during the last glacial cycle, measured with 10Be

    USGS Publications Warehouse

    Reusser, L.; Bierman, P.; Pavich, M.; Larsen, J.; Finkel, R.

    2006-01-01

    We use 10Be to infer when, how fast, and why the Susquehanna River incised through bedrock along the U.S. Atlantic seaboard, one of the world's most prominent and ancient passive margins. Although the rate at which large rivers incise rock is a fundamental control on the development of landscapes, relatively few studies have directly measured how quickly such incision occurs either in tectonically active environments or along passive margins. Exposure ages of fluvially carve d, bedrock strath terraces, preserved along the lower Susquehanna River, demonstrate that even along a passive margin, large rivers are capable of incising through rock for short periods of time at rates approaching those recorded in tectonically active regions, such as the Himalayas. Over eighty samples, collected along and between three prominent levels of strath terraces within Holtwood Gorge, indicate that the Susquehanna River incised more than 10 meters into the Appalachian Piedmont during the last glacial cycle. Beginning ???36 ka, incision rates increased dramatically, and remained elevated until ???14 ka. The northern half of the Susquehanna basin was glaciated during the late Wisconsinan; however, similar rates and timing of incision occurred in the unglaciated Potomac River basin immediately to the south. The concurrence of incision periods on both rivers suggests that glaciation and associated meltwater were not the primary drivers of incision. Instead, it appears that changing climatic conditions during the late Pleistocene promoted an increase in the frequency and magnitude of flood events capable of exceeding thresholds for rock detachment and bedrock erosion, thus enabling a short-lived episode of rapid incision into rock. Although this study has constraine d the timing and rate of bedrock incision along the largest river draining the Atlantic passive margin, the dates alone cannot explain fully why, or by what processes, this incision occurred. However, cosmogenic dating offers

  6. Safety of cesarean delivery through placental incision in patients with anterior placenta previa

    PubMed Central

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa

    2016-01-01

    Objective To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. Methods We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. Results There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Conclusion Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique. PMID:27004200

  7. Paraglacial fluvial bedrock incision in postglacial landscapes: the NW Scottish Highlands

    NASA Astrophysics Data System (ADS)

    Whitbread, Katie; Jansen, John; Bishop, Paul; Fabel, Derek

    2010-05-01

    Glacial landscape forms are inherited by rivers following deglaciation. Hillslopes and valley floors configured by glacial erosion control the distribution of bedrock channels and potential sites for fluvial incision. The importance of 'stream power' parameters, channel slope and drainage area (discharge), in controlling the rate of incision is widely accepted, but the rate, timing and mechanisms of incision have yet to be quantified in these settings. The dual controls of glacially conditioned bedrock slopes and sediment supply set two of the key boundary conditions for temporally and spatially dynamic fluvial bedrock incision. Measurement of incision rates in these settings is key to understanding the influence of controls on fluvial erosion, and the role of the process in long-term evolution of deglaciated landscapes. In tectonically-passive, hard-rock terrains, such as the Scottish Highlands, incisional fluvial features such as bedrock channels, gorges and waterfalls are common on glacially carved valley steps. Here we report preliminary data on fluvial incision rates measured with cosmogenic 10Be. Our results confirm a postglacial age of bedrock straths in the NW Scottish Highlands and indicate a vertical incision rate of 0.3 mm/yr into resistant quartzites. Further work will explore erosion mechanisms and rates of incision across the Scottish Highlands, and assess controls on fluvial incision, including the potential role of paraglacial sediment.

  8. 18. DETAIL OF COMBINATION HANDWASH SINK/KNIFE STERILIZER ON SPLITTERS' PLATFORM; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. DETAIL OF COMBINATION HANDWASH SINK/KNIFE STERILIZER ON SPLITTERS' PLATFORM; KNIVES AND CLEAVERS WERE CLEANED FREQUENTLY BY DIPPING THEM INTO STEAM-HEATED WATER IN THE RECTANGULAR TANK; NOTE FOOT-OPERATED FAUCETS - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  9. Extracranial Facial Nerve Schwannoma Treated by Hypo-fractionated CyberKnife Radiosurgery

    PubMed Central

    Miyazaki, Shinichiro; Hori, Tomokatsu

    2016-01-01

    Facial nerve schwannoma is a rare intracranial tumor. Treatment for this benign tumor has been controversial. Here, we report a case of extracranial facial nerve schwannoma treated successfully by hypo-fractionated CyberKnife (Accuray, Sunnyvale, CA) radiosurgery and discuss the efficacy of this treatment. A 34-year-old female noticed a swelling in her right mastoid process. The lesion enlarged over a seven-month period, and she experienced facial spasm on the right side. She was diagnosed with a facial schwannoma via a magnetic resonance imaging (MRI) scan of the head and neck and was told to wait until the facial nerve palsy subsides. She was referred to our hospital for radiation therapy. We planned a fractionated CyberKnife radiosurgery for three consecutive days. After CyberKnife radiosurgery, the mass in the right parotid gradually decreased in size, and the facial nerve palsy disappeared. At her eight-month follow-up, her facial spasm had completely disappeared. There has been no recurrence and the facial nerve function has been normal. We successfully demonstrated the efficacy of CyberKnife radiosurgery as an alternative treatment that also preserves neurofunction for facial nerve schwannomas. PMID:27774363

  10. Development of an air-knife system for highly reproducible fabrication of polydimethylsiloxane microstencils

    NASA Astrophysics Data System (ADS)

    Choi, Jin Ho; Kim, Gyu Man

    2015-08-01

    In this study, an air-knife system was developed for the automated fabrication of polymer microstencils with microscale perforated patterns. Blowing compressed N2 gas through the air knife provided a uniform laminar gas flow of high intensity suitable for perforating holes in the stencil. The polydimethylsiloxane (PDMS) stencil was replicated from a master mold prepared by photolithography. When the prepolymer of PDMS was spin-coated onto the master mold, a thin layer of the prepolymer remained on top of the master's structure and consequently prevented the formation of the perforated patterns. This residual layer was easily removed by the presented air knife. The air-knife system controlled the flow rate of N2 gas and the conveying speed of the master mold; therefore, the system possessed high reproducibility compared to manual gas blowing. Its use reduced the fabrication time for perforated biocompatible polymer microstencils, allowing for their mass production via an automated system. The validity of this suggested method was proven through experiments and was evaluated by application in various fields.

  11. Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)

    PubMed Central

    Kwon, Chang-Il; Kim, Gwangil; Kim, Won Hee; Ko, Kwang Hyun; Hong, Sung Pyo; Jeong, Seok; Lee, Don Haeng

    2014-01-01

    Background/Aims In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives. Methods This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed. Results A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities. Conclusions ESD with a versatile knife appeared to be an easy, safe, and technically efficient method. PMID:25505721

  12. The Effects of Swedish Knife Model on Students' Understanding of the Digestive System

    ERIC Educational Resources Information Center

    Cerrah Ozsevgec, Lale; Artun, Huseyin; Unal, Melike

    2012-01-01

    This study was designed to examine the effect of Swedish Knife Model on students' understanding of digestive system. A simple experimental design (pretest-treatment-posttest) was used in the study and internal comparison of the results of the one group was made. The sample consisted of 40 7th grade Turkish students whose ages range from 13 to 15.…

  13. Chief Dull Knife Community Is Strengthening the Northern Cheyenne Language and Culture.

    ERIC Educational Resources Information Center

    Littlebear, Richard E.

    2003-01-01

    Language revitalization programs should focus on whether they want to teach the language, teach about the language, teach with the language, or teach the language for academic credit. A program at Chief Dull Knife College (Montana) teaches the Cheyenne language using the Total Physical Response method, which replicates the manner in which first…

  14. Knife River: Early Village Life on the Plains. Teaching with Historic Places.

    ERIC Educational Resources Information Center

    Metcalf, Fay

    This document, from the lesson plan series, "Teaching with Historic Places," examines the Native Americans who lived on the plains along the Knife River in what is now North Dakota. Following an introductory section, the document sets out student objectives, teaching activities, readings, and illustrations. The teaching activity suggestions…

  15. Implementation of a quantitative Foucault knife-edge method by means of isophotometry

    NASA Astrophysics Data System (ADS)

    Zhevlakov, A. P.; Zatsepina, M. E.; Kirillovskii, V. K.

    2014-06-01

    Detailed description of stages of computer processing of the shadowgrams during implementation of a modern quantitative Foucault knife-edge method is presented. The map of wave-front aberrations introduced by errors of an optical surface or a system, along with the results of calculation of the set of required characteristics of image quality, are shown.

  16. Quantitative phase tomography by using x-ray microscope with Foucault knife-edge scanning filter

    NASA Astrophysics Data System (ADS)

    Watanabe, Norio; Tsuburaya, Yuji; Shimada, Akihiro; Aoki, Sadao

    2016-01-01

    Quantitative phase tomography was evaluated by using a differential phase microscope with a Foucault knife-edge scanning filter. A 3D x-ray phase image of polystyrene beads was obtained at 5.4 keV. The reconstructed refractive index was fairly good agreement with the Henke's tabulated data.

  17. Whole-procedure clinical accuracy of Gamma Knife treatments of large lesions

    SciTech Connect

    Ma Lijun; Chuang, Cynthia; Descovich, Martina; Petti, Paula; Smith, Vernon; Verhey, Lynn

    2008-11-15

    The mechanical accuracy of Gamma Knife radiosurgery based on single-isocenter measurement has been established to within 0.3 mm. However, the full delivery accuracy for Gamma Knife treatments of large lesions has only been estimated via the quadrature-sum analysis. In this study, the authors directly measured the whole-procedure accuracy for Gamma Knife treatments of large lesions to examine the validity of such estimation. The measurements were conducted on a head-phantom simulating the whole treatment procedure that included frame placement, computed tomography imaging, treatment planning, and treatment delivery. The results of the measurements were compared with the dose calculations from the treatment planning system. Average agreements of 0.1-1.6 mm for the isodose lines ranging from 25% to 90% of the maximum dose were found despite potentially large contributing uncertainties such as 3-mm imaging resolution, 2-mm dose grid size, 1-mm frame registration, multi-isocenter deliveries, etc. The results of our measurements were found to be significantly smaller (>50%) than the calculated value based on the quadrature-sum analysis. In conclusion, Gamma Knife treatments of large lesions can be delivered much more accurately than predicted from the quadrature-sum analysis of major sources of uncertainties from each step of the delivery chain.

  18. Comparative analyses of linac and Gamma Knife radiosurgery for trigeminal neuralgia treatments

    NASA Astrophysics Data System (ADS)

    Ma, L.; Kwok, Y.; Chin, L. S.; Yu, C.; Regine, W. F.

    2005-11-01

    Dedicated linac-based radiosurgery has been reported for trigeminal neuralgia treatments. In this study, we investigated the dose fall-off characteristics and setup error tolerance of linac-based radiosurgery as compared with standard Gamma Knife radiosurgery. In order to minimize the errors from different treatment planning calculations, consistent imaging registration, dose calculation and dose volume analysis methods were developed and implemented for both Gamma Knife and linac-based treatments. Intra-arc setup errors were incorporated into the treatment planning process of linac-based deliveries. The effects of intra-arc setup errors with increasing number of arcs were studied and benchmarked against Gamma Knife deliveries with and without plugging patterns. Our studies found equivalent dose fall-off properties between Gamma Knife and linac-based radiosurgery given a sufficient number of arcs (>7) and small intra-arc errors (<0.5 mm) were satisfied for linac-based deliveries. Increasing the number of arcs significantly decreased the variations in the dose fall-off curve at the low isodose region (e.g. from 40% to 10%) and also improved dose uniformity at the high isodose region (e.g. from 70% to 90%). As the number of arcs increased, the effects of intra-arc setup errors on the dose fall-off curves decreased. Increasing the number of arcs also reduced the integral dose to the distal normal brain tissues. In conclusion, linac-based radiosurgery produces equivalent dose fall-off characteristics to Gamma Knife radiosurgery with a high number of arcs. However, one must note the increased treatment time for a large number of arcs and isocentre accuracies.

  19. MRI-based polymer gel dosimetry for validating plans with multiple matrices in Gamma Knife stereotactic radiosurgery.

    PubMed

    Gopishankar, N; Watanabe, Yoichi; Subbiah, Vivekanandhan

    2011-01-31

    One of treatment planning techniques with Leksell GammaPlan (LGP) for Gamma Knife stereotactic radiosurgery (GKSRS) uses multiple matrices with multiple dose prescriptions. Computational complexity increases when shots are placed in multiple matrices with different grid sizes. Hence, the experimental validation of LGP calculated dose distributions is needed for those cases. For the current study, we used BANG3 polymer gel contained in a head-sized glass bottle to simulate the entire treatment process of GKSRS. A treatment plan with three 18 mm shots and one 8 mm shot in separate matrices was created with LGP. The prescribed maximum dose was 8 Gy to three shots and 16 Gy to one of the 18 mm shots. The 3D dose distribution recorded in the gel dosimeter was read using a Siemens 3T MRI scanner. The scanning parameters of a CPMG pulse sequence with 32 equidistant echoes were as follows: TR = 7 s, echo step = 13.6 ms, field-of-view = 256 mm × 256 mm, and pixel size = 1 mm × 1 mm. Interleaved acquisition mode was used to obtain 15 to 45 2-mm-thick slices. Using a calibration relationship between absorbed dose and the spin-spin relaxation rate (R2), we converted R2 images to dose images. MATLAB-based in-house programs were used for R2 estimation and dose comparison. Gamma-index analysis for the 3D data showed gamma values less than unity for 86% of the voxels. Through this study we accomplished the first application of polymer gel dosimetry for a true comparison between measured 3D dose distributions and LGP calculations for plans using multiple matrices for multiple targets.

  20. The Umbilical Benz Incision for Reduced Port Surgery in Pediatric Patients

    PubMed Central

    Amano, Hizuru; Kawashima, Hiroshi; Deie, Kyoichi; Murase, Naruhiko; Makita, Satoshi; Yokota, Kazuki; Tanaka, Yujiro

    2015-01-01

    Background and Objectives: For reduced port surgery in pediatric patients, the initial umbilical incision plays an important role in both functional ability and cosmetic impact. Larger umbilical incisions enable better manipulation of forceps, extraction of larger surgical specimens, and easier exteriorization of the intestine for anastomosis. We have pursued an incision of the small pediatric umbilicus that allows for enlargement of the orifice of the abdominal opening with preservation of the natural umbilical profile. This article aims to present a new umbilical incision technique and describe the outcomes. Methods: We devised a new umbilical incision technique for reduced port surgery in pediatric patients. Our incision is made in an inverted Y shape (Benz incision), allowing for access port device insertion. The Benz incision technique was applied between November 2010 and May 2014 and was retrospectively studied. Results: Seventy-five patients underwent Benz incisions. The median age of all patients was 6 years 6 months (range, 26 days to 18 years), and the median body weight was 21.7 kg (range, 3.1–54.3 kg). Benz incisions were applied for various procedures, including reduced port surgery with hepaticojejunostomy for congenital biliary dilatation, portojejunostomy for biliary atresia, Meckel diverticulectomy, tumor resection, varicocelectomy, cholecystectomy, splenectomy, ileus surgery, ileocecal resection, and total colectomy. All patients were successfully treated, without a significant increase in operating time or severe complications. The cosmetic profile of the umbilicus was maintained after surgery. Conclusion: The Benz incision is a feasible, effective, and scarless approach for reduced port surgery in pediatric patients whose umbilical rings are too small for the conventional approach. PMID:25848185

  1. Quantifying canyon incision and Andean Plateau surface uplift, southwest Peru: A thermochronometer and numerical modeling approach

    NASA Astrophysics Data System (ADS)

    Schildgen, Taylor F.; Ehlers, Todd A.; Whipp, David M.; van Soest, Matthijs C.; Whipple, Kelin X.; Hodges, Kip V.

    2009-11-01

    Apatite and zircon (U-Th)/He ages from Ocoña canyon at the western margin of the Central Andean plateau record rock cooling histories induced by a major phase of canyon incision. We quantify the timing and magnitude of incision by integrating previously published ages from the valley bottom with 19 new sample ages from four valley wall transects. Interpretation of the incision history from cooling ages is complicated by a southwest to northeast increase in temperatures at the base of the crust due to subduction and volcanism. Furthermore, the large magnitude of incision leads to additional three-dimensional variations in the thermal field. We address these complications with finite element thermal and thermochronometer age prediction models to quantify the range of topographic evolution scenarios consistent with observed cooling ages. Comparison of 275 model simulations to observed cooling ages and regional heat flow determinations identify a best fit history with ≤0.2 km of incision in the forearc region prior to ˜14 Ma and up to 3.0 km of incision starting between 7 and 11 Ma. Incision starting at 7 Ma requires incision to end by ˜5.5 to 6 Ma. However, a 2.2 Ma age on a volcanic flow on the current valley floor and 5 Ma gravels on the uplifted piedmont surface together suggest that incision ended during the time span between 2.2 and 5 Ma. These additional constraints for incision end time lead to a range of best fit incision onset times between 8 and 11 Ma, which must coincide with or postdate surface uplift.

  2. Mandibular incisive canal in relation to periapical surgery

    PubMed Central

    Bilginaylar, Kani; Orhan, Kaan; Uyanik, Lokman Onur

    2016-01-01

    The aim of the present paper is to emphasize the importance of the mandibular interforaminal neurovascular bundle with a case and make a warning to dentists and surgeons during oral and maxillofacial surgeries, such as implant replacement, bone harvesting, genioplasty, open reduction of a mandibular fracture, and cyst enucleations at this region. In this paper, we present a 58-year-old male who referred with pain and a tingling sensation on the left lower lip. After radiographical, extraoral and intraoral examinations, findings indicated the lesion to be a cyst which was related with a periapical lesion of the canine tooth and extracted socket of first premolar tooth. After removal of a cyst, the mandibular incisive nerve was documented which was in relation to cyst cavity. PMID:27041907

  3. Nucleus management in manual small incision cataract surgery by phacosection.

    PubMed

    Ravindra, M S

    2009-01-01

    Nucleus management is critical in manual small incision cataract surgery (MSICS), as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

  4. [Indications for relaxation in geriatrics].

    PubMed

    Richard, J; Picot, A; de Bus, P; Andreoli, A; Dalakaki, X

    1975-11-01

    On a three years base experience in the geriatiic department of Geneva's University Psychiatric Clinic the paper studies the problem of selecting aged patients to be treated by relaxation according to the method of J. De Ajuriaguerra et M. Cahen. Observations are presented in an attempt to define three main points: a) the role played by relaxation when there is an objective [corrected] impairment of the body's integrity; b) relaxation effect on aged persons neurotic states evolution; c) the reality of considering dementia as a counter-indication of relaxation therapy. These remarks complete those presented previously about the training of therapists in relaxation, the type of control to be organized for them and their patients, the technical management of the cure, the place of relaxation in the post graduate psychiatric training, the effects of the therapy on the patients human environnement behavior in and out of the hospital, the way body is perceived through relaxation by the aged patients and it's consequences on the adjustment of an aging person.

  5. Progressive muscle relaxation, breathing exercises, and ABC relaxation theory.

    PubMed

    Matsumoto, M; Smith, J C

    2001-12-01

    This study compared the psychological effects of Progressive Muscle Relaxation (PMR) and breathing exercises. Forty-two students were divided randomly into two groups and taught PMR or breathing exercises. Both groups practiced for five weeks and were given the Smith Relaxation States Inventory before and after each session. As hypothesized, PMR practitioners displayed greater increments in relaxation states (R-States) Physical Relaxation and Disengagement, while breathing practitioners displayed higher levels of R-State Strength and Awareness. Slight differences emerged at Weeks 1 and 2; major differences emerged at Weeks 4 and 5. A delayed and potentially reinforcing aftereffect emerged for PMR only after five weeks of training--increased levels of Mental Quiet and Joy. Clinical and theoretical implications are discussed.

  6. Can Black Hole Relax Unitarily?

    NASA Astrophysics Data System (ADS)

    Solodukhin, S. N.

    2005-03-01

    We review the way the BTZ black hole relaxes back to thermal equilibrium after a small perturbation and how it is seen in the boundary (finite volume) CFT. The unitarity requires the relaxation to be quasi-periodic. It is preserved in the CFT but is not obvious in the case of the semiclassical black hole the relaxation of which is driven by complex quasi-normal modes. We discuss two ways of modifying the semiclassical black hole geometry to maintain unitarity: the (fractal) brick wall and the worm-hole modification. In the latter case the entropy comes out correctly as well.

  7. Incisal margin condition after LEEP for cervical intraepithelial neoplasia patients and prognosis

    PubMed Central

    Chen, Hong; Liu, Xiufeang; Xu, Lina

    2016-01-01

    The aim of the study was to examine the relationship between incisal condition after loop electrosurgical excision procedure (LEEP) operation for cervical intraepithelial neoplasia (CIN) patients and prognosis. A study of high-risk incisal margin positive cases was also performed. We compared the differences in the prognosis of the 1-year follow-up visit in the 120 CIN patients admitted to the hospital during the period from April 2013 to April 2014. A total of 43 cases of positive incisal margin (35.8%), and 77 negative cases were included in the study. The differences in age, course of disease, and CIN level between the two groups showed no statistical significance (P>0.05). In the positive group, the positive ratio was significantly higher than that of the negative group (P<0.05). The positive incisal margin showed a significant positive correlation with human papillomavirus (HPV) positivity (r=0.327, P=0.035). The condition of most patients with positive incisal margin and HPV was critical, which was followed by positive incisal margin and negative HPV. The patients with the best prognosis were those with significant negative incisal margin as well as HPV (P<0.05). In conclusion, the positive incisal margin after LEEP operation was associated with relapse of the disease. Thus, considering the HPV test into consideration is valuable for the prognosis of the disease. PMID:27446314

  8. Double incision wound healing bioassay using Hamelia patens from El Salvador.

    PubMed

    Gomez-Beloz, Alfredo; Rucinski, James C; Balick, Michael J; Tipton, Camille

    2003-10-01

    Hamelia patens Jacq. (Rubiaceae) has received little attention in the laboratory for its wound healing ability even though it is commonly used as a treatment for wounds throughout Central America. A double incision wound healing bioassay was carried out with a crude extract of Hamelia patens collected from El Salvador. Animals were divided into three groups. Group I (n = 14) had the left incision treated with 5% (w/w) Hamelia patens and the contralateral side with petroleum jelly (PJ). Group II (n = 14) had the left incision treated with 10% (w/w) ointment and the contralateral side with petroleum jelly. Group III (n = 10) had the left incision treated with petroleum jelly and the contralateral side left untreated. Breaking strength of the incisions was measured on day 7 and day 12. For Groups I and II, there was no significant difference between treatment and control incisions at day 7. On day 12, there was a significant difference between the treated and control incisions for Groups I and II. There was no significant difference between petroleum jelly and untreated incisions for Group III on day 7 and day 12. Hamelia patens does increase breaking strength of wounds significantly more than the control group. Further wound healing studies of this plant are warranted.

  9. Two-year experience with the commercial Gamma Knife Check software.

    PubMed

    Xu, Andy Yuanguang; Bhatnagar, Jagdish; Bednarz, Greg; Novotny, Josef; Flickinger, John; Lunsford, L Dade; Huq, M Saiful

    2016-01-01

    The Gamma Knife Check software is an FDA approved second check system for dose calculations in Gamma Knife radiosurgery. The purpose of this study was to evaluate the accuracy and the stability of the commercial software package as a tool for independent dose verification. The Gamma Knife Check software version 8.4 was commissioned for a Leksell Gamma Knife Perfexion and a 4C unit at the University of Pittsburgh Medical Center in May 2012. Independent dose verifications were performed using this software for 319 radiosurgery cases on the Perfexion and 283 radiosurgery cases on the 4C units. The cases on each machine were divided into groups according to their diagnoses, and an averaged absolute percent dose difference for each group was calculated. The percentage dose difference for each treatment target was obtained as the relative difference between the Gamma Knife Check dose and the dose from the tissue maximum ratio algorithm (TMR 10) from the GammaPlan software version 10 at the reference point. For treatment plans with imaging skull definition, results obtained from the Gamma Knife Check software using the measurement-based skull definition method are used for comparison. The collected dose difference data were also analyzed in terms of the distance from the treatment target to the skull, the number of treatment shots used for the target, and the gamma angles of the treatment shots. The averaged percent dose differences between the Gamma Knife Check software and the GammaPlan treatment planning system are 0.3%, 0.89%, 1.24%, 1.09%, 0.83%, 0.55%, 0.33%, and 1.49% for the trigeminal neuralgia, acoustic neuroma, arteriovenous malformation (AVM), meningioma, pituitary adenoma, glioma, functional disorders, and metastasis cases on the Perfexion unit. The corresponding averaged percent dose differences for the 4C unit are 0.33%, 1.2%, 2.78% 1.99%, 1.4%, 1.92%, 0.62%, and 1.51%, respectively. The dose difference is, in general, larger for treatment targets in the

  10. The lazy lateral incision: an innovative approach to the skin-sparing mastectomy.

    PubMed

    Dutton, Walter; Ghareeb, Paul A; McClellan, W Thomas

    2013-01-01

    The skin-sparing mastectomy has many advantages over a simple mastectomy, including preservation of the native breast skin, inframammary fold, and improved aesthetics for immediate reconstruction. The traditional transverse elliptical access incision is anterior on the breast mound, requires a second incision for previous biopsy sites, and provides restricted access to the axilla. We describe a novel mastectomy incision that improves scar appearance, improves access to the axillary contents, and reduces skin flap retraction. This incision starts at the nipple-areolar complex and extends laterally in a curvilinear fashion toward the axilla incorporating the biopsy scar along the way. This simple sinusoidal design results in an aesthetically superior alternative to the traditional linear mastectomy incision.

  11. Simulation of DNA Supercoil Relaxation.

    PubMed

    Ivenso, Ikenna D; Lillian, Todd D

    2016-05-24

    Several recent single-molecule experiments observe the response of supercoiled DNA to nicking endonucleases and topoisomerases. Typically in these experiments, indirect measurements of supercoil relaxation are obtained by observing the motion of a large micron-sized bead. The bead, which also serves to manipulate DNA, experiences significant drag and thereby obscures supercoil dynamics. Here we employ our discrete wormlike chain model to bypass experimental limitations and simulate the dynamic response of supercoiled DNA to a single strand nick. From our simulations, we make three major observations. First, extension is a poor dynamic measure of supercoil relaxation; in fact, the linking number relaxes so fast that it cannot have much impact on extension. Second, the rate of linking number relaxation depends upon its initial partitioning into twist and writhe as determined by tension. Third, the extensional response strongly depends upon the initial position of plectonemes.

  12. Measuring knife stab penetration into skin simulant using a novel biaxial tension device.

    PubMed

    Gilchrist, M D; Keenan, S; Curtis, M; Cassidy, M; Byrne, G; Destrade, M

    2008-05-01

    This paper describes the development and use of a biaxial measurement device to analyse the mechanics of knife stabbings. In medicolegal situations it is typical to describe the consequences of a stabbing incident in relative terms that are qualitative and descriptive without being numerically quantitative. Here, the mechanical variables involved in the possible range of knife-tissue penetration events are considered so as to determine the necessary parameters that would need to be controlled in a measurement device. These include knife geometry, in-plane mechanical stress state of skin, angle and speed of knife penetration, and underlying fascia such as muscle or cartilage. Four commonly available household knives with different geometries were used: the blade tips in all cases were single-edged, double-sided and without serrations. Appropriate synthetic materials were used to simulate the response of skin, fat and cartilage, namely polyurethane, compliant foam and ballistic soap, respectively. The force and energy applied by the blade of the knife and the out of plane displacement of the skin were all used successfully to identify the occurrence of skin penetration. The skin tension is shown to have a direct effect on both the force and energy for knife penetration and the depth of out of plane displacement of the skin simulant prior to penetration: larger levels of in-plane tension in the skin are associated with lower penetration forces, energies and displacements. Less force and energy are also required to puncture the skin when the plane of the blade is parallel to a direction of greater skin tension than when perpendicular. This is consistent with the observed behaviour when cutting biological skin: less force is required to cut parallel to the Langer lines than perpendicularly and less force is required to cut when the skin is under a greater level of tension. Finally, and perhaps somewhat surprisingly, evidence is shown to suggest that the quality control

  13. The effect of incision choice on outcomes of nipple-sparing mastectomy reconstruction

    PubMed Central

    Rawlani, Vinay; Fiuk, Julia; Johnson, Sarah A; Buck, Donald W; Hirsch, Elliot; Hansen, Nora; Khan, Seema; Fine, Neil A; Kim, John YS

    2011-01-01

    INTRODUCTION The indications for nipple-sparing mastectomy (NSM) are broadening as more breast surgeons appreciate the utility of preserving the nipple-areolar complex. A number of incision locations are available to the mastectomy surgeon, including inframammary, lateral and periareolar approaches. The present study investigated the effect of these three incisions on reconstructive outcomes; specifically, nipple necrosis. METHODS A single-centre, retrospective review of 37 breast NSM reconstructions treated with immediate tissue expander reconstruction with acellular dermis between 2007 and 2008 was performed. The primary outcome was the incidence of nipple necrosis associated with periareolar, lateral and inframammary incisions. Secondary outcomes were the effects of radiation, chemotherapy and breast size on nipple necrosis. RESULTS Thirty-seven breast procedures performed on 20 patients were included in the present study. Periareolar incisions were used in 21 cases, lateral incisions in 14 and inframammary incisions in two. The periareolar incision was associated with a significantly higher incidence of nipple necrosis compared with lateral or inframammary incisions (38.1% versus 6.3%, P=0.028). Patients receiving breast radiation (45.5% versus 15.4%, P=0.066) and those with larger breast size (540.4 g versus 425.7 g, P=0.130) also demonstrated a modest trend toward an increased rate of nipple necrosis. CONCLUSION The periareolar incision results in a higher rate of nipple necrosis following NSM and immediate tissue expander breast reconstruction. Using the lateral or inframammary incision reduces the incidence of nipple necrosis and may help improve overall reconstructive and cosmetic outcomes. PMID:23204883

  14. Transurethral optical-laser knife and probe director for lateral firing laser probes

    NASA Astrophysics Data System (ADS)

    Malek, Reza S.

    1994-02-01

    Laser energy has been used by many for transurethral incision of small, obstructive prostates, vesical neck contractures, and urethral strictures. The customary techniques of moving the tip of the laser fiber through a cystoscope with a conventional laser guide, almost tangentially to the tissue to be incised, or drilling radially arranged holes in the scar, or both, have been cumbersome and imprecise. To provide exact control of the laser fiber and precise delivery of laser energy, a new guide was devised. It conducts the quartz fiber through the sheath and along the lens of an optical urethrotome. The tip of the quartz fiber contacts the tissue at an angle of 20 degree(s). KTP/532 laser energy is used to perform internal urethrotomy for urethral stricture, transurethral incision of postoperative contracture of the vesical neck, and transurethral incision of the small prostate under constant visual control.

  15. Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

    PubMed Central

    Jain, Sudhir Kumar; Kaza, Ram Chandra Murthy; Singh, Bipin Kumar

    2014-01-01

    Objectives: Sachse cold knife is conventionally used for optical internal urethrotomy intended to manage urethral strictures and Ho: YAG laser is an alternative to it. The aim of this study was to evaluate the role of urethral stricture treatment outcomes, efficacy, and complications using cold knife and Ho: YAG (Holmium laser) for optical internal urethrotomy Materials and Methods: In this prospective study included, 90 male patients age >18 years, with diagnosis of urethral stricture admitted for internal optical urethrotomy during April 2010 to March 2012. The patients were randomized into two groups containing 45 patients each using computer generated random number. In group A (Holmium group), internal urethrotomy was done with Holmium laser and in group B (Cold knife group) Sachse cold knife was used. Patients were followed up for 6 months after surgery in Out Patient Department on 15, 30 and 180 post-operative days. At each follow up visit physical examination, and uroflowmetry was performed along with noting complaints, if any. Results: The peak flow rates (PFR) were compared between the two groups on each follow up. At 180 days (6 month interval) the difference between mean of PFR for Holmium and Cold knife group was statistically highly significant (P < 0.001). Complications were seen in 12.22% of cases. Conclusion: Both modalities are effective in providing immediate relief to patients with single and short segment (<2 cm long) urethral strictures but more sustained response was attained with Cold knife urethrotomy. PMID:25371611

  16. Extensive adipose tissue necrosis following pfannenstiel incision for endometrial cancer.

    PubMed

    Lavoie, Maryse Céline; Plante, Marie; Lemieux, Marie-Carine; Roberge, Céline; Renaud, Marie-Claude; Grégoire, Jean; Roy, Michel; Sebastianelli, Alexandra

    2014-03-01

    Contexte : Les hématomes sont des complications postopératoires qui peuvent en venir à se manifester à la suite du recours à des incisions de Pfannenstiel. Habituellement, ils se résorbent de façon spontanée ou font l’objet d’un drainage (en fonction de leur ampleur). Des facteurs de risque importants (comme l’obésité et le diabète) pourraient mener à des complications surajoutées et aggraver davantage l’issue. Cas : Dix jours après avoir subi une hystérectomie abdominale totale par incision de Pfannenstiel en raison d’un cancer de l’endomètre, une femme de 73 ans a présenté un gros hématome sous-cutané. L’hématome en question a évolué et a mené à une nécrose étendue du tissu adipeux sous-cutané. La mise en œuvre d’un débridement de grande envergure s’est avérée nécessaire et la plaie a été traitée par pression négative au moyen de gaze afin de permettre une cicatrisation par deuxième intention. Une guérison satisfaisante a été constatée après 82 jours de traitement, sans greffe cutanée. Conclusion : Ce cas souligne l’utilité du traitement de plaie par pression négative au moyen de gaze, ainsi que la nécessité d’avoir recours à une approche multidisciplinaire au moment d’assurer la prise en charge de complications de plaie d’une telle complexité.

  17. Paraventricular hypothalamic lesions and medial hypothalamic knife cuts produce similar hyperphagia syndromes.

    PubMed

    Aravich, P F; Sclafani, A

    1983-12-01

    The hyperphagia/obesity syndrome produced by paraventricular hypothalamic (PVH) lesions and that produced by medial hypothalamic (MH) knife cuts were compared in adult female rats. Each treatment produced hyperphagia and overweight on a chow diet, although the PVH effect was less than the knife-cut effect. Each treatment also produced qualitatively similar ingestive responses to unpalatable quinine- and sucrose octaacetate-adulterated diets and to palatable dextrose and fat diets during the dynamic and static weight-gain phases. The PVH lesions and MH cuts disrupted day/night feeding patterns and elevated water intakes but not water/food intake ratios. However, PVH lesions, unlike MH cuts, did not increase emotional reactivity. The relation of the PVH syndrome to the classic hypothalamic hyperphagia syndrome is discussed. Also considered is the neuroanatomical substrate responsible for the PVH hyperphagic effect.

  18. Macroscopic and microscopic analysis of knife stab wounds on fleshed and clothed ribs.

    PubMed

    Ferllini, Roxana

    2012-05-01

    Stab wounds upon bone are analyzed to interpret the weapon used and the physical context in which the attack occurred. The literature demonstrates that most research conducted pertaining to wound patterns has been carried out on defleshed and unclothed bone samples, not adequately replicating actual circumstances. For this research, six half pig torsos (Sus scrofa), fleshed (including muscle, fat, epidermis, and dermis layers) and clothed, were stabbed using three knife types, applying both straight and downward thrusts. Analysis conducted macroscopically and through a scanning electron microscope with an environmental secondary electron detector revealed a general lack of consistency in wound pattern and associated secondary effects. Consequently, it was not possible to establish wound pattern per knife type as suggested in previous research or relate it to stab motion. Advantage of microscopic analysis was evident in recognizing wound traits and observation of trace evidence not visible macroscopically.

  19. [Similar skin lesions in victim and perpetrator caused by a knife with a serrated blade].

    PubMed

    Vendura, K; Geserick, G

    2000-01-01

    Reported in this paper is an attack of two adolescents on a man who was killed in the fight, with several kitchen knives being used, including two with grooved and wave-grooved blades. One of the offenders held the victim tight from behind and was injured by his attacking accomplice++. A grid mark on the left side of the victim's face and the left forearm of the second offender in the back supported the assumption of a knife with simple wave profile. Skin lesions of finer structure below the left ear and on the left forearm of the victim suggested involvement of a smaller kitchen knife with groove-milled wave profile. Offender-victim position and course of offence were verified and confirmed by evaluation of these specific findings.

  20. Fraunhofer diffraction of a slit aperture between a knife-edge and a metal cylinder.

    PubMed

    Fukaya, J; Sasaki, A; Matsuda, Y; Aoyama, H

    1995-12-01

    The Fraunhofer diffraction pattern of a slit aperture formed between a reference knife-edge and a metal-cylinder surface is different from that of an ideal slit aperture. This pattern should include reflected light coming from both the front and rear sides of a cylinder surface. To investigate the influence of light reflected from the cylinder surface, we discuss the theoretical consideration based on the simple model of the reflected light on the surface. The experimental setup is designed and constructed to measure the actual diffraction pattern produced by the slit between the knife-edge and the cylinder surface. As a result it is obvious that the reflection of diffracted light on the rear side is dominant in both the simulation and the experiment.

  1. Cutting a Drop of Water Pinned by Wire Loops Using a Superhydrophobic Surface and Knife

    PubMed Central

    Yanashima, Ryan; García, Antonio A.; Aldridge, James; Weiss, Noah; Hayes, Mark A.; Andrews, James H.

    2012-01-01

    A water drop on a superhydrophobic surface that is pinned by wire loops can be reproducibly cut without formation of satellite droplets. Drops placed on low-density polyethylene surfaces and Teflon-coated glass slides were cut with superhydrophobic knives of low-density polyethylene and treated copper or zinc sheets, respectively. Distortion of drop shape by the superhydrophobic knife enables a clean break. The driving force for droplet formation arises from the lower surface free energy for two separate drops, and it is modeled as a 2-D system. An estimate of the free energy change serves to guide when droplets will form based on the variation of drop volume, loop spacing and knife depth. Combining the cutting process with an electrofocusing driving force could enable a reproducible biomolecular separation without troubling satellite drop formation. PMID:23029297

  2. Gamma knife radiosurgery to the trigeminal ganglion for treatment of trigeminal neuralgia secondary to vertebrobasilar ectasia

    PubMed Central

    Somaza, Salvador; Hurtado, Wendy; Montilla, Eglee; Ghaleb, Jose

    2014-01-01

    Background: We report the result obtained using Gamma knife stereotactic radiosurgery on the trigeminal ganglion (TG) in a patient with trigeminal neuralgia (TN) secondary to vertebrobasilar ectasia (VBE). Case Description: Retrospective review of medical records corresponding to one patient with VBE-related trigeminal pain treated with radiosurgery. Because of the impossibility of visualization of the entry zone or the path of trigeminal nerve through the pontine cistern, we proceeded with stereotactic radiosurgery directed to the TG. The maximum radiation dose was 86 Gy with a 8-mm and a 4-mm collimator. The follow-up period was 24 months. The pain disappeared in 15 days, passing from Barrow Neurological Institute (BNI) grade V to BNI grade IIIa in 4 months and then to grade I. The patient did not experience noticeable subjective facial numbness. Conclusions: This experience showed that Gamma knife radiosurgery was effective in the management of VBE-related trigeminal pain, using the TG as radiosurgical target. PMID:25593782

  3. Scuba diver with a knife in his chest: homicide or suicide?

    PubMed

    Petri, Nadan M; Definis-Gojanović, Marija; Andrić, Dejan

    2003-06-01

    A scuba diver was found dead at the bottom of an undersea cave at 54.1 m water depth, with a knife protruding from his chest. Autopsy confirmed death due to both drowning and a penetrating knife wound. The incident was first considered a homicide and two suspects were arrested. Careful forensic analysis of the profile of the diver's last dive stored in the dive computer, dimensions of the undersea cave, as well as other forensic findings, showed that the case was a suicide, which the diver most probably committed while running out of air, in an attempt to avoid the agony of drowning. To the best of our knowledge, this is the first report on a suicide during diving.

  4. Relaxation schemes for Chebyshev spectral multigrid methods

    NASA Technical Reports Server (NTRS)

    Kang, Yimin; Fulton, Scott R.

    1993-01-01

    Two relaxation schemes for Chebyshev spectral multigrid methods are presented for elliptic equations with Dirichlet boundary conditions. The first scheme is a pointwise-preconditioned Richardson relaxation scheme and the second is a line relaxation scheme. The line relaxation scheme provides an efficient and relatively simple approach for solving two-dimensional spectral equations. Numerical examples and comparisons with other methods are given.

  5. An intermediate term benefits and complications of gamma knife surgery in management of glomus jugulare tumor.

    PubMed

    Hafez, Raef F A; Morgan, Magad S; Fahmy, Osama M

    2016-01-01

    Glomus tumors are rare skull base slow-growing, hypervascular neoplasms that frequently involve critical neurovascular structures, and delay in diagnosis is frequent. Surgical removal is rarely radical and is usually associated with morbidity or mortality. Gamma knife surgery (GKS) has gained an increasing dependable role in the management of glomus jugulare tumors, with high rate of tumor growth control, preserving or improving clinical status and with limited complications. This study aims to evaluate intermediate term benefits and complications of gamma knife surgery in management of twenty-two patients bearing growing glomus jugulare tumors at the International Medical Center (IMC), Cairo, Egypt, between 2005 and 2011. The mean follow-up period was 56 months (range 36-108 months); there were 3 males, 19 females; mean age was 43.6 years; 15 patients had GKS as the primary treatment; 2 patients had surgical residuals; 2 had previous radiation therapy; and 3 previously underwent endovascular embolization. The average tumor volume was 7.26 cm3, and the mean marginal dose was 14.7 Gy. Post gamma knife surgery through the follow-up period neurological status was improved in 12 patients, 7 showed stable clinical condition and 3 patients developed new moderate deficits. Tumor volume post GKS was unchanged in 13 patients, decreased in 8, and showed tumor regrowth in 1 patient. Tumor progression-free survival in our studied patients was 95.5% at 5 and 7 years of the follow-up period post GKS. Gamma knife surgery could be used safely and effectively with limited complications as a primary management tool in the treatment of glomus jugulare tumors controlling tumor growth with preserving or improving clinical status especially those who do not have significant cranial or cervical extension, elderly, and surgically unfit patients; moreover, it is safe and highly effective as adjuvant therapy as well. PMID:26879488

  6. Differential phase microscope and micro-tomography with a Foucault knife-edge scanning filter

    NASA Astrophysics Data System (ADS)

    Watanabe, N.; Hashizume, J.; Goto, M.; Yamaguchi, M.; Tsujimura, T.; Aoki, S.

    2013-10-01

    An x-ray differential phase microscope with a Foucault knife-edge scanning filter was set up at the bending magnet source BL3C, Photon Factory. A reconstructed phase profile from the differential phase image of an aluminium wire at 5.36 keV was fairly good agreement with the numerical simulation. Phase tomography of a biological specimen, such as an Artemia cyst, could be successfully demonstrated.

  7. TH-A-9A-06: Inverse Planning of Gamma Knife Radiosurgery Using Natural Physical Models

    SciTech Connect

    Riofrio, D; Ma, L; Zhou, J; Luan, S

    2014-06-15

    Purpose: Treatment-planning systems rely on computer intensive optimization algorithms in order to provide radiation dose localization. We are investigating a new optimization paradigm based on natural physical modeling and simulations, which tend to evolve in time and find the minimum energy state. In our research, we aim to match physical models with radiation therapy inverse planning problems, where the minimum energy state coincides with the optimal solution. As a prototype study, we have modeled the inverse planning of Gamma Knife radiosurgery using the dynamic interactions between charged particles and demonstrate the potential of the paradigm. Methods: For inverse planning of Gamma Knife radiosurgery: (1) positive charges are uniformly placed on the surface of tumors and critical structures. (2) The Gamma Knife dose kernels of 4mm, 8mm and 16mm radii are modeled as geometric objects with variable charges. (3) The number of shots per each kernel radii is obtained by solving a constrained integer-linear problem. (4) The shots are placed into the tumor volume and move under electrostatic forces. The simulation is performed until internal forces are zero or maximum iterations are reached. (5) Finally, non-negative least squares (NNLS) is used to calculate the beam-on times for each shot. Results: A 3D C-shaped tumor surrounding a spherical critical structure was used for testing the new optimization paradigm. These tests showed that charges spread out evenly covering the tumor while keeping distance from the critical structure, resulting in a high quality plan. Conclusion: We have developed a new paradigm for dose optimization based on the simulation of physical models. As prototype studies, we applied electrostatic models to Gamma Knife radiosurgery and demonstrated the potential of the new paradigm. Further research and fine-tuning of the model are underway. NSF CBET-0853157.

  8. An intermediate term benefits and complications of gamma knife surgery in management of glomus jugulare tumor.

    PubMed

    Hafez, Raef F A; Morgan, Magad S; Fahmy, Osama M

    2016-02-15

    Glomus tumors are rare skull base slow-growing, hypervascular neoplasms that frequently involve critical neurovascular structures, and delay in diagnosis is frequent. Surgical removal is rarely radical and is usually associated with morbidity or mortality. Gamma knife surgery (GKS) has gained an increasing dependable role in the management of glomus jugulare tumors, with high rate of tumor growth control, preserving or improving clinical status and with limited complications. This study aims to evaluate intermediate term benefits and complications of gamma knife surgery in management of twenty-two patients bearing growing glomus jugulare tumors at the International Medical Center (IMC), Cairo, Egypt, between 2005 and 2011. The mean follow-up period was 56 months (range 36-108 months); there were 3 males, 19 females; mean age was 43.6 years; 15 patients had GKS as the primary treatment; 2 patients had surgical residuals; 2 had previous radiation therapy; and 3 previously underwent endovascular embolization. The average tumor volume was 7.26 cm3, and the mean marginal dose was 14.7 Gy. Post gamma knife surgery through the follow-up period neurological status was improved in 12 patients, 7 showed stable clinical condition and 3 patients developed new moderate deficits. Tumor volume post GKS was unchanged in 13 patients, decreased in 8, and showed tumor regrowth in 1 patient. Tumor progression-free survival in our studied patients was 95.5% at 5 and 7 years of the follow-up period post GKS. Gamma knife surgery could be used safely and effectively with limited complications as a primary management tool in the treatment of glomus jugulare tumors controlling tumor growth with preserving or improving clinical status especially those who do not have significant cranial or cervical extension, elderly, and surgically unfit patients; moreover, it is safe and highly effective as adjuvant therapy as well.

  9. Incidence of Port-Site Incisional Hernia After Single-Incision Laparoscopic Surgery

    PubMed Central

    Rainville, Harvey; Ikedilo, Ojinika; Vemulapali, Pratibha

    2014-01-01

    Background and Objectives: Single-incision laparoscopic surgery is gaining popularity among minimally invasive surgeons and is now being applied to a broad number of surgical procedures. Although this technique uses only 1 port, the diameter of the incision is larger than in standard laparoscopic surgery. The long-term incidence of port-site hernias after single-incision laparoscopic surgery has yet to be determined. Methods: All patients who underwent a single-incision laparoscopic surgical procedure from May 2008 through May 2009 were included in the study. Single-incision laparoscopic surgical operations were performed either by a multiport technique or with a 3-trocar single-incision laparoscopic surgery port. The patients were seen at 30 to 36 months' follow-up, at which time they were examined for any evidence of port-site incisional hernia. Patients found to have hernias on clinical examination underwent repairs with mesh. Results: A total of 211 patients met the criteria for inclusion in the study. The types of operations included were cholecystectomy, appendectomy, sleeve gastrectomy, gastric banding, Nissen fundoplication, colectomy, and gastrojejunostomy. We found a port-site hernia rate of 2.9% at 30 to 36 months' follow-up. Conclusion: Port-site incisional hernia after single-incision laparoscopic surgical procedures remains a major setback for patients. The true incidence remains largely unknown because most patients are asymptomatic and therefore do not seek surgical aid. PMID:24960483

  10. Histologic evaluation of porcine skin incisions produced by CO2 laser, electrosurgery, and scalpel.

    PubMed

    Arashiro, D S; Rapley, J W; Cobb, C M; Killoy, W J

    1996-10-01

    The purpose of this study was to histologically compare the healing of porcine skin incisions made by CO2 laser, electrosurgery, and conventional scalpel. Incisions were made on the dorsal thorax of two microswine at staggered time intervals allowing the harvest of specimens at 0, 4, 7, 14, and 21 days postsurgery at the time of sacrifice. Each of the following histologic zones were identified and measured for both laser and electrosurgery incisions: (1) zone of tissue ablation. (2) zone of thermal necrosis, and (3) width of surface damage. The depth of cut and width of surface opening was measured for the scalpel incision. Furthermore, for each specimen, the presence and character of inflammatory cell infiltrate was noted, as well as the relative times at which bridging of the incision by connective tissue and coverage of the wound by an intact epithelial layer had occurred. Results showed that in this wound-healing model, the scalpel incisions produced more defined borders, healed more rapidly, and resulted in less collateral tissue damage than those produced by CO2 laser or electrosurgery. It was also noted that to create a wound 1.29 mm in depth required at least five passes of the laser beam within the same line of incision using 206.4 J/cm2 (6 W, continuous mode). PMID:9084320

  11. Quality of linear incisions performed by dental students using Er:YAG laser in soft tissue

    NASA Astrophysics Data System (ADS)

    Novelli, Moacyr Domingos; Vasques, Mayra Torres; Meneguzzo, Daiane Thaís; Aranha, Ana Cecília Corrêa; Corrêa, Luciana

    2008-02-01

    Introduction: New technologies in dental practice, such as laser, have enabled new strategies to be established in dental education. The aim of this study was to analyze the difficulties that dental students encountered with performing surgical incisions using Er:YAG laser (LE), and the morphology of these incisions. Material and Methods: Sixteen undergraduate dental students and ten dental professionals (DP) enrolled at The Master of Science Program in Laser Dentistry were asked to perform 15 incisions using an LE and 15 with a conventional scalpel. The incisions were compared, based on the shape factor (relation between area and perimeter), which was obtained by a digital image system and by a morphometry software. Data was submitted to statistical analysis of variance (p 0.05). Results: Considering the incisions performed by scalpel, DP showed statistically significant differences (p < 0.01) in relation to control group (CG). Considering the LE, all groups showed significant differences (p<0.0001) in relation to CG, especially the DP group. The main laser technical failures were performing an incision that was not in a straight line, without defined borders, using an inconstant cutting speed, and absence of suction and water jet appliances. None of the groups performed adequate incisions using LE. Conclusion: Greater emphasis is required in relating laser therapy practice to the physical properties of laser, particularly for dental professionals that specialize in laser.

  12. Incision properties and thermal effects of CO2 lasers in soft tissue

    NASA Astrophysics Data System (ADS)

    Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Liaw, Lih-Huei L.; Berns, Michael W.

    1995-05-01

    Thermal and histological events resulting from soft tissue incision using CO2 lasers at 9.3 (mu) or 10.6 (mu) , fitted with a hollow wave guide or an articulated arm delivery system respectively, were investigated. In 9 fresh pigs' mandibles, standardized incisions 3 cm in length were made in the oral mucosa. Incisions were performed in the cw mode at 1 W, 4 W, and 12 W. Thermal events were measured in adjacent soft tissues using thermocouples. Incisions were dissected out, fixed, embedded in paraffin wax, sectioned and stained with Serius Red. The Students' t-test for paired data was used to compare zones of necrosis, zones of collagen damage and thermal events. No significant temperature rise was measured during irradiation at any timepoints or power settings (p < 0.05). Results were very similar for the two lasers with significantly different results obtained only at the 12 W setting (p < 0.05). Vertical incision depths and horizontal incision widths did not differ significantly (p < 0.0001) at 12 W and 4 W. Horizontal and vertical zones of necrosis did not differ significantly (p < 0.0001) either between the two lasers at 12 W and 4 W. Thus the thermal and histological events occurring during soft tissue incision were similar using these two lasers, despite the difference in wavelength and delivery system.

  13. Small Incision Lenticule Extraction for Postkeratoplasty Myopia and Astigmatism

    PubMed Central

    Ibrahim, Osama; Shehata, Kitty; Abdalla, Moones F.

    2016-01-01

    Purpose. To evaluate the visual and refractive outcomes after small incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism after penetrating keratoplasty (PKP). Design. Case-series. Methods. Ten eyes of 10 patients with previous PKP and residual myopic astigmatism for whom pentacam imaging and thickness measurements were acceptable for laser vision correction. Manifest refraction (MR), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained preoperatively and one day, one week, and one, 3, and 6 months postoperatively. Cases were operated on the VisuMax® femtosecond laser platform with 500 kHz repetition rate. Results. The mean correction ratio for spherical errors was 0.84 ± 0.19 D and for the mean refractive spherical equivalent (MRSE) was 0.79 ± 0.13 D. Vector analysis showed a mean astigmatism reduction at the intended axis of 67 ± 25.25%, a correction index of 0.81 ± 0.21, and an overall mean percentage of success of astigmatism surgery of 53 ± 37.9%. The postoperative MRSE was stable throughout the 6-month follow-up period. The efficacy index was 0.93 and the safety index was 1.12. Conclusion. SMILE for correction of post-PKP myopia and astigmatism is effective, safe, and stable with moderate accuracy and predictability. Centration of the treatment within the grafts was easily performed. PMID:27446606

  14. Surface electromyography analysis of blepharoptosis correction by transconjunctival incisions.

    PubMed

    Tu, Lung-Chen; Wu, Ming-Chya; Chu, Hsueh-Liang; Chiang, Yi-Pin; Kuo, Chih-Lin; Li, Hsing-Yuan; Chang, Chia-Ching

    2016-06-01

    Upper eyelid movement depends on the antagonistic actions of orbicularis oculi muscle and levator aponeurosis. Blepharoptosis is an abnormal drooping of upper eyelid margin with the eye in primary position of gaze. Transconjunctival incisions for upper eyelid ptosis correction have been a well-developed technique. Conventional prognosis however depends on clinical observations and lacks of quantitatively analysis for the eyelid muscle controlling. This study examines the possibility of using the assessments of temporal correlation in surface electromyography (SEMG) as a quantitative description for the change of muscle controlling after operation. Eyelid SEMG was measured from patients with blepharoptosis preoperatively and postoperatively, as well as, for comparative study, from young and aged normal subjects. The data were analyzed using the detrended fluctuation analysis method. The results show that the temporal correlation of the SEMG signals can be characterized by two indices associated with the correlation properties in short and long time scales demarcated at 3ms, corresponding to the time scale of neural response. Aging causes degradation of the correlation properties at both time scales, and patient group likely possess more serious correlation degradation in long-time regime which was improved moderately by the ptosis corrections. We propose that the temporal correlation in SEMG signals may be regarded as an indicator for evaluating the performance of eyelid muscle controlling in postoperative recovery.

  15. A simple method of independent treatment time verification in gamma knife radiosurgery using integral dose

    SciTech Connect

    Jin Jianyue; Drzymala, Robert; Li Zuofeng

    2004-12-01

    The purpose of this study is to develop a simple independent dose calculation method to verify treatment plans for Leksell Gamma Knife radiosurgery. Our approach uses the total integral dose within the skull as an end point for comparison. The total integral dose is computed using a spreadsheet and is compared to that obtained from Leksell GammaPlan registered . It is calculated as the sum of the integral doses of 201 beams, each passing through a cylindrical volume. The average length of the cylinders is estimated from the Skull-Scaler measurement data taken before treatment. Correction factors are applied to the length of the cylinder depending on the location of a shot in the skull. The radius of the cylinder corresponds to the collimator aperture of the helmet, with a correction factor for the beam penumbra and scattering. We have tested our simple spreadsheet program using treatment plans of 40 patients treated with Gamma Knife registered in our center. These patients differ in geometry, size, lesion locations, collimator helmet, and treatment complexities. Results show that differences between our calculations and treatment planning results are typically within {+-}3%, with a maximum difference of {+-}3.8%. We demonstrate that our spreadsheet program is a convenient and effective independent method to verify treatment planning irradiation times prior to implementation of Gamma Knife radiosurgery.

  16. Experimental and computational studies on Coanda nozzle flow for the air knife application

    NASA Astrophysics Data System (ADS)

    Kwon, Soon-Bum; Lee, Dong-Won; Kwon, Young-Doo

    2007-05-01

    To control the film thickness of zinc in the process of continuous hot-dip galvanizing, it is known from the early days that the gas wiping through an air knife is the most effective one. The gas wiping using in galvanizing process brings about a problem of splashing from the strip edge for a certain high speed of coating. So, in the present study, the effects of the deflection angle of Coanda nozzle on jet structure and the distribution of impinging pressure at the plate surface are investigated numerically and experimentally. In numerical analysis, the governing equations consisted of three-dimensional time dependent full Navier-Stokes equations, standard k-ɛ turbulence model to solve turbulent stress and so on are employed. In experiment, 16 channel pressure scanning valve and 3-axis auto traversing unit are used to measure the impinging pressure at the strip surface. As a result, it is found that the smaller the deflection angle for the same nozzle slit of air knife is, the larger the impinging pressure is. To reduce the size of separation bubble and to enhance the cutting ability, it is recommendable to use an air knife with the Coanda nozzle.

  17. A comparison of fatal with non-fatal knife injuries in Edinburgh.

    PubMed

    Webb, E; Wyatt, J P; Henry, J; Busuttil, A

    1999-01-25

    Assault using a knife is a common problem in the United Kingdom. Between February 1992 and December 1996, 120 individuals died or received hospital treatment in Edinburgh after being assaulted with a knife. Twenty individuals (17%) died as a result of their injuries. Comparison of the survivors with non-survivors revealed both groups to have similar age and sex distributions, but those who died had significantly more severe injuries when scored according to the Abbreviated Injury Scale. Eight individuals died of unsurvivable chest injuries at the scene of the attack and of the remainder, only five reached hospital with signs of life. Analysis of hospital treatment using TRISS methodology revealed there to be two unexpected survivors and no unexpected deaths. The risk of death appears to depend mostly upon injuries sustained and also to a lesser extent upon other factors such as alcohol consumption and the presence of a bystander capable and willing to request emergency medical assistance. There does not appear to be much potential to save lives by improving hospital treatment for those assaulted with a knife in Edinburgh. Instead, greater focus needs to be placed upon rapid transfer to hospital and upon restricting the possession and use of knives.

  18. Does the stoichiometric carbon:phosphorus knife edge apply for predaceous copepods?

    PubMed

    Laspoumaderes, Cecilia; Modenutti, Beatriz; Elser, James J; Balseiro, Esteban

    2015-06-01

    Recent work has indicated that stoichiometric food quality in terms of the carbon:phosphorus (C:P) ratio affects consumers whether the imbalance involves a deficit or an excess of nutrients; hence, organisms exist on a "stoichiometric knife edge". While previous studies have focused primarily on autotroph-herbivore trophic transfer, nutritional imbalances may also affect the interactions between species at higher trophic levels. Since the foods of carnivores are normally stoichiometrically similar to the body compositions of those carnivores, they may be more severely affected than herbivores if imbalances become pronounced. We analysed the response of the predatory copepod Parabroteas sarsi to monospecific diet treatments consisting of high and low C:P prey items. These dietary treatments strongly affected the predator's elemental composition and growth, although prey selection, excretion, egestion, and respiration rates were not affected. We suggest that, due to their low threshold elemental ratio and a narrow C:P stoichiometric knife edge, these predators are highly vulnerable to stoichiometric imbalances, whether an excess or a deficit of nutrients is involved. Our results demonstrating this high sensitivity to prey C:P ratio show that the stoichiometric knife edge may apply to not only herbivores but also higher trophic levels. Thus, predators such as P. sarsi, with a much narrower range of food quality, may also be strongly affected by fluctuations in the quality of their prey, with negative consequences for their secondary production.

  19. Statistical bounds and maximum likelihood performance for shot noise limited knife-edge modeled stellar occultation

    NASA Astrophysics Data System (ADS)

    McNicholl, Patrick J.; Crabtree, Peter N.

    2014-09-01

    Applications of stellar occultation by solar system objects have a long history for determining universal time, detecting binary stars, and providing estimates of sizes of asteroids and minor planets. More recently, extension of this last application has been proposed as a technique to provide information (if not complete shadow images) of geosynchronous satellites. Diffraction has long been recognized as a source of distortion for such occultation measurements, and models subsequently developed to compensate for this degradation. Typically these models employ a knife-edge assumption for the obscuring body. In this preliminary study, we report on the fundamental limitations of knife-edge position estimates due to shot noise in an otherwise idealized measurement. In particular, we address the statistical bounds, both Cramér- Rao and Hammersley-Chapman-Robbins, on the uncertainty in the knife-edge position measurement, as well as the performance of the maximum-likelihood estimator. Results are presented as a function of both stellar magnitude and sensor passband; the limiting case of infinite resolving power is also explored.

  20. Stereotactic radiosurgery of prostate cancer - dose distribution for VMAT and CyberKnife techniques

    NASA Astrophysics Data System (ADS)

    Ślosarek, Krzysztof; Osewski, Wojciech; Grządziel, Aleksandra; Stąpór-Fudzińska, Małgorzata; Szlag, Marta

    2016-06-01

    New capabilities of biomedical accelerators allow for very precise depositing of the radiation dose and imaging verification during the therapy. In addition, computer algorithms calculating dose distributions are taking into account the increasing number of physical effects. Therefore, administration of high dose fractionation, which is consistent with radiobiology used in oncology, becomes safer and safer. Stereotactic radiosurgery (SRS), which is very precise irradiation with high dose fractionation is increasingly widespread use in radiotherapy of prostate cancer. For this purpose different biomedical accelerators are used. The aim of this study is to compare dose distributions for two techniques: VMAT and CyberKnife. Statistical analysis was performed for the two groups of patients treated by VMAT technique (25 patients), and CyberKnife technique (15 patients). The analysis shows that the dose distributions are comparable, both in the treated area (prostate) and in the critical organs (rectum, urinary bladder, femoral heads). The results show that stereotactic radiosurgery of prostate cancer can be carried out on CyberKnife accelerator as well as on the classical accelerator with the use of VMAT technique.

  1. Electric Field Screening by the Proximity of Two Knife-Edge Field Emitters of Finite Width

    NASA Astrophysics Data System (ADS)

    Wong, P.; Tang, W.; Lau, Y. Y.; Hoff, B.

    2015-11-01

    Field emitter arrays have the potential to provide high current density, low voltage operation, and high pulse repetition for radar and communication. It is well known that packing density of the field emitter arrays significantly affect the emission current. Previously we calculated analytically the electric field profile of two-dimensional knife-edge cathodes with arbitrary separation by using a Schwarz-Christoffel transformation. Here we extend this previous work to include the finite width of two identical emitters. From the electric field profile, the field enhancement factor, thereby the severity of the electric field screening, are determined. It is found that for two identical emitters with finite width, the magnitude of the electric field on the knife-edge cathodes depends strongly on the ratio h / a and h / r , where h is the height of the knife-edge cathode, 2a is the distance between the cathodes, and 2 r represents their width. Particle-in-cell simulations are performed to compare with the analytical results on the emission current distribution. P. Y. Wong was supported by a Directed Energy Summer Scholar internship at Air Force Research Laboratory, Kirtland AFB, and by AFRL Award No. FA9451-14-1-0374.

  2. A technique to sharpen the beam penumbra for Gamma Knife radiosurgery

    NASA Astrophysics Data System (ADS)

    Guerrero, M.; Li, X. Allen; Ma, Lijun

    2003-06-01

    In stereotactic radiosurgery, a narrow beam penumbra is often desired for producing steep dose fall-off between the target volume and adjacent critical structures. Due to limited source sizes and the scattering effects, the physical penumbra of the Gamma Knife (GK) is often restricted to a width of 1-2 mm. In this work, we developed a technique to further reduce the beam penumbra and improve the dose profile for the Gamma Knife delivery. Under this technique, a conic filter is inserted into an individual plug collimator of a GK helmet to flatten the beam profile. Monte Carlo calculations were carried out to simulate the GK geometry of the individual plug collimator and to optimize the physical shapes of the filters. The calculations were performed for a series of filter shapes with different collimator sizes. Our results show that a proper filter significantly reduces the single GK beam penumbra width (defined as the distance from the 90% to 50% isodose lines) by 30-60%. The beam intensity is reduced by about 20-50% when the filter is used. A treatment plan was developed for a trigeminal neuralgia case by commissioning the filtered beam profile for Leksell Gamma Plan (version 5.31). Compared with the conventional treatment plan, a significant improvement was found on the critical structure sparing and on the target dose uniformity. In conclusion, the proposed technique is feasible and effective in sharpening the beam penumbra for Gamma Knife beam profiles.

  3. Selective source blocking for Gamma Knife radiosurgery of trigeminal neuralgia based on analytical dose modelling

    NASA Astrophysics Data System (ADS)

    Li, Kaile; Ma, Lijun

    2004-08-01

    We have developed an automatic critical region shielding (ACRS) algorithm for Gamma Knife radiosurgery of trigeminal neuralgia. The algorithm selectively blocks 201 Gamma Knife sources to minimize the dose to the brainstem while irradiating the root entry area of the trigeminal nerve with 70-90 Gy. An independent dose model was developed to implement the algorithm. The accuracy of the dose model was tested and validated via comparison with the Leksell GammaPlan (LGP) calculations. Agreements of 3% or 3 mm in isodose distributions were found for both single-shot and multiple-shot treatment plans. After the optimized blocking patterns are obtained via the independent dose model, they are imported into the LGP for final dose calculations and treatment planning analyses. We found that the use of a moderate number of source plugs (30-50 plugs) significantly lowered (~40%) the dose to the brainstem for trigeminal neuralgia treatments. Considering the small effort involved in using these plugs, we recommend source blocking for all trigeminal neuralgia treatments with Gamma Knife radiosurgery.

  4. Retrospective evaluation of CTV to PTV margins using CyberKnife in patients with thoracic tumors.

    PubMed

    Floriano, Alejandro; García, Rafael; Moreno, Ramon; Sánchez-Reyes, Alberto

    2014-11-08

    The objectives of this study were to estimate global uncertainty for patients with thoracic tumors treated in our center using the CyberKnife VSI after placement of fiducial markers and to compare our findings with the standard CTV to PTV margins used to date. Datasets for 16 patients (54 fractions) treated with the CyberKnife and the Synchrony Respiratory Tracking System were analyzed retrospectively based on CT planning, tracking information, and movement data generated and saved in the logs files by the system. For each patient, we analyzed all the main uncertainty sources and assigned a value. We also calculated an expanded global uncertainty to ensure a robust estimation of global uncertainty and to enable us to determine the position of 95% of the CTV points with a 95% confidence level during treatment. Based on our estimation of global uncertainty and compared with our general mar- gin criterion (5 mm in all three directions: superior/inferior [SI], anterior/posterior [AP], and lateral [LAT]), 100% were adequately covered in the LAT direction, as were 94% and 94% in the SI and AP directions. We retrospectively analyzed the main sources of uncertainty in the CyberKnife process patient by patient. This individualized approach enabled us to estimate margins for patients with thoracic tumors treated in our unit and compare the results with our standard 5 mm margin. 

  5. Fractionated Stereotactic Gamma Knife Radiosurgery for Large Brain Metastases: A Retrospective, Single Center Study

    PubMed Central

    Park, Hye Ran; Lee, Jae Meen; Kim, Jin Wook; Chung, Hyun-Tai; Kim, Dong Gyu; Jung, Hee-Won

    2016-01-01

    Purpose Stereotactic radiosurgery (SRS) is widely used for brain metastases but has been relatively contraindicated for large lesions (>3 cm). In the present study, we analyzed the efficacy and toxicity of hypofractionated Gamma Knife radiosurgery to treat metastatic brain tumors for which surgical resection were not considered as the primary treatment option. Methods and Materials Thirty-six patients, forty cases were treated with Gamma Knife-based fractionated SRS for three to four consecutive days with the same Leksell frame on their heads. The mean gross tumor volume was 18.3 cm³, and the median dose was 8 Gy at 50% isodose line with 3 fractions for three consecutive days (range, 5 to 11 Gy and 2 to 4 fractions for 2 to 4 consecutive days). Survival rates and prognostic factors were analyzed. Results The overall survival rate at one and two years was 66.7 and 33.1%, respectively. The median survival time was 16.2 months, and the local control rate was 90%. RTOG toxicity grade 1 was observed in 3 (8.3%) patients, grade 2 in 1 (2.7%) patient and grade 3 in 1 (2.7%) patient respectively. Radiation necrosis was developed in 1 (2.7%) patient. KPS scores and control of primary disease resulted in significant differences in survival. Conclusions Our findings suggest that consecutive hypofractionated Gamma Knife SRS could be applied to large metastatic brain tumors with effective tumor control and low toxicity rates. PMID:27661613

  6. Bulk flow coupled to a viscous interfacial film sheared by a rotating knife edge

    NASA Astrophysics Data System (ADS)

    Raghunandan, Aditya; Rasheed, Fayaz; Hirsa, Amir; Lopez, Juan

    2015-11-01

    The measurement of the interfacial properties of highly viscous biofilms, such as DPPC (the primary component of lung surfactant), present on the surface of liquids (bulk phase) continues to attract significant attention. Most measurement techniques rely on shearing the interfacial film and quantifying its viscous response in terms of a surface (excess) viscosity at the air-liquid interface. The knife edge viscometer offers a significant advantage over other approaches used to study highly viscous films as the film is directly sheared by a rotating knife edge in direct contact with the film. However, accurately quantifying the viscous response is non-trivial and involves accounting for the coupled interfacial and bulk phase flows. Here, we examine the nature of the viscous response of water insoluble DPPC films sheared in a knife edge viscometer over a range of surface packing, and its influence on the strength of the coupled bulk flow. Experimental results, obtained via Particle Image Velocimetry in the bulk and at the surface (via Brewster Angle Microscopy), are compared with numerical flow predictions to quantify the coupling across hydrodynamic flow regimes, from the Stokes flow limit to regimes where flow inertia is significant. Supported by NNX13AQ22G, National Aeronautics and Space Administration.

  7. Retrospective evaluation of CTV to PTV margins using CyberKnife in patients with thoracic tumors.

    PubMed

    Floriano, Alejandro; García, Rafael; Moreno, Ramon; Sánchez-Reyes, Alberto

    2014-01-01

    The objectives of this study were to estimate global uncertainty for patients with thoracic tumors treated in our center using the CyberKnife VSI after placement of fiducial markers and to compare our findings with the standard CTV to PTV margins used to date. Datasets for 16 patients (54 fractions) treated with the CyberKnife and the Synchrony Respiratory Tracking System were analyzed retrospectively based on CT planning, tracking information, and movement data generated and saved in the logs files by the system. For each patient, we analyzed all the main uncertainty sources and assigned a value. We also calculated an expanded global uncertainty to ensure a robust estimation of global uncertainty and to enable us to determine the position of 95% of the CTV points with a 95% confidence level during treatment. Based on our estimation of global uncertainty and compared with our general mar- gin criterion (5 mm in all three directions: superior/inferior [SI], anterior/posterior [AP], and lateral [LAT]), 100% were adequately covered in the LAT direction, as were 94% and 94% in the SI and AP directions. We retrospectively analyzed the main sources of uncertainty in the CyberKnife process patient by patient. This individualized approach enabled us to estimate margins for patients with thoracic tumors treated in our unit and compare the results with our standard 5 mm margin.  PMID:25493508

  8. Analysis of electric field screening by the proximity of two knife-edge field emitters

    NASA Astrophysics Data System (ADS)

    Tang, Wilkin; Shiffler, Don; Cartwright, Keith L.

    2011-08-01

    The electric field of two semi-infinitely wide knife-edge cathodes with arbitrary separation is calculated by using a Schwarz-Christoffel transformation. This geometry could also represent a trench (or scratch) on a flat surface. It is found that the magnitude of the electric field on the knife-edge cathodes depends strongly on the ratio h/a, where h is the height of the knife-edge cathodes and 2a is the distance between the cathodes. When h/a increases, the magnitude of the electric field on the cathode's surface decreases. This shows the screening of one cathode by another cathode; for example, keeping the height fixed and decreasing the distance between the cathodes, the field enhancement on the corner decreases. Analytic approximations for the divergent electric field in the immediate vicinity of the sharp edge are derived for the cases where h /a>>1, and h /a≪1. These results lead to insight on the relationship of the density of field emitter in field emitting arrays and field emission from rough surfaces.

  9. Stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife

    SciTech Connect

    Lunsford, L.D.; Flickinger, J.; Lindner, G.; Maitz, A.

    1989-02-01

    The first United States 201 cobalt-60 source gamma knife for stereotactic radiosurgery of brain tumors and arteriovenous malformations became operational at the University of Pittsburgh on August 14, 1987. Four and one-half years of intensive planning, regulatory agency review, and analysis of published results preceded the first radiosurgical procedure. Installation of this 18,000-kg device and loading of the 201 cobalt-60 sources posed major challenges in engineering, architecture, and radiophysics. In the first 4 months of operation, we treated 52 patients (29 with arteriovenous malformations, 19 with extra-axial neoplasms of the skull base, and 4 with intra-axial malignant tumors). Most patients either had lesions considered inoperable or had residual lesions after attempted surgical resection. Neither surgical mortality nor significant morbidity was associated with gamma knife radiosurgery. As compared with treatment by conventional intracranial surgery (craniotomy), the average length of stay for radiosurgery was reduced by 4 to 14 days, and hospital charges were reduced by as much as 65%. Based on both the previously published results of treatment of more than 2,000 patients worldwide and on our initial clinical experience, we believe that gamma knife stereotactic radiosurgery is a therapeutically effective and economically sound alternative to more conventional neurosurgical procedures, in selected cases.

  10. Heat hyperalgesia after incision requires TRPV1 and is distinct from pure inflammatory pain.

    PubMed

    Pogatzki-Zahn, Esther M; Shimizu, Isao; Caterina, Michael; Raja, Srinivasa N

    2005-06-01

    Postoperative pain significantly impacts patient recovery. However, postoperative pain management remains suboptimal, perhaps because treatment strategies are based mainly on studies using inflammatory pain models. We used a recently developed mouse model of incisional pain to investigate peripheral and spinal mechanisms contributing to heat hyperalgesia after incision. Behavioral experiments involving TRPV1 KO mice demonstrate that, as previously observed in inflammatory models, TRPV1 is necessary for heat (but not mechanical) hyperalgesia after incision. However, in WT mice, neither the proportion of TRPV1 immunoreactive neurons in the DRG nor the intensity of TRPV1 staining in the sciatic nerve was different from that in controls up to 4 days after incision. This result was corroborated by immunoblot analysis of sciatic nerve in rats subjected to an incision, and is distinct from that following inflammation of the rat hind paw, a situation in which TRPV1 expression levels in sciatic nerve increases. In the absence of heat exposure, spinal c-Fos staining was similar between incised TRPV1 KO and WT mice. However, differences in c-Fos staining between heat exposed TRPV1 KO and WT mice after incision suggest that the incision-mediated enhancement of heat-evoked signaling to the spinal cord involves a TRPV1-dependent mechanism. Finally, heat hyperalgesia after incision was reversed by antagonism of spinal non-NMDA receptors, unlike inflammatory hyperalgesia, which is mediated via NMDA receptors . Thus, TRPV1 is important for the generation of thermal hyperalgesia after incision. Our observations suggest that all experimental pain models may not be equally appropriate to guide the development of postoperative pain therapies.

  11. Phase transitions in semidefinite relaxations

    PubMed Central

    Javanmard, Adel; Montanari, Andrea; Ricci-Tersenghi, Federico

    2016-01-01

    Statistical inference problems arising within signal processing, data mining, and machine learning naturally give rise to hard combinatorial optimization problems. These problems become intractable when the dimensionality of the data is large, as is often the case for modern datasets. A popular idea is to construct convex relaxations of these combinatorial problems, which can be solved efficiently for large-scale datasets. Semidefinite programming (SDP) relaxations are among the most powerful methods in this family and are surprisingly well suited for a broad range of problems where data take the form of matrices or graphs. It has been observed several times that when the statistical noise is small enough, SDP relaxations correctly detect the underlying combinatorial structures. In this paper we develop asymptotic predictions for several detection thresholds, as well as for the estimation error above these thresholds. We study some classical SDP relaxations for statistical problems motivated by graph synchronization and community detection in networks. We map these optimization problems to statistical mechanics models with vector spins and use nonrigorous techniques from statistical mechanics to characterize the corresponding phase transitions. Our results clarify the effectiveness of SDP relaxations in solving high-dimensional statistical problems. PMID:27001856

  12. Phase transitions in semidefinite relaxations.

    PubMed

    Javanmard, Adel; Montanari, Andrea; Ricci-Tersenghi, Federico

    2016-04-19

    Statistical inference problems arising within signal processing, data mining, and machine learning naturally give rise to hard combinatorial optimization problems. These problems become intractable when the dimensionality of the data is large, as is often the case for modern datasets. A popular idea is to construct convex relaxations of these combinatorial problems, which can be solved efficiently for large-scale datasets. Semidefinite programming (SDP) relaxations are among the most powerful methods in this family and are surprisingly well suited for a broad range of problems where data take the form of matrices or graphs. It has been observed several times that when the statistical noise is small enough, SDP relaxations correctly detect the underlying combinatorial structures. In this paper we develop asymptotic predictions for several detection thresholds, as well as for the estimation error above these thresholds. We study some classical SDP relaxations for statistical problems motivated by graph synchronization and community detection in networks. We map these optimization problems to statistical mechanics models with vector spins and use nonrigorous techniques from statistical mechanics to characterize the corresponding phase transitions. Our results clarify the effectiveness of SDP relaxations in solving high-dimensional statistical problems. PMID:27001856

  13. Rapid late pleistocene incision of Atlantic passive-margin river gorges

    USGS Publications Warehouse

    Reusser, L.J.; Bierman, P.R.; Pavich, M.J.; Zen, E.-A.; Larsen, J.; Finkel, R.

    2004-01-01

    The direct and secondary effects of rapidly changing climate caused large rivers draining the Atlantic passive margin to incise quickly into bedrock beginning about 35,000 years ago. Measured in samples from bedrock fluvial terraces, 10-beryllium shows that both the Susquehanna and Potomac Rivers incised 10- to 20-meter-deep gorges along steep, convex lower reaches during the last glacial cycle. This short-lived pulse of unusually rapid downcutting ended by 13,000 to 14,000 years ago. The timing and rate of downcutting are similar on the glaciated Susquehanna and unglaciated Potomac Rivers, indicating that regional changes, not simply glacial melt-water, initiated incision.

  14. The construction of sutureless cataract incision and the management of corneal astigmatism.

    PubMed

    Hall, G W; Krischer, C; Mobasher, B; Rajan, S D

    1993-02-01

    Extrapolating information from equations that govern fluid flow, a theoretical formula is developed for a sutureless cataract incision. This theoretical formula defines the resistance of aqueous outflow as a function of three variables: length of cataract incision, the length of the scleral tunnel, the tortuosity of the outflow channel, and one constant friction factor. The nonlinear relationship of corneal incisions to length, depth, and distance from the visual axis is also examined with respect to their effect on central corneal curvature and control of astigmatism. Finite element analysis of differential equations is discussed as the most plausible technique for predicting these incisional effects.

  15. Anisotropic spin relaxation in graphene.

    PubMed

    Tombros, N; Tanabe, S; Veligura, A; Jozsa, C; Popinciuc, M; Jonkman, H T; van Wees, B J

    2008-07-25

    Spin relaxation in graphene is investigated in electrical graphene spin valve devices in the nonlocal geometry. Ferromagnetic electrodes with in-plane magnetizations inject spins parallel to the graphene layer. They are subject to Hanle spin precession under a magnetic field B applied perpendicular to the graphene layer. Fields above 1.5 T force the magnetization direction of the ferromagnetic contacts to align to the field, allowing injection of spins perpendicular to the graphene plane. A comparison of the spin signals at B=0 and B=2 T shows a 20% decrease in spin relaxation time for spins perpendicular to the graphene layer compared to spins parallel to the layer. We analyze the results in terms of the different strengths of the spin-orbit effective fields in the in-plane and out-of-plane directions and discuss the role of the Elliott-Yafet and Dyakonov-Perel mechanisms for spin relaxation. PMID:18764351

  16. Ellipsoidal Relaxation of Deformed Vesicles

    NASA Astrophysics Data System (ADS)

    Yu, Miao; Lira, Rafael B.; Riske, Karin A.; Dimova, Rumiana; Lin, Hao

    2015-09-01

    Theoretical analysis and experimental quantification on the ellipsoidal relaxation of vesicles are presented. The current work reveals the simplicity and universal aspects of this process. The Helfrich formula is shown to apply to the dynamic relaxation of moderate-to-high tension membranes, and a closed-form solution is derived which predicts the vesicle aspect ratio as a function of time. Scattered data are unified by a time scale, which leads to a similarity behavior, governed by a distinctive solution for each vesicle type. Two separate regimes in the relaxation are identified, namely, the "entropic" and the "constant-tension" regimes. The bending rigidity and the initial membrane tension can be simultaneously extracted from the data analysis, posing the current approach as an effective means for the mechanical analysis of biomembranes.

  17. A mixed relaxed clock model.

    PubMed

    Lartillot, Nicolas; Phillips, Matthew J; Ronquist, Fredrik

    2016-07-19

    Over recent years, several alternative relaxed clock models have been proposed in the context of Bayesian dating. These models fall in two distinct categories: uncorrelated and autocorrelated across branches. The choice between these two classes of relaxed clocks is still an open question. More fundamentally, the true process of rate variation may have both long-term trends and short-term fluctuations, suggesting that more sophisticated clock models unfolding over multiple time scales should ultimately be developed. Here, a mixed relaxed clock model is introduced, which can be mechanistically interpreted as a rate variation process undergoing short-term fluctuations on the top of Brownian long-term trends. Statistically, this mixed clock represents an alternative solution to the problem of choosing between autocorrelated and uncorrelated relaxed clocks, by proposing instead to combine their respective merits. Fitting this model on a dataset of 105 placental mammals, using both node-dating and tip-dating approaches, suggests that the two pure clocks, Brownian and white noise, are rejected in favour of a mixed model with approximately equal contributions for its uncorrelated and autocorrelated components. The tip-dating analysis is particularly sensitive to the choice of the relaxed clock model. In this context, the classical pure Brownian relaxed clock appears to be overly rigid, leading to biases in divergence time estimation. By contrast, the use of a mixed clock leads to more recent and more reasonable estimates for the crown ages of placental orders and superorders. Altogether, the mixed clock introduced here represents a first step towards empirically more adequate models of the patterns of rate variation across phylogenetic trees.This article is part of the themed issue 'Dating species divergences using rocks and clocks'.

  18. A mixed relaxed clock model

    PubMed Central

    2016-01-01

    Over recent years, several alternative relaxed clock models have been proposed in the context of Bayesian dating. These models fall in two distinct categories: uncorrelated and autocorrelated across branches. The choice between these two classes of relaxed clocks is still an open question. More fundamentally, the true process of rate variation may have both long-term trends and short-term fluctuations, suggesting that more sophisticated clock models unfolding over multiple time scales should ultimately be developed. Here, a mixed relaxed clock model is introduced, which can be mechanistically interpreted as a rate variation process undergoing short-term fluctuations on the top of Brownian long-term trends. Statistically, this mixed clock represents an alternative solution to the problem of choosing between autocorrelated and uncorrelated relaxed clocks, by proposing instead to combine their respective merits. Fitting this model on a dataset of 105 placental mammals, using both node-dating and tip-dating approaches, suggests that the two pure clocks, Brownian and white noise, are rejected in favour of a mixed model with approximately equal contributions for its uncorrelated and autocorrelated components. The tip-dating analysis is particularly sensitive to the choice of the relaxed clock model. In this context, the classical pure Brownian relaxed clock appears to be overly rigid, leading to biases in divergence time estimation. By contrast, the use of a mixed clock leads to more recent and more reasonable estimates for the crown ages of placental orders and superorders. Altogether, the mixed clock introduced here represents a first step towards empirically more adequate models of the patterns of rate variation across phylogenetic trees. This article is part of the themed issue ‘Dating species divergences using rocks and clocks’. PMID:27325829

  19. Molecular relaxations in amorphous phenylbutazone

    NASA Astrophysics Data System (ADS)

    Sahra, M.; Thayyil, M. Shahin; Capaccioli, S.

    2016-05-01

    Molecular dynamics of phenylbutazone in the supercooled liquid and glassy state is studied using broadband dielectric spectroscopy for test frequencies 1 kHz, 10 kHz and 100 kHz over a wide temperature range. Above the glass transition temperature Tg, the presence of the structural α-relaxation peak was observed which shifts towards lower frequencies as the temperature decreases and kinetically freezes at Tg. Besides the structural α-relaxation peak, a β-process which arises due to the localized molecular fluctuations is observed at lower temperature.

  20. Modeling post-wildfire fluvial incision and terrace formation

    NASA Astrophysics Data System (ADS)

    Rengers, F. K.; Tucker, G. E.

    2013-12-01

    Wildfires often lead to rapid erosion, sedimentation, and morphologic change. One of the challenges in developing quantitative models of post-fire landscape dynamics is a lack of high-quality datasets that document fluvial system evolution in the years to decades following a destructive fire. This study takes advantage of a natural experiment in post-fire fluvial incision to explore how the magnitude and timing of large flow events following a wildfire can change fluvial channel patterns. The study site is the Spring Creek watershed located in the foothills of central Colorado approximately 26 miles southwest of Denver, Colorado. The site burned during the Buffalo Creek wildfire, which was contained in May 1996. Within the Spring Creek watershed, 79% of the basin was burned and 63% of the burned area was considered high severity (Moody and Martin, 2001). In July 1996 a large rain storm hit the burned watershed and 110 mm of rain fell in one hour (Jarrett, 2001). This storm was larger than the estimated 100-year rainfall intensity of 60 mm/hr. Due to the increased surface erodibility after the wildfire, rapid erosion occurred within the watershed, while the main valley of Spring Creek aggraded with up to 2 m of sediment after this storm. Spring Creek has been incising through this post-wildfire sediment since the 1996 storm, and the terraces from this initial storm are still prevalent and identifiable along the valley. Repeated measurements of valley cross-sections since 1996 provide a comprehensive dataset for testing models of fluvial-system evolution on a decadal time scale. We hypothesize that the current channel pattern results from the specific sequence of rain events that occurred within the four years after the initial 1996 storm filled the valley with sediment. This hypothesis was tested using a two-dimensional coupled model of shallow-water flow, sediment transport, and topographic evolution. Discharge data were obtained from a stream gage installed at

  1. Phacoemulsification versus small incision cataract surgery in patients with uveitis

    PubMed Central

    Bhargava, Rahul; Kumar, Prachi; Sharma, Shiv Kumar; Kumar, Manoj; Kaur, Avinash

    2015-01-01

    AIM To compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract. METHODS In a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically significant. RESULTS One hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance visual acuity (CDVA) was

  2. A "bicycle-handlebar" type of incision for primary and secondary abdominoplasty.

    PubMed

    Baroudi, R; Moraes, M

    1995-01-01

    The authors register a revision of the literature regarding the types of low transversal pubic incisions used in abdominoplasty. Since 1987, the traditional open W-type incision changed to a new type called the bicycle handlebar. In this procedure, the pubic segment remains in a lower line at the level of the pubic hair, while the lateral limbs are in a high position. The anterior superior iliac spine is used as reference. Different types of procedures where the umbilical skin hole reaches the pubic incision are described and illustrated. This procedure is also used in secondary abdominoplasty. In all cases, the incision's new position should remain hidden under a bathing suit. PMID:7484469

  3. Effects of incision and irradiation on regional lymph node metastasis in carcinoma of the hamster tongue

    SciTech Connect

    Ohtake, K.; Shingaki, S.; Nakajima, T. )

    1990-07-01

    The effects of incision and irradiation on regional lymph node metastasis in DMBA-induced squamous cell carcinomas of the hamster tongue are reported. Metastasis to the submandibular lymph nodes was confirmed histologically in 48.0% of the animals. The incidence of lymph node metastasis was significantly increased (65.9%) after repeated incisions of tongue carcinomas. Three gray whole-body irradiation also increased the rate of metastasis from 31.0% to 46.3%. Higher incidences of lymphatic vessel invasion after incision and concomitant lymph node metastasis in the lymphatic invasion-positive group indicated a stepwise relationship leading to an increase in lymph node metastasis after incision. Because of the high incidence of metastases and close resemblance to human carcinomas in the tumor cell deposition and establishment of metastatic foci, DMBA-induced tongue carcinoma with invasion may serve as an experimental model of human oral carcinomas.

  4. Cochlear implantation with Pulsar Med El: a novel small incision technique.

    PubMed

    Cuda, D

    2009-04-01

    Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. Overall, 30 teen-age and adult patients were operated upon with a novel small incision (4-5 cm). Full insertion of the electrode array was achieved in all cases. No major intra-operative complications occurred. At follow-up, no flap-related complications and no migration of the receiver-stimulator were observed in the "device suture" (14 patients) or "no device suture" groups (16 patients). All patients are full-time users of the device. In conclusion, a small incision for the Pulsar Med-El cochlear implant is feasible, safe and reproducible. Ligature fixation of the device is not critical with this operation. Also with this device, in adult and teen-age patients, it is, therefore, possible to retain several typical advantages of small incision approaches.

  5. Stratigraphy of the Mississippi-Alabama shelf and the Mobile River incised-valley system

    USGS Publications Warehouse

    Kindinger, Jack G.; Balson, Peter S.; Flocks, James G.; Dalrymple, Robert W.; Boyd, Ron; Zaitlin, Brian A.

    1994-01-01

    The Holocene incised-valley fill (estuarine facies) underlying Mobile Buy fit well into the conceptual facies model of a microtidal wave-dominated estuary. The model does not fit as well, however, with the rapidly transgressed shelf portion of the incised valley. The down dip section does not contain a clearly identifiable (from seismic profiles) estuarine facies; the valley fill is primarily fluvial and is overlain by marine shoals. In the Mobile River incised valley, the distal portion of the valley was rapidly drowned, allowing the thin estuarine facies to be reworked. The proximal portion was drowned more slowly, leaving the estuarine facies intact. Thus, the single incised valley contains two very different types of fill.

  6. Late Cenozoic Colorado River Incision and Implications for Neogene Uplift of the Colorado Rockies

    NASA Astrophysics Data System (ADS)

    Aslan, A.; Karlstrom, K. E.; Kirby, E.; Heizler, M. T.

    2012-12-01

    Basalt flows and volcanic ashes serve as a datum for calculating post-10 Ma river incision rates in western Colorado. The main picture that emerges from the data is one of regional variability of incision rates, which we hypothesize to reflect differential uplift of the Colorado Rockies during the Neogene. Maximum rates (90-180 m/Ma) and magnitudes (750-1500 m) of river incision are recorded between Grand Mesa and Glenwood Canyon, and in the Flat Tops. Minimum rates (<30 m/Ma) and magnitudes (<250 m) of river incision are associated post-Laramide normal faults within the Browns Park-Sand Wash basin in northwestern Colorado and in Middle Park of north-central Colorado. Differential uplift of the Colorado Rockies during the late Cenozoic can be inferred by comparing incision rates and magnitudes at locations upstream and downstream of knickzones. Along the Colorado River, post-10 Ma incision rates and magnitudes incision remain fairly constant (rates >100 m/Ma; magnitudes >1000 m) from Grand Mesa upstream to Gore Canyon, and then decrease markedly in Middle Park (rates <10 m/Ma; magnitudes <100 m) across the Gore Canyon knickzone. Normal-faulting of ca. 10 Ma deposits in Middle Park shows that incision rate variations partly reflect late Cenozoic faulting. Along the Yampa River, post-10 Ma incision rates and magnitudes are low (rates 15-27 m/Ma; magnitudes < 230 m) immediately upstream of Yampa Canyon, and then increase significantly (rates 96-132 m/Ma; magnitudes ~1250 m) upstream near the headwaters. We interpret this upstream increase in river incision rate and magnitude to reflect Neogene uplift of the Yampa River headwaters relative to its lower reaches. Lastly, differential late Cenozoic uplift of the Colorado Rockies is suggested by differences in the timing of regional exhumation and river incision within different drainage basins. Colorado River incision and regional exhumation occurred between 9.8 and 7.8 Ma. In contrast, Yampa River incision began between

  7. HYDROLOGY OF CENTRAL GREAT BASIN MEADOW ECOSYSTEMS – EFFECTS OF STREAM INCISION

    EPA Science Inventory

    Riparian wet meadow complexes in the mountains of the central Great Basin are scarce, ecologically important systems that are threatened by stream incision. Our interdisciplinary group has investigated 1) the interrelationships of geomorphology, hydrology, and vegetation; and 2) ...

  8. Channel Incision and Suspended Sediment Delivery at Caspar Creek, Mendocino County, California.

    NASA Astrophysics Data System (ADS)

    Dewey, N. J.; Lisle, T. E.; Reid, L. M.

    2003-12-01

    Tributary and headwater valleys in the Caspar Creek watershed, in coastal Mendocino County, California, show signs of incision along much of their lengths. An episode of incision followed initial-entry logging which took place between 1860 and 1906. Another episode of incision cut into skid-trails created for second-entry logging in the 1970's. Gullies resulting from both of these episodes of incision are sensitive to hydrologic fluctuations and feature active headcuts, deepening plungepools, and unstable banks, which continue to contribute sediment to the Caspar Creek channel network. Headcuts are numerous in each channel. In some cases headcuts define the upstream extent of an incised reach; in many cases headcuts migrate up previously incised reaches, increasing the depth of incision. Surveys indicate that bank retreat, plunge pool deepening, and headcut retreat all contributed sediment to the channels between 2000 and 2003. Since bank walls have considerably more surface area than headwalls per given length of channel, and headcuts have largely migrated into positions temporarily constrained by resistant lips, bankwall retreat appears to be a more significant chronic source of sediment than headwall retreat. Stream gage records show that some channels consistently deliver higher levels of suspended sediment than others. In comparing channels, ongoing levels of suspended sediment delivery correlate well with total amount of exposed channel bank (depth of incision integrated over length of channel) in the reaches upstream of stream gages. On an annual to decadal time-scale, rates of suspended sediment delivery per unit area of catchment correlate better with the amount of exposed bank area in reaches upstream of stream gages, than with the volume of sediment delivered by landslide events, with total catchment area, or with peak storm flow per unit area. The correlation between amount of exposed bank area and ongoing levels of suspended sediment delivery is

  9. A new technique for robotic thyroidectomy: "the daVinci gasless single-incision axillary approach".

    PubMed

    Rodriguez, Francisco N S; Low, Rick A; Singer, Jeffrey A; Bornstein, Alan M; Bradford Doxey, J; Hashimoto, Luis A; Rassadi, Roozbeh; Dolce, Charles J; Hollingworth, Alexzandra; Hayes, Chester; Shively, Cynthia J

    2011-09-01

    Robotic thyroidectomy has been recently introduced as a new modality of treatment for selected benign and malignant thyroid lesions. The standard technique, popularized by a leading Korean group, combines an axillary and a thoracic approach to accomplish thyroid resection without neck incision. We recently introduced a modified technique that has enabled us to complete robotic thyroidectomy through a single axillary incision. We herein report our initial successful experience in 35 cases with the modified technique.

  10. "Stressing" Relaxation in the Classroom.

    ERIC Educational Resources Information Center

    Prager-Decker, Iris

    A rationale is offered for incorporating relaxation training in elementary school classroom activities. Cited are research studies which focus on the reaction of children to stressful life changes and resulting behavioral and physical disorders. A list is given of significant life events which may be factors in causing diseases or misbehavior in…

  11. Theory of nuclear magnetic relaxation

    NASA Technical Reports Server (NTRS)

    Mcconnell, J.

    1983-01-01

    A theory of nuclear magnetic interaction is based on the study of the stochastic rotation operator. The theory is applied explicitly to relaxation by anisotropic chemical shift and to spin-rotational interactions. It is applicable also to dipole-dipole and quadrupole interactions.

  12. Relaxation times estimation in MRI

    NASA Astrophysics Data System (ADS)

    Baselice, Fabio; Caivano, Rocchina; Cammarota, Aldo; Ferraioli, Giampaolo; Pascazio, Vito

    2014-03-01

    Magnetic Resonance Imaging is a very powerful techniques for soft tissue diagnosis. At the present, the clinical evaluation is mainly conducted exploiting the amplitude of the recorded MR image which, in some specific cases, is modified by using contrast enhancements. Nevertheless, spin-lattice (T1) and spin-spin (T2) relaxation times can play an important role in many pathology diagnosis, such as cancer, Alzheimer or Parkinson diseases. Different algorithms for relaxation time estimation have been proposed in literature. In particular, the two most adopted approaches are based on Least Squares (LS) and on Maximum Likelihood (ML) techniques. As the amplitude noise is not zero mean, the first one produces a biased estimator, while the ML is unbiased but at the cost of high computational effort. Recently the attention has been focused on the estimation in the complex, instead of the amplitude, domain. The advantage of working with real and imaginary decomposition of the available data is mainly the possibility of achieving higher quality estimations. Moreover, the zero mean complex noise makes the Least Square estimation unbiased, achieving low computational times. First results of complex domain relaxation times estimation on real datasets are presented. In particular, a patient with an occipital lesion has been imaged on a 3.0T scanner. Globally, the evaluation of relaxation times allow us to establish a more precise topography of biologically active foci, also with respect to contrast enhanced images.

  13. Distributed Relaxation for Conservative Discretizations

    NASA Technical Reports Server (NTRS)

    Diskin, Boris; Thomas, James L.

    2001-01-01

    A multigrid method is defined as having textbook multigrid efficiency (TME) if the solutions to the governing system of equations are attained in a computational work that is a small (less than 10) multiple of the operation count in one target-grid residual evaluation. The way to achieve this efficiency is the distributed relaxation approach. TME solvers employing distributed relaxation have already been demonstrated for nonconservative formulations of high-Reynolds-number viscous incompressible and subsonic compressible flow regimes. The purpose of this paper is to provide foundations for applications of distributed relaxation to conservative discretizations. A direct correspondence between the primitive variable interpolations for calculating fluxes in conservative finite-volume discretizations and stencils of the discretized derivatives in the nonconservative formulation has been established. Based on this correspondence, one can arrive at a conservative discretization which is very efficiently solved with a nonconservative relaxation scheme and this is demonstrated for conservative discretization of the quasi one-dimensional Euler equations. Formulations for both staggered and collocated grid arrangements are considered and extensions of the general procedure to multiple dimensions are discussed.

  14. Ellipsoidal relaxation of electrodeformed vesicles

    NASA Astrophysics Data System (ADS)

    Yu, Miao; Lin, Hao; Lira, Rafael; Dimova, Rumiana; Riske, Karin

    2015-11-01

    Electrodeformation has been extensively applied to investigate the mechanical behavior of vesicles and cells. While the deformation process often exhibits complex behavior and reveals interesting physics, the relaxation process post-pulsation is equally intriguing yet less frequently studied. In this work theoretical analysis and experimental quantification on the ellipsoidal relaxation of vesicles are presented, which reveal the simplicity and universal aspects of this process. The Helfrich formula, which is derived only for equilibrated shapes, is shown to be applicable to dynamic situations such as in relaxation. A closed-form solution is derived which predicts the vesicle aspect ratio as a function of time. Scattered data are unified by a timescale, which leads to a similarity behavior, governed by a distinctive solution for each vesicle type. Two separate regimes in the relaxation are identified, namely, the ``entropic'' and the ``constant-tension'' regime. The bending rigidity and the initial membrane tension can be simultaneously extracted from the data/model analysis, posing the current approach as an effective means for the mechanical analysis of biomembranes.

  15. Relaxation properties in classical diamagnetism.

    PubMed

    Carati, A; Benfenati, F; Galgani, L

    2011-06-01

    It is an old result of Bohr that, according to classical statistical mechanics, at equilibrium a system of electrons in a static magnetic field presents no magnetization. Thus a magnetization can occur only in an out of equilibrium state, such as that produced through the Foucault currents when a magnetic field is switched on. It was suggested by Bohr that, after the establishment of such a nonequilibrium state, the system of electrons would quickly relax back to equilibrium. In the present paper, we study numerically the relaxation to equilibrium in a modified Bohr model, which is mathematically equivalent to a billiard with obstacles, immersed in a magnetic field that is adiabatically switched on. We show that it is not guaranteed that equilibrium is attained within the typical time scales of microscopic dynamics. Depending on the values of the parameters, one has a relaxation either to equilibrium or to a diamagnetic (presumably metastable) state. The analogy with the relaxation properties in the Fermi Pasta Ulam problem is also pointed out.

  16. Spin relaxation in disordered media

    NASA Astrophysics Data System (ADS)

    Dzheparov, F. S.

    2011-10-01

    A review is given on theoretical grounds and typical experimental appearances of spin dynamics and relaxation in solids containing randomly distributed nuclear and/or electronic spins. Brief content is as follows. Disordered and magnetically diluted systems. General outlines of the spin transport theory. Random walks in disordered systems (RWDS). Observable values in phase spin relaxation, free induction decay (FID). Interrelation of longitudinal and transversal relaxation related to dynamics of occupancies and phases. Occupation number representation for equations of motion. Continuum media approximation and inapplicability of moment expansions. Long-range transitions vs percolation theory. Concentration expansion as a general constructive basis for analytical methods. Scaling properties of propagators. Singular point. Dynamical and kinematical memory in RWDS. Ways of regrouping of concentration expansions. CTRW and semi-phenomenology. Coherent medium approximation for nuclear relaxation via paramagnetic impurities. Combining of memory functions and cumulant expansions for calculation of FID. Path integral representations for RWDS. Numerical simulations of RWDS. Spin dynamics in magnetically diluted systems with low Zeeman and medium low dipole temperatures. Cluster expansions, regularization of dipole interactions and spectral dynamics.

  17. Relaxation properties in classical diamagnetism

    NASA Astrophysics Data System (ADS)

    Carati, A.; Benfenati, F.; Galgani, L.

    2011-06-01

    It is an old result of Bohr that, according to classical statistical mechanics, at equilibrium a system of electrons in a static magnetic field presents no magnetization. Thus a magnetization can occur only in an out of equilibrium state, such as that produced through the Foucault currents when a magnetic field is switched on. It was suggested by Bohr that, after the establishment of such a nonequilibrium state, the system of electrons would quickly relax back to equilibrium. In the present paper, we study numerically the relaxation to equilibrium in a modified Bohr model, which is mathematically equivalent to a billiard with obstacles, immersed in a magnetic field that is adiabatically switched on. We show that it is not guaranteed that equilibrium is attained within the typical time scales of microscopic dynamics. Depending on the values of the parameters, one has a relaxation either to equilibrium or to a diamagnetic (presumably metastable) state. The analogy with the relaxation properties in the Fermi Pasta Ulam problem is also pointed out.

  18. The prevalence of mandibular incisive nerve canal and to evaluate its average location and dimension in Indian population

    PubMed Central

    Ramesh, A. S.; Rijesh, K.; Sharma, Aruna; Prakash, R.; Kumar, Arun; Karthik

    2015-01-01

    Aim: The aim of this study was to find the prevalence of the mandibular incisive canal, evaluate its location and dimensions using cone beam computer tomography (CBCT) in Indian population. Materials and Methods: CBCT scan images of 120 subjects were analyzed for the presence of the mandibular incisive canal, its location, size, and its length. The distance between the incisive canal and the buccal and lingual plate of the alveolar bone, and the distance from the canal to the inferior border of the mandible were also measured to position the canal in the mandible. Results: About 71.66% of the CBCT scans of Indian subjects examined showed the presence of the Incisive canal, of which 48.33% exhibited canals bilaterally and 23.33% showed unilateral canals. 28.33% of the subjects CBCT scans did not exhibit the presence of incisive nerve canal. The average length of the incisive canal was 10.173 mm. The average diameter of the Incisive canal in the CBCT scans was 2.578 mm. The distance from the Inferior border of the mandible to (a) the origin of the Incisive canal was 9.425 mm and (b) to the apex of the Incisive canal was 9.095 mm. The distance from the buccal cortex of the mandible to (a) the origin of the incisive canal was 1.48 mm and (b) to the apex of the incisive canal was 4.476 mm. The distance from the lingual cortex of the mandible to (a) the origin of the incisive canal was 4.464 mm and (b) to the apex of the incisive canal was 5.561 mm. Conclusion: The presence, location, and dimensions of the mandibular incisive canal are an additional required data that needs to be elicited before planning an inter-foraminal placement of implants. PMID:26538925

  19. Controls on aggradation and incision in the NE Negev, Israel, since the middle Pleistocene

    DOE PAGES

    Matmon, A.; Elfasi, S.; Hidy, A. J.; Geller, Y.; Porat, N.; Team, ASTER

    2016-02-23

    Here, we investigated the mid-Pleistocene to recent aggradation-incision pattern of two drainage systems (Nahal Peres and Nahal Tahmas) in the hyperarid north eastern Negev desert, southern Israel. Although these drainage systems drain into the tectonically active Dead Sea basin, lake level fluctuations cannot account for the aggradation-incision pattern as bedrock knickpoints disconnect the investigated parts of these drainage systems from base level influence. We applied geomorphic mapping, soil stratigraphy, optically stimulated luminescence (OSL) and cosmogenic (in situ 10Be) exposure dating to reconstruct cycles of aggradation and incision of alluvial terraces and to study their temporal association with regional periods ofmore » humidity and aridity and global glacial-interglacial cycles. The spatial and temporal relationships between the alluvial units suggest changes in the drainage system behavior since the middle Pleistocene, and show a pattern in which prolonged periods of sediment aggradation alternated with short periods of rapid and intense degradation through erosion and incision into sediment and bedrock. We obtain ages for several Pleistocene-Holocene periods of incision: ~ 1.1 Ma, ~ 300 ka, ~ 120 ka, ~ 20 ka, ~ 12 ka and ~ 2 ka. Although broadly synchronous, the Nahal Peres and Nahal Tahmas systems exhibit temporal differences in aggradation and incision.« less

  20. Temperature-controlled laser-soldering system and its clinical application for bonding skin incisions.

    PubMed

    Simhon, David; Gabay, Ilan; Shpolyansky, Gregory; Vasilyev, Tamar; Nur, Israel; Meidler, Roberto; Hatoum, Ossama Abu; Katzir, Abraham; Hashmonai, Moshe; Kopelman, Doron

    2015-01-01

    Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing. PMID:26720882

  1. Temperature-controlled laser-soldering system and its clinical application for bonding skin incisions

    NASA Astrophysics Data System (ADS)

    Simhon, David; Gabay, Ilan; Shpolyansky, Gregory; Vasilyev, Tamar; Nur, Israel; Meidler, Roberto; Hatoum, Ossama Abu; Katzir, Abraham; Hashmonai, Moshe; Kopelman, Doron

    2015-12-01

    Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing.

  2. Evaluation of four suture materials for surgical incision closure in Siberian sturgeon

    USGS Publications Warehouse

    Boone, S. Shaun; Hernandez, Sonia M.; Camus, Alvin C.; Peterson, Douglas C.; Jennings, Cecil A.; Shelton, James L.; Divers, Stephen J.

    2015-01-01

    The visual and microscopic tissue reactions to the absorbable monofilament Monocryl, absorbable monofilament triclosan-coated Monocryl-Plus, absorbable multifilament Vicryl, and nonabsorbable monofilament Prolene were evaluated for their use of surgical closure in Siberian Sturgeon Acipenser baerii. Postoperative assessments were conducted at 1, 2, 8, 12, and 26 and 55 weeks to visually evaluate the surgical incision for suture retention, incision healing, erythema, and swelling. Incisions were also assessed microscopically at 1, 2, and 8 weeks for necrosis, inflammation, hemorrhage, and fibroplasia. The results indicated that incisions closed with either Vicryl or Prolene suture materials were more likely to exhibit more erythema or incomplete healing compared with those closed with Monocryl or Monocryl-Plus. The surgical implantation of a transmitter in the coelomic cavity did not significantly affect the response variables among the four suture materials. Monocryl or Monocryl-Plus were equally effective and superior to other suture materials used for closing surgical incisions in Siberian Sturgeon or closely related species of sturgeon. Furthermore, Monocryl or Monocryl-Plus may decrease the risk of transmitter expulsion through the incision, as surgical wounds appear to heal faster and exhibit less erythema compared with those closed with Vicryl.

  3. Watershed-scale modeling of streamflow change in incised montane meadows

    USGS Publications Warehouse

    Essaid, Hedeff I.; Hill, Barry R.

    2014-01-01

    Land use practices have caused stream channel incision and water table decline in many montane meadows of the Western United States. Incision changes the magnitude and timing of streamflow in water supply source watersheds, a concern to resource managers and downstream water users. The hydrology of montane meadows under natural and incised conditions was investigated using watershed simulation for a range of hydrologic conditions. The results illustrate the interdependence between: watershed and meadow hydrology; bedrock and meadow aquifers; and surface and groundwater flow through the meadow for the modeled scenarios. During the wet season, stream incision resulted in less overland flow and interflow and more meadow recharge causing a net decrease in streamflow and increase in groundwater storage relative to natural meadow conditions. During the dry season, incision resulted in less meadow evapotranspiration and more groundwater discharge to the stream causing a net increase in streamflow and a decrease in groundwater storage relative to natural meadow conditions. In general, for a given meadow setting, the magnitude of change in summer streamflow and long-term change in watershed groundwater storage due to incision will depend on the combined effect of: reduced evapotranspiration in the eroded meadow; induced groundwater recharge; replenishment of dry season groundwater storage depletion in meadow and bedrock aquifers by precipitation during wet years; and groundwater storage depletion that is not replenished by precipitation during wet years.

  4. Equivalent Relaxations of Optimal Power Flow

    SciTech Connect

    Bose, S; Low, SH; Teeraratkul, T; Hassibi, B

    2015-03-01

    Several convex relaxations of the optimal power flow (OPF) problem have recently been developed using both bus injection models and branch flow models. In this paper, we prove relations among three convex relaxations: a semidefinite relaxation that computes a full matrix, a chordal relaxation based on a chordal extension of the network graph, and a second-order cone relaxation that computes the smallest partial matrix. We prove a bijection between the feasible sets of the OPF in the bus injection model and the branch flow model, establishing the equivalence of these two models and their second-order cone relaxations. Our results imply that, for radial networks, all these relaxations are equivalent and one should always solve the second-order cone relaxation. For mesh networks, the semidefinite relaxation and the chordal relaxation are equally tight and both are strictly tighter than the second-order cone relaxation. Therefore, for mesh networks, one should either solve the chordal relaxation or the SOCP relaxation, trading off tightness and the required computational effort. Simulations are used to illustrate these results.

  5. A Precise 6 Ma Start Date for Fluvial Incision of the Northeastern Colorado Plateau Canyonlands

    NASA Astrophysics Data System (ADS)

    Thomson, S. N.; Soreghan, G. S.; Reiners, P. W.; Peyton, S. L.; Murray, K. E.

    2015-12-01

    Outstanding questions regarding late Cenozoic Colorado Plateau landscape evolution include: (1) the relative roles of isostatic rebound as result Colorado River incision versus longer-term geodynamic processes in driving overall rock uplift of the plateau; and (2) whether incision was triggered by river integration or by a change in deep-seated mantle lithosphere dynamics. A key to answering these questions is to date more precisely the onset of incision to refine previous estimates of between 6 and 10 Ma. We present new low-temperature thermochronologic results from bedrock and deep borehole samples in the northeastern Colorado Plateau to show that rapid river incision began here at 6 Ma (5.93±0.66 Ma) with incision rates increasing from 15-50 m/Myr to 160-200 m/Myr. The onset time is constrained independently by both inverse time-temperature modeling and by the break-in-slope in fission track age-elevation relationships. This new time constraint has several important implications. First, the coincidence in time with 5.97-5.3 Ma integration of the lower Colorado River through the Grand Canyon to the Gulf of California strongly favors downstream river integration triggering carving of the canyonlands of the upper Colorado River system. Second, it implies integration of the entire Colorado River system in less than 2 million years. Third, rock uplift of the plateau driven by the flexural isostatic response to river incision is restricted to just the last 6 Ma, as is associated increased sediment budget. Fourth, incision starting at 6 Ma means that previous estimates of upper Colorado River incision rates based on 10-12 Ma basalt datum levels are too low. This also changes the dependency of measured time interval on incision rate from a non-steady-state negative power-law dependence (exponent of -0.24) to a near steady-state dependence (exponent of 0.07) meaning that long-term upper Colorado river incision rates can provide a reliable proxy for rock uplift rates.

  6. Relaxation Models for Glassy Systems

    NASA Astrophysics Data System (ADS)

    Ajay

    In this thesis we explore some models based on constrained dynamics to understand the origin and ubiquity of the stretched exponential relaxation q(t) = exp(-(t/tau)^{ beta}). The first chapter has a pedagogical introduction to this field. Then we explore two models based primarily on constraints to see whether they would exhibit a stretched exponential relaxation. The first is a sliding block type of model based on a child's puzzle which has blocks and vacancies. The blocks can move only when they are nearest neighbor to a vacancy. We simulate random walk of the blocks and explore the relaxation behavior to equilibrium. We obtain three regimes of relaxation. In the short time regime (where the constraints are strong) we see a stretched exponential behavior. The intermediate time regime is best described as a simple random walk and we obtain a power law (with exponent 1/2). The long time behavior is a simple exponential, as expected. We do a Monte Carlo simulation of random walk on a bond-diluted hypercube. The site-diluted version of this model was suggested by Campbell as an explanation of the relaxation behavior seen in spin glasses. We come to it from the perspective of a system which exemplifies only constraints and nothing else (we have hard constraints with {cal H} = 0). We see that the relaxation to equilibrium is exponential for all p >=q 1/2 and below that it is a stretched exponential. In fact, the beta decreases as p decreases and attains a value of 1/4 at the percolation threshold of p = 1/n, where n is the dimensionality of the hypercube. We also do a calculation for determining the probability of connectivity for finite graphs. This demonstrates that the usual numerical results provided in graph theory, which are in the limit of infinite graphs, are not accurate for finite graphs. The final chapter has a conclusion. We also propose a model based on random graphs and percolation for studying sliding block kind of models.

  7. Restricting query relaxation through user constraints

    SciTech Connect

    Gaasterland, T.

    1993-07-01

    This paper describes techniques to restrict and to heuristically control relaxation of deductive database queries. The process of query relaxation provides a user with a means to automatically identify new queries that are related to the user`s original query. However, for large databases, many relaxations may be possible. The methods to control and restrict the relaxation process introduced in this paper focus the relaxation process and make it more efficient. User restrictions over the data base domain may be expressed as user constraints. This paper describes how user constraints can restrict relaxed queries. Also, a set of heuristics based on cooperative answering techniques are presented for controlling the relaxation process. Finally, the interaction of the methods for relaxing queries, processing user constraints, and applying the heuristic rules is described.

  8. SU-E-T-536: Inhomogeneity Correction in Planning of Gamma Knife Treatments for Acoustic Schwannoma

    SciTech Connect

    Lu, L; Gupta, N; Hessler, J; Liu, A; Weldon, M; McGregor, J; Ammirati, M; Guiou, M; Xia, F; Grecula, J

    2014-06-01

    Purpose: To find out the dose difference on targets and organs at risk for the treatment of acoustic schwannoma if the inhomogeneity correction (Convolution algorithm) is applied. Methods: Images of patients treated for acoustic schwannoma with Gamma Knife using TMR 10 algorithm were retrieved from database and replanned with Convolution and TMR 10 algorithm respectively. These patients were treated using a preplan scheme in following: (1) Before the actual treatment day, using the MRI image that was taken without a head frame on the patient's skull, a pre-treatment plan was made based on the default skull coordinates in the Gamma Knife treatment planning system (LGP); (2) then on treatment day, a head frame was placed on the patient's skull, and a CT image was taken. The CT image with head frame was registered and fused with the completed preplan; (3) the treatment plan was finalized and the treatment was delivered. To find out the dosimetry impact of inhomogeneity correction, we used the retrieved CT images to replan the treatment using Convolution algorithm in LGP software version 10.1.1. The dose distributions and the dose volume histograms for targets and OARs were compared for these two dose calculation algorithms. Results: The dose calculated with the Convolution algorithm in general is slightly lower than the one from TMR 10 around the boney area. The effect from the inhomogeneity correction is observable but not significant, and varies with the location of the tumor. Conclusion: Inhomogeneity correction slightly improve the dose accuracy for acoustic schwannoma Gamma Knife treatments although the correction may not be very significant. Our Result provides evidence for dose prescription adjustment to treat acoustic schwannoma. The actual clinical outcome of switching from using TMR10 to using Convolution needs to be further investigated.

  9. Implementation of Monte Carlo Dose calculation for CyberKnife treatment planning

    NASA Astrophysics Data System (ADS)

    Ma, C.-M.; Li, J. S.; Deng, J.; Fan, J.

    2008-02-01

    Accurate dose calculation is essential to advanced stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) especially for treatment planning involving heterogeneous patient anatomy. This paper describes the implementation of a fast Monte Carlo dose calculation algorithm in SRS/SRT treatment planning for the CyberKnife® SRS/SRT system. A superposition Monte Carlo algorithm is developed for this application. Photon mean free paths and interaction types for different materials and energies as well as the tracks of secondary electrons are pre-simulated using the MCSIM system. Photon interaction forcing and splitting are applied to the source photons in the patient calculation and the pre-simulated electron tracks are repeated with proper corrections based on the tissue density and electron stopping powers. Electron energy is deposited along the tracks and accumulated in the simulation geometry. Scattered and bremsstrahlung photons are transported, after applying the Russian roulette technique, in the same way as the primary photons. Dose calculations are compared with full Monte Carlo simulations performed using EGS4/MCSIM and the CyberKnife treatment planning system (TPS) for lung, head & neck and liver treatments. Comparisons with full Monte Carlo simulations show excellent agreement (within 0.5%). More than 10% differences in the target dose are found between Monte Carlo simulations and the CyberKnife TPS for SRS/SRT lung treatment while negligible differences are shown in head and neck and liver for the cases investigated. The calculation time using our superposition Monte Carlo algorithm is reduced up to 62 times (46 times on average for 10 typical clinical cases) compared to full Monte Carlo simulations. SRS/SRT dose distributions calculated by simple dose algorithms may be significantly overestimated for small lung target volumes, which can be improved by accurate Monte Carlo dose calculations.

  10. Verification of Gamma Knife extend system based fractionated treatment planning using EBT2 film

    SciTech Connect

    Natanasabapathi, Gopishankar; Bisht, Raj Kishor

    2013-12-15

    Purpose: This paper presents EBT2 film verification of fractionated treatment planning with the Gamma Knife (GK) extend system, a relocatable frame system for multiple-fraction or serial multiple-session radiosurgery.Methods: A human head shaped phantom simulated the verification process for fractionated Gamma Knife treatment. Phantom preparation for Extend Frame based treatment planning involved creating a dental impression, fitting the phantom to the frame system, and acquiring a stereotactic computed tomography (CT) scan. A CT scan (Siemens, Emotion 6) of the phantom was obtained with following parameters: Tube voltage—110 kV, tube current—280 mA, pixel size—0.5 × 0.5 and 1 mm slice thickness. A treatment plan with two 8 mm collimator shots and three sectors blocking in each shot was made. Dose prescription of 4 Gy at 100% was delivered for the first fraction out of the two fractions planned. Gafchromic EBT2 film (ISP Wayne, NJ) was used as 2D verification dosimeter in this process. Films were cut and placed inside the film insert of the phantom for treatment dose delivery. Meanwhile a set of films from the same batch were exposed from 0 to 12 Gy doses for calibration purposes. An EPSON (Expression 10000 XL) scanner was used for scanning the exposed films in transparency mode. Scanned films were analyzed with inhouse written MATLAB codes.Results: Gamma index analysis of film measurement in comparison with TPS calculated dose resulted in high pass rates >90% for tolerance criteria of 1%/1 mm. The isodose overlay and linear dose profiles of film measured and computed dose distribution on sagittal and coronal plane were in close agreement.Conclusions: Through this study, the authors propose treatment verification QA method for Extend frame based fractionated Gamma Knife radiosurgery using EBT2 film.

  11. Technical Note: PRESAGE three-dimensional dosimetry accurately measures Gamma Knife output factors

    PubMed Central

    Klawikowski, Slade J.; Yang, James N.; Adamovics, John; Ibbott, Geoffrey S.

    2014-01-01

    Small-field output factor measurements are traditionally very difficult because of steep dose gradients, loss of lateral electronic equilibrium, and dose volume averaging in finitely sized detectors. Three-dimensional (3D) dosimetry is ideal for measuring small output factors and avoids many of these potential challenges of point and two-dimensional detectors. PRESAGE 3D polymer dosimeters were used to measure the output factors for the 4 mm and 8 mm collimators of the Leksell Perfexion Gamma Knife radiosurgery treatment system. Discrepancies between the planned and measured distance between shot centers were also investigated. A Gamma Knife head frame was mounted onto an anthropomorphic head phantom. Special inserts were machined to hold 60 mm diameter, 70 mm tall cylindrical PRESAGE dosimeters. The phantom was irradiated with one 16 mm shot and either one 4 mm or one 8 mm shot, to a prescribed dose of either 3 Gy or 4 Gy to the 50% isodose line. The two shots were spaced between 30 mm and 60 mm apart and aligned along the central axis of the cylinder. The Presage dosimeters were measured using the DMOS-RPC optical CT scanning system. Five independent 4 mm output factor measurements fell within 2% of the manufacturer’s Monte Carlo simulation-derived nominal value, as did two independent 8 mm output factor measurements. The measured distances between shot centers varied by ± 0.8 mm with respect to the planned shot displacements. On the basis of these results, we conclude that PRESAGE dosimetry is excellently suited to quantify the difficult-to-measure Gamma Knife output factors. PMID:25368961

  12. Clinical Evaluation of Targeting Accuracy of Gamma Knife Radiosurgery in Trigeminal Neuralgia

    SciTech Connect

    Massager, Nicolas Abeloos, Laurence; Devriendt, Daniel; Op de Beeck, Marc; Levivier, Marc

    2007-12-01

    Purpose: The efficiency of radiosurgery is related to its highly precise targeting. We assessed clinically the targeting accuracy of radiosurgical treatment with the Leksell Gamma Knife for trigeminal neuralgia. We also studied the applied radiation dose within the area of focal contrast enhancement on the trigeminal nerve root following radiosurgery. Methods and Materials: From an initial group of 78 patients with trigeminal neuralgia treated with gamma knife radiosurgery using a 90-Gy dose, we analyzed a subgroup of 65 patients for whom 6-month follow-up MRI showed focal contrast enhancement of the trigeminal nerve. Follow-up MRI was spatially coregistered to the radiosurgical planning MRI. Target accuracy was assessed from deviation of the coordinates of the intended target compared with the center of enhancement on postoperative MRI. Radiation dose delivered at the borders of contrast enhancement was evaluated. Results: The median deviation of the coordinates between the intended target and the center of contrast enhancement was 0.91 mm in Euclidean space. The radiation doses fitting within the borders of the contrast enhancement of the trigeminal nerve root ranged from 49 to 85 Gy (median value, 77 {+-} 8.7 Gy). Conclusions: The median deviation found in clinical assessment of gamma knife treatment for trigeminal neuralgia is low and compatible with its high rate of efficiency. Focal enhancement of the trigeminal nerve after radiosurgery occurred in 83% of our patients and was not associated with clinical outcome. Focal enhancement borders along the nerve root fit with a median dose of 77 {+-} 8.7 Gy.

  13. Plasmon-mediated energy relaxation in graphene

    NASA Astrophysics Data System (ADS)

    Ferry, D. K.; Somphonsane, R.; Ramamoorthy, H.; Bird, J. P.

    2015-12-01

    Energy relaxation of hot carriers in graphene is studied at low temperatures, where the loss rate may differ significantly from that predicted for electron-phonon interactions. We show here that plasmons, important in the relaxation of energetic carriers in bulk semiconductors, can also provide a pathway for energy relaxation in transport experiments in graphene. We obtain a total loss rate to plasmons that results in energy relaxation times whose dependence on temperature and density closely matches that found experimentally.

  14. Plasmon-mediated energy relaxation in graphene

    SciTech Connect

    Ferry, D. K.; Somphonsane, R.; Ramamoorthy, H.; Bird, J. P.

    2015-12-28

    Energy relaxation of hot carriers in graphene is studied at low temperatures, where the loss rate may differ significantly from that predicted for electron-phonon interactions. We show here that plasmons, important in the relaxation of energetic carriers in bulk semiconductors, can also provide a pathway for energy relaxation in transport experiments in graphene. We obtain a total loss rate to plasmons that results in energy relaxation times whose dependence on temperature and density closely matches that found experimentally.

  15. Viscoelastic Relaxation of Lunar Basins

    NASA Astrophysics Data System (ADS)

    Mohit, P. S.; Phillips, R. J.

    2004-12-01

    The large lunar impact basins provide a unique glimpse into early lunar history. Here we investigate the possibility that the relief of the oldest lunar basins (with the exception of South-Pole Aitken) has decayed through viscous relaxation. We identify nine ancient multi-ring basins with very low relief and low-amplitude Bouguer and free-air gravity anomalies. The characteristics of these basins are consistent with either 1) relaxation of topographic relief by ductile flow (e.g. Solomon et al., 1982) or 2) obliteration of basin topography during crater collapse immediately following impact. Both scenarios require that the basins formed early in lunar history, when the Moon was hot. The latter possibility appears to be unlikely due to the great topographic relief of South Pole-Aitken basin (SPA), the largest and oldest impact basin on the Moon (with the possible exception of the putative Procellarum basin; Wilhelms, 1987). On the other hand, the thin crust beneath SPA may not have allowed ductile flow in its lower portions, even for a hot Moon, implying that a thicker crust is required beneath other ancient basins for the hypothesis of viscous relaxation to be tenable. Using a semi-analytic, self-gravitating viscoelastic model, we investigate the conditions necessary to produce viscous relaxation of lunar basins. We model topographic relaxation for a crustal thickness of 30 km, using a dry diabase flow law for the crust and dry olivine for the mantle. We find that the minimum temperature at the base of the crust (Tb) permitting nearly complete relaxation of topography by ductile flow on a timescale < 108 yrs is 1400 K, corresponding to a heat flow of 55mW/m2, into the crust. Ductile flow in the lower crust becomes increasingly difficult as the crustal thickness decreases. The crust beneath SPA, thinned by the impact, is only 15-20 km thick and would require Tb ≥ 1550 K for relaxation to occur. The fact that SPA has maintained high-amplitude relief suggests that

  16. Kinetic activation-relaxation technique.

    PubMed

    Béland, Laurent Karim; Brommer, Peter; El-Mellouhi, Fedwa; Joly, Jean-François; Mousseau, Normand

    2011-10-01

    We present a detailed description of the kinetic activation-relaxation technique (k-ART), an off-lattice, self-learning kinetic Monte Carlo (KMC) algorithm with on-the-fly event search. Combining a topological classification for local environments and event generation with ART nouveau, an efficient unbiased sampling method for finding transition states, k-ART can be applied to complex materials with atoms in off-lattice positions or with elastic deformations that cannot be handled with standard KMC approaches. In addition to presenting the various elements of the algorithm, we demonstrate the general character of k-ART by applying the algorithm to three challenging systems: self-defect annihilation in c-Si (crystalline silicon), self-interstitial diffusion in Fe, and structural relaxation in a-Si (amorphous silicon).

  17. Models of violently relaxed galaxies

    NASA Astrophysics Data System (ADS)

    Merritt, David; Tremaine, Scott; Johnstone, Doug

    1989-02-01

    The properties of spherical self-gravitating models derived from two distribution functions that incorporate, in a crude way, the physics of violent relaxation are investigated. The first distribution function is identical to the one discussed by Stiavelli and Bertin (1985) except for a change in the sign of the 'temperature', i.e., e exp(-aE) to e exp(+aE). It is shown that these 'negative temperature' models provide a much better description of the end-state of violent relaxation than 'positive temperature' models. The second distribution function is similar to the first except for a different dependence on angular momentum. Both distribution functions yield single-parameter families of models with surface density profiles very similar to the R exp 1/4 law. Furthermore, the central concentration of models in both families increases monotonically with the velocity anisotropy, as expected in systems that formed through cold collapse.

  18. Localized relaxation in stabilized zirconia

    NASA Astrophysics Data System (ADS)

    Ohta, M.; Kirimoto, K.; Nobugai, K.; Wigmore, J. K.; Miyasato, T.

    2002-05-01

    Stabilized zirconia is well known for long-range transport of oxygen ions which is caused by diffusion relaxation of oxygen vacancies. We used torsional vibrations to measure the temperature dependence of internal friction in yttria-stabilized zirconia (YSZ) doped with 9.5 mol% Y 2O 3 and calcia-stabilized zirconia (CSZ) doped with 12 mol% CaO. In the temperature range 300- 700 K, the internal friction peak exhibits anisotropy, different in YSZ from CSZ, which we attribute to localized relaxation of oxygen vacancies. The results imply that some oxygen vacancies are bound within the local structure, a greater number in CSZ than in YSZ, and suggest that the defect symmetry of local structure depends on the type of dopant ion.

  19. Initial Experience Using Closed Incision Negative Pressure Therapy after Immediate Postmastectomy Breast Reconstruction.

    PubMed

    Gabriel, Allen; Sigalove, Steven R; Maxwell, G Patrick

    2016-07-01

    Although immediate postmastectomy breast reconstruction is favored over delayed reconstruction, it remains associated with high complication rates. Potential complications include seroma formation, dehiscence, infection, and tissue necrosis along incision edges. Closed incision negative pressure therapy (ciNPT; Prevena Incision Management System, KCI, an Acelity company, San Antonio, Tex.) has been reported to help hold incision edges together, protect incisions from external contamination, and remove fluid and infectious material. We investigated outcomes of applying ciNPT with a customizable dressing over closed incisions in 13 patients (25 breasts) who received immediate postmastectomy reconstruction as part of 2-stage expander/implant breast reconstruction. Nipple-sparing mastectomy was performed on 14 breasts, reduction-pattern mastectomy on 6 breasts, and skin-sparing mastectomy on 5 breasts. All breasts had ciNPT with a customizable dressing applied over the entire clean closed incision immediately after surgery at -125 mmHg for an average of 4.3 days. At 3-month follow-up, 24 of the 25 (96%) breasts had achieved healing. Delayed hematoma occurred on postoperative day 13 in 1 breast in the nipple-sparing mastectomy group and resolved. In the reduction-pattern mastectomy group, superficial dehiscence occurred on 3 breasts and resolved with local wound care. One breast in that group developed flap necrosis requiring surgical revision. Less drainage was observed in attached closed-suction drains, so time to drain removal was reduced from an estimated average of 12-14 days to 8.2 days. Based on the initial experience in this study, larger studies are warranted to evaluate the use of ciNPT with customizable or peel-and-place dressings after immediate postmastectomy breast reconstruction. PMID:27536498

  20. Cephalad-caudad versus transverse blunt expansion of the low transverse uterine incision during cesarean delivery.

    PubMed

    Xodo, Serena; Saccone, Gabriele; Cromi, Antonella; Ozcan, Pinar; Spagnolo, Emanuela; Berghella, Vincenzo

    2016-07-01

    It is imperative to have evidence-based guidelines for cesarean delivery. The aim of this meta-analysis was to evaluate the effectiveness of a cephalad-caudad compared to transverse blunt expansion of the uterine incision to reduce blood loss in women who underwent low-segment transverse cesarean delivery. We therefore performed a systematic search in electronic databases from their inception until March 2016. We included all randomized trials comparing cephalad-caudad versus transverse (control group) blunt expansion of the uterine incision in women who underwent a low transverse cesarean delivery. The primary outcome was postpartum blood loss, defined as the mean amount of blood loss (mL). Two trials (921 women) were analyzed. After the transverse uterine incision in the lower uterine segment with the scalpel, the uterine incision was then bluntly expanded by the designated method. Blunt expansion of the primary incision was derived by placing the index fingers of the operating surgeon into the incision and pulling the fingers apart laterally (transverse group) or cephalad (cephalad-caudad group). Women who were randomized in the cephalad-caudad group had lower: mean of postpartum blood loss, hemoglobin drop and hematocrit drop 24h after cesarean, unintended extension, uterine vessels injury, blood loss >1500mL and need for additional stitches. There was no statistically significant difference in the incidence of blood loss >1000mL, in the operating time and in post-operative pain. In conclusion, expansion of the uterine incision with fingers in a cephalad-caudad direction is associated with better maternal outcomes and, therefore, should be preferred to transverse expansion during a cesarean delivery. PMID:27180273

  1. Effect of Corneal Incision Enlargement on Surgically Induced Astigmatism in Biaxial Microincision Cataract Surgery

    PubMed Central

    Tetikoğlu, Mehmet; Yeter, Celal; Helvacıoğlu, Fırat; Aktaş, Serdar; Sağdık, Hacı Murat; Özcura, Fatih

    2016-01-01

    Objectives: To evaluate surgically induced astigmatism (SIA) in biaxial microincision cataract surgery with enlargement of one corneal incision during intraocular lens implantation (IOL). Materials and Methods: Data from 683 eyes with cataract that underwent biaxial microincision cataract surgery and IOL were retrospectively analyzed. The operated eyes were divided into 4 groups defined by final corneal incision length after IOL implantation. There were 83 eyes with 1.6 mm corneal incisions (group 1) and 200 eyes in each of the 2, 2.4, and 2.8 mm corneal incision groups (groups 2, 3 and 4, respectively). SIA was assessed using preoperative and postoperative keratometric values at one month. Results: The mean magnitude of SIA was 0.83±0.4 D in group 1, 0.93±0.5 D in group 2, 1.03±0.6 D in group 3 and 1.04±0.7 D in group 4. The SIA showed statistically significant differences between the four groups (p=0.05). Pairwise group comparisons revealed significant differences between groups 1 and 3 and groups 1 and 4 (p=0.005). Conclusion: Biaxial microincision cataract surgery with an incision size of 1.6 mm resulted in the least SIA. Enlargement of the corneal incision beyond 2.0 mm during IOL implantation led to significant increases in SIA. We believe that with the development and dissemination of IOLs which can be inserted through small corneal incisions, biaxial microincision cataract surgery will be the best choice to prevent SIA and increase visual acuity. PMID:27800270

  2. Initial Experience Using Closed Incision Negative Pressure Therapy after Immediate Postmastectomy Breast Reconstruction

    PubMed Central

    Sigalove, Steven R.; Maxwell, G. Patrick

    2016-01-01

    Summary: Although immediate postmastectomy breast reconstruction is favored over delayed reconstruction, it remains associated with high complication rates. Potential complications include seroma formation, dehiscence, infection, and tissue necrosis along incision edges. Closed incision negative pressure therapy (ciNPT; Prevena Incision Management System, KCI, an Acelity company, San Antonio, Tex.) has been reported to help hold incision edges together, protect incisions from external contamination, and remove fluid and infectious material. We investigated outcomes of applying ciNPT with a customizable dressing over closed incisions in 13 patients (25 breasts) who received immediate postmastectomy reconstruction as part of 2-stage expander/implant breast reconstruction. Nipple-sparing mastectomy was performed on 14 breasts, reduction-pattern mastectomy on 6 breasts, and skin-sparing mastectomy on 5 breasts. All breasts had ciNPT with a customizable dressing applied over the entire clean closed incision immediately after surgery at −125 mmHg for an average of 4.3 days. At 3-month follow-up, 24 of the 25 (96%) breasts had achieved healing. Delayed hematoma occurred on postoperative day 13 in 1 breast in the nipple-sparing mastectomy group and resolved. In the reduction-pattern mastectomy group, superficial dehiscence occurred on 3 breasts and resolved with local wound care. One breast in that group developed flap necrosis requiring surgical revision. Less drainage was observed in attached closed-suction drains, so time to drain removal was reduced from an estimated average of 12–14 days to 8.2 days. Based on the initial experience in this study, larger studies are warranted to evaluate the use of ciNPT with customizable or peel-and-place dressings after immediate postmastectomy breast reconstruction. PMID:27536498

  3. Climate and lithological control on fluvial bedrock incision in an active mountain belt

    NASA Astrophysics Data System (ADS)

    Hartshorn, K.; Hovius, N.; Dade, W. B.; Slingerland, R.

    2003-04-01

    Of all geomorphological processes, the creation of mountain landscapes is among the most spectacular. Tectonic uplift, climate, and denudation of active mountain belts are in themselves large-scale processes, but the link between these, bedrock river channel incision, can be measured at the rate of millimetres per year. Fluvial bedrock incision creates relief, controls local base-level, and drives mass wasting of adjacent hillslopes. Key questions in the study of fluvial bedrock incision include the mechanisms and processes driving fluvial bedrock incision, and how bedrock incision shapes relief and affects local hillslopes. The focus of this study is on precise real-time measurement of bedrock incision rates, observation of wear styles, processes and distribution in bedrock channels, and connection between bedrock channel erosion and the surrounding landscapes. Erosion rates were measured in three lithologies over two wet seasons and two dry seasons in a catchment in the eastern Central Mountain Range in Taiwan. As well as keeping pace with longer-term estimations of uplift and denudation, our results show variable patterns of wear style and distribution under different flow conditions. Rare, large floods tend to widen the channel, while common low to moderate flows incise and deepen the channel. We also observe a strong lithological control on process and style of wear, which in turn affects the resulting geometry of the bedrock channel. Narrower, steeper channels tend to be associated with massive lithologies, and wider channels with foliated or jointed lithologies. Both of these observations have implications for connection of the bedrock channel to the adjacent hillslopes, and therefore control in some part the process of hillslope mass-wasting.

  4. Measurement of Gaussian laser beam radius using the knife-edge technique: improvement on data analysis

    SciTech Connect

    Araujo, Marcos A. de; Silva, Rubens; Lima, Emerson de; Pereira, Daniel P.; Oliveira, Paulo C. de

    2009-01-10

    We revisited the well known Khosrofian and Garetz inversion algorithm [Appl. Opt.22, 3406-3410 (1983)APOPAI0003-6935] that was developed to analyze data obtained by the application of the traveling knife-edge technique. We have analyzed the approximated fitting function that was used for adjusting their experimental data and have found that it is not optimized to work with a full range of the experimentally-measured data. We have numerically calculated a new set of coefficients, which makes the approximated function suitable for a full experimental range, considerably improving the accuracy of the measurement of a radius of a focused Gaussian laser beam.

  5. Phantom Positioning Variation in the Gamma Knife® Perfexion Dosimetry

    NASA Astrophysics Data System (ADS)

    Costa, N. A.; Potiens, M. P. A.; Saraiva, C. W. C.

    2016-07-01

    The use of small volume ionization chamber has become required for the dosimetry of equipments that use small radiation fields such as the Gamma Knife® Perfexion (GKP) unit. In this work, a pinpoint ionization chamber was inserted into the dosimetry phantom and measurements were performed with the phantom in different positions, in order to verify if the change in the phantom positioning affects the dosimetry of the GKP. Four different phantom positions were performed. The variation in the result is within the range allowed for the dosimetry of a GKP equipment.

  6. X-ray Phase Imaging Microscopy with Two-Dimensional Knife-Edge Filters

    NASA Astrophysics Data System (ADS)

    Choi, Jaeho; Park, Yong-Sung

    2012-04-01

    A novel scheme of X-ray differential phase imaging was implemented with an array source and a two-dimensional Foucault knife-edge (2DFK). A pinhole array lens was employed to manipulate the X-ray beam on the Fourier space. An emerging biaxial scanning procedure was also demonstrated with the periodic 2DFK. The differential phase images (DPIs) of the midrib in a leaf of a rose bush were visualized to verify the phase imaging of biological specimens by the proposed method. It also has features of depicting multiple-stack phase images, and rendering morphological DPIs, because it acquires pure phase information.

  7. Fractionated Stereotactic Gamma Knife Radiosurgery for Medial Temporal Lobe Epilepsy: A Case Report

    PubMed Central

    Park, Hye Ran; Chung, Hyun-Tai; Lee, Sang Kun; Kim, Dong Gyu

    2016-01-01

    An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE. PMID:27122996

  8. Radiation shielding evaluation based on five years of data from a busy CyberKnife center.

    PubMed

    Yang, Jun; Feng, Jing

    2014-11-08

    We examined the adequacy of existing shielding guidelines using five-year clinical data from a busy CyberKnife center. From June 2006 through July 2011, 1,370 patients were treated with a total of 4,900 fractions and 680,691 radiation beams using a G4 CyberKnife. Prescription dose and total monitor units (MU) were analyzed to estimate the shielding workload and modulation factor. In addition, based on the beam's radiation source position, targeting position, MU, and beam collimator size, the MATLAB program was used to project each beam toward the shielding barrier. The summation of the projections evaluates the distribution of the shielding load. On average, each patient received 3.6 fractions, with an average 9.1 Gy per fraction prescribed at the 71.1% isodose line, using 133.7 beams and 6,200 MU. Intracranial patients received an average of 2.7 fractions, with 8.6 Gy per fraction prescribed at the 71.4% isodose line, using 133 beams and 5,083 MU. Extracranial patients received an average of 3.94 fractions, with 9.2 Gy per frac- tion prescribed at the 71% isodose line, using 134 beams and 6,514 MU. Most- used collimator sizes for intracranial patients were smaller (7.5 to 20 mm) than for extracranial patients (20 to 40 mm). Eighty-five percent of the beams exited through the floor, and about 40% of the surrounding wall area received no direct beam. For the rest of the wall, we found "hot" areas that received above-average MU. The locations of these areas were correlated with the projection of the nodes for extracranial treatments. In comparison, the beam projections on the wall were more spread for intracranial treatments. The maximum MU any area received from intracranial treatment was less than 0.25% of total MU used for intracranial treatments, and was less than 1.2% of total MU used for extracranial treatments. The combination of workload, modulation factor, and use factor in our practice are about tenfold less than recommendations in the existing CyberKnife

  9. Benchmark Experiment of Dose Rate Distributions Around the Gamma Knife Medical Apparatus

    NASA Astrophysics Data System (ADS)

    Oishi, K.; Kosako, K.; Kobayashi, Y.; Sonoki, I.

    2014-06-01

    Dose rate measurements around a gamma knife apparatus were performed by using an ionization chamber. Analyses have been performed by using the Monte Carlo code MCNP-5. The nuclear library used for the dose rate distribution of 60Co was MCPLIB04. The calculation model was prepared with a high degree of fidelity, such as the position of each Cobalt source and shielding materials. Comparisons between measured results and calculated ones were performed, and a very good agreement was observed. It is concluded that the Monte Carlo calculation method with its related nuclear data library is very effective for such a complicated radiation oncology apparatus.

  10. Delayed cerebrospinal fluid rhinorrhea four years after gamma knife surgery for juvenile angiofibroma.

    PubMed

    Min, Hyun Jin; Chung, Hyo Jin; Kim, Chang-Hoon

    2014-11-01

    Juvenile angiofibroma (JA) is a highly vascularized tumor that often recurs or regrows. Recently, gamma knife surgery (GKS) was attempted on unresectable or remnant JA. We experienced a JA case that developed cerebrospinal fluid (CSF) rhinorrhea 4 years after GKS. Two surgical excisions using midfacial degloving approach were performed before GKS. After radiosurgery, the tumor was controlled, and no early complications were observed. However, 4 years after, intractable CSF leakage developed as a late complication, and we thus performed 4 subsequent endoscopic surgical repairs. The CSF leakage is very rare but can occur as a late complication of GKS and should be treated aggressively.

  11. Relaxation: A Fourth "R" for Education.

    ERIC Educational Resources Information Center

    Frederick, A. B.

    Relaxation training helps the individual handle tension through concentrating upon efficient use of muscles. A program of progressive relaxation can be easily incorporated into elementary and secondary schools. Objectives of such a program include the following: (a) to learn to relax technically for purposes of complete rest (deep muscle…

  12. Dynamic Relaxation of Financial Indices

    NASA Astrophysics Data System (ADS)

    Shen, J.; Zheng, B.; Lin, H.; Qiu, T.

    The dynamic relaxation of the German DAX both before and after a large price-change is investigated. The dynamic behavior is characterized by a power law. At the minutely time scale, the exponent p governing the power-law behavior takes a same value before and after the large price change, while at the daily time scale, it is different. Numerical simulations of an interacting EZ herding model are performed for comparison.

  13. Shear Relaxations of Confined Liquids.

    NASA Astrophysics Data System (ADS)

    Carson, George Amos, Jr.

    Ultrathin (<40 A) films of octamethylcyclotetrasiloxane (OMCTS), hexadecane, and dodecane were subjected to linear and non-linear oscillatory shear between flat plates. Shearing frequencies of 0.1 to 800 s^{-1} were applied at pressures from zero to 0.8 MPa using a surface rheometer only recently developed. In most cases the plates were atomically smooth mica surfaces; the role of surface interactions was examined by replacing these with alkyl chain monolayers. OMCTS and hexadecane were examined at a temperature about 5 Celsius degrees above their melting points and tended to solidify. Newtonian plateaus having enormous viscosities were observed at low shear rates. The onset of shear thinning implied relaxation times of about 0.1 s in the linear structure of the confined liquids. Large activation volumes (~80 nm ^3) suggested that shear involved large-scale collective motion. Dodecane was studied at a much higher temperature relative to its melting point and showed no signs of impending solidification though it exhibited well-defined regions of Newtonian response and power law shear thinning. When treated with molecular sieves before use, dodecane had relaxation times which were short (0.02 s) compared to hexadecane, but still exhibited large-scale collective motion. When treated with silica gel, an unexplained long -time relaxation (10 s) was seen in the Newtonian viscosity of dodecane. The relaxation time of the linear structure, 0.005 s was very small, and the storage modulus was unresolvable. The small activation volume (7nm^3) indicated a much lower level of collective motion. The activation volume remained small when dodecane was confined between tightly bound, low energy, alkyl monolayers. At low strains the storage and loss moduli became very large (>10^4 Pa), probably due to interactions with flaws in the monolayers. Dramatic signs of wall slip were observed at large strains even at low pressures.

  14. Spin relaxation in metallic ferromagnets

    NASA Astrophysics Data System (ADS)

    Berger, L.

    2011-02-01

    The Elliott theory of spin relaxation in metals and semiconductors is extended to metallic ferromagnets. Our treatment is based on the two-current model of Fert, Campbell, and Jaoul. The d→s electron-scattering process involved in spin relaxation is the inverse of the s→d process responsible for the anisotropic magnetoresistance (AMR). As a result, spin-relaxation rate 1/τsr and AMR Δρ are given by similar formulas, and are in a constant ratio if scattering is by solute atoms. Our treatment applies to nickel- and cobalt-based alloys which do not have spin-up 3d states at the Fermi level. This category includes many of the technologically important magnetic materials. And we show how to modify the theory to apply it to bcc iron-based alloys. We also treat the case of Permalloy Ni80Fe20 at finite temperature or in thin-film form, where several kinds of scatterers exist. Predicted values of 1/τsr and Δρ are plotted versus resistivity of the sample. These predictions are compared to values of 1/τsr and Δρ derived from ferromagnetic-resonance and AMR experiments in Permalloy.

  15. Arresting relaxation in Pickering Emulsions

    NASA Astrophysics Data System (ADS)

    Atherton, Tim; Burke, Chris

    2015-03-01

    Pickering emulsions consist of droplets of one fluid dispersed in a host fluid and stabilized by colloidal particles absorbed at the fluid-fluid interface. Everyday materials such as crude oil and food products like salad dressing are examples of these materials. Particles can stabilize non spherical droplet shapes in these emulsions through the following sequence: first, an isolated droplet is deformed, e.g. by an electric field, increasing the surface area above the equilibrium value; additional particles are then adsorbed to the interface reducing the surface tension. The droplet is then allowed to relax toward a sphere. If more particles were adsorbed than can be accommodated by the surface area of the spherical ground state, relaxation of the droplet is arrested at some non-spherical shape. Because the energetic cost of removing adsorbed colloids exceeds the interfacial driving force, these configurations can remain stable over long timescales. In this presentation, we present a computational study of the ordering present in anisotropic droplets produced through the mechanism of arrested relaxation and discuss the interplay between the geometry of the droplet, the dynamical process that produced it, and the structure of the defects observed.

  16. Effects of Various Forms of Relaxation Training on Physiological and Self-Report Measures of Relaxation

    ERIC Educational Resources Information Center

    Reinking, Richard H.; Kohl, Marilyn L.

    1975-01-01

    Examines relative effectiveness of four types of relaxation training including Jacobson-Wolpe and electromyograph (EMG) feedback. Dependent measures are EMG recordings and self-report measures of relaxation. All groups reported increased relaxation, but EMG groups were superior in EMG measures of speed of learning and depth of relaxation.…

  17. Relation between Direct Observation of Relaxation and Self-Reported Mindfulness and Relaxation States

    ERIC Educational Resources Information Center

    Hites, Lacey S.; Lundervold, Duane A.

    2013-01-01

    Forty-four individuals, 18-47 (MN 21.8, SD 5.63) years of age, took part in a study examining the magnitude and direction of the relationship between self-report and direct observation measures of relaxation and mindfulness. The Behavioral Relaxation Scale (BRS), a valid direct observation measure of relaxation, was used to assess relaxed behavior…

  18. Transurethral optical laser knife and probe director for lateral firing laser probes

    NASA Astrophysics Data System (ADS)

    Malek, Reza S.

    1993-05-01

    Laser energy has been used by many for transurethral incision of small, obstructive prostates, vesical neck contractures, and urethral strictures. The customary techniques of moving the tip of the laser fiber through a cystoscope with a conventional laser guide, almost tangentially to the tissue to be incised, or drilling radially arranged holes in the scar, or both, have been cumbersome and imprecise. To provide exact control of the laser fiber and precise delivery of laser energy, a new guide was devised. It conducts the quartz fiber through the sheath and along the lens of an optical urethrotome. The tip of the quartz fiber contacts the tissue at an angle of 20 degree(s). KTP/532 laser energy is used to perform internal urethrotomy for urethral stricture, transurethral incision of postoperative contracture of the vesical neck, and transurethral incision of the small prostate under constant visual control. Recently, a straight version of this guide, called probe director, was devised to conduct the newly marketed lateral firing laser probes. This probe director allows precise control of such a probe within the prostatic urethral lumen and excellent maneuverability of the probe during transurethral laser prostatectomy.

  19. Climate-sensitive feedbacks between hillslope processes and fluvial erosion in sediment-driven incision models

    NASA Astrophysics Data System (ADS)

    Skov, Daniel S.; Egholm, David L.

    2016-04-01

    Surface erosion and sediment production seem to have accelerated globally as climate cooled in the Late Cenozoic, [Molnar, P. 2004, Herman et al 2013]. Glaciers emerged in many high mountain ranges during the Quaternary, and glaciation therefore represents a likely explanation for faster erosion in such places. Still, observations and measurements point to increases in erosion rates also in landscapes where erosion is driven mainly by fluvial processes [Lease and Ehlers (2013), Reusser (2004)]. Flume experiments and fieldwork have shown that rates of incision are to a large degree controlled by the sediment load of streams [e.g. Sklar and Dietrich (2001), Beer and Turowski (2015)]. This realization led to the formulation of sediment-flux dependent incision models [Sklar and Dietrich (2004)]. The sediment-flux dependence links incision in the channels to hillslope processes that supply sediment to the channels. The rates of weathering and soil transport on the hillslopes are processes that are likely to respond to changing temperatures, e.g. because of vegetation changes or the occurrence of frost. In this study, we perform computational landscape evolution experiments, where the coupling between fluvial incision and hillslope processes is accounted for by coupling a sediment-flux-dependent model for fluvial incision to a climate-dependent model for weathering and hillslope sediment transport. The computational experiments first of all demonstrate a strong positive feedback between channel and hillslope processes. In general, faster weathering leads to higher rates of channel incision, which further increases the weathering rates, mainly because of hillslope steepening. Slower weathering leads to the opposite result. The experiments also demonstrate, however, that the feedbacks vary significantly between different parts of a drainage network. For example, increasing hillslope sediment production may accelerate incision in the upper parts of the catchment, while at

  20. Controls on aggradation and incision in the NE Negev, Israel, since the middle Pleistocene

    NASA Astrophysics Data System (ADS)

    Matmon, A.; Elfassi, S.; Hidy, A.; Geller, Y.; Porat, N.

    2016-05-01

    We investigated the mid-Pleistocene to recent aggradation-incision pattern of two drainage systems (Nahal Peres and Nahal Tahmas) in the hyperarid north eastern Negev desert, southern Israel. Although these drainage systems drain into the tectonically active Dead Sea basin, lake level fluctuations cannot account for the aggradation-incision pattern as bedrock knickpoints disconnect the investigated parts of these drainage systems from base level influence. We applied geomorphic mapping, soil stratigraphy, optically stimulated luminescence (OSL) and cosmogenic (in situ 10Be) exposure dating to reconstruct cycles of aggradation and incision of alluvial terraces and to study their temporal association with regional periods of humidity and aridity and global glacial-interglacial cycles. The spatial and temporal relationships between the alluvial units suggest changes in the drainage system behavior since the middle Pleistocene, and show a pattern in which prolonged periods of sediment aggradation alternated with short periods of rapid and intense degradation through erosion and incision into sediment and bedrock. We obtain ages for several Pleistocene-Holocene periods of incision: ~ 1.1 Ma, ~ 300 ka, ~ 120 ka, ~ 20 ka, ~ 12 ka and ~ 2 ka. Although broadly synchronous, the Nahal Peres and Nahal Tahmas systems exhibit temporal differences in aggradation and incision. Hyperarid conditions have persisted in the region at least since the middle Pleistocene, as evidenced by gypsic-salic soils that ubiquitously cap the investigated alluvial terraces. This observation is consistent with other observations throughout the Negev indicating prolonged aridity. Thus, alternation between sediment aggradation and degradation cannot be correlated in a simple and straightforward way to climatic changes. We explain the temporal differences in aggradation and incision between Nahal Peres and Nahal Tahmas as resulting from the differences in stream gradient, basin hypsometry, and drainage

  1. Dual daughter strand incision is processive and increases the efficiency of DNA mismatch repair.

    PubMed

    Hermans, Nicolaas; Laffeber, Charlie; Cristovão, Michele; Artola-Borán, Mariela; Mardenborough, Yannicka; Ikpa, Pauline; Jaddoe, Aruna; Winterwerp, Herrie H K; Wyman, Claire; Jiricny, Josef; Kanaar, Roland; Friedhoff, Peter; Lebbink, Joyce H G

    2016-08-19

    DNA mismatch repair (MMR) is an evolutionarily-conserved process responsible for the repair of replication errors. In Escherichia coli, MMR is initiated by MutS and MutL, which activate MutH to incise transiently-hemimethylated GATC sites. MMR efficiency depends on the distribution of these GATC sites. To understand which molecular events determine repair efficiency, we quantitatively studied the effect of strand incision on unwinding and excision activity. The distance between mismatch and GATC site did not influence the strand incision rate, and an increase in the number of sites enhanced incision only to a minor extent. Two GATC sites were incised by the same activated MMR complex in a processive manner, with MutS, the closed form of MutL and MutH displaying different roles. Unwinding and strand excision were more efficient on a substrate with two nicks flanking the mismatch, as compared to substrates containing a single nick or two nicks on the same side of the mismatch. Introduction of multiple nicks by the human MutLα endonuclease also contributed to increased repair efficiency. Our data support a general model of prokaryotic and eukaryotic MMR in which, despite mechanistic differences, mismatch-activated complexes facilitate efficient repair by creating multiple daughter strand nicks.

  2. A More Favorable Lower-Lip Incision for the Removal of Deep Intraoral Malignancies.

    PubMed

    Xiang, Xian Wang; Feng, Da Jun; Chen, XiaoYang; Chen, Chuan Jun

    2016-05-01

    The straight midline lower lip-splitting incision has traditionally been performed with different types of deep intraoral malignancies for obtaining wide surgical access, and it can also be extended to the submandibular region or the neck to concurrently perform a neck dissection. But meanwhile, it is associated with unfavorable aesthetic and functional complications such as conspicuous facial scar, lip vermilion notching, stenosis of the labial sulcus, decreased lip sensation and movement, and oral incontinence. We designed a more favorable lower-lip incision, namely, para-lower lip incision, using the exposure and en blot resection of deep intraoral tumors. Compared with the traditional incision line, our designed line is shorter, and 20 outpatients (primary tumor site including buccal mucosa, tongue, mandibular gingiva, maxillary sinus, palate, and mouth floor) follow-ups indicated the postoperative scar is inconspicuous, no lip contour deformity and dysfunction or complications of facial paralysis such as distortion of commissure happened. This article reports one case of our patients who underwent para-lower-lip incision approach for the removal of squamous cell carcinoma (T3N2M0) in the left plate and the results of the patient were favorable. PMID:27159868

  3. Modified Tubularized Incised Plate Urethroplasty Repair: Frenuloplasty and Long-Term Results in 155 Patients.

    PubMed

    Karakuş, Süleyman Cüneyt; Koku, Naim

    2015-12-01

    To describe a modification of tubularized incised plate (TIP) urethroplasty which we refer to as "frenuloplasty". We retrospectively reviewed 155 children who underwent TIP urethroplasty between June 2008 and August 2011 in our institution. In our technique, the circumcision incision went on through the mucocutaneous junction obliquely in order to form frenular wings instead of linear circumscribing incision joined the urethral plate vertically. The little triangle-shaped skin flaps between the oblique mucocutaneous incisions and urethral plate incisions were excised. The glans wings and frenular wings were re-approximated without tension after uretroplasty. The mean age of the patients was 4.63 ± 3.82 years. The mean follow-up was 15.94 ± 5.46 months. Location of hypospadias was distal penile in 126 patients (81.3 %) and mid-shaft in 29 (18.7 %). The following complications occurred in 21 patients (13.5 %): urethrocutaneous fistula formation in 7 (4.5 %), meatal stenosis in 14 (9 %) and no dehiscence. We suppose that there is no incompletely formed prepuce but a ventral fusion defect in the midline. Frenuloplasty reduces the necessity of ventral preputial flaps and provides satisfactory cosmetic outcomes with the appearence of normal circumcised penis.

  4. Coordination of dual incision and repair synthesis in human nucleotide excision repair

    PubMed Central

    Staresincic, Lidija; Fagbemi, Adebanke F; Enzlin, Jacqueline H; Gourdin, Audrey M; Wijgers, Nils; Dunand-Sauthier, Isabelle; Giglia-Mari, Giuseppina; Clarkson, Stuart G; Vermeulen, Wim; Schärer, Orlando D

    2009-01-01

    Nucleotide excision repair (NER) requires the coordinated sequential assembly and actions of the involved proteins at sites of DNA damage. Following damage recognition, dual incision 5′ to the lesion by ERCC1-XPF and 3′ to the lesion by XPG leads to the removal of a lesion-containing oligonucleotide of about 30 nucleotides. The resulting single-stranded DNA (ssDNA) gap on the undamaged strand is filled in by DNA repair synthesis. Here, we have asked how dual incision and repair synthesis are coordinated in human cells to avoid the exposure of potentially harmful ssDNA intermediates. Using catalytically inactive mutants of ERCC1-XPF and XPG, we show that the 5′ incision by ERCC1-XPF precedes the 3′ incision by XPG and that the initiation of repair synthesis does not require the catalytic activity of XPG. We propose that a defined order of dual incision and repair synthesis exists in human cells in the form of a ‘cut-patch-cut-patch' mechanism. This mechanism may aid the smooth progression through the NER pathway and contribute to genome integrity. PMID:19279666

  5. Coordination of dual incision and repair synthesis in human nucleotide excision repair.

    PubMed

    Staresincic, Lidija; Fagbemi, Adebanke F; Enzlin, Jacqueline H; Gourdin, Audrey M; Wijgers, Nils; Dunand-Sauthier, Isabelle; Giglia-Mari, Giuseppina; Clarkson, Stuart G; Vermeulen, Wim; Schärer, Orlando D

    2009-04-22

    Nucleotide excision repair (NER) requires the coordinated sequential assembly and actions of the involved proteins at sites of DNA damage. Following damage recognition, dual incision 5' to the lesion by ERCC1-XPF and 3' to the lesion by XPG leads to the removal of a lesion-containing oligonucleotide of about 30 nucleotides. The resulting single-stranded DNA (ssDNA) gap on the undamaged strand is filled in by DNA repair synthesis. Here, we have asked how dual incision and repair synthesis are coordinated in human cells to avoid the exposure of potentially harmful ssDNA intermediates. Using catalytically inactive mutants of ERCC1-XPF and XPG, we show that the 5' incision by ERCC1-XPF precedes the 3' incision by XPG and that the initiation of repair synthesis does not require the catalytic activity of XPG. We propose that a defined order of dual incision and repair synthesis exists in human cells in the form of a 'cut-patch-cut-patch' mechanism. This mechanism may aid the smooth progression through the NER pathway and contribute to genome integrity. PMID:19279666

  6. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    PubMed Central

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region. PMID:27672611

  7. Molecular and physiological mechanisms regulating tissue reunion in incised plant tissues.

    PubMed

    Asahina, Masashi; Satoh, Shinobu

    2015-05-01

    Interactions among the functionally specialized organs of higher plants ensure that the plant body develops and functions properly in response to changing environmental conditions. When an incision or grafting procedure interrupts the original organ or tissue connection, cell division is induced and tissue reunion occurs to restore physiological connections. Such activities have long been observed in grafting techniques, which are advantageous not only for agriculture and horticulture but also for basic research. To understand how this healing process is controlled and how this process is initiated and regulated at the molecular level, physiological and molecular analyses of tissue reunion have been performed using incised hypocotyls of cucumber (Cucumis sativus) and tomato (Solanum lycopersicum) and incised flowering stems of Arabidopsis thaliana. Our results suggest that leaf gibberellin and microelements from the roots are required for tissue reunion in the cortex of the cucumber and tomato incised hypocotyls. In addition, the wound-inducible hormones ethylene and jasmonic acid contribute to the regulation of the tissue reunion process in the upper and lower parts, respectively, of incised Arabidopsis stems. Ethylene and jasmonic acid modulate the expression of ANAC071 and RAP2.6L, respectively, and auxin signaling via ARF6/8 is essential for the expression of these transcription factors. In this report, we discuss recent findings regarding molecular and physiological mechanisms of the graft union and the tissue reunion process in wounded tissues of plants.

  8. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    PubMed Central

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  9. Force modeling for incisions into various tissues with MRF haptic master

    NASA Astrophysics Data System (ADS)

    Kim, Pyunghwa; Kim, Soomin; Park, Young-Dai; Choi, Seung-Bok

    2016-03-01

    This study proposes a new model to predict the reaction force that occurs in incisions during robot-assisted minimally invasive surgery. The reaction force is fed back to the manipulator by a magneto-rheological fluid (MRF) haptic master, which is featured by a bi-directional clutch actuator. The reaction force feedback provides similar sensations to laparotomy that cannot be provided by a conventional master for surgery. This advantage shortens the training period for robot-assisted minimally invasive surgery and can improve the accuracy of operations. The reaction force modeling of incisions can be utilized in a surgical simulator that provides a virtual reaction force. In this work, in order to model the reaction force during incisions, the energy aspect of the incision process is adopted and analyzed. Each mode of the incision process is classified by the tendency of the energy change, and modeled for realistic real-time application. The reaction force model uses actual reaction force information with three types of actual tissues: hard tissue, medium tissue, and soft tissue. This modeled force is realized by the MRF haptic master through an algorithm based on the position and velocity of a scalpel using two different control methods: an open-loop algorithm and a closed-loop algorithm. The reaction forces obtained from the proposed model are compared with a desired force in time domain.

  10. Dynamics of Glass Relaxation at Room Temperature

    NASA Astrophysics Data System (ADS)

    Welch, Roger C.; Smith, John R.; Potuzak, Marcel; Guo, Xiaoju; Bowden, Bradley F.; Kiczenski, T. J.; Allan, Douglas C.; King, Ellyn A.; Ellison, Adam J.; Mauro, John C.

    2013-06-01

    The problem of glass relaxation under ambient conditions has intrigued scientists and the general public for centuries, most notably in the legend of flowing cathedral glass windows. Here we report quantitative measurement of glass relaxation at room temperature. We find that Corning® Gorilla® Glass shows measurable and reproducible relaxation at room temperature. Remarkably, this relaxation follows a stretched exponential decay rather than simple exponential relaxation, and the value of the stretching exponent (β=3/7) follows a theoretical prediction made by Phillips for homogeneous glasses.

  11. Distinguishing spin relaxation mechanisms in organic semiconductors.

    PubMed

    Harmon, N J; Flatté, M E

    2013-04-26

    A theory is introduced for spin relaxation and spin diffusion of hopping carriers in a disordered system. For disorder described by a distribution of waiting times between hops (e.g., from multiple traps, site-energy disorder, and/or positional disorder) the dominant spin relaxation mechanisms in organic semiconductors (hyperfine, hopping-induced spin-orbit, and intrasite spin relaxation) each produce different characteristic spin relaxation and spin diffusion dependences on temperature. The resulting unique experimental signatures predicted by the theory for each mechanism in organic semiconductors provide a prescription for determining the dominant spin relaxation mechanism. PMID:23679752

  12. Unusual fast secondary relaxation in metallic glass

    PubMed Central

    Wang, Q.; Zhang, S.T.; Yang, Y.; Dong, Y.D.; Liu, C.T.; Lu, J.

    2015-01-01

    The relaxation spectrum of glassy solids has long been used to probe their dynamic structural features and the fundamental deformation mechanisms. Structurally complicated glasses, such as molecular glasses, often exhibit multiple relaxation processes. By comparison, metallic glasses have a simple atomic structure with dense atomic packing, and their relaxation spectra were commonly found to be simpler than those of molecular glasses. Here we show the compelling evidence obtained across a wide range of temperatures and frequencies from a La-based metallic glass, which clearly shows two peaks of secondary relaxations (fast versus slow) in addition to the primary relaxation peak. The discovery of the unusual fast secondary relaxation unveils the complicated relaxation dynamics in metallic glasses and, more importantly, provides us the clues which help decode the structural features serving as the ‘trigger' of inelasticity on mechanical agitations. PMID:26204999

  13. Biaxial stress relaxation in glassy polymers - Polymethylmethacrylate.

    NASA Technical Reports Server (NTRS)

    Sternstein, S. S.; Ho, T. C.

    1972-01-01

    Biaxial stress relaxation studies were performed on glassy polymethylmethacrylate in combined torsion-tension strain fields using a specially designed apparatus with exceptionally high stiffness and low cross talk between the torsional and tensile load measuring transducers. It was found that at low strain levels uniaxial tension relaxation is slower than pure torsion relaxation; tensile-component relaxation rates are unaffected by the level of torsional strain; torsional-component relaxation rates decrease as tensile strain is increased; uniaxial tension relaxation rates approach the pure torsion rates at higher strains (about 2%). A phenomenological treatment is presented which shows that relaxation rates can be coupled to the strain fields in which they are observed and yet be consistent with the concepts of linear viscoelasticity and the Boltzmann superposition integral.

  14. Dosimetric characterization of CyberKnife radiosurgical photon beams using polymer gels

    SciTech Connect

    Pantelis, E.; Antypas, C.; Petrokokkinos, L.; Karaiskos, P.; Papagiannis, P.; Kozicki, M.; Georgiou, E.; Sakelliou, L.; Seimenis, I.

    2008-06-15

    Dose distributions registered in water equivalent, polymer gel dosimeters were used to measure the output factors and off-axis profiles of the radiosurgical photon beams employed for CyberKnife radiosurgery. Corresponding measurements were also performed using a shielded silicon diode commonly employed for CyberKnife commissioning, the PinPoint ion chamber, and Gafchromic EBT films, for reasons of comparison. Polymer gel results of this work for the output factors of the 5, 7.5, and 10 mm diameter beams are (0.702{+-}0.029), (0.872{+-}0.039), and (0.929{+-}0.041), respectively. Comparison of polymer gel and diode measurements shows that the latter overestimate output factors of the two small beams (5% for the 5 mm beam and 3% for the 7.5 mm beams). This is attributed to the nonwater equivalence of the high atomic number silicon material of the diode detector. On the other hand, the PinPoint chamber is found to underestimate output factors up to 10% for the 5 mm beam due to volume averaging effects. Polymer gel and EBT film output factor results are found in close agreement for all beam sizes, emphasizing the importance of water equivalence and fine detector sensitive volume for small field dosimetry. Relative off-axis profile results are in good agreement for all dosimeters used in this work, with noticeable differences observed only in the PinPoint estimate of the 80%-20% penumbra width, which is relatively overestimated.

  15. Image guidance quality assurance of a G4 CyberKnife robotic stereotactic radiosurgery system

    NASA Astrophysics Data System (ADS)

    Pantelis, E.; Petrokokkinos, L.; Antypas, C.

    2009-05-01

    The image guidance of a CyberKnife robotic radiosurgery system was quality controlled, including the overall performance of the target locating subsystem and the performance of the x-ray generators and flat panel digital cameras subcomponents. Accuracy and precision of the kV and exposure time settings of the x-ray generators, linearity of the x-ray output, spatial resolution and geometrical distortion of the acquired x-ray images were measured. Total accuracy and precision of the target locating subsystem in defining the position of an anthropomorphic head and neck phantom placed on treatment couch was also measured. Accuracy and precision of the kV as well as exposure time settings and linearity of the x-ray output were found within the acceptance limits suggested in diagnostic radiology. The acquired x-ray images were found to depict the shapes of the imaging objects without any geometrical distortion, being able to resolve differences in the features of imaging objects with critical frequency of 1.3 lp/mm and 1.5 lp/mm for camera A and B, respectively. Total target locating system accuracy was found within 0.2 mm and 0.2° in translations and rotations, respectively. Corresponding precision was found lower than 0.5%. These findings render the target locating subsystem of the CyberKnife capable of accurately registering the patient to treatment position and monitoring patient's movement during treatment delivery.

  16. Initial Experience with the Extracorporeal HIFU Knife with 49 Patients: Japanese Experience

    NASA Astrophysics Data System (ADS)

    Ganaha, F.; Okuno, T.; Lee, C. O.; Shimizu, T.; Osako, K.; Oka, S.; Lee, K. H.; Chen, W. Z.; Zhu, H.; Park, S. H.; Qi, Z.; Shi, D.; Song, H. S.

    2005-03-01

    Forty nine patients with 63 tumours were treated with the Chongqing Haifu knife, as an adjunct to intra-arterial chemoinfusion. Treatment targets included breast (20 lesions), liver (16), bone (8), lymph-node (6), soft tissue (4), lung and pleura (4), pancreas (2), kidney (2) and adrenal gland (1). Follow-up contrast MRI was performed at 3 weeks to assess the effects of HIFU ablation. All cases completed the planned treatment. Of 25 lesions treated with the intention of complete tumour ablation, complete necrosis was obtained in 19 lesions (76%) including 4 secondary success cases. Among 32 lesions having partial and palliative treatment, tumour size was decreased in 6 lesions (21%), and good pain control was obtained in 6 out of 7 patients (86%). Skin injury was the most common complication after HIFU (16%), and was mostly a superficial dermal burn that did not necessitate any treatment. However, there was one patient with deep skin injury at an operation scar which resulted in skin perforation. Other adverse events included soft tissue swelling, prolonged fever, anorexia, persistent pain, shortness of the breath, sacroiliac joint fracture and prolonged diarrhoea. In our limited experience, superficial lesions (e.g. breast cancer, bone, soft tissue, lymph-node and pleural metastasis) appear to be good candidates for HIFU treatment. There appears to be a role for the HIFU knife in pain control for patients with bone metastasis and pancreatic cancer.

  17. Stereotactic gamma knife radiosurgery. Initial North American experience in 207 patients

    SciTech Connect

    Lunsford, L.D.; Flickinger, J.; Coffey, R.J. )

    1990-02-01

    The first North American gamma knife for stereotactic radiosurgery of brain tumors and arteriovenous malformations entered the therapeutic armamentarium at the University of Pittsburgh (Pa) on August 14, 1987. In this article, we report our initial testing and subsequent experience with this technique. In the first 16 months of operation, 207 patients were treated (113 had arteriovenous malformations, 78 had extra-axial skull base neoplasms, 9 had glial neoplasms, and 7 had metastatic tumors). The patients' lesions either were considered previously as inoperable or were residual lesions after attempted surgical resection, or the radiosurgery was performed after the patient declined surgical excision. Gamma radiosurgery was associated with no surgical mortality and no significant early morbidity, and the results were encouraging during the minimum follow-up period of 6 months. Compared with treatment by conventional intracranial surgery (craniotomy), both the average length of stay and hospital charges for radiosurgery were significantly lower. Our initial experience further suggests that stereotactic radiosurgery using the gamma knife is a therapeutically effective and economically sound alternative to microneurosurgical removal of selected intracranial tumors and vascular malformations.

  18. Gamma Knife Radiosurgery as a Therapeutic Strategy for Intracranial Sarcomatous Metastases

    SciTech Connect

    Flannery, Thomas; Kano, Hideyuki; Niranjan, Ajay M.Ch.; Monaco, Edward A.; Flickinger, John C.; Kofler, Julia; Lunsford, L. Dade; Kondziolka, Douglas

    2010-02-01

    Purpose: To determine the indication and outcomes for Gamma Knife stereotactic radiosurgery (GKSRS) in the care of patients with intracranial sarcomatous metastases. Methods and Materials: Data from 21 patients who underwent radiosurgery for 60 sarcomatous intracranial metastases (54 parenchymal and 6 dural-based) were studied. Nine patients had radiosurgery for solitary tumors and 12 for multiple tumors. The primary pathology was metastatic leiomyosarcoma (4 patients), osteosarcoma (3 patients), soft-tissue sarcoma (5 patients), chondrosarcoma (2 patients), alveolar soft part sarcoma (2 patients), and rhabdomyosarcoma, Ewing's sarcoma, liposarcoma, neurofibrosarcoma, and synovial sarcoma (1 patient each). Twenty patients received multimodality management for their primary tumor, and 1 patient had no evidence of systemic disease. The mean tumor volume was 6.2 cm{sup 3} (range, 0.07-40.9 cm{sup 3}), and a median margin dose of 16 Gy was administered. Three patients had progressive intracranial disease despite fractionated whole-brain radiotherapy before SRS. Results: A local tumor control rate of 88% was achieved (including patients receiving boost, up-front, and salvage SRS). New remote brain metastases developed in 7 patients (33%). The median survival after diagnosis of intracranial metastasis was 16 months, and the 1-year survival rate was 61%. Conclusions: Gamma Knife radiosurgery was a well-tolerated and initially effective therapy in the management of patients with sarcomatous intracranial metastases. However, many patients, including those who also received fractionated whole-brain radiotherapy, developed progressive new brain disease.

  19. Steady incision of Grand Canyon at the million year timeframe: a case for mantle-driven differential uplift

    USGS Publications Warehouse

    Crow, Ryan S; Karl Karlstrom,; Laura Crossey,; Richard Young,; Michael Ort,; Yemane Asmerom,; Victor Polyak,; Andrew Darling,

    2014-01-01

    The Grand Canyon region provides an excellent laboratory to examine the interplay between river incision, magmatism, and the geomorphic and tectonic processes that shape landscapes. Here we apply U-series, Ar–Ar, and cosmogenic burial dating of river terraces to examine spatial variations in incision rates along the 445 km length of the Colorado River through Grand Canyon. We also analyze strath terrace sequences that extend to heights of several hundred meters above the river, and integrate these with speleothem constrained maximum incision rates in several reaches to examine any temporal incision variations at the million-year time frame. This new high-resolution geochronology shows temporally steady long-term incision in any given reach of Grand Canyon but significant variations along its length from 160 m/Ma in the east to 101 m/Ma in the west. Spatial and temporal patterns of incision, and the long timescale of steady incision rule out models where geomorphic controls such as climate oscillations, bedrock strength, sediment load effects, or isostatic response to differential denudation are the first order drivers of canyon incision. The incision pattern is best explained by a model of Neogene and ongoing epeirogenic uplift due to an eastward propagating zone of increased upper mantle buoyancy that we infer from propagation of Neogene basaltic volcanism and a strong lateral gradient in modern upper mantle seismic structure.

  20. Comparison of the effects of 23-gauge and 25-gauge microincision vitrectomy blade designs on incision architecture

    PubMed Central

    Inoue, Makoto; Abulon, Dina Joy K; Hirakata, Akito

    2014-01-01

    Purpose To compare the effects of different 23- and 25-gauge microincision vitrectomy trocar cannula entry systems on incision architecture. Methods We tested one ridged microvitreoretinal (MVR), one non-ridged MVR, one pointed beveled, and one round-tipped beveled blade (n=10 per blade design per incision type). Each blade’s straight and oblique incision architecture was assessed in a silicone disc simulating the sclera. Wound leakage under pressure and endoscopic observations were conducted on sclerotomy sites of isolated porcine eyes (n=4 per blade design) after simulated vitrectomy. Results Differences in blade design created distinct incision architecture. Incisions were linear with the ridged MVR blade, flattened “M-shaped” with the non-ridged MVR blade, asymmetrical chevron-shaped with the pointed beveled blade, and curved with the round-tipped beveled blade. With the exception of oblique entry incision thickness, both MVR blade designs created thinner incisions than the beveled blades at entry and exit sites. Only the ridged MVR blade created incisions with no leakage. Vitreous incarceration was observed with all trocar cannula systems. Conclusion Wound closure in porcine eyes was similar with all blades despite differences in incision architecture. Wound leakage occurred at low to moderate infusion pressures with most blades; no wound leakage was observed with ridged MVR blades. PMID:25429201

  1. Scar due to skin incision for screw fixation through the transbuccal approach after sagittal split ramus osteotomy.

    PubMed

    Muto, Toshitaka

    2012-05-01

    Most rigid fixation techniques after sagittal split ramus osteotomies of the mandible involve the transbuccal approach. A skin incision in the cheek carries with it possible undesirable sequelae, such as noticeable scarring. The aim of this study was to investigate whether there is scarring in the face after this technique. For screw insertion, a 5-mm stab incision was performed on 40 Japanese patients (20 men and 20 women) with class III occlusion. After surgery, gross examination (via the naked eyes) of the skin incision was performed monthly for 1 year by the same oral surgeon. In all cases, the skin incision had disappeared by 1 year after the surgery. PMID:22627425

  2. Steady incision of Grand Canyon at the million year timeframe: A case for mantle-driven differential uplift

    NASA Astrophysics Data System (ADS)

    Crow, Ryan; Karlstrom, Karl; Darling, Andrew; Crossey, Laura; Polyak, Victor; Granger, Darryl; Asmerom, Yemane; Schmandt, Brandon

    2014-07-01

    The Grand Canyon region provides an excellent laboratory to examine the interplay between river incision, magmatism, and the geomorphic and tectonic processes that shape landscapes. Here we apply U-series, Ar-Ar, and cosmogenic burial dating of river terraces to examine spatial variations in incision rates along the 445 km length of the Colorado River through Grand Canyon. We also analyze strath terrace sequences that extend to heights of several hundred meters above the river, and integrate these with speleothem constrained maximum incision rates in several reaches to examine any temporal incision variations at the million-year time frame. This new high-resolution geochronology shows temporally steady long-term incision in any given reach of Grand Canyon but significant variations along its length from 160 m/Ma in the east to 101 m/Ma in the west. Spatial and temporal patterns of incision, and the long timescale of steady incision rule out models where geomorphic controls such as climate oscillations, bedrock strength, sediment load effects, or isostatic response to differential denudation are the first order drivers of canyon incision. The incision pattern is best explained by a model of Neogene and ongoing epeirogenic uplift due to an eastward propagating zone of increased upper mantle buoyancy that we infer from propagation of Neogene basaltic volcanism and a strong lateral gradient in modern upper mantle seismic structure.

  3. Correlation and prediction uncertainties in the CyberKnife Synchrony respiratory tracking system

    SciTech Connect

    Pepin, Eric W.; Wu, Huanmei; Zhang, Yuenian; Lord, Bryce

    2011-07-15

    Purpose: The CyberKnife uses an online prediction model to improve radiation delivery when treating lung tumors. This study evaluates the prediction model used by the CyberKnife radiation therapy system in terms of treatment margins about the gross tumor volume (GTV). Methods: From the data log files produced by the CyberKnife synchrony model, the uncertainty in radiation delivery can be calculated. Modeler points indicate the tracked position of the tumor and Predictor points predict the position about 115 ms in the future. The discrepancy between Predictor points and their corresponding Modeler points was analyzed for 100 treatment model data sets from 23 de-identified lung patients. The treatment margins were determined in each anatomic direction to cover an arbitrary volume of the GTV, derived from the Modeler points, when the radiation is targeted at the Predictor points. Each treatment model had about 30 min of motion data, of which about 10 min constituted treatment time; only these 10 min were used in the analysis. The frequencies of margin sizes were analyzed and truncated Gaussian normal functions were fit to each direction's distribution. The standard deviation of each Gaussian distribution was then used to describe the necessary margin expansions in each signed dimension in order to achieve the desired coverage. In this study, 95% modeler point coverage was compared to 99% modeler coverage. Two other error sources were investigated: the correlation error and the targeting error. These were added to the prediction error to give an aggregate error for the CyberKnife during treatment of lung tumors. Results: Considering the magnitude of 2{sigma} from the mean of the Gaussian in each signed dimension, the margin expansions needed for 95% modeler point coverage were 1.2 mm in the lateral (LAT) direction and 1.7 mm in the anterior-posterior (AP) direction. For the superior-inferior (SI) direction, the fit was poor; but empirically, the expansions were 3.5 mm

  4. The Effect of Caffeic Acid on Wound Healing in Skin-incised Mice

    PubMed Central

    Song, Ho Sun; Park, Tae Wook; Sohn, Uy Dong; Shin, Yong Kyoo; Choi, Byung Chul; Kim, Chang Jong

    2008-01-01

    This study was carried out to investigate the wound healing effect of caffeic acid in skin-incised mice. Caffeic acid showed significant effects on anti-inflammatory activity and wound healing, such as myeloperoxidase activity, lipid peroxidation, phospholipase A2 activity and collagen-like polymer synthesis, in incised-wound tissue. On the other hand, it significantly stimulated collagen-like polymer synthesis in NIH 3T3 fibroblast cells, while inhibited both silica-induced reactive oxygen species generation and melittin-induced arachidonic acid release and PGE2 production in Raw 264.7 cells, and histamine release in RBL 2H3 cells stimulated by melittin or arachidonic acid. Therefore, caffeic acid appears to have a potent antioxidant and anti-inflammatory effect in cell culture system, which may be related to wound healing in skin-incised mice. PMID:19967077

  5. Fluvial incision history that controlled the distribution of landslides in the Central Range of Taiwan

    NASA Astrophysics Data System (ADS)

    Tsou, Ching-Ying; Chigira, Masahiro; Matsushi, Yuki; Chen, Su-Chin

    2014-12-01

    Hillslope processes, which are affected by long-term river incision, give rise to the risk of landsliding in active orogens. We studied the river incision history and the subsequent response of rock slopes in the upstream Dahan River catchment, north Taiwan, by analyzing river long profiles, hillslopes, and landslide scars. The results were combined with chronological data from several landform surfaces to reconstruct the history of landscape evolution. At the study area, the landscape comprises three levels of knickpoints and corresponding slope breaks. These knickpoints propagated upstream along trunk and tributary rivers, undercutting and destabilizing nearby slopes, of which the oldest is a paleosurface dated to ca. 150 kyr by cosmogenic nuclide dating. Consequently, three levels of V-shaped inner gorges (up to 600 m deep) are incised into the paleosurface. The inner slopes of the three levels of gorges have mean inclinations of 35.6°, 37.7°, and 39.8°, and steepen from the higher to the lower inner gorges. These three series of knickpoints and corresponding slope breaks suggest the occurrence of three phases of river incision. Based on analyses of the steepness indices of the river long profiles, cosmogenic nuclide dating, and the regional tectonic and climatic history, the two earlier phases of incision are inferred to have been caused by prevailing tectonic uplifts during the middle to late Pleistocene, and the most recent phase by climate change in addition to uplift. The long-term history of river incision has controlled the distribution of deep-seated gravitational slope deformation and landslides. Many areas of deep-seated gravitational slope deformation and deep-seated rockslide-avalanches are aligned along the higher and middle slope breaks, and debris slide avalanches are concentrated along the middle and lower slope breaks.

  6. Detection of nucleotide excision repair incisions in human fibroblasts by immunostaining for PCNA.

    PubMed

    Aboussekhra, A; Wood, R D

    1995-12-01

    During nucleotide excision repair, damaged DNA is incised on both sides of a lesion and an oligomer containing the damage is excised and replaced by repair DNA synthesis. The latter step is accomplished in vitro by proteins that include the DNA polymerase accessory factor PCNA, which binds to DNA ends to initiate repair synthesis. An increased association of PCNA with nuclei occurs after UV irradiation of nonreplicating DNA in normal human fibroblasts, probably following incision of damaged DNA. This property was used to detect the catalysis of nucleotide excision repair incisions in damaged DNA in vivo, by immunostaining of quiescent human fibroblasts with the widely available PC10 antibody. We summarize here a comprehensive survey of PCNA immunostaining in repair-defective xeroderma pigmentosum (XP) cells in comparison to normal cells. XP-A and XP-G cells were completely defective in staining for PCNA 30 min after UV irradiation. This strongly suggests that XPA and XPG proteins are absolutely required in cells before any incisions can be formed in damaged DNA. XP-B, XP-C, XP-D, and XP-F cells showed an intermediate level of staining for PCNA after UV irradiation, indicative of partial incision capacity in those cells. UV-irradiated XP-E and XP-V cells showed normal PCNA immunostaining levels, consistent with evidence that the corresponding factors are not essential for the incision step of repair. The results provide further evidence for the involvement of PCNA in the repair process in vivo and give an alternative to traditional approaches for measurement of nucleotide excision repair capability. PMID:7493631

  7. Sequence stratigraphic and tectonic controls on Shannon incised-valley distribution, Hartzog Draw, Wyoming

    SciTech Connect

    Sullivan, M.D.; Van Wagoner, J.C.; Jennette, D.C.

    1996-12-31

    The Upper Cretaceous Shannon Sandstone in the Powder River Basin, Wyoming is interpreted as stacked tidal bars infilling northwest-southeast trending incised valleys. The Shannon Sandstone can be subdivided into 3 sequences: Copenhagen Blue, Crimson Red, and Canary Yellow. The Copenhagen Blue sequence boundary is a regional unconformity at the base of the Shannon Sandstone marked by distal tidal-bar deposits resting on offshore mudstones of the Cody. The overlying Crimson Red sequence is the main reservoir interval at Hartzog Draw and is composed of proximal tidal-bar deposits. The highly erosional Canary Yellow sequence boundary forms the trap at Hartzog Draw by juxtaposing the reservoir sandstones of the Crimson Red sequence with the overlying offshore mudstones of the Canary Yellow sequence. The Shannon Sandstone is therefore an erosional remnant of originally more extensive tide-dominated deltas deposited within northwest-southeast trending incised valleys. The orientation and distribution of the Shannon incised valleys is the result of the interplay between tectonics and eustacy. During lowstand incised valley development the orientation of fluvial systems incising the shelf was strongly controlled by pre-existing northwest-southeast trending structural elements in the basin. During the subsequent sea-level rise the shoreline backstepped in a landward direction. The shoreline also gradually rotated from an east-west orientation during the lowstand to a north-south orientation during the highstand systems tract. Ultimately the highstand shorelines were located over 160 kms landward of the lowstand shorelines and oriented subparallel to the lowstand incised valleys.

  8. Sequence stratigraphic and tectonic controls on Shannon incised-valley distribution, Hartzog Draw, Wyoming

    SciTech Connect

    Sullivan, M.D.; Van Wagoner, J.C.; Jennette, D.C. )

    1996-01-01

    The Upper Cretaceous Shannon Sandstone in the Powder River Basin, Wyoming is interpreted as stacked tidal bars infilling northwest-southeast trending incised valleys. The Shannon Sandstone can be subdivided into 3 sequences: Copenhagen Blue, Crimson Red, and Canary Yellow. The Copenhagen Blue sequence boundary is a regional unconformity at the base of the Shannon Sandstone marked by distal tidal-bar deposits resting on offshore mudstones of the Cody. The overlying Crimson Red sequence is the main reservoir interval at Hartzog Draw and is composed of proximal tidal-bar deposits. The highly erosional Canary Yellow sequence boundary forms the trap at Hartzog Draw by juxtaposing the reservoir sandstones of the Crimson Red sequence with the overlying offshore mudstones of the Canary Yellow sequence. The Shannon Sandstone is therefore an erosional remnant of originally more extensive tide-dominated deltas deposited within northwest-southeast trending incised valleys. The orientation and distribution of the Shannon incised valleys is the result of the interplay between tectonics and eustacy. During lowstand incised valley development the orientation of fluvial systems incising the shelf was strongly controlled by pre-existing northwest-southeast trending structural elements in the basin. During the subsequent sea-level rise the shoreline backstepped in a landward direction. The shoreline also gradually rotated from an east-west orientation during the lowstand to a north-south orientation during the highstand systems tract. Ultimately the highstand shorelines were located over 160 kms landward of the lowstand shorelines and oriented subparallel to the lowstand incised valleys.

  9. 3D knife-edge characterization of two-photon absorption volume in silicon for integrated circuit testing.

    PubMed

    Shao, K; Morisset, A; Pouget, V; Faraud, E; Larue, C; Lewis, D; McMorrow, D

    2011-11-01

    We have performed three-dimensional characterization of the TPA effective laser spot size in silicon using an integrated knife-edge sensor. The TPA-induced response of a CMOS integrated circuit is analyzed based on these results and compared to simulation; we have found that the charge injection capacity in IC's active layer could be influenced by irradiance energy and focus depth.

  10. Incision of the Yangtze River at the First Bend Determined by Three-Nuclide Burial Dating

    NASA Astrophysics Data System (ADS)

    McPhillips, D. F.; Hoke, G. D.; Rood, D. H.; Bierman, P. R.

    2015-12-01

    On the southeast margin of the Tibetan Plateau, the evolution of the Yangtze River and its major tributaries has become an important source of data for investigating geodynamics. In particular, the timing of river incision is frequently interpreted as a proxy for the timing of surface uplift in the absence of structural evidence. We investigate the timing of the incision of the gorge at the First Bend using cosmogenic nuclide burial dating of coarse, quartz sediments from caves. Sediments were deposited when the caves were near river level and subsequently abandoned as the river incised. To resolve burial ages >5 Ma, we measured the radionuclides 10Be and 26Al, and the stable nuclide 21Ne. Results from 4 caves show that 26Al and 10Be concentrations are an order of magnitude lower in abandoned cave samples than in a river-level cave sample where deposition is active (10Be: 1.3x104 and 3.4x105 at/g). In contrast, 26Al/10Be ratios in all caves are ≥6.2 and indistinguishable within error. 21Ne concentrations range from 2.1x106 to 7.8x106 at/g. The results are consistent with an old age for the abandoned cave deposits, such that most of the radionuclides initially present have decayed and the concentrations that we measure today are the result of millions of years of exposure to muons. We solve for burial ages, taking into account in situ muogenic production, and find that the majority of the gorge (1 km) was likely incised between ~12 and 9 Ma. The results also require that the rate of river incision declined after the gorge was cut below the lowest elevation cave at 9 Ma. Inverse modeling of published low-temperature thermochronology (Ouimet et al., 2010) supports our burial age results. River capture near the First Bend, which likely integrated the modern Yangtze, likely occurred prior to the mid-Miocene incision of the gorge. In view of the geographic position of the First Bend—just downslope from the southeast margin of the Plateau—it is difficult to explain

  11. Cenozoic incision history of the Little Colorado River and its role in carving Grand Canyon

    NASA Astrophysics Data System (ADS)

    Karlstrom, K. E.

    2015-12-01

    Multi-stage incision/denudation history for the southwestern Colorado Plateau involved: carving of 70-30 Ma Laramide paleotopography controlled by strike valleys at the base of retreating cliffs, 25-15 Ma incision of an East Kaibab paleovalley that cut to about half the modern depth of eastern Grand Canyon, and 5-6 Ma integration of the Colorado River (CR) through Grand Canyon. A synthesis of Little Colorado River (LCR) incision history informs aspects of each episode. Refined evidence for the first two episodes is from new thermochronology modeling that shows post-Laramide NE cliff retreat and a 35-25 Ma LCR paleovalley that flowed NW across the Kaibab uplift. Next was 16-14 Ma playa/ marsh deposition of Lower Bidahochi Formation, 13-8 Ma non-deposition, and 6-8 fluvial upper Bidahochi Formation with base level defined by Hopi Buttes maars. Little denudation in the LCR valley from 16 to 6 Ma is documented by similar elevations of 16 and 6 Ma paleo baselevels. The third pulse of regional incision/denudation was associated with integration of the CR across the Vermillion Cliffs after 5-6 Ma. Earliest integration reoccupied the East Kaibab paleocanyon, inferred from thermochronology to have been at ~1500-1700 m elevation at 15 Ma. Topographically inverted dated basalt mesas in the LCR headwater region show steady incision of 43 m/Ma since 6 Ma. New 2 Ma sanidine ages for Crooked Ridge and Blue Point ash show ~100 m/Ma differential incision across the LCR knickpoint over the last ~ 2 Ma: ~400 m (~200 m/Ma) at the confluence, 400-500 m (200-250 m/Ma) at the projected confluence of Crooked Ridge and the LCR, 220 m (110 m/Ma) for topographically inverted basalt mesas in LCR tributaries in the central reaches, and 116-204 m (61-43 m/Ma) in the headwaters. Headwater uplift of the Rocky Mountains likely facilitated CR integration; post-2 Ma differential incision in the LCR may reflect a combination of regional mantle-driven epeirogenic uplift and additional mantle

  12. Relaxation damping in oscillating contacts.

    PubMed

    Popov, M; Popov, V L; Pohrt, R

    2015-01-01

    If a contact of two purely elastic bodies with no sliding (infinite coefficient of friction) is subjected to superimposed oscillations in the normal and tangential directions, then a specific damping appears, that is not dependent on friction or dissipation in the material. We call this effect "relaxation damping". The rate of energy dissipation due to relaxation damping is calculated in a closed analytic form for arbitrary axially-symmetric contacts. In the case of equal frequency of normal and tangential oscillations, the dissipated energy per cycle is proportional to the square of the amplitude of tangential oscillation and to the absolute value of the amplitude of normal oscillation, and is dependent on the phase shift between both oscillations. In the case of low frequency tangential oscillations with superimposed high frequency normal oscillations, the dissipation is proportional to the ratio of the frequencies. Generalization of the results for macroscopically planar, randomly rough surfaces as well as for the case of finite friction is discussed. PMID:26549011

  13. Violent relaxation of ellipsoidal clouds

    NASA Astrophysics Data System (ADS)

    Benhaiem, David; Sylos Labini, Francesco

    2015-04-01

    An isolated, initially cold and ellipsoidal cloud of self-gravitating particles represents a relatively simple system in which to study the effects of deviations from spherical symmetry in the mechanism of violent relaxation. Initial deviations from spherical symmetry are shown to play a dynamical role that is equivalent to that of density fluctuations in the case of an initially spherical cloud. Indeed, these deviations control the amount of particle-energy change and thus determine the properties of the final energy distribution, particularly the appearance of two species of particles: bound and free. Ejection of mass and energy from the system, together with the formation of a density profile decaying as ρ(r) ˜ r-4 and a Keplerian radial velocity dispersion profile, are prominent features similar to those observed after the violent relaxation of spherical clouds. In addition, we find that ejected particles are characterized by highly non-spherical shapes, the features of which can be traced in the initial deviations from spherical symmetry that are amplified during the dynamical evolution: particles can indeed form anisotropic configurations, like bars and/or discs, even though the initial cloud was very close to spherical.

  14. Relaxation damping in oscillating contacts

    PubMed Central

    Popov, M.; Popov, V.L.; Pohrt, R.

    2015-01-01

    If a contact of two purely elastic bodies with no sliding (infinite coefficient of friction) is subjected to superimposed oscillations in the normal and tangential directions, then a specific damping appears, that is not dependent on friction or dissipation in the material. We call this effect “relaxation damping”. The rate of energy dissipation due to relaxation damping is calculated in a closed analytic form for arbitrary axially-symmetric contacts. In the case of equal frequency of normal and tangential oscillations, the dissipated energy per cycle is proportional to the square of the amplitude of tangential oscillation and to the absolute value of the amplitude of normal oscillation, and is dependent on the phase shift between both oscillations. In the case of low frequency tangential oscillations with superimposed high frequency normal oscillations, the dissipation is proportional to the ratio of the frequencies. Generalization of the results for macroscopically planar, randomly rough surfaces as well as for the case of finite friction is discussed. PMID:26549011

  15. Comparative evaluation of fracture resistance of Ceramic Veneer with three different incisal design preparations - An In-vitro Study

    PubMed Central

    Jankar, Ajit S; Kale, Yogesh; Kangane, Suresh; Ambekar, Anand; Sinha, Manish; Chaware, Sachin

    2014-01-01

    Background: Ceramic veneer fracture has occurred mainly at the incisal edge of the veneer because of greater stress. This study compares and evaluates the fracture resistance ceramic veneers with three different incisal preparations. Materials & Methods: 15 human permanent maxillary central incisor extracted were selected which were divided into three groups of 5 each having a different Incial design Preparation. Group 1: No Incisal reduction with facio- incisal bevel, Group 2 : 1 mm incisal reduction with butt joint, Group 3 : 1 mm incisal reduction with 1 mm height of Palatal chamfer. It was found that Group III had greater fracture resistance as compared to Group I and Group II. Group I had least fracture resistance as compared to Group II and III. Group II had greater fracture resistance as compared to Group I but less than Group III. Results: Ceramic veneer with 1mm incisal reduction with 1mm height of palatal chamfer showed highest fracture resistance as compared to 1mm incisal reduction with butt joint and no incisal reduction with facial-incisal bevel, in order to achieve better esthetic and functional results. Conclusion: The palatal chamfer margin results in preservation of some peripheral enamel layer, which eliminates the micro leakage at the palatal margin-restoration interface and also effectively counteracting shear stress. This design provides a definite seat for cementation. How to cite the article: Jankar AS, Kale Y, Kangane S, Ambekar A, Sinha M, Chaware S. Comparative evaluation of fracture resistance of Ceramic Veneer with three different incisal design preparations - An In-vitro Study. J Int Oral Health 2014;6(1):48-54. PMID:24653603

  16. Correction of measured Gamma-Knife output factors for angular dependence of diode detectors and PinPoint ionization chamber.

    PubMed

    Hršak, Hrvoje; Majer, Marija; Grego, Timor; Bibić, Juraj; Heinrich, Zdravko

    2014-12-01

    Dosimetry for Gamma-Knife requires detectors with high spatial resolution and minimal angular dependence of response. Angular dependence and end effect time for p-type silicon detectors (PTW Diode P and Diode E) and PTW PinPoint ionization chamber were measured with Gamma-Knife beams. Weighted angular dependence correction factors were calculated for each detector. The Gamma-Knife output factors were corrected for angular dependence and end effect time. For Gamma-Knife beams angle range of 84°-54°. Diode P shows considerable angular dependence of 9% and 8% for the 18 mm and 14, 8, 4 mm collimator, respectively. For Diode E this dependence is about 4% for all collimators. PinPoint ionization chamber shows angular dependence of less than 3% for 18, 14 and 8 mm helmet and 10% for 4 mm collimator due to volumetric averaging effect in a small photon beam. Corrected output factors for 14 mm helmet are in very good agreement (within ±0.3%) with published data and values recommended by vendor (Elekta AB, Stockholm, Sweden). For the 8 mm collimator diodes are still in good agreement with recommended values (within ±0.6%), while PinPoint gives 3% less value. For the 4 mm helmet Diodes P and E show over-response of 2.8% and 1.8%, respectively. For PinPoint chamber output factor of 4 mm collimator is 25% lower than Elekta value which is generally not consequence of angular dependence, but of volumetric averaging effect and lack of lateral electronic equilibrium. Diodes P and E represent good choice for Gamma-Knife dosimetry.

  17. Development of an algorithm to improve the accuracy of dose delivery in Gamma Knife radiosurgery

    NASA Astrophysics Data System (ADS)

    Cernica, George Dumitru

    2007-12-01

    Gamma Knife stereotactic radiosurgery has demonstrated decades of successful treatments. Despite its high spatial accuracy, the Gamma Knife's planning software, GammaPlan, uses a simple exponential as the TPR curve for all four collimator sizes, and a skull scaling device to acquire ruler measurements to interpolate a threedimensional spline to model the patient's skull. The consequences of these approximations have not been previously investigated. The true TPR curves of the four collimators were measured by blocking 200 of the 201 sources with steel plugs. Additional attenuation was provided through the use of a 16 cm tungsten sphere, designed to enable beamlet measurements along one axis. TPR, PDD, and beamlet profiles were obtained using both an ion chamber and GafChromic EBT film for all collimators. Additionally, an in-house planning algorithm able to calculate the contour of the skull directly from an image set and implement the measured beamlet data in shot time calculations was developed. Clinical and theoretical Gamma Knife cases were imported into our algorithm. The TPR curves showed small deviations from a simple exponential curve, with average discrepancies under 1%, but with a maximum discrepancy of 2% found for the 18 mm collimator beamlet at shallow depths. The consequences on the PDD of the of the beamlets were slight, with a maximum of 1.6% found with the 18 mm collimator beamlet. Beamlet profiles of the 4 mm, 8 mm, and 14 mm showed some underestimates of the off-axis ratio near the shoulders (up to 10%). The toes of the profiles were underestimated for all collimators, with differences up to 7%. Shot times were affected by up to 1.6% due to TPR differences, but clinical cases showed deviations by no more than 0.5%. The beamlet profiles affected the dose calculations more significantly, with shot time calculations differing by as much as 0.8%. The skull scaling affected the shot time calculations the most significantly, with differences of up to 5

  18. A numerical study of vector resonant relaxation

    NASA Astrophysics Data System (ADS)

    Kocsis, Bence; Tremaine, Scott

    2015-04-01

    Stars bound to a supermassive black hole interact gravitationally. Persistent torques acting between stellar orbits lead to a rapid resonant relaxation of the orbital orientation vectors (`vector' resonant relaxation) and slower relaxation of the eccentricities (`scalar' resonant relaxation), both at rates much faster than two-body or non-resonant relaxation. We describe a new parallel symplectic integrator, N-RING, which follows the dynamical evolution of a cluster of N stars through vector resonant relaxation, by averaging the pairwise interactions over the orbital period and periapsis precession time-scale. We use N-RING to follow the evolution of clusters containing over 104 stars for tens of relaxation times. Among other results, we find that the evolution is dominated by torques among stars with radially overlapping orbits, and that resonant relaxation can be modelled as a random walk of the orbit normals on the sphere, with angular step size ranging from ˜0.5-1 rad. The relaxation rate in a cluster with a fixed number of stars is proportional to the root mean square (rms) mass of the stars. The rms torque generated by the cluster stars is reduced below the torque between Kepler orbits due to apsidal precession and declines weakly with the eccentricity of the perturbed orbit. However, since the angular momentum of an orbit also decreases with eccentricity, the relaxation rate is approximately eccentricity-independent for e ≲ 0.7 and grows rapidly with eccentricity for e ≳ 0.8. We quantify the relaxation using the autocorrelation function of the spherical multipole moments; this decays exponentially and the e-folding time may be identified with the vector resonant relaxation time-scale.

  19. Dielectric relaxation in a protein matrix

    SciTech Connect

    Pierce, D.W.; Boxer, S.G.

    1992-06-25

    The dielectric relaxation of a sperm whale ApoMb-DANCA complex is measured by the fluorescence dynamic Stokes shift method. Emission energy increases with decreasing temperature, suggesting that the relaxation activation energies of the rate-limiting motions either depend on the conformational substrate or different types of protein motions with different frequencies participate in the reaction. Experimental data suggest that there may be relaxations on a scale of <100 ps. 61 refs., 7 figs., 2 tabs.

  20. Comparing consistency of clear corneal incisions using a traditional diamond keratome and a newly designed diamond keratome

    PubMed Central

    Swan, Russell J; Byrd, Julia M; Bettis, Daniel I; Olson, Randall J

    2015-01-01

    Purpose To compare the consistency of incision architecture utilizing a traditional diamond keratome and a newly designed diamond keratome. Methods We used a traditional diamond keratome and newly designed diamond keratome to create clear corneal incisions in human cadaveric donor eyes. Three surgeons with varying levels of experience made 30 incisions with each keratome; and the wound architecture was measured including incision lengths, epithelial and endothelial widths, and the central epithelial incision’s deviation from a straight line entrance. Results The mean absolute difference in right and left incision lengths (traditional: 0.182 ± 0.158 mm and new 0.088±0.077 mm [P<0.003]), mean absolute difference in epithelial and endothelial incision width (traditional: 0.181±0.144 mm and new 0.080±0.092 mm [P<0.002]), endothelial incision central deviation from a straight line (traditional: 0.128±0.242 mm and new −0.046±0.124 mm [P<0.001]) were all significantly more consistent with the newly designed diamond keratome than with the traditional diamond keratome. Conclusion The newly designed diamond keratome creates a more consistent clear corneal incision than a traditional diamond keratome across a variety of surgical skill levels and does not require advanced levels of training to achieve this consistency. PMID:26261415

  1. Efficacy of Single-Suture Incision Closures in Tagged Juvenile Chinook Salmon Exposed to Simulated Turbine Passage

    SciTech Connect

    Boyd, James W.; Deters, Katherine A.; Brown, Richard S.; Eppard, M. B.

    2011-09-01

    Reductions in the size of acoustic transmitters implanted in migrating juvenile salmonids have resulted in the use of a shorter incision-one that may warrant only a single suture for closure. However, it is not known whether a single suture will sufficiently hold the incision closed when fish are decompressed and when outward pressure is placed on the surgical site during turbine passage through hydroelectric dams. The objective of this study was to evaluate the effectiveness of single-suture incision closures on five response variables in juvenile Chinook salmon Oncorhynchus tshawytscha that were subjected to simulated turbine passage. An acoustic transmitter (0.43 g in air) and a passive integrated transponder tag (0.10 g in air) were implanted in each fish; the 6-mm incisions were closed with either one suture or two sutures. After exposure to simulated turbine passage, none of the fish exhibited expulsion of transmitters. In addition, the percentage of fish with suture tearing, incision tearing, or mortal injury did not differ between treatments. Expulsion of viscera through the incision was higher among fish that received one suture (12%) than among fish that received two sutures (1%). The higher incidence of visceral expulsion through single-suture incisions warrants concern. Consequently, for cases in which tagged juvenile salmonidsmay be exposed to turbine passage, we do not recommend the use of one suture to close 6-mm incisions associated with acoustic transmitter implantation.

  2. Temperature relaxation in dense plasma mixtures

    NASA Astrophysics Data System (ADS)

    Faussurier, Gérald; Blancard, Christophe

    2016-09-01

    We present a model to calculate temperature-relaxation rates in dense plasma mixtures. The electron-ion relaxation rates are calculated using an average-atom model and the ion-ion relaxation rates by the Landau-Spitzer approach. This method allows the study of the temperature relaxation in many-temperature electron-ion and ion-ion systems such as those encountered in inertial confinement fusion simulations. It is of interest for general nonequilibrium thermodynamics dealing with energy flows between various systems and should find broad use in present high energy density experiments.

  3. Delayed Over-Relaxation for iterative methods

    NASA Astrophysics Data System (ADS)

    Antuono, M.; Colicchio, G.

    2016-09-01

    We propose a variant of the relaxation step used in the most widespread iterative methods (e.g. Jacobi Over-Relaxation, Successive Over-Relaxation) which combines the iteration at the predicted step, namely (n + 1), with the iteration at step (n - 1). We provide a theoretical analysis of the proposed algorithm by applying such a delayed relaxation step to a generic (convergent) iterative scheme. We prove that, under proper assumptions, this significantly improves the convergence rate of the initial iterative method. As a relevant example, we apply the proposed algorithm to the solution of the Poisson equation, highlighting the advantages in comparison with classical iterative models.

  4. Lavender fragrance cleansing gel effects on relaxation.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria; Cisneros, Wendy; Feijo, Larissa; Vera, Yanexy; Gil, Karla; Grina, Diana; Claire He, Qing

    2005-02-01

    Alertness, mood, and math computations were assessed in 11 healthy adults who sniffed a cosmetic cleansing gel with lavender floral blend aroma, developed to be relaxing using Mood Mapping. EEG patterns and heart rate were also recorded before, during, and after the aroma session. The lavender fragrance blend had a significant transient effect of improving mood, making people feel more relaxed, and performing the math computation faster. The self-report and physiological data are consistent with relaxation profiles during other sensory stimuli such as massage and music, as reported in the literature. The data suggest that a specific cosmetic fragrance can have a significant role in enhancing relaxation.

  5. [Comparison of total hip arthroplasty via a posterior mini-incision versus a classic anterolateral approach].

    PubMed

    Rittmeister, M; Peters, A

    2006-07-01

    Surgical approaches to the hip for total hip arthroplasty (THA) are termed minimally invasive when allowing for a skin incision length of 10 cm or less. The aim of this study was to explore if a minimally invasive posterior approach compared to a classic anterolateral approach negatively influenced surgical time, blood loss, implant position, or perioperative complications. Two groups of THA patients mainly differing with respect to the surgical approach were compared. Results of 76 consecutive THA via a posterior mini-incision approach were recorded prospectively and those of 76 controls operated via a classic anterolateral approach were recorded retrospectively. THA was performed by the same surgeon in every case. Surgical time or intraoperative blood loss were not different among the groups. Total 24-h blood loss was significantly less in patients undergoing THA via minimally invasive posterior approaches. Median cup inclination was 45 degrees in both groups. Cup anteversion was 15 degrees (classic anterolateral) and 12 degrees (minimally invasive posterior), respectively. Stem position was regarded as neutral in 80% of THA through classic anterolateral and in 76 % through minimally invasive dorsal incisions. Complications occurred in 8% (classic anterolateral) and 9% (minimally invasive posterior) of THA patients. Surgical time, blood loss, risk of malpositioned implants, or complications were not increased for THA patients operated through minimally invasive posterior incisions compared to those operated via classic anterolateral approaches.

  6. Modelling Incision in Mixed Bedrock-Alluvial Rivers: The Role of Sediment Waves (Invited)

    NASA Astrophysics Data System (ADS)

    Parker, G.; Zhang, L.; Stark, C. P.; Viparelli, E.; Fu, X.

    2013-12-01

    The delineation of the Sklar-Dietrich (S-D) model for bedrock incision due to wear has allowed modeling to move beyond phenomenological models to treatments with both measurable and physically interpretable input parameters. The S-D model assumes that incision is due to abrasion caused by bedload particles striking the bedrock surface, and that the ratio of the bedload supply rate to the capacity transport rate controls the areal fraction of bed surface available for abrasion. The model does not, however, route the alluvium itself downstream. As such, it cannot track the spatiotemporal evolution of downstream-migrating sediment waves created by such episodic events such as landslides and debris flows. The passage of these waves can cause complete alluviation of the bed, thus shutting down incision. The absence of these events can also shut down incision due to a paucity of tools. We introduce a new model which ties an 'Exner' equation for mass balance of bedrock with an Exner equation for conservation of alluvium. As a first step, we apply the model to a 1D configuration with temporally varying sediment input at the upstream end. Model results illustrate the competing roles of advection (which causes deviation from the results of S-D) and diffusion (which drives the process toward S-D). The model is adaptable to a) 2D meandering channels and b) distributed landscape evolution models.

  7. Groundwater-surface water interaction in the riparian zone of an incised channel, Walnut Creek, Iowa

    USGS Publications Warehouse

    Schilling, K.E.; Li, Z.; Zhang, Y.-K.

    2006-01-01

    Riparian zones of many incised channels in agricultural regions are cropped to the channel edge leaving them unvegetated for large portions of the year. In this study we evaluated surface and groundwater interaction in the riparian zone of an incised stream during a spring high flow period using detailed stream stage and hydraulic head data from six wells, and water quality sampling to determine whether the riparian zone can be a source of nitrate pollution to streams. Study results indicated that bank storage of stream water from Walnut Creek during a large storm water runoff event was limited to a narrow 1.6 m zone immediately adjacent to the channel. Nitrate concentrations in riparian groundwater were highest near the incised stream where the unsaturated zone was thickest. Nitrate and dissolved oxygen concentrations and nitrate-chloride ratios increased during a spring recharge period then decreased in the latter portion of the study. We used MODFLOW and MT3DMS to evaluate dilution and denitrification processes that would contribute to decreasing nitrate concentrations in riparian groundwater over time. MT3DMS model simulations were improved with a denitrification rate of 0.02 1/d assigned to the floodplain sediments implying that denitrification plays an important role in reducing nitrate concentrations in groundwater. We conclude that riparian zones of incised channels can potentially be a source of nitrate to streams during spring recharge periods when the near-stream riparian zone is largely unvegetated. ?? 2005 Elsevier B.V. All rights reserved.

  8. 9 CFR 310.11 - Cleaning of hog carcasses before incising.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Cleaning of hog carcasses before incising. 310.11 Section 310.11 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT... AND VOLUNTARY INSPECTION AND CERTIFICATION POST-MORTEM INSPECTION § 310.11 Cleaning of hog...

  9. Exposure of both the radius and ulna through a single posterior incision: a technical note.

    PubMed

    Wahsh, Abdel-Azim Hassan

    2015-01-01

    Fractures of both the radius and ulna are usually treated with two separate incisions and rarely with one single incision. However, both methods have disadvantages. For this we describe a relatively safe single straight posterior incision for exposure of the whole shafts of both the radius and ulna with the forearm rested on a board across the chest. This procedure was used in 116 forearms in 115 patients. The incision was in a straight line from the lateral humeral epicondyle to the ulnar head. The ulna was exposed between the extensor carpi ulnaris muscle and flexor digitorum profundus muscle covered by the aponeurosis of the flexor carpi ulnaris muscle and the radius between the extensor digitorum muscle and the extensor carpi radialis brevis muscle. During operation there was no difficulty in reducing or fixing any of the fractures in the whole shafts of the radius and ulna and at follow-up (average 5.2 years) there was no radioulnar synostosis or neurovascular injury in any of the forearms. PMID:27163077

  10. Using airborne LiDAR to investigated the bedrock incision in the Tsaoling Landslide surface, Taiwan

    NASA Astrophysics Data System (ADS)

    Hou, Chin-Shyong; Chen, Yi-Zhong; Hsieh, Yu-Chung; Chen, Rou-Fei; Wu, Ruo-Ying

    2014-05-01

    In recent decades, a great number of studies have investigated the tectonic topographic evolution and development of active orogenic belts that cause the dynamics related to a variety of terrain features. In particular, the incision of bedrock via erosion by rivers plays a crucial research role. Erosion gullies reflect the incision of bedrock by rivers during the tectonic and topographic evolution of active orogenic zones; however, a limited amount of measurement data is currently available. Therefore, this study explored the incision erosion rate of different lithologies in the collapsed surface of a landslide induced by the 1999 Chi-chi earthquake in the Tsaoling area. This study uses the 1 m high-resolution DEM established by the Central Geological Survey via airborne LiDAR, organized by the Ministry of Economic Affairs (MOEA. In this study, we investigated the distribution of erosion gullies produced in different rock formations by the Tsaoling landslide based on an openness analysis using a red relief image map (RRIM) and calculated the bedrock incision rate for the Cholan Formation and Chishui Shale for 1999, 2011 and 2012, which was 30-40 cm/yr and 54-90 cm/yr on average, respectively. These results indicated that the Cholan Formation has a higher resistance to erosion than the Chishui Shale, where the erosion was more serious.

  11. Human FAN1 promotes strand incision in 5'-flapped DNA complexed with RPA.

    PubMed

    Takahashi, Daisuke; Sato, Koichi; Hirayama, Emiko; Takata, Minoru; Kurumizaka, Hitoshi

    2015-09-01

    Fanconi anaemia (FA) is a human infantile recessive disorder. Seventeen FA causal proteins cooperatively function in the DNA interstrand crosslink (ICL) repair pathway. Dual DNA strand incisions around the crosslink are critical steps in ICL repair. FA-associated nuclease 1 (FAN1) is a DNA structure-specific endonuclease that is considered to be involved in DNA incision at the stalled replication fork. Replication protein A (RPA) rapidly assembles on the single-stranded DNA region of the stalled fork. However, the effect of RPA on the FAN1-mediated DNA incision has not been determined. In this study, we purified human FAN1, as a bacterially expressed recombinant protein. FAN1 exhibited robust endonuclease activity with 5'-flapped DNA, which is formed at the stalled replication fork. We found that FAN1 efficiently promoted DNA incision at the proper site of RPA-coated 5'-flapped DNA. Therefore, FAN1 possesses the ability to promote the ICL repair of 5'-flapped DNA covered by RPA.

  12. Meta‐analysis of negative‐pressure wound therapy for closed surgical incisions

    PubMed Central

    Birke‐Sorensen, H.; Kruse, M.; Vinter, C.; Joergensen, J. S.; Sorensen, J. A.; Mogensen, O.; Lamont, R. F.; Bille, C.

    2016-01-01

    Abstract Background Postoperative wound complications are common following surgical procedures. Negative‐pressure wound therapy (NPWT) is well recognized for the management of open wounds and has been applied recently to closed surgical incisions. The evidence base to support this intervention is limited. The aim of this study was to assess whether NPWT reduces postoperative wound complications when applied to closed surgical incisions. Methods This was a systematic review and meta‐analysis of randomized clinical trials of NPWT compared with standard postoperative dressings on closed surgical incisions. Results Ten studies met the inclusion criteria, reporting on 1311 incisions in 1089 patients. NPWT was associated with a significant reduction in wound infection (relative risk (RR) 0·54, 95 per cent c.i. 0·33 to 0·89) and seroma formation (RR 0·48, 0·27 to 0·84) compared with standard care. The reduction in wound dehiscence was not significant. The numbers needed to treat were three (seroma), 17 (dehiscence) and 25 (infection). Methodological heterogeneity across studies led to downgrading of the quality of evidence to moderate for infection and seroma, and low for dehiscence. Conclusion Compared with standard postoperative dressings, NPWT significantly reduced the rate of wound infection and seroma when applied to closed surgical wounds. Heterogeneity between the included studies means that no general recommendations can be made yet. PMID:26994715

  13. Right parasternal incision: a uniform minimally invasive approach for valve operations.

    PubMed

    Lazzara, R R; Kidwell, F E

    1998-01-01

    The right parasternal incision can be used for replacing or repairing cardiac valves. A specialized retractor system produces excellent exposure and helps avoid groin cannulation. The approach reduces surgical dissection and trauma, does not require sacrifice of mammary arteries, prevents rib spreading, avoids sternotomy, reduces the risk of cardiac injury at subsequent redo operations, and does not require specialized video or thoracoscopic equipment.

  14. The impact of surgical site occurrences and the role of closed incision negative pressure therapy.

    PubMed

    Willy, Christian; Engelhardt, Michael; Stichling, Marcus; Grauhan, Onnen

    2016-09-01

    Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews ('SSI', 'deep sternal wound infections' (DSWI), 'closed incision negative pressure wound therapy' (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a 'snowball' method of continued searches of the references in the identified publications. Search criteria included publications in all languages, various study types and publication in a peer-reviewed journal. The SSI literature search identified 1325, the DSWI search 590 and the ciNPT search 103 publications that fulfilled the search criteria. Patient-related SSI risk factors (diabetes mellitus, obesity, smoking, hypertension, female gender) and operation-related SSI risk factors (re-exploration, emergency operations, prolonged ventilation, prolonged operation duration) exist. We found that patient- and operation-related SSI risk factors were often different for each speciality and/or operative procedure. Based on the evidence, we found that high-risk incisions (sternotomy and incisions in extremities after high-energy open trauma) are principally recommended for ciNPT use. In 'lower'-risk incisions, the addition of patient-related or operation-related risk factors justifies the application of ciNPT. PMID:27547962

  15. RELATIONSHIPS OF MEADOW VEGETATION TO GROUNDWATER DEPTH: EFFECTS OF PRECIPITATION VARIABILITY AND STREAM INCISION

    EPA Science Inventory

    The composition of riparian meadow vegetation is controlled by access to groundwater. Depth to groundwater is controlled by meadow architecture and water source, and changes in either meadow architecture or water source through stream incision or changes in annual precipitation c...

  16. Use of the inverted “T” incision to approach a plantar nodular lesion*

    PubMed Central

    Sampaio, Felipe Maurício Soeiro; Gualberto, Gustavo Vieira; de Souza, Paulo Roberto Cotrim; Lourenço, Fabrício Tinoco; de Cerqueira, Fernando Gustavo Mósca

    2015-01-01

    Knowledge of the inverted "T" incision - used in plastic, oncologic and orthopedic surgery - has allowed its adaptation for the diagnostic assessment and therapeutical approach of acral, nodular lesions. The authors describe the use of this technique for the surgical approach of a patient with a plantar nodular lesion, further diagnosed as a calcified angioleiomyoma. PMID:25672316

  17. The influence of incisal malocclusion on the social attractiveness of young adults in Finland.

    PubMed

    Kerosuo, H; Hausen, H; Laine, T; Shaw, W C

    1995-12-01

    The aim of this study was to investigate the importance of dentofacial appearance on the perceived social attractiveness of young adults in Finland. The dental arrangements studied were incisal crowding, median diastema, protruding incisors, and ideal incisal occlusion. Facial photographs of six young adults were obtained and modified, so that for each face, four different dental arrangements could be portrayed. The photographs were shown to 1007 Finnish students to estimate social and personal characteristics of the person in the photograph. Dental arrangement had a significant influence on the perceived beauty and success of the persons. Test faces with incisal crowding and median diastema were ranked as significantly less intelligent, beautiful and sexually attractive, and judged to belong to lower social class than the same faces with ideal occlusion. Protruded incisors did not affect the ratings compared to ideal occlusion. On the average, female test faces were judged more favourably than the male ones. The results indicate that among Finnish students conspicuous incisal crowding or spacing represent a social disadvantage compared to normal or protruded incisors.

  18. [A case of giant hemorrhagic adrenal pseudocystectomy with a flank incision].

    PubMed

    Takeuchi, Yasuharu; Ozaki, Yumi; Suyama, Taisuke; Sawada, Yoshitomo; Kuroda, Kanami; Nakajima, Kouichi; Oharaseki, Toshiaki; Wakayama, Megumi

    2011-06-01

    The patient was a 43-year-old woman who underwent detailed examinations for a retroperitoneal cystic lesion that was incidentally found during orthopedic treatment. Although the tumor was a non-functioning tumor, and diagnostic imaging was negative for malignancy, the tumor was surgically resected with a flank incision. The histopathological diagnosis was adrenal pseudocyst.

  19. The influence of incisal malocclusion on the social attractiveness of young adults in Finland.

    PubMed

    Kerosuo, H; Hausen, H; Laine, T; Shaw, W C

    1995-12-01

    The aim of this study was to investigate the importance of dentofacial appearance on the perceived social attractiveness of young adults in Finland. The dental arrangements studied were incisal crowding, median diastema, protruding incisors, and ideal incisal occlusion. Facial photographs of six young adults were obtained and modified, so that for each face, four different dental arrangements could be portrayed. The photographs were shown to 1007 Finnish students to estimate social and personal characteristics of the person in the photograph. Dental arrangement had a significant influence on the perceived beauty and success of the persons. Test faces with incisal crowding and median diastema were ranked as significantly less intelligent, beautiful and sexually attractive, and judged to belong to lower social class than the same faces with ideal occlusion. Protruded incisors did not affect the ratings compared to ideal occlusion. On the average, female test faces were judged more favourably than the male ones. The results indicate that among Finnish students conspicuous incisal crowding or spacing represent a social disadvantage compared to normal or protruded incisors. PMID:8682167

  20. Successful Retrieval of a Retained Capsule Endoscope with Single Incision Laparoscopic Surgery

    PubMed Central

    Tashiro, Yoshihiko; Kawai, Masaya; Takehara, Kazuhiro; Munakata, Shinya; Ishiyama, Shun; Sugimoto, Kiichi; Takahashi, Makoto; Kojima, Yutaka; Goto, Michitoshi; Tomiki, Yuichi; Shibuya, Tomoyoshi; Osada, Taro; Watanabe, Sumio; Sakamoto, Kazuhiro

    2014-01-01

    Capsule endoscopy (CE) is commonly used for examining and diagnosing gastrointestinal disease, especially small bowel disease. Capsule retention is a well-known and significant complication of CE and requires surgical or endoscopic removal. Most reports described the retrieval of retained CE via laparotomy. We report a case of successful retrieval of the capsule using single incision laparoscopic surgery. PMID:25028577

  1. Rock slope response to fluvial incision in the central Swiss Alps

    NASA Astrophysics Data System (ADS)

    Leith, Kerry; Fox, Matthew; Moore, Jeffrey R.

    2016-04-01

    The longitudinal profile of rivers intersecting the Rhone Valley in the central Swiss Alps suggests the development of topography throughout much of this region has been dominated by interglacial fluvial incision and ongoing tectonic uplift with only minimal glacial erosion since the mid-Pleistocene transition. Evidence indicates bedrock river incision during this period reflects a base level fall of between 500 m and 800 m (depending on the degree of overdeepening following an early period of enhanced glacial incision). This observation raises important questions regarding the preservation, or development of hillslope morphologies through multiple glacial-interglacial cycles. Since the pioneering works of Richter (1900) and Penck and Brückner (1909), Alpine geomorphologists have commented on a sequence of between three and five moderately dipping matched terraces that converge toward inferred paleo-river channels up to 800 m above the axis of many valleys. Here, we use a combination of integral analysis, forward streampower models, and a new method of topographic analysis based on high resolution LiDAR DEMs in order to test the correspondence of valley morphologies in this formerly glaciated landscape, with hillslope processes initiated by fluvial incision up to 700,000 years ago. Results indicate topography adjacent to reaches subjected to transient fluvial incision is characterized by a coherent region of consistently steep slopes, while narrow gorges correspond to rapid incision close to the Rhone valley since MIS 5. A majority of hillslopes converge to our initial fluvial valley floor, or the location of propagating knickpoints. The correspondence between intermediate-level terraces and modeled stages of river incision is, however, currently unclear. These results offer a unique insight into the long-term response of bedrock slopes to varying rates of base level fall, and the cumulative impact of glacial erosion on Alpine valley walls since MIS 11. Penck, A

  2. Incision Along the Red River, Yunnan Province, China: a Transient Response to Regional Surface Uplift

    NASA Astrophysics Data System (ADS)

    Schoenbohm, L. M.; Whipple, K. X.; Burchfiel, B. C.; Chen, L.

    2002-12-01

    On the basis of digital elevation data and field observations, we observe a low-relief relict landscape in the vicinity of the Red River, Yunnan Province, China, which correlates to a regional erosion surface preserved over the eastern margin of the Tibetan Plateau (Clark et al. 2002). As with other major rivers of the eastern margin, the Red River has incised the relict landscape, creating a river valley system up to 2 km deep, which we refer to as the active landscape. Abandonment of the relict landscape and subsequent river incision is likely related to surface uplift from inflation of regions adjacent to the Tibetan Plateau by pressure-gradient driven flow of lower crust from beneath Tibet (Clark and Royden, 2000). The relict landscape is preserved as low-relief patches along the margins of the of the Red River basin; however, this is a transient state. If the new conditions (change in uplift rate) persist over a long enough timescale, full equilibration to the active landscape will occur and the relict landscape will be destroyed. We examine the expression of the transient condition in the Red River basin, using longitudinal river profiles for 102 tributaries to the Red River. Most profiles consist of an upper channel with low steepness and normal concavity, and a lower channel with high steepness and concavity, separated by a sharp knickpoint. The upper channel portions correspond to the relict landscape and have not yet felt the effect of river incision. Below the knickpoint the channels are incising rapidly. Extremely high concavities in the lower channel segments likely result from a complicated regional incision history. We argue that rapid regional surface uplift, followed by slower surface uplift and a correspondent decrease over time in uplift rate is responsible for the overall river incision pattern and in particular for the high concavities in the lower channel segments. However, this conclusion is complicated by the effects of changing erosion

  3. The Role of Incision and Sedimentation in Continental Gravity Gliding - Insight from Numerical Modelling

    NASA Astrophysics Data System (ADS)

    Riad, H.; Messager, G.; Nivihre, B.

    2010-12-01

    Large scale gravity gliding are usually observed in deltas and passive margins. They imply the rigid translation of a body down a slope, with coeval upslope extension and downslope contraction. Displacement vectors are parallel to a buried detachment plane gently dipping basinward (1-5°). Field examples suggest that gravity gliding could be found in continental domains but contrary to oceanic environments, upslope sedimentation and pore fluid overpressure do not play a major role. These lacks must be compensated. This study investigates mechanisms generating gravity gliding in a continental domains through the use of a two-dimensional (2D) finite-element model and a 2D analytical failure analysis. We focus on the role of tectonic uplifts and the subsequent fluvial incision and sedimentation at the toes of the slopes. The geometries of the numerical models are based on a field example in the Andean foothills of Argentina. Gravity gliding occurs along the long limb of an asymmetric crustal-scale anticline, above a 1000 m depth salt layers. The numerical models simulate the deformations and estimate quantitatively the circumstances under which failure at the head and toe of the frictional-plastic sedimentary cover initiates. Analytical solutions give simplified approximation of the numerical results taking into account many configurations with various values of the incision, sedimentation, internal friction angle and thickness of the décollement layer. The principal effect of the incision and sedimentation is to reduce and strengthen the downslope resistance to the contractional failure. Consequently, the magnitude of the critical slope for which the gravity gliding initiates, is reduced by the incision and is increased by the sedimentation. Results show that large-scale gravity gliding can be found in continental domains as a consequence of tectonic uplifts and where overburden thickness is lower than 2000 m. Incision facilitates and localizes the gliding

  4. Isometric squeeze relaxation (progressive relaxation) vs meditation: absorption and focusing as predictors of state effects.

    PubMed

    Weinstein, M; Smith, J C

    1992-12-01

    We taught isometric squeeze relaxation (a variant of progressive relaxation) or meditation to 52 anxious subjects (16 men, 36 women). For meditation, pretreatment high absorption correlated with reductions in state cognitive and somatic anxiety as well as increments in state focusing. For isometric squeeze relaxation, pretreatment low state focusing correlated with reductions in somatic anxiety and increments in focusing. Results suggest that isometric squeeze relaxation (and progressive relaxation) may be more appropriate for individuals who have difficulty focusing, and meditation for those who already possess well-developed relaxation skills at a trait level. The results appear more consistent with Smith's cognitive-behavioral model of relaxation than with Benson's relaxation response or Davidson and Schwartz's specific effects models.

  5. Zen meditation and ABC relaxation theory: an exploration of relaxation states, beliefs, dispositions, and motivations.

    PubMed

    Gillani, N B; Smith, J C

    2001-06-01

    This study is an attempt to rigorously map the psychological effects of Zen meditation among experienced practitioners. Fifty-nine Zen meditators with at least six years of experience practiced an hour of traditional Zazen seated meditation. A control group of 24 college students spent 60 min silently reading popular magazines. Before relaxation, all participants took the Smith Relaxation States Inventory (SRSI), the Smith Relaxation Dispositions/Motivations Inventory (SRD/MI), and the Smith Relaxation Beliefs Inventory (SRBI). After practice, participants again took the SRSI. Analyses revealed that meditators are less likely to believe in God, more likely to believe in Inner Wisdom, and more likely to display the relaxation dispositions Mental Quiet, Mental Relaxation, and Timeless/Boundless/Infinite. Pre- and postsession analyses revealed that meditators showed greater increments in the relaxation states Mental Quiet, Love and Thankfulness, and Prayerfulness, as well as reduced Worry. Results support Smith's ABC Relaxation Theory.

  6. Right thoracoabdominal stab injury penetrating the liver and gallbladder: case report and lessons in penetrating knife wounds to the chest and abdomen

    PubMed Central

    Griffiths, Ewen A; Mohamed, Ahmed; Ball, Chris S

    2010-01-01

    The authors report a patient who suffered a penetrating knife injury to the right thoracoabdominal region which penetrated through the liver and both sides of the gallbladder. This injury was treated successfully by laparotomy and cholecystectomy. PMID:22778183

  7. Supernova hemorrhage: obliterative hemorrhage of brain arteriovenous malformations following γ knife radiosurgery.

    PubMed

    Alexander, Matthew D; Hetts, Steven W; Young, William L; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T; English, Joey D

    2012-09-01

    Hemorrhage represents the most feared complication of cerebral arteriovenous malformations (AVMs) in both untreated patients and those treated with gamma knife radiosurgery. Radiosurgery does not immediately lead to obliteration of the malformation, which often does not occur until years following treatment. Post-obliteration hemorrhage is rare, occurring months to years after radiosurgery, and has been associated with residual or recurrent AVM despite prior apparent nidus elimination. Three cases are reported of delayed intracranial hemorrhage in patients with cerebral AVMs treated with radiosurgery in which no residual AVM was found on catheter angiography at the time of delayed post-treatment hemorrhage. That the pathophysiology of these hemorrhages involves progressive venous outflow occlusion is speculated and the possible mechanistic link to subsequent vascular rupture is discussed.

  8. Measurement Of Transverse Jc Profiles Of Coated Conductors Using A Magnetic Knife Of Permanent Magnets

    SciTech Connect

    Hanisch, J; Mueller, F M; Ashworth, S P; Coulter, J Y; Matias, Vlad

    2008-01-01

    The transverse J{sub c} distribution in YBCO coated conductors was measured nondestructively with high resolution using a 'magnetic knife' made of permanent magnets. The method utilizes the strong depression of J{sub c} in applied magnetic fields. A narrow region of low (including zero) magnetic field, in a surrounding higher field, is moved transversely across the sample in order to reveal the critical-current density distribution. The net resolution of this device is approximately 65 {mu}m, and the J{sub c} resolution is better than 0.5%. A Fourier series inversion process was used to determine the transverse J{sub c} distribution in the sample. The J{sub c} profile was correlated with other sample properties of coated conductors prepared by pulsed laser deposition. Because of its straight-forward and inexpensive design, this J{sub c} imaging technique can be a powerful tool for quality control in coated-conductor production.

  9. Endoscopic Needle Knife Sphincterotome-an Alternative for Retrieval of an Entrapped Nasogastric Tube.

    PubMed

    Kataria, Hanish; Sharma, Rajeev; Bansiwal, Rajesh; Jindal, Anurag; Attri, A K

    2015-12-01

    Knowledge of the use of a nasogastric tube (NG) is integral in medical practice as a whole and more so in gastrointestinal diseases because of its wide range of uses. Accidental fixation of the nasogastric tube during surgery is a rare complication. Various methods have been described for retrieval of an entrapped, retained or stapled nasogastric tube. We describe here a novel technique in which an endoscopic needle knife sphincterotome using a side-view endoscope was used successfully to cut the knots and release the entrapped NG tube. Although stress should always be laid on prevention, the flexible endoscopic approach is a small-duration procedure, a minimally invasive, cost-effective technique for the removal of a nasogastric tube that avoids the need of redo surgery and unnecessary exposure to anaesthesia.

  10. Moyamoya syndrome associated with γ knife surgery for cerebral arteriovenous malformation: case report.

    PubMed

    Uozumi, Yoichi; Sumitomo, Masaki; Maruwaka, Mikio; Araki, Yoshio; Izumi, Takashi; Miyachi, Shigeru; Kato, Takenori; Hasegawa, Toshinori; Kida, Yoshihisa; Okamoto, Sho; Wakabayashi, Toshihiko

    2012-01-01

    A 30-year-old female developed moyamoya syndrome after gamma knife surgery (GKS) for cerebral arteriovenous malformation (AVM), and was treated with bypass surgery. She suffered from flittering scotoma, right transient hemianopsia, and headache for 1 year. Cerebral angiography revealed a Spetzler-Martin grade III AVM located in the left occipital lobe. After staged embolization, GKS was performed with a minimum dose of 20 Gy to the periphery of the nidus at the 50% isodose level of the maximum target dose. Gradual nidus regression was achieved, and the clinical symptoms disappeared completely. However, at 30 months after GKS, the patient suffered transient ischemic attack. Cerebral angiography showed left middle cerebral artery occlusion with moyamoya vessels. The patient underwent direct and indirect bypass surgery. After surgery, the patient was free from ischemic symptoms. Chronic inflammation and long-term changes in expression of cytokines and growth factors after GKS may have triggered this case.

  11. Heat Treatment Optimization and Fabrication of a 440C Stainless Steel Knife

    NASA Astrophysics Data System (ADS)

    Bush, Ralph; Gill, Jacob; Teakell, Jarred

    2016-09-01

    There is ample evidence in the literature that the austenitization temperature and a post-quench liquid nitrogen soak play a significant role in the hardness/strength of martensitic stainless steels typically used in the fabrication of knives. However, there is a lack of quantitative data documenting the role these parameters have on the microstructure of these steels. A systematic study quantifies the volume fraction and composition of the microstructural constituents and hardness of 440C as a function of austenitization temperature and liquid nitrogen soak. Chromium carbide composition is independent of austenitization temperature. However, composition of the martensite matrix, and volume fractions of tempered martensite and carbides change with austenitization temperature. The liquid nitrogen soak is effective only at high temperatures that result in retained austenite. The results are used to rationalize and select an optimum heat-treat process for a knife fabricated in anticipation of the 2017 TMS Bladesmithing competition.

  12. Stereotactic radiosurgery XX: ocular neuromyotonia in association with gamma knife radiosurgery

    PubMed Central

    McQuillan, Joe; Plowman, P Nicholas; MacDougall, Niall; Blackburn, Philip; Sabin, H Ian; Ali, Nadeem; Drake, William M

    2015-01-01

    Summary We report three patients who developed symptoms and signs of ocular neuromyotonia (ONM) 3–6 months after receiving gamma knife radiosurgery (GKS) for functioning pituitary tumours. All three patients were complex, requiring multi-modality therapy and all had received prior external irradiation to the sellar region. Although direct causality cannot be attributed, the timing of the development of the symptoms would suggest that the GKS played a contributory role in the development of this rare problem, which we suggest clinicians should be aware of as a potential complication. Learning points GKS can cause ONM, presenting as intermittent diplopia.ONM can occur quite rapidly after treatment with GKS.Treatment with carbamazepine is effective and improve patient's quality of life. PMID:26294961

  13. Electromagnetic Casimir forces of parabolic cylinder and knife-edge geometries

    SciTech Connect

    Graham, Noah; Shpunt, Alexander; Kardar, Mehran; Emig, Thorsten; Rahi, Sahand Jamal; Jaffe, Robert L.

    2011-06-15

    An exact calculation of electromagnetic scattering from a perfectly conducting parabolic cylinder is employed to compute Casimir forces in several configurations. These include interactions between a parabolic cylinder and a plane, two parabolic cylinders, and a parabolic cylinder and an ordinary cylinder. To elucidate the effect of boundaries, special attention is focused on the 'knife-edge' limit in which the parabolic cylinder becomes a half-plane. Geometrical effects are illustrated by considering arbitrary rotations of a parabolic cylinder around its focal axis, and arbitrary translations perpendicular to this axis. A quite different geometrical arrangement is explored for the case of an ordinary cylinder placed in the interior of a parabolic cylinder. All of these results extend simply to nonzero temperatures.

  14. Noncontact measurement of liquid-surface properties with knife-edge electric field tweezers technique.

    PubMed

    Shimokawa, Yuji; Sakai, Keiji

    2013-06-01

    We have developed a technique for the simultaneous measurement of the surface tension and the viscosity of a liquid in a noncontact manner. In this method, a small linear deformation of the liquid surface is induced by a local dielectric force that is brought about by a knife-edge electrode. The surface tension and the viscosity are obtained from the shape of the induced meniscus and from the dynamic response of the surface, respectively. The surface tension obtained was examined in comparison with the values measured by the Wilhelmy plate method. We also measured time constants of the surface deformation for a variety of standard viscosity samples and obtained the relation between the time constant and the viscosity. The demonstrated advantage of the system is the ability to uniquely determine the surface tension and the viscosity.

  15. Optical knife-edge displacement sensor for high-speed atomic force microscopy

    SciTech Connect

    Braunsmann, Christoph; Schäffer, Tilman E.; Prucker, Veronika

    2014-03-10

    We show that an optical knife-edge technique can be used to detect the parallel shift of an object with sub-nanometer resolution over a wide bandwidth. This allows to design simple, contact-free, and high-speed displacement sensors that can be implemented in high-speed atomic force microscope scanners. In an experimental setup, we achieved a root-mean-square sensor noise of 0.8 nm within a bandwidth from 1 Hz to 1.1 MHz. We used this sensor to detect and correct the nonlinear z-piezo displacement during force curves acquired with rates of up to 5 kHz. We discuss the fundamental resolution limit and the linearity of the sensor.

  16. Convergent Hydraulics and Knickpoint Migration in an Incising Gravel-Cobble River

    NASA Astrophysics Data System (ADS)

    Wyrick, J. R.; Pasternack, G. B.

    2007-12-01

    Regulated gravel-cobble rivers are known to incise, but the mechanism of incision is not well documented by process-based research. Widespread use of simple "stream power law" equations assumes that incision is caused by continuous downcutting that increases with discharge. To provide an alternate explanation that recognizes the inherent non-uniformity of natural channels, we hypothesize that regulated rivers experience waves of migrating knickpoints that retreat through riffles during low flow when riffle crests function as supercritical weirs and are rejuvenated by floods that downcut the intervening width-constricted pools. To test this new hypothesis, monitoring was performed on the rapidly incising 7-km Timbuctoo Bend of the lower Yuba River, CA, where 463,000 cubic meters of sediment have been scoured out in just the last seven years alone. Direct field measurements of velocity and depth fields were obtained at three migrating, horseshoe-shaped knickpoints in this reach. Also, detailed channel DEMs were obtained at different stages of knickpoint migration to track geomorphic change over seven years. At one of the knickpoints, a special torque sensor was deployed to map near-bed lift and drag stress components. Velocity fields reveal convergent hydraulics controlled by the horseshoe morphology that focus scour in the upstream center of the U-shape. At a relatively low discharge, supercritical flow and near-critical standing waves were observed. Furthermore, the peak near-bed drag stress that was directly measured exceeded 1000 Pa during this relatively low discharge regime, which explains why the bedforms are retreating so rapidly. These direct measurements were compared to similar measurements previously reported for horseshoe waterfalls analyzed in a flume, and will aid in determining the real mechanism for knickpoint migration and channel incision in regulated gravel-cobble rivers.

  17. Bulk density and compaction behavior of knife mill chopped switchgrass,wheat straw, and corn stover

    SciTech Connect

    Chevanan, Nehru; Womac, A.R.; Bitra, V.S.P.; Igathinathane, C.; Yang, Y.T.; Miu, P.I; Sokhansanj, Shahabaddine

    2009-08-01

    Bulk density of comminuted biomass significantly increased by vibration during handling and transportation, and by normal pressure during storage. Compaction characteristics affecting the bulk density of switchgrass, wheat straw, and corn stover chopped in a knife mill at different operating conditions and using four different classifying screens were studied. Mean loose-filled bulk densities were 67.5 18.4 kg/m3 for switchgrass, 36.1 8.6 kg/m3 for wheat straw, and 52.1 10.8 kg/m3 for corn stover. Mean tapped bulk densities were 81.8 26.2 kg/m3 for switchgrass, 42.8 11.7 kg/m3 for wheat straw, and 58.9 13.4 kg/m3 for corn stover. Percentage changes in compressibility due to variation in particle size obtained from a knife mill ranged from 64.3 to 173.6 for chopped switchgrass, 22.2 51.5 for chopped wheat straw and 42.1 117.7 for chopped corn stover within the tested consolidation pressure range of 5 120 kPa. Pressure and volume relationship of chopped biomass during compression with application of normal pressure can be characterized by the Walker model and Kawakita and Ludde model. Parameter of Walker model was correlated to the compressibility with Pearson correlation coefficient greater than 0.9. Relationship between volume reduction in chopped biomass with respect to number of tappings studied using Sone s model indicated that infinite compressibility was highest for chopped switchgrass followed by chopped wheat straw and corn stover. Degree of difficulty in packing measured using the parameters of Sone s model indicated that the chopped wheat straw particles compacted very rapidly by tapping compared to chopped switchgrass and corn stover. These results are very useful for solving obstacles in handling bulk biomass supply logistics issues for a biorefinery.

  18. Gamma Knife Radiosurgery for Skull Base Meningiomas: Long-Term Radiologic and Clinical Outcome

    SciTech Connect

    Han, Jung Ho; Kim, Dong Gyu Chung, Hyun-Tai; Park, Chul-Kee; Paek, Sun Ha; Kim, Chae-Yong; Jung, Hee-Won

    2008-12-01

    Purpose: To analyze the long-term outcomes in patients with skull base meningiomas (SBMNGs) treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: Of the 98 consecutive patients with SBMNGs treated with GKRS between 1998 and 2002, 63 were followed up for more than 48 months. The mean ({+-}SD) age of the patients was 50 {+-} 12 years, the mean tumor volume was 6.5 cm{sup 3} (range, 0.5-18.4 cm{sup 3}), the mean marginal dose was 12.6 Gy (range, 7.0-20.0 Gy), and the mean follow-up duration was 77 {+-} 18 months. The mean number of shots was 13.7 {+-} 3.8. The tumor volume was decreased at the last follow-up in 28 patients (44.4%) and increased in 6 (9.6%). The actuarial tumor control rate was 90.2% at 5 years. No notable prognostic factor related to tumor control was identified. Ten patients (15.9%) with a cranial neuropathy showed unfavorable outcomes. The rate of improvement in patients with a cranial neuropathy was 45.1%. Age >70 years was likely correlated with an unfavorable outcome in patients with cranial neuropathy (odds ratio = 0.027; p = 0.025; 95% confidence interval 0.001-0.632). Cavernous sinus location was significantly associated with improvement of a cranial neuropathy (odds ratio = 7.314; p = 0.007; 95% confidence interval 1.707-31.34). Conclusions: Gamma Knife radiosurgery is an effective modality for the treatment of SBMNGs and provides favorable outcomes in patients with cranial neuropathy, even in the long-term follow-up period. However, radiosurgery for patients with no or only mild symptoms should be performed cautiously because neither complication rate is low enough to be negligible, especially in elderly patients. A cranial neuropathy by MNGs involving the cavernous sinus seems to have a higher chance of improvement after radiosurgery than other SBMNGs.

  19. Real-time Cherenkov emission portal imaging during CyberKnife® radiotherapy

    NASA Astrophysics Data System (ADS)

    Roussakis, Yiannis; Zhang, Rongxiao; Heyes, Geoff; Webster, Gareth; Mason, Suzannah; Green, Stuart; Pogue, Brian; Dehghani, Hamid

    2015-11-01

    The feasibility of real-time portal imaging during radiation therapy, through the Cherenkov emission (CE) effect is investigated via a medical linear accelerator (CyberKnife®) irradiating a partially-filled water tank with a 60 mm circular beam. A graticule of lead/plywood and a number of tissue equivalent materials were alternatively placed at the beam entrance face while the induced CE at the exit face was imaged using a gated electron-multiplying-intensified-charged-coupled device (emICCD) for both stationary and dynamic scenarios. This was replicated on an Elekta Synergy® linear accelerator with portal images acquired using the iViewGT™ system. Profiles across the acquired portal images were analysed to reveal the potential resolution and contrast limits of this novel CE based portal imaging technique and compared against the current standard. The CE resolution study revealed that using the lead/plywood graticule, separations down to 3.4  ±  0.5 mm can be resolved. A 28 mm thick tissue-equivalent rod with electron density of 1.69 relative to water demonstrated a CE contrast of 15% through air and 14% through water sections, as compared to a corresponding contrast of 19% and 12% using the iViewGT™ system. For dynamic scenarios, video rate imaging with 30 frames per second was achieved. It is demonstrated that CE-based portal imaging is feasible to identify both stationary and dynamic objects within a CyberKnife® radiotherapy treatment field.

  20. CyberKnife-based prostate cancer patient radioablation – early results of irradiation in 200 patients

    PubMed Central

    Napieralska, Aleksandra; Namysł-Kaletka, Agnieszka; Głowacki, Grzegorz; Grabińska, Kinga; Woźniak, Grzegorz; Stąpór-Fudzińska, Małgorzata

    2015-01-01

    Introduction Prostrate cancer (PC) is one of the most common malignancies and is frequently treated with an 8-week course of radiotherapy. CyberKnife (CK) based radioablation enables completion of therapy within 5-9 days. The aim of this study is an evaluation of the effectiveness and tolerance of CyberKnife-based radioablation in prostate cancer patients. Material and methods 200 PC patients (94 low risk [LR], 106 intermediate risk [IR]) underwent CK irradiation every other day (fraction dose [fd] 7.25 Gy, total dose [TD] 36.25 Gy, time 9 days). PSA varied from 1.1 to 19.5 (median 7.7) and T stage from T1c to T2c. The percentage of patients with Androgen Deprivation Therapy (ADT), GI (gastrointestinal) and GU (genitourinary) toxicity (EORTC/RTOG scale), and PSA were checked at 1, 4 and 8 months, and thereafter every 6 months – up to a total of 26 months – post-treatment. Results The percentage of patients without ADT increased from 47.5% to 94.1% after 26 months. The maximum percentage of acute G3 adverse effects was 0.6% for GI, 1% for GU and G2 – 2.1% for GI and 8.5% for GU. No late G3 toxicity was observed. The maximum percentage of late G2 toxicity was 0.7% for GI and 3.4% for GU. Median PSA decreased from 7.7 to 0.1 ng/ml during FU. One patient relapsed and was treated with salvage brachytherapy. Conclusions We conclude that CK-based radioablation in low and intermediate risk PC patients is an effective treatment modality enabling OTT reduction and presents a very low percentage of adverse effects. PMID:26568868

  1. Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results.

    PubMed

    Simonova, Gabriela; Kozubikova, Petra; Liscak, Roman; Novotny, Josef

    2016-07-01

    OBJECTIVE The purpose of this study was to evaluate long-term treatment results, radiation-related toxicity, and prognostic factors for the progression-free survival (PFS) of patients with pilocytic astrocytomas treated by means of stereotactic radiosurgery with a Leksell Gamma Knife. METHODS A total of 25 patients with pilocytic astrocytomas underwent Gamma Knife surgery during the period 1992-2002. The median target volume was 2700 mm(3) (range 205-25,000 mm(3)). The 18 patients treated with 5 daily fractions received a median minimum target dose of 25 Gy. Doses for the 2 patients treated with 10 fractions over 5 days (2 fractions delivered on the same day at least 6 hours apart) were 23 and 28 Gy. For the 5 patients treated with a single fraction, the minimum target dose ranged from 13 to 20 Gy (median 16 Gy). RESULTS Complete regression occurred in 10 patients (40%) and partial regression in 10 patients (40%). The 10-year overall survival rate was 96% and the 10-year PFS rate was 80%. Target volume appeared to be a significant prognostic factor for PFS (p = 0.037). Temporary Grade 3 toxicity appeared in 2 patients (8%), and these patients were treated with corticosteroids for 2 months. Permanent Grade 4 toxicity appeared in 2 patients (8%) and was associated with neurocognitive dysfunction. In these 2 individuals, the neurocognitive dysfunction was also felt to be in part the result of the additional therapeutic interventions (4 in one case and 6 in the other) required to achieve durable control of their tumors. CONCLUSIONS Radiosurgery represents an alternative treatment modality for small residual or recurrent volumes of pilocytic astrocytomas and provides long-term local control. Target volume appears to be the most important factor affecting PFS. PMID:26991883

  2. CyberKnife Radiosurgery – Value as an Adjunct to Surgical Treatment of HCC?

    PubMed Central

    Schoenberg, Markus; Khandoga, Andrey; Stintzing, Sebastian; Trumm, Christoph; Schiergens, Tobias Simon; Angele, Martin; op den Winkel, Mark; Werner, Jens; Rentsch, Markus

    2016-01-01

    Introduction CyberKnife radiosurgery (CK) is an effective tool for the treatment of malignancies. Its greatest potential is in high-dose radiosurgery delivered to targets in organs that move with respiration, e.g., liver tumors. For hepatocellular carcinoma (HCC), however, surgical treatment (resection, transplantation) is most likely to produce long-term survival; for non-resectable tumors, therapies other than radiosurgery are typically recommended. This study evaluated the long-lasting anti-tumor effects of CK combined with surgery in patients with HCC. Materials and methods  Eighteen patients (three women, 15 men) were included in this prospective observational study. They received 21 single-fraction CK treatments (26 Gy). Patient characteristics, treatment effects, tumor response (according to the Response Evaluation Criteria In Solid Tumors (RECIST) grading) and survival were measured for a median period of 29 months. Results Local tumor control was achieved in 15 patients, with complete and partial remission observed in 10 and five patients, respectively. One patient was treated for two separate lesions in one session, and one received three treatments each separated by two-year intervals; both patients are tumor-free. Two patients showed minimal response, and in one patient local tumor viability could not be excluded by MRI. Nine patients had HCC recurrence, all distant to the treated site. Nine patients died during follow-up, including two with clear relation to tumor progress. Tumor-free survival was 79.4% after one year and 29.8% after three years, and the corresponding overall survival was 84.8% and 66%. Conclusion  This study shows the high effectiveness of single-session frameless CyberKnife radiosurgery for treatment of hepatocellular carcinoma and reconfirms previous results of fractioned radiotherapy of HCC. It also demonstrates the potential of radiosurgery to be combined with surgical concepts. PMID:27284498

  3. Quality assurance of stereotactic alignment and patient positioning mechanical accuracy for robotized Gamma Knife radiosurgery.

    PubMed

    Ma, Lijun; Chiu, Joshua; Hoye, Jocelyn; McGuiness, Christopher; Perez-Andujar, Angelica

    2014-12-01

    The automatic patient positioning system and its alignment is critical and specified to be less than 0.35 mm for a radiosurgical treatment with the latest robotized Gamma Knife Perfexion (GKPFX). In this study, we developed a quantitative QA procedure to verify the accuracy and robustness of such a system. In particular, we applied the test to a unit that has performed >1000 procedures at our institution. For the test, a radiochromic film was first placed inside a spherical film phantom and then irradiated with a sequence of linearly placed shots of equal collimator size (e.g. 4 mm) via the Leksell Gamma Knife Perfexion system (PFX). The shots were positioned with either equal or unequal gaps of approximately 8 mm both at center and off-center positions of the patient positioning system. Two independent methods of localizing the irradiation shot center coordinates were employed to measure the gap spacing between adjacent shots. The measured distance was then compared with the initial preset values for the test. On average, the positioning uncertainty for the PFX delivery system was found to be 0.03 ± 0.2 mm (2σ). No significant difference in the positioning uncertainty was noted among measurements in the x-, y- and z-axis orientations. In conclusion, a simple, fast, and quantitative test was developed and demonstrated for routine QA of the submillimeter PFX patient positioning system. This test also enables independent verification of any patient-specific shot positioning for a critical treatment such as a tumor in the brainstem.

  4. Gamma Knife® radiosurgery for recurrent intracranial olfactory neuroblastoma (esthesioneuroblastoma): a case report

    PubMed Central

    2012-01-01

    Background We report the use of salvage radiosurgery to manage an aggressive olfactory neuroblastoma (esthesioneuroblastoma) with multiple recurrences and intracranial extension. Case presentation A 43-year-old Caucasian woman presented 11 years ago with progressive nasal blockage and headaches. A necrotic polyp originating in her left middle meatus and extending to the ethmoid air cells and cribriform plate (Kadish stage C) was radically resected via a craniofacial approach. Four years later, a local recurrence extending into her left cavernous sinus was identified and deemed inoperable. She received vincristine, ifosfamide, doxorubicin and etoposide chemotherapy (with minimal benefit) and external beam radiotherapy (60Gy in 30 fractions) to her skull base. Two years later, tumour extension in her left neck was treated with radical radiotherapy. She developed visual disturbances in her left eye, which progressed to blindness in the next two years. Having exhausted chemoradiotherapy, the left cavernous sinus esthesioneuroblastoma was treated with Gamma Knife® radiosurgery 2 years ago (20Gy at 50% isodose, tumour volume 7.5cm3). At one year, there was dramatic reduction in the tumour and no new symptoms; however, there were new tumour foci (in her left frontal lobe and above her right orbital apex). These were again treated with radiosurgery (20Gy at 50% isodose, total tumour volume 0.67cm3). Repeat imaging at six months showed no further disease progression. Conclusion Whilst rare, olfactory neuroblastoma (esthesioneuroblastoma) can present management challenges and Gamma Knife® radiosurgery may prove a useful strategy in controlling intracranial spread. PMID:22889266

  5. An efficient method of measuring the 4 mm helmet output factor for the Gamma Knife

    NASA Astrophysics Data System (ADS)

    Ma, Lijun; Li, X. Allen; Yu, Cedric X.

    2000-03-01

    It is essential to have accurate measurements of the 4 mm helmet output factor in the treatment of trigeminal neuralgia patients using the Gamma Knife. Because of the small collimator size and the sharp dose gradient at the beam focus, this measurement is generally tedious and difficult. We have developed an efficient method of measuring the 4 mm helmet output factor using regular radiographic films. The helmet output factor was measured by exposing a single Kodak XV film in the standard Leksell spherical phantom using the 18 mm helmet with 30-40 of its plug collimators replaced by the 4 mm plug collimators. The 4 mm helmet output factor was measured to be 0.876 ± 0.009. This is in excellent agreement with our EGS4 Monte Carlo simulated value of 0.876 ± 0.005. This helmet output factor value also agrees with more tedious TLD, diode and radiochromic film measurements that were each obtained using two separate measurements with the 18 mm helmet and the 4 mm helmet respectively. The 4 mm helmet output factor measured by the diode was 0.884 ± 0.016, and the TLD measurement was 0.890 ± 0.020. The radiochromic film measured value was 0.870 ± 0.018. Because a single-exposure measurement was performed instead of a double-exposure measurement, most of the systematic errors that appeared in the double-exposure measurements due to experimental setup variations were cancelled out. Consequently, the 4 mm helmet output factor is more precisely determined by the single-exposure approach. Therefore, routine measurement and quality assurance of the 4 mm helmet output factor of the Gamma Knife could be efficiently carried out using the proposed single-exposure technique.

  6. Gamma Knife irradiation method based on dosimetric controls to target small areas in rat brains

    SciTech Connect

    Constanzo, Julie; Paquette, Benoit; Charest, Gabriel; Masson-Côté, Laurence; Guillot, Mathieu

    2015-05-15

    Purpose: Targeted and whole-brain irradiation in humans can result in significant side effects causing decreased patient quality of life. To adequately investigate structural and functional alterations after stereotactic radiosurgery, preclinical studies are needed. The purpose of this work is to establish a robust standardized method of targeted irradiation on small regions of the rat brain. Methods: Euthanized male Fischer rats were imaged in a stereotactic bed, by computed tomography (CT), to estimate positioning variations relative to the bregma skull reference point. Using a rat brain atlas and the stereotactic bregma coordinates obtained from CT images, different regions of the brain were delimited and a treatment plan was generated. A single isocenter treatment plan delivering ≥100 Gy in 100% of the target volume was produced by Leksell GammaPlan using the 4 mm diameter collimator of sectors 4, 5, 7, and 8 of the Gamma Knife unit. Impact of positioning deviations of the rat brain on dose deposition was simulated by GammaPlan and validated with dosimetric measurements. Results: The authors’ results showed that 90% of the target volume received 100 ± 8 Gy and the maximum of deposited dose was 125 ± 0.7 Gy, which corresponds to an excellent relative standard deviation of 0.6%. This dose deposition calculated with GammaPlan was validated with dosimetric films resulting in a dose-profile agreement within 5%, both in X- and Z-axes. Conclusions: The authors’ results demonstrate the feasibility of standardizing the irradiation procedure of a small volume in the rat brain using a Gamma Knife.

  7. Precision dosimetry for narrow photon beams used in radiosurgery-determination of Gamma Knife output factors.

    PubMed

    Mack, Andreas; Scheib, Stefan G; Major, Jörg; Gianolini, Stefano; Pazmandi, Gyorgy; Feist, Harald; Czempiel, Heinz; Kreiner, Hans-Jürg

    2002-09-01

    Treatment units for radiosurgery, like Leksell Gamma Knife and adapted, or dedicated, linear accelerators use small circular beams of ionizing radiation down to 4 mm in diameter at the isocenter. By cross-firing, these beams generate a high dose region at the isocenter together with steep dose gradients of up to 30% per mm. These units are used to treat small complex shaped lesions, often located close to critical structures within the brain, by superimposing several single high dose regions. In order to commission such treatment units for stereotactic irradiations, to carry out quality assurance and to simulate treatment conditions, as well as to collect input data for treatment planning, a precise dosimetric system is necessary. Commercially available radiation dosimeters only partially meet the requirements for narrow photon beams and small field sizes as used in stereotactic treatment modalities. The aim of this study was the experimental determination of the output factors for the field defining collimators used in Gamma Knife radiosurgery, in particular for the smallest, the 4 mm collimator helmet. For output factor measurements a pin point air ionization chamber, a liquid ionization chamber, a diode detector, a diamond detector, TLD microcubes and microrods, alanine pellets, and radiochromic films were used. In total, more than 1000 measurements were performed with these different detection systems, at the sites in Munich and Zurich. Our results show a resultant output factor for the 4 mm collimator helmet of 0.8741 +/- 0.0202, which is in good agreement with recently published results and demonstrates the feasibility of such measurements. The measured output factors for the 8 mm and 14 mm collimator helmets are 0.9578 +/- 0.0057 and 0.9870 +/- 0.0086, respectively. PMID:12349929

  8. Bulk density and compaction behavior of knife mill chopped switchgrass, wheat straw, and corn stover.

    PubMed

    Chevanan, Nehru; Womac, Alvin R; Bitra, Venkata S P; Igathinathane, C; Yang, Yuechuan T; Miu, Petre I; Sokhansanj, Shahab

    2010-01-01

    Bulk density of comminuted biomass significantly increased by vibration during handling and transportation, and by normal pressure during storage. Compaction characteristics affecting the bulk density of switchgrass, wheat straw, and corn stover chopped in a knife mill at different operating conditions and using four different classifying screens were studied. Mean loose-filled bulk densities were 67.5+/-18.4 kg/m(3) for switchgrass, 36.1+/-8.6 kg/m(3) for wheat straw, and 52.1+/-10.8 kg/m(3) for corn stover. Mean tapped bulk densities were 81.8+/-26.2 kg/m(3) for switchgrass, 42.8+/-11.7 kg/m(3) for wheat straw, and 58.9+/-13.4 kg/m(3) for corn stover. Percentage changes in compressibility due to variation in particle size obtained from a knife mill ranged from 64.3 to 173.6 for chopped switchgrass, 22.2-51.5 for chopped wheat straw and 42.1-117.7 for chopped corn stover within the tested consolidation pressure range of 5-120 kPa. Pressure and volume relationship of chopped biomass during compression with application of normal pressure can be characterized by the Walker model and Kawakita and Ludde model. Parameter of Walker model was correlated to the compressibility with Pearson correlation coefficient greater than 0.9. Relationship between volume reduction in chopped biomass with respect to number of tappings studied using Sone's model indicated that infinite compressibility was highest for chopped switchgrass followed by chopped wheat straw and corn stover. Degree of difficulty in packing measured using the parameters of Sone's model indicated that the chopped wheat straw particles compacted very rapidly by tapping compared to chopped switchgrass and corn stover. These results are very useful for solving obstacles in handling bulk biomass supply logistics issues for a biorefinery.

  9. Real-time Cherenkov emission portal imaging during CyberKnife® radiotherapy.

    PubMed

    Roussakis, Yiannis; Zhang, Rongxiao; Heyes, Geoff; Webster, Gareth; Mason, Suzannah; Green, Stuart; Pogue, Brian; Dehghani, Hamid

    2015-11-21

    The feasibility of real-time portal imaging during radiation therapy, through the Cherenkov emission (CE) effect is investigated via a medical linear accelerator (CyberKnife(®)) irradiating a partially-filled water tank with a 60 mm circular beam. A graticule of lead/plywood and a number of tissue equivalent materials were alternatively placed at the beam entrance face while the induced CE at the exit face was imaged using a gated electron-multiplying-intensified-charged-coupled device (emICCD) for both stationary and dynamic scenarios. This was replicated on an Elekta Synergy(®) linear accelerator with portal images acquired using the iViewGT(™) system. Profiles across the acquired portal images were analysed to reveal the potential resolution and contrast limits of this novel CE based portal imaging technique and compared against the current standard. The CE resolution study revealed that using the lead/plywood graticule, separations down to 3.4  ±  0.5 mm can be resolved. A 28 mm thick tissue-equivalent rod with electron density of 1.69 relative to water demonstrated a CE contrast of 15% through air and 14% through water sections, as compared to a corresponding contrast of 19% and 12% using the iViewGT(™) system. For dynamic scenarios, video rate imaging with 30 frames per second was achieved. It is demonstrated that CE-based portal imaging is feasible to identify both stationary and dynamic objects within a CyberKnife(®) radiotherapy treatment field. PMID:26513015

  10. Analysis of sawtooth relaxation oscillations in tokamaks

    SciTech Connect

    Yamazaki, K.; McGuire, K.; Okabayashi, M.

    1982-07-01

    Sawtooth relaxation oscillations are analyzed using the Kadomtsev's disruption model and a thermal relaxation model. The sawtooth period is found to be very sensitive to the thermal conduction loss. Qualitative agreement between these calculations and the sawtooth period observed in several tokamaks is demonstrated.

  11. Magnetization Transfer Induced Biexponential Longitudinal Relaxation

    PubMed Central

    Prantner, Andrew M.; Bretthorst, G. Larry; Neil, Jeffrey J.; Garbow, Joel R.; Ackerman, Joseph J.H.

    2009-01-01

    Longitudinal relaxation of brain water 1H magnetization in mammalian brain in vivo is typically analyzed on a per voxel basis using a monoexponential model, thereby assigning a single relaxation time constant to all 1H magnetization within a given voxel. This approach was tested by obtaining inversion recovery data from grey matter of rats at 64 exponentially-spaced recovery times. Using Bayesian probability for model selection, brain water data were best represented by a biexponential function characterized by fast and slow relaxation components. At 4.7 T, the amplitude fraction of the rapidly relaxing component is 3.4 ± 0.7 % with a rate constant of 44 ± 12 s-1 (mean ± SD; 174 voxels from 4 rats). The rate constant of the slow relaxing component is 0.66 ± 0.04 s-1. At 11.7 T, the corresponding values are 6.9 ± 0.9 %, 19 ± 5 s-1, and 0.48 ± 0.02 s-1 (151 voxels from 4 rats). Several putative mechanisms for biexponential relaxation behavior were evaluated, and magnetization transfer between bulk water protons and non-aqueous protons was determined to be the source of biexponential longitudinal relaxation. MR methods requiring accurate quantification of longitudinal relaxation may need to take this effect explicitly into account. PMID:18759367

  12. Enthalpy relaxation and annealing effect in polystyrene.

    PubMed

    Sakatsuji, Waki; Konishi, Takashi; Miyamoto, Yoshihisa

    2013-07-01

    The effects of thermal history on the enthalpy relaxation in polystyrene are studied by differential scanning calorimetry. The temperature dependence of the specific heat in the liquid and the glassy states, that of relaxation time, and the exponent of the Kohlrausch-Williams-Watts function are determined by measurements of the thermal response against sinusoidal temperature variation. A phenomenological model equation previously proposed to interpret the memory effect in the frozen state is applied to the enthalpy relaxation and the evolution of entropy under a given thermal history is calculated. The annealing below the glass transition temperature produces two effects on enthalpy relaxation: the decay of excess entropy with annealing time in the early stage of annealing and the increase in relaxation time due to physical aging in the later stage. The crossover of these effects is reflected in the variation of temperature of the maximum specific heat observed in the heating process after annealing and cooling.

  13. River Incision, Sediment Storage, and Sediment Residence Times at the Western Tibetan Plateau Margin

    NASA Astrophysics Data System (ADS)

    Bloethe, J. H.; Munack, H.; Fülling, A.; Resentini, A.; Garzanti, E.; Kubik, P.; Korup, O.

    2012-12-01

    Intermediate sediment storage protects underlying bedrock from incision, buffers sediment delivery from adjacent hillslopes and provides the source for potentially catastrophic sediment release. Along the western Tibetan plateau margin, broad alluviated valleys host large valley fills. Besides sediment storage in major valleys, deeply incised bedrock gorges also have the potential to store sediment for > 104 yrs, even though they are typically portrayed as conveyor belts for incoming sediment. Here we report on cyclic aggradation and re-incision of fluvial terraces near the Tibetan plateau margin in the Ladakh and Zanskar Ranges, NW Himalaya, India. Recently reported 10Be-derived bedrock incision rates of up to 3 mm/yr suggest locally focused fast incision that contrasts with the low (~0.02 mm/yr) denudation rates of this dry high-altitude mountain desert. We combine Optically Stimulated Luminescence (OSL) and 10Be dating techniques, provenance analyses and morphometric analyses of digital elevation models (DEMs), in order to understand the Quaternary evolution of the region and to estimate sediment storage and residence times. We present the first OSL-derived dataset of fluvial fill terrace ages in the lower Zanskar gorge, a major tributary of the upper Indus River. These data are complemented by new 10Be exposure ages from fluvially polished surfaces and a 10Be depth profile of a fluvial terrace situated at the Zanskar-Indus confluence. Our data indicate at least two cycles of aggradation and re-incision. OSL ages from a terrace level 35 m above the river point to a phase of aggradation between 50 ka and 20 ka, which we attribute either to a late- or postglacial sediment pulse from the Zanskar headwaters, and/or to natural damming downstream. Preliminary results for the 10Be depth profile from the top of a terrace ~160 m above river level suggest a deposition age of > 100 ka, dating an older aggradation cycle. This higher terrace level is also present in the

  14. Incision of the Three Rivers Region, southeastern Tibetan Plateau, using low-temperature thermochronometry

    NASA Astrophysics Data System (ADS)

    Yang, Rong; Herman, Frédéric; Giuditta Fellin, Maria; Valla, Pierre G.; Willett, Sean; Wang, Wei

    2014-05-01

    The time and geodynamic processes of building the Tibetan Plateau are still controversial despite decades of studies. The Three Rivers Region (TRR: (Yangtze, Mekong and Salween rivers), located at the southeastern margin of the Tibetan plateau in China, is characterized by spectacular erosion and relief increase where the old low-relief landscape defining the Tibetan plateau surface is currently being incised by drainage networks. Rapid fluvial incision by the three major rivers and their tributaries has created deep and narrow gorges up to 2 to 3 km in depth along this portion of the plateau margin, promoting efficient hillslope response. However, timing, forcing magnitude and potential triggers for this erosional response are still debated and require precise quantification of landscape evolution in the TRR area. In this study, we report new apatite (U-Th)/He (AHe) and apatite fission track (AFT) ages from this region, collected mainly along the main trunk rivers with the objective of constraining the propagation of river incision from the plateau margin into its interior. Our AHe data range from ~1 to >80 Ma, while our AFT ages are between ~3 and 50 Ma. Old thermochronology ages >20 Ma indicate slow long-term erosion on the Tibetan plateau, while most of the ages along the trunk channels are younger than 10-15 Ma and clearly indicate exhumation related to plateau incision. Zircons are currently being analyzed by (U-Th)/He dating to get better timing for the onset of plateau incision. Composite age-elevation relationships from the three different rivers reveal mean exhumation rates of ~0.15-0.25 km/Ma (AFT and AHe, respectively), for the Mekong river, and apparently higher rates for the Salween and Yangtze rivers (0.7 and 0.4 km/Ma, respectively). After compiling the existing low-temperature thermochronologic data, we used a linear inversion method to investigate the exhumation history in both space and time using the method of Fox et al. (2013). Our results show

  15. Travertine in western Grand Canyon: paleoclimatically driven aggradation and incision directly dated by U-Series

    NASA Astrophysics Data System (ADS)

    Karlstrom, K. E.; Crossey, L. J.; Sharp, W. D.; Lyons, A.; Rittenour, T.

    2005-12-01

    Quaternary travertines of the Grand Canyon region provide a rich rock record for understanding interactions between canyon incision, geomorphology, paleohydrology, and paleoclimate. Travertine Grotto (TG) displays a long history of travertine deposition recorded by travertine-cemented alluvial terraces and spring mounds derived from a fault-controlled, CO2-rich spring, and exposed along a deeply incised, modern inner gorge carved by TG Creek (TGC). U-Series geochronology has been effective at dating travertine deposition and hence limits the timing of stream aggradation and incision. The oldest dated travertine (354 +/- 15 ka, 2 sigma) is a flowstone remnant on bedrock within a few meters of the present bedrock channel of TGC; this sample indicates that at this location there has been little net bedrock incision in the last 350 ka. The highest and oldest dated terrace remnant (T5- 70 m above TGC) is 243+/- 4 ka . An extensive fill terrace topped by a travertine dam (T4-60-66 m above TGC) yields a 137+/- 10 ka age . The most prominent fill terrace (T3 - 22-25 m) yields ages of 53.9 +/- 1 and 52.8 +/- 1 ka along its base, 31.4 +- 8 ka by optically stimulated luminescence (OSL) to 22.5 +/- 1 ka half way up, and 11.3 +/- 0.2 ka at its top. T3 is interpreted to represent semi continuous alluviation from ca. 50 to 11 ka; incision of the modern TGC inner gorge began after 11.5 ka. OSL dates broadly agree with U-Series dates. Fill terraces T3 and T4 show upward change from cemented alluvium to flowstone, interpreted to reflect climatic-paleohydrologic cycles as follows. Approaching terminations of glacial cycles, colluvial loads delivered to streams apparently decreased, perhaps due to dense vegetation related to high effective moisture levels. Concurrent high spring discharges deposited the relatively pure capping flowstones. Incision ensued during interglacial and early glacial times, possibly characterized by lower effective moisture levels, hence reduced vegetation and

  16. Experimental investigation of fluvial incision on Titan by low-velocity sediment impacts

    NASA Astrophysics Data System (ADS)

    Polito, P. J.; Zygielbaum, B. R.; Sklar, L. S.; Collins, G.

    2008-12-01

    Images returned by the Cassini-Huygens mission reveal evidence for widespread fluvial incision in the polar regions of Titan. Dendritic channel networks draining to large lakes and the absence of cratering suggest active incision into Titan's water-ice bedrock surface. Previous work using the saltation-abrasion bedrock incision model suggests that a terrestrial channel transposed to Titan conditions would incise at remarkably similar rates, because the effects of Titan's lower gravity and less-dense sediments are offset by a much lower resistance to abrasion for ice than rock of similar strength. Here we report new laboratory measurements of ice erosion by low-velocity sediment impacts, part of a larger study investigating the temperature dependence of the material properties that control ice erodibility. We measure the energy required to erode a unit volume of ice using drop tests, in which a 110-150 g ice clast falls 5-10 cm onto a 20 cm diameter ice disk, and differences in mass and measurements of ice density are used to calculate the volume eroded. We construct the 10cm thick ice disks using 2-4 mm seed crystals and near-freezing distilled water. After freezing at 253 K a disk is placed in the bottom of a steel cylinder surrounded by dry ice and liquid nitrogen is pumped into the cylinder from below, chilling the ice to near-Titan temperatures for several hours but never submerging the samples (all drop test trials are completed in air). Our preliminary drop test results show that 4 J and 25 J are required to erode 1 cm3 of ice at temperatures of 205 K and110 K respectively, suggesting that ice may be no more than 2-3 times more erodible than previously-tested rocks of similar tensile strengths. A key limitation of this experimental method is the small size of our target disks, which fail catastrophically by through-cracking after several hundred drops. To avoid through-cracking and obtain direct measurements of ice surface erosion, we are preparing new

  17. Cull sow knife-separable lean content evaluation at harvest and lean mass content prediction equation development.

    PubMed

    Abell, Caitlyn E; Stalder, Kenneth J; Hendricks, Haven B; Fitzgerald, Robert F

    2012-07-01

    The objectives of this study were to develop a prediction equation for carcass knife-separable lean within and across USDA cull sow market weight classes (MWC) and to determine carcass and individual primal cut knife separable lean content from cull sows. There were significant percent lean and fat differences in the primal cuts across USDA MWC. The two lighter USDA MWC had a greater percent carcass lean and lower percent fat compared to the two heavier MWC. In general, hot carcass weight explained the majority of carcass lean variation. Additionally, backfat was a significant variation source when predicting cull sow carcass lean. The findings support using a single lean prediction equation across MWC to assist processors when making cull sow purchasing decisions and determine the mix of animals from various USDA MWC that will meet their needs when making pork products with defined lean:fat content.

  18. A Retrospective Review of CyberKnife Stereotactic Body Radiotherapy for Adrenal Tumors (Primary and Metastatic): Winthrop University Hospital Experience

    PubMed Central

    Desai, Amishi; Rai, Hema; Haas, Jonathan; Witten, Matthew; Blacksburg, Seth; Schneider, Jeffrey G.

    2015-01-01

    The adrenal gland is a common site of cancer metastasis. Surgery remains a mainstay of treatment for solitary adrenal metastasis. For patients who cannot undergo surgery, radiation is an alternative option. Stereotactic body radiotherapy (SBRT) is an ablative treatment option allowing larger doses to be delivered over a shorter period of time. In this study, we report on our experience with the use of SBRT to treat adrenal metastases using CyberKnife technology. We retrospectively reviewed the Winthrop University radiation oncology data base to identify 14 patients for whom SBRT was administered to treat malignant adrenal disease. Of the factors examined, the biological equivalent dose (BED) of radiation delivered was found to be the most important predictor of local adrenal tumor control. We conclude that CyberKnife-based SBRT is a safe, non-invasive modality that has broadened the therapeutic options for the treatment of isolated adrenal metastases. PMID:26347852

  19. Two days with a broken knife blade in the neck – an interesting case of Horner's syndrome

    PubMed Central

    Dubois-Marshall, S; De Kock, S

    2010-01-01

    A 25-year-old man presented to the Emergency department in a rural South African hospital after a left, submental neck stab with a knife. Examination was deemed unremarkable, and the patient was discharged, but re-attended 2 days later complaining of a painful, swollen neck. Further examination identified Horner's syndrome, and further investigation revealed that the blade of the knife had remained in the patient's neck. This was successfully removed in theatre. This case illustrates the importance of careful history, examination and diagnostic imaging in the management of penetrating neck injuries. Horner's syndrome can be easily missed in a busy Emergency department and may indicate life-threatening pathology in the context of neck trauma. The difficulties in assessing and managing this type of injury are discussed. PMID:22766569

  20. Postseismic relaxation and transient creep

    USGS Publications Warehouse

    Savage, J.C.; Svarc, J.L.; Yu, S.-B.

    2005-01-01

    Postseismic deformation has been observed in the epicentral area following the 1992 Landers (M = 7.3), 1999 Chi-Chi (M = 7.6), 1999 Hector Mine (M = 7.1), 2002 Denali (M = 7.9), 2003 San Simeon (M = 6.5), and 2004 Parkfield (M = 6.0) earthquakes. The observations consist of repeated GPS measurements of the position of one monument relative to another (separation ???100 km). The early observations (t < 0.1 year) are well fit by the function a' + c'log(t), where t is the time after the earthquake and a' and c' are constants chosen to fit the data. Because a log(t) time dependence is characteristic of transient (primary) creep, the early postseismic response may be governed by transient creep as Benioff proposed in 1951. That inference is provisional as the stress conditions prevailing in postseismic relaxation are not identical to the constant stress condition in creep experiments. The observed logarithmic time dependence includes no characteristic time that might aid in identifying the micromechanical cause.

  1. Cone Beam Computed Tomography Assessment of the Maxillary Incisive Canal and Foramen: Considerations of Anatomical Variations When Placing Immediate Implants

    PubMed Central

    Al-Amery, Samah M.; Nambiar, Phrabhakaran; Jamaludin, Marhazlinda; John, Jacob; Ngeow, Wei Cheong

    2015-01-01

    Introduction The maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one’s ability to place immediate implants in ideal position. Objective To avoid causing complication, variations in their dimensions were studied. Material and Methods Images of ninety Mongoloids patients examined with i-CAT Cone Beam Computed Tomography were included. The sizes of the nasopalatine foramen, the incisive canal and foramen, and anterior maxillary bone thickness were measured. The direction and course of the canals were assessed. Results The mean labiopalatal and mesiodistal measurements of the incisive foramen were 2.80mm and 3.49 mm respectively, while the labiopalatal width of the nasal foramen was 6.06mm. The incisive canal was 16.33mm long and 3.85 mm wide. The anterior maxillary bone has an average thickness of 7.63 mm. The dimensions of the incisive foramen and incisive canal, and anterior maxillary bone thickness demonstrated gender differences with males showing greater values. The anterior maxillary bone thickness was affected by age but this difference was not observed in canal dimensions. The majority of subjects have a funnel shape-like incisive canal with the broader opening located at its superior. They seem to have a longer slanted-curve canal with one channel at its middle portion and a narrower incisive foramen opening than those reported elsewhere. Conclusions This study found that gender is an important factor that affected the characteristics of the IC and the amount of bone anterior to it. Male generally had bigger IC and thicker anterior bone. In addition, the anterior maxillary bone thickness was affected by aging, where it becomes thinner with increased age even though the subjects were fully dentate. PMID:25679505

  2. Seismic facies of incised-channel fill deposits of paleo-Seomjin River in the South Sea, Korea

    NASA Astrophysics Data System (ADS)

    Bae, Sung Ho; Kong, Gee Soo; Choul Kim, Dae; Lee, Gwang Soo; Yoo, Dong Geun

    2016-04-01

    High-resolution (Chirp and Sparker system) seismic profiles and piston core samples were analyzed to investigate the depositional environment of paleo-channel in the continental shelf of South Sea. Approximately 1,940 line-km data of chirp and sparker profiles was acquired. Along with seismic profiles, 20 piston core and 10 box core samples collected in 2015. The paleo-channel of Seomjin River is distributed in the continental shelf, with approximately 109 km long, 800-5,000 m wide, and more than 890 km2. The paleo-channel of meandering and straight type is dominant in the inner shelf while changed to braided type in the outer shelf. The paleo-channels in sparker seismic data formed presumably as fluvial systems when the shelf was exposed during the Last Glacial Maximum (LGM). The seismic facies of incision fill divided into five types basis of an erosional surface and internal seismic reflectors: (1) transparent to semi-transparent incised channel fill, (2) parallel to sub-parallel incised channel fill, (3) complex incised channel fill, (4) divergent incised channel fill, and (5) chaotic incised channel fill. The chaotic incised channel fill deposits are consists of gravel with shell fragments in the outer shelf and indicate the LGM to early transgressive (fluvial lag deposits). The complex incised channel fill deposits are dominated by sand and gravel with shell fragments in the mid to outer shelf. The cores which were obtained above the transparent to semi-transparent and parallel to sub-parallel incised channel fill deposits are dominated by mud. These types are dominant in the upstream (inner shelf). The acoustically transparent zones of this type with low-energy, passively infilling depositional environment, suggest the presence of basin muddy deposits. These muddy sediments were likely deposited during a more advanced stage of the Holocene transgression. Thus, the paleo-channel of Seomjin River is strongly controlled by sea-level change and sediment

  3. Quality of life in the follow-up of uveal melanoma patients after CyberKnife treatment.

    PubMed

    Klingenstein, Annemarie; Fürweger, Christoph; Nentwich, Martin M; Schaller, Ulrich C; Foerster, Paul I; Wowra, Berndt; Muacevic, Alexander; Eibl, Kirsten H

    2013-12-01

    To assess quality of life in uveal melanoma patients within the first and second year after CyberKnife radiosurgery. Overall, 91 uveal melanoma patients were evaluated for quality of life through the Short-form (SF-12) Health Survey at baseline and at every follow-up visit over 2 years after CyberKnife radiosurgery. Statistical analysis was carried out using SF Health Outcomes Scoring Software and included subgroup analysis of patients developing secondary glaucoma and of patients maintaining a best corrected visual acuity (BCVA) of the treated eye of 0.5 log(MAR) or better. Analysis of variance, Greenhouse-Geisser correction, Student's t-test, and Fisher's exact test were used to determine statistical significance. Physical Functioning (PF) and Role Physical (RP) showed a significant decrease after CyberKnife radiosurgery, whereas Mental Health (MH) improved (P=0.007, P<0.0001 and P=0.023). MH and Social Functioning (SF) increased significantly (P=0.0003 and 0.026) in the no glaucoma group, MH being higher compared with glaucoma patients (P=0.02). PF and RP were significantly higher in patients with higher BCVA at the second follow-up (P=0.02). RP decreased in patients with BCVA<0.5 log(MAR) (P=0.013). Vitality (VT) increased significantly in patients whose BCVA could be preserved (P=0.031). Neither tumor localization nor size influenced the development of secondary glaucoma or change in BCVA. Although PF and RP decreased over time, MH improved continuously. Prevention of secondary glaucoma has a significant influence on both SF and MH, whereas preservation of BCVA affects VT. Emotional stability throughout follow-up contributes positively toward overall quality of life. CyberKnife radiosurgery may contribute to attenuation of emotional distress in uveal melanoma patients.

  4. Advances in fiducial-free image-guidance for spinal radiosurgery with CyberKnife--a phantom study.

    PubMed

    Fürweger, Christoph; Drexler, Christian; Kufeld, Markus; Muacevic, Alexander; Wowra, Berndt

    2010-12-22

    The image-guided CyberKnife radiosurgery system is apable of tracking spinal targets without fiducial implants. Recently, a new version of this fiducial-free image guidance modality ("enhanced Xsight spine tracking") has been introduced. We assessed the accuracy of this novel technique versus its precursor in a comparative phantom study. The CyberKnife consists of a 6 MV linac on a six-axis robot and a stereoscopic kV image guidance system. An anthropomorphic head-and-neck phantom with a cervical spine section was mounted on the linac nozzle. The robotic manipulator was used to precisely move the phantom to defined positions in the CyberKnife workspace. Multiple stereoscopic images were acquired at different translational and rotational positions. The enhanced Xsight spine tracking readouts were recorded and compared to the nominal phantom position. These tests were repeated with the original Xsight spine tracking version to analyze potential differences. Enhanced Xsight spine tracking correctly reported translational offsets with an RMS error of less than 0.4 mm. Yaw and roll rotations were detected with an accuracy of 0.2°, 0.25°. Pitch offsets were slightly underestimated, with up to 0.3° for an offset of ± 2°. Nominal X (left-right) translational offsets were partially misinterpreted as roll (0.2° at a 10 mm offset). Apart from this, no correlation between rotational and translational directions was found. In comparison, the original Xsight spine tracking showed identical results for translations, but larger systematic and statistical errors for rotations. Enhanced Xsight spine tracking measurably improves precision in fiducial-free spinal radiosurgery with the CyberKnife.

  5. A comparative study of corneal incisions induced by diamond and steel knives and two ultraviolet radiations from an excimer laser.

    PubMed Central

    Marshall, J; Trokel, S; Rothery, S; Krueger, R R

    1986-01-01

    This paper reviews the potential role of excimer lasers in corneal surgery. The morphology of incisions induced by two wavelengths of excimer laser radiation, 193 nm and 248 nm, are compared with the morphology of incisions produced by diamond and steel knives. Analysis suggests that ablation induced by excimer laser results from highly localised photochemical reactions and that 193 nm is the optimal wavelength for surgery. The only significant complication of laser surgery is loss of endothelial cells when incisions are within 40 micron of Descemet's membrane. Images PMID:3013283

  6. Single-Incision Slings (SIS) – a New Option for the Surgical Treatment of Female Stress Urinary Incontinence

    PubMed Central

    Naumann, G.; Albrich, S.; Skala, C.; Laterza, R.; Kölbl, H.

    2012-01-01

    The new development of single-incision slings (SIS) for the treatment of female stress urinary incontinence offers comparable results with only minimal side effects and will find wide acceptance in modern incontinence surgery. This mini-sling is inserted over a single vaginal incision and fixed on both sides to the pelvic wall tissue with special anchors, without passing through the groin and avoiding a blind tape passage. Compared with the established sub-urethral tapes, there are comparable success rates with fewer complications. Randomised prospective studies are needed to evaluate whether, in the long run, the benefits of the single incision technique can be correlated with satisfying continence results. PMID:25284829

  7. Measurement of Young's relaxation modulus using nanoindentation

    NASA Astrophysics Data System (ADS)

    Huang, Gang; Lu, Hongbing

    2006-09-01

    In a previous paper (Lu et al., Mechanics of Time-Dependent Materials, 7, 2003, 189 207), we described methods to measure the creep compliance of polymers using Berkovich and spherical indenters by nanoindentation. However, the relaxation modulus is often needed in stress and deformation analysis. It has been well known that the interconversion between creep compliance and relaxation function presents an ill-posed problem, so that converting the creep compliance function to the relaxation function cannot always give accurate results, especially considering that the creep data at short times in nanoindentation are often not reliable, and the overall nanoindentation time is short, typically a few hundred seconds. In this paper, we present methods to measure Young’s relaxation functions directly using nanoindentation. A constant-rate displacement loading history is usually used in nanoindentations. Using viscoelastic contact mechanics, Young’s relaxation modulus is extracted using nanoindentation load-displacement data. Three bulk polymers, Polymethyl Methacrylate (PMMA), Polycarbonate (PC) and Polyurethane (PU), are used in this study. The Young’s relaxation functions measured from the nanoindentation are compared with data measured from conventional tensile and shear tests to evaluate the precision of the methods. A reasonably good agreement has been reached for all these materials for indentation depth higher than a certain value, providing reassurance for these methods for measuring relaxation functions.

  8. Effects of Acupuncture Knife on Inflammatory Factors and Pain in Third Lumbar Vertebrae Transverse Process Syndrome Model Rats

    PubMed Central

    Yu, Jia Ni; Guo, Chang Qing; Hu, Bo; Liu, Nai Gang; Sun, Hong Mei; Xu, Hong; Wu, Hai Xia; Guo, Yan; Liang, Chu Xi; Chen, Zhan Xia; Li, Xiao Hong

    2014-01-01

    The aim of this paper was to explore the long-term effects and pain relief mechanism of acupuncture knife on third lumbar vertebrae (L3) transverse process syndrome. Forty SD rats were randomized into control, model, electroacupuncture (EA), and acupuncture knife (AK) group. Except control rats, other rats were subjected to an operation to emulate L3 transverse process syndrome. Fourteen days after the operation, EA and AK rats were given electroacupuncture and acupuncture knife treatments, respectively. Fifty-six days after the operation, enzyme-linked immunosorbent assay was used to measure substance P (SP), 5-hydroxytryptamine (5-HT), interleukin-1β (IL-1β), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β) in peripheral blood. The tail flick test was used to observe pain threshold. We found that rats with the simulation operation had significantly higher levels of SP, 5-HT, IL-1, IL-10, TNF-α, and TGF-β, while the AK rats had lower levels. In addition, the pain threshold of AK rats was similar to that of control rats. AK pretreatment could alleviate pain through modulating inflammatory response. PMID:25544854

  9. Cuts to the offender's own hand--unintentional self-infliction in the course of knife attacks.

    PubMed

    Schmidt, Ulrike; Faller-Marquardt, Maria; Tatschner, Thomas; Walter, Klaus; Pollak, Stefan

    2004-12-01

    In a knife attack the perpetrator can unintentionally injure his own hand, if the knife does not have an adequate handguard and the tip of the blade hits a solid, mostly bony structure while being violently thrust into the victim's body. The injuries occurring under these conditions are localized on the flexor side of the knife-holding hand and may include the index, middle, ring and little fingers. They are seen particularly often on the little finger at the level of the proximal phalanx and in the skin fold of the proximal interphalangeal joint. The majority of these cuts run transversely to the longitudinal axis of the fingers and can show a step-like arrangement with different distances to the metacarpophalangeal joints, often from ulnar-proximal to radial-distal. In the six cases presented the injuries were most pronounced on the ulnar side of the hand. When the flexor tendons of the fingers are also severed and the tendon stumps are strongly retracted this indicates that the fist was firmly closed at the time of the injury.

  10. Fluorescence-based knife-edge beam diameter measurement to characterize X-ray beam profiles in reflection geometry

    NASA Astrophysics Data System (ADS)

    Bassel, Léna; Tauzin, Xavier; Queffelec, Alain; Ferrier, Catherine; Lacanette, Delphine; Chapoulie, Rémy; Bousquet, Bruno

    2016-04-01

    The diameter of an X-ray beam was determined, using the knife-edge technique, widely applied for beam profiling, by taking advantage of the fluorescence emission generated by the X-ray beam. The knife-edge has to be appropriate to the configuration of the device, in our case a double-material target made of plastic and cardboard was scanned in a transversal plane compared to the beam propagation direction. Along the scanning axis, for each position, the intensity of the Kα line of chlorine was recorded. The first derivative of the intensity evolution as a function of the edge position, fitted by a Gaussian function, makes it possible to obtain the beam diameter along the scan direction. We measured a slightly elliptic diameter close to 3 mm. In this note we underline the significance of the knife-edge technique which represents a useful tool, easy to be set up, to control X-ray beam dimensions in portable devices often routinely used by non-specialists.

  11. DIFFUSE PERIPAPILLARY CHOROIDAL MELANOMA THAT EVOLVED FROM A SMALL PRESUMED CHOROIDAL NEVUS SUCCESSFULLY TREATED WITH GAMMA KNIFE RADIOTHERAPY

    PubMed Central

    Duker, Jacob S.

    2016-01-01

    Purpose: To report a case of diffuse peripapillary choroidal melanoma which began as a small choroidal nevus and was successfully treated with gamma knife radiotherapy. Methods: Observational case report. Results: A 31-year-old visually asymptomatic man presented for a routine eye examination and was noted to have a small choroidal nevus. Six years later, the lesion had become a diffuse juxtapapillary choroidal melanoma with a thickness of 1.9 mm. Given the peripapillary location of the tumor with involvement of about 6 clock hours of the disk, Leksell Gamma Knife radiotherapy was performed. At 5.5 years after radiation therapy, visual acuity remained 20/20. The lesion thickness had decreased to 1.5 mm, and there was no interval growth of any margins. Conclusion: Small choroidal nevi carry low malignant potential but still deserve photographic documentation when possible with regular follow intervals. Gamma knife radiotherapy can be considered for tumors abutting the optic nerve, especially when plaque radiotherapy may be technically difficult. PMID:26963960

  12. Stress regulation and incision in borderline personality disorder--a pilot study modeling cutting behavior.

    PubMed

    Reitz, Sarah; Krause-Utz, Annegret; Pogatzki-Zahn, Esther M; Ebner-Priemer, Ulrich; Bohus, Martin; Schmahl, Christian

    2012-08-01

    Emotion dysregulation in Borderline Personality Disorder (BPD) is characterized by high baseline negative intensity, high reactivity, and slow return to baseline. Patients with BPD often engage in self-injurious behavior because it leads to immediate relief of stress levels. We aimed to assess stress regulation as well as the influence of tissue damage on subjective (aversive tension) and objective (heart rate) stress correlates in BPD. In 14 unmedicated patients with BPD and 18 healthy controls, a stress induction was followed by an incision into the forearm conducted by an investigator. For aversive tension, we found elevated baseline levels as well as slower return to baseline in BPD. In controls, incision resulted in a short-term increase of aversive tension, whereas tension and heart rate decreased in the BPD group. Our preliminary results support the hypothesis that tissue damage may play a role in disturbed stress regulation in BPD.

  13. Yet another method for marking incisal edges of teeth for bitemark analysis.

    PubMed

    Metcalf, Roger D

    2008-03-01

    Over the years many methods have been proposed and presented for marking or "highlighting" the incisal edges of anterior teeth on a dental stone model -- one of the critical steps in production of transparent overlays for bitemark analysis. A method is presented here that is an extension and refinement of the "paint the edges" method shown at least as early as 1966 by Gustafson. This method uses "invisible ink" and ultraviolet illumination to produce a very high contrast image of the incisal edges of the teeth on the model. The advantages of this new method are that it is nondestructive, it does not leave visible marks on the models, operator subjectivity in selecting the portions of anterior teeth to be highlighted is reduced, and the author submits that this technique lends itself to easy construction of overlays using computer image-processing software such as Adobe Photoshop and ImageJ. PMID:18366575

  14. Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

    PubMed

    Galvez, Carlos; Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

    2016-08-01

    Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy. PMID:27570778

  15. Single-incision Laparoscopic Surgery (SILS) in general surgery: a review of current practice.

    PubMed

    Froghi, Farid; Sodergren, Mikael Hans; Darzi, Ara; Paraskeva, Paraskevas

    2010-08-01

    Single-incision laparoscopic surgery (SILS) aims to eliminate multiple port incisions. Although general operative principles of SILS are similar to conventional laparoscopic surgery, operative techniques are not standardized. This review aims to evaluate the current use of SILS published in the literature by examining the types of operations performed, techniques employed, and relevant complications and morbidity. This review considered a total of 94 studies reporting 1889 patients evaluating 17 different general surgical operations. There were 8 different access techniques reported using conventional laparoscopic instruments and specifically designed SILS ports. There is extensive heterogeneity associated with operating methods and in particular ways of overcoming problems with retraction and instrumentation. Published complications, morbidity, and hospital length of stay are comparable to conventional laparoscopy. Although SILS provides excellent cosmetic results and morbidity seems similar to conventional laparoscopy, larger randomized controlled trials are needed to assess the safety and efficacy of this novel technique.

  16. Review of 500 single incision laparoscopic colorectal surgery cases - Lessons learned

    PubMed Central

    Keller, Deborah S; Flores-Gonzalez, Juan R; Ibarra, Sergio; Haas, Eric M

    2016-01-01

    Single incision laparoscopic surgery (SILS) is a minimally invasive platform with specific benefits over traditional multiport laparoscopic surgery. The safety and feasibility of SILS has been proven, and the applications continue to grow with experience. After 500 cases at a high-volume, single-institution, we were able to standardize instrumentation and operative steps, as well as develop adaptations in technique to help overcome technical and ergonomic challenges. These technical adaptations have allowed the successful application of SILS to technically difficult patient populations, such as pelvic cases, inflammatory bowel disease cases, and high body mass index patients. This review is a frame of reference for the application and wider integration of the single incision laparoscopic platform in colorectal surgery. PMID:26811615

  17. Minimal access aortic valve replacement via limited skin incision and complete median sternotomy

    PubMed Central

    Benedetto, Umberto

    2013-01-01

    Surgical aortic valve replacement (AVR) via complete median sternotomy is a safe and time-tested technique associated with excellent short- and long-term outcome. Over the last two decades, different minimally-invasive approaches for AVR have been developed and are increasingly being utilized. All these approaches have been developed with the main objective of decreased invasiveness and less surgical trauma. Advantages of minimal invasive AVR have been shown as better cosmesis, shorter ventilation time, decreased blood loss, shorter intensive care unit and hospital length of stay, and less postoperative pain with mortality and morbidity comparable to conventional complete median sternotomy. One well-recognized but less practiced surgical technique for surgical AVR is the complete median sternotomy via limited skin incision. This review article provides a detailed insight into the technical aspects, outcomes, advantages and disadvantages associated with minimal access AVR via limited skin incision and complete median sternotomy. PMID:24251023

  18. Two-incision minimally invasive total hip arthroplasty--results and complications.

    PubMed

    Van Oldenrijk, Jakob; Hoogervorst, Paul; Schaap, Gerard R; van Dijk, C Niek; Schafroth, Matthias U

    2011-01-01

    The purpose of this study was to determine the complication rate and functional result after two-incision minimally invasive total hip arthroplasty in a retrospective consecutive case series of the first 45 patients treated by a single surgeon. The mean follow up period was 2.1 years. There were 4 early major complications (2 peri-operative fractures and 2 re-interventions) and 28 early minor complications (1 superficial infection and 27 patients with a loss of sensation of the lateral aspect of the thigh). One stem loosening required revision within two years. The mean modified Harris Hip Score at final follow-up was 91.5. Our experience shows a relatively high complication risk after two-incision minimally invasive total hip arthroplasty, and we have since abandoned this technique.

  19. OSL dating of fluvial terraces for incision rate estimation and indication of neotectonic activity in Pamir

    NASA Astrophysics Data System (ADS)

    Fuchs, M. C.; Gloaguen, R.; Krbetschek, M.; Szulc, A.

    2012-04-01

    ThePamir owes its special attraction for geo-scientists to being among Earth's largest intra-continental orogens and to display some of the highest uplift rates as well as to host among the most powerful river systems on the planet. The evolution of the drainage network as a proxy for the landscape's response to tectonic signals provides a powerful tool to study neotectonics. The relation between tectonic forcing and surface response is indicated by structural anomalies (e.g. river-capture, river-reversal or -deflection) and spatial differences of process rates (e.g. incision rates). We combine OSL dating with remote sensing tectonic geomorphology in order to determine the zones of active deformation in the Quaternary. The local drainage system of the study region aligns mainly to the east-west-trending belts of shortening, which results from the ongoing northward propagation of the Indian plate. In contrast the major trunk river, the Panj, is unusual in that it deflects northwards and then doubles back to the southwest, cutting the southern and central Pamir doming and several other major Cenozoic deformation zones. We use fluvial terraces along the deflected north-south orientated part including the doubled back prolongation of the more or less normal orientated Panj. These sediment bodies are used as a geomorphic record to reveal changes in the balance between sediment flux and discharge. Dating these fluvial terraces by OSL provides the burial ages of the sediments indicating periods of sedimentation. The remains of those periods are far from equally distributed and mark the time of local conditions for sedimentation as especially the close neighbourhood of most of the terraces from the two youngest periods demonstrate. Precise measurements of the heights of the dated terraces with respect to the present river level based on relative kinematic GPS quantify the total vertical incision of the river subsequent to the sedimentation and abandonment. Incision rates

  20. Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma

    PubMed Central

    Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

    2016-01-01

    Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy. PMID:27570778

  1. A physiological and subjective evaluation of meditation, hypnosis, and relaxation.

    PubMed

    Morse, D R; Martin, J S; Furst, M L; Dubin, L L

    1977-01-01

    Ss were monitored for respiratory rate, pulse rate, blood pressure, skin resistance, EEG activity, and muscle activity. They were monitored during the alert state, meditation (TM or simple word type), hypnosis (relaxation and task types), and relaxation. Ss gave a verbal comparative evaluation of each state. The results showed significantly better relaxation responses for the relaxation states (relaxation, relaxation-hypnosis, meditation) than for the alert state. There were no significant differences between the relaxation states except for the measure "muscle activity" in which meditation was significantly better than the other relaxation states. Overall, there were significant differences between task-hypnosis and relaxation-hypnosis. No significant differences were found between TM and simple word meditation. For the subjective measures, relaxation-hypnosis and meditation were significantly better than relaxation, but no significant differences were found between meditation and relaxation-hypnosis.

  2. Spin-Lattice Relaxation Times in 1H NMR Spectroscopy.

    ERIC Educational Resources Information Center

    Wink, Donald J.

    1989-01-01

    Discussed are the mechanisms of nuclear magnetic relaxation, and applications of relaxation times. The measurement of spin-lattice relaxations is reviewed. It is stressed that sophisticated techniques such as these are becoming more important to the working chemist. (CW)

  3. Quantifying Transient Incision to Determine the Timing and Style of Baselevel Change in Central Idaho

    NASA Astrophysics Data System (ADS)

    Larimer, J. E.; Yanites, B.

    2014-12-01

    Throughout the tributaries of Salmon River watershed, there is an observable break in slope that separates the low relief (<400m deep valleys) headwaters from the high relief (1200- 1600m deep valleys) main stem of the Salmon River gorge. This transience was triggered by baselevel lowering along the Salmon River sometime during the late Cenozoic. However, the timing of the incision is unknown as is the mechanism that drove it. To provide insight into the drivers of landscape evolution in this region, we integrate field data with numerical modeling to constrain the timing of incision and gorge formation. We present 10Be cosmogenic radionuclide concentrations from bedload sediment in ten different tributaries of the mainstem Salmon located between the South Fork and the Little Salmon. The samples record basin wide erosion rates ranging from ~0.05mm/yr in relict topography to ~0.15mm/yr in refreshed topography over the last 103-104 yrs. These erosion rates combined with topographic metrics using channel slope and drainage area are used to calibrate a river incision model for rivers draining the Idaho Batholith rocks. Using the calibrated model, we quantify the migration of knickpoints from the mouth of the tributary to their present location in order to constrain a date for the regional baselevel change. Preliminary model results suggest an increase in the incision rate of the Salmon River occurred roughly 8 million years ago continues at the same rate today. Finally, we discuss the implications of this date in relation to the cessation of the Columbia River Basalts and the integration of the Snake River basin.

  4. Single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy.

    PubMed

    Zhang, Jin-Shan; Li, Long; Cheng, Wei

    2016-10-01

    Single incision laparoscopic surgery as a surgical approach in treatment of pancreatic disease has recently been reported in adults. However, its application in persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in children is limited. In this article, we report single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy. Between July 2011 and February 2015, the single incision laparoscopic 90 % pancreatectomy was performed in three children with PHHI. All patients underwent (18)F-FDOPA PET/CT before the surgeries. The scans showed diffuse physiologic (18)F-FDOPA activity in entire pancreas. All patients were followed up. The levels of blood sugar and insulin were recorded postoperatively. The time required for surgery was 120-230 min, and blood loss was minimal. The hospital stay was 6 days. The duration of postoperative abdominal drainage was 4-5 days. The levels of fasting blood glucose after surgery were higher than those before surgery (4.38-8.9 vs. 0.54-1.8 mmol/L). The levels of fasting insulin after surgery were lower than those before surgery (2.4-5.5 vs. 14-33.3 uU/ml). The duration of follow-up was 4-46 months. During follow-up, the levels of blood glucose and insulin were normal in three patients. There was no recurrence of hypoglycemia after operation in all patients. Single incision laparoscopic 90 % pancreatectomy for children with PHHI is feasible and safe in well-selected cases in the experienced centers.

  5. Differential uplift and incision of the Yakima River terraces, central Washington State

    NASA Astrophysics Data System (ADS)

    Bender, Adrian M.; Amos, Colin B.; Bierman, Paul; Rood, Dylan H.; Staisch, Lydia; Kelsey, Harvey; Sherrod, Brian

    2016-01-01

    The fault-related Yakima folds deform Miocene basalts and younger deposits of the Columbia Plateau in central Washington State. Geodesy implies ~2 mm/yr of NNE directed shortening across the folds, but until now the distribution and rates of Quaternary deformation among individual structures has been unclear. South of Ellensburg, Washington, the Yakima River cuts a ~600 m deep canyon across several Yakima folds, preserving gravel-mantled strath terraces that record progressive bedrock incision and related rock uplift. Here we integrate cosmogenic isochron burial dating of the strath terrace gravels with lidar analysis and field mapping to quantify rates of Quaternary differential incision and rock uplift across two folds transected by the Yakima River: Manastash and Umtanum Ridge. Isochron burial ages from in situ produced 26Al and 10Be at seven sites across the folds date episodes of strath terrace formation over the past ~2.9 Ma. Average bedrock incision rates across the Manastash (~88 m/Myr) and Umtanum Ridge (~46 m/Myr) anticlines are roughly 4 to 8 times higher than rates in the intervening syncline (~14 m/Myr) and outside the canyon (~10 m/Myr). These contrasting rates demonstrate differential bedrock incision driven by ongoing Quaternary rock uplift across the folds at rates corresponding to ~0.13 and ~0.06 mm/yr shortening across postulated master faults dipping 30 ± 10°S beneath the Manastash and Umtanum Ridge anticlines, respectively. The reported Quaternary shortening across the anticlines accounts for ~10% of the ~2 mm/yr geodetic budget, suggesting that other Yakima structures actively accommodate the remaining contemporary deformation.

  6. Single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy.

    PubMed

    Zhang, Jin-Shan; Li, Long; Cheng, Wei

    2016-10-01

    Single incision laparoscopic surgery as a surgical approach in treatment of pancreatic disease has recently been reported in adults. However, its application in persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in children is limited. In this article, we report single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy. Between July 2011 and February 2015, the single incision laparoscopic 90 % pancreatectomy was performed in three children with PHHI. All patients underwent (18)F-FDOPA PET/CT before the surgeries. The scans showed diffuse physiologic (18)F-FDOPA activity in entire pancreas. All patients were followed up. The levels of blood sugar and insulin were recorded postoperatively. The time required for surgery was 120-230 min, and blood loss was minimal. The hospital stay was 6 days. The duration of postoperative abdominal drainage was 4-5 days. The levels of fasting blood glucose after surgery were higher than those before surgery (4.38-8.9 vs. 0.54-1.8 mmol/L). The levels of fasting insulin after surgery were lower than those before surgery (2.4-5.5 vs. 14-33.3 uU/ml). The duration of follow-up was 4-46 months. During follow-up, the levels of blood glucose and insulin were normal in three patients. There was no recurrence of hypoglycemia after operation in all patients. Single incision laparoscopic 90 % pancreatectomy for children with PHHI is feasible and safe in well-selected cases in the experienced centers. PMID:27473008

  7. Immediate Implant-based Prepectoral Breast Reconstruction Using a Vertical Incision

    PubMed Central

    Lind, Jeffrey G.; Hopkins, Elizabeth G.

    2015-01-01

    Background: Ideally, breast reconstruction is performed at the time of mastectomy in a single stage with minimal scarring. However, postoperative complications with direct-to-implant subpectoral reconstruction remain significant. These include asymmetry, flap necrosis, animation deformity, and discomfort. We report on a series of patients who have undergone immediate single-stage prepectoral, implant-based breast reconstruction with a smooth, adjustable saline implant covered with mesh/acellular dermal matrix for support using a vertical mastectomy incision. This technique, when combined with an adjustable implant, addresses the complications related to subpectoral implant placement of traditional expanders. Our follow-up time, 4.6 years (55 months), shows a low risk of implant loss and elimination of animation deformity while also providing patients with a safe and aesthetically pleasing result. Methods: All patients who underwent immediate implant-based prepectoral breast reconstruction using a vertical mastectomy incision as a single-staged procedure were included. Charts were reviewed retrospectively. Adjustable smooth round saline implants and mesh/acellular dermal matrix were used for fixation in all cases. Results: Thirty-one patients (62 breasts) underwent single-staged implant-based prepectoral breast reconstruction using a vertical mastectomy incision. Postoperative complications occurred in 9 patients, 6 of which were resolved with postoperative intervention while only 2 cases resulted in implant loss. Conclusions: There can be significant morbidity associated with traditional subpectoral implant-based breast reconstruction. As an alternative, the results of this study show that an immediate single-stage prepectoral breast reconstruction with a smooth saline adjustable implant, using a vertical incision, in conjunction with mesh/matrix support can be performed with excellent aesthetic outcomes and minimal complications. PMID:26180713

  8. Climate-sensitive feedbacks between hillslope processes and fluvial erosion in sediment-driven incision models

    NASA Astrophysics Data System (ADS)

    Skov, Daniel; Egholm, David

    2015-04-01

    Surface erosion and sediment production accelerated dramatically in most parts of the world as the climate cooled in the Late Cenozoic, (e.g. Molnar, Annu. Rev. Earth Planet. Sci. 32, 2004). In many high mountain ranges, glaciers emerged for the first time during the Quaternary, and they represent a likely explanation for the accelerated erosion in such places. Still, observations and measurements point to increases in erosion rate also in landscapes where erosion is driven mainly by fluvial processes (e.g. Lease and Ehlers, Science 341, 2013). Why fluvial incision responds to climate change remains enigmatic, in particular because the obvious links to variations in precipitation, and hence water flux, are not generally supported by erosion rate measures (Stock et al., GSA Bulletin 117, 2005). This study explores potential links between accelerating rates of river incision and sediment production on hillslopes that surround the channel network. Hillslope soil production and soil transport are processes that are likely to respond to decreasing temperatures, because the density of vegetation and for example the occurrence of frost influence rates of weathering and sediment flow. We perform computational landscape evolution experiments where a sediment-flux-dependent model for fluvial incision (e.g. Sklar and Dietrich, Geology 29, 2001) is coupled to models for sediment production and transport on hillslopes. The resulting coupled landscape dynamics is of a highly nonlinear nature, where even small changes in hillslope sediment production far up in a drainage network propagate all the way through the downstream fluvial system. Dependent on the total sediment load, the fluvial system may respond with increased incision that steepens the hillslopes and starts a positive feedback loop that accelerates overall erosion.

  9. Standardized technique for single-incision laparoscopic-assisted stoma creation

    PubMed Central

    Miyoshi, Norikatsu; Fujino, Shiki; Ohue, Masayuki; Yasui, Masayoshi; Noura, Shingo; Wada, Yuma; Kimura, Ryuichiro; Sugimura, Keijiro; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Omori, Takeshi; Fujiwara, Yoshiyuki; Yano, Masahiko

    2016-01-01

    To describe the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade II (the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infections were cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

  10. Impact of rock uplift on rates of late Cenozoic Rocky Mountain river incision

    NASA Astrophysics Data System (ADS)

    Riihimaki, Catherine A.; Anderson, Robert S.; Safran, Elizabeth B.

    2007-09-01

    The high relief of the modern Rocky Mountain landscape formed in the late Cenozoic by downcutting of a fluvial network that links a series of easily eroded sedimentary basins across relatively resistant crystalline cores of adjacent ranges. Using a numerical model of fluvial erosion and the flexural isostatic response to the associated unloading, we first calculate the expected pattern and pace of incision caused by rock uplift related to migration of the Yellowstone hot spot and to growth of the northern portion of the Rio Grande rift. Calculated incision rates are <60 m/Myr, and total depth of erosion of sedimentary basins is <300 m, well below the long-term incision rates and amounts of erosion interpreted from the geologic record. Broad-scale tilting of the region toward the east, accomplished by a gradient in rock uplift of ˜1 km along the north-south axis of the central Rockies, declining to zero 1000 km to the east, can account for the additional erosion needed to match observations. In each modeling scenario, stream incision is nonsteady, with rock uplift outpacing erosion for <1 Myr in perimeter basins and 1-5 Myr in interior basins. Three factors dominate the spatial and temporal pattern of regional landscape evolution: (1) the time since uplift began, (2) the uplift pattern, and (3) the distribution of relatively resistant bedrock within the region. Our results suggest that the spatial variability in late Cenozoic exhumation can be explained by a long-lived transience in the stream network response to these various late Cenozoic geophysical events.

  11. Single-incision and single-element array electrode to lower the defibrillation threshold.

    PubMed

    Kühlkamp, V; Khalighi, K; Dörnberger, V; Ziemer, G

    1997-10-01

    Occasional patients have excessive defibrillation energy requirements despite appropriate transvenous defibrillation lead position and the use of biphasic shocks. A single-element subcutaneous array electrode was implanted in 2 patients with a high defibrillation threshold. The array electrode was implanted through the same infraclavicular incision that was used for implantation of the transvenous lead. The defibrillation threshold decreased from 30 J to 15 J and from 24 J to 9 J with the subcutaneous array electrode.

  12. Differential uplift and incision of the Yakima River terraces, central Washington State

    USGS Publications Warehouse

    Bender, Adrian M; Amos, Colin B.; Bierman, Paul R.; Rood, Dylan; Staisch, Lydia; Kelsey, Harvey M.; Sherrod, Brian

    2016-01-01

    The fault-related Yakima folds deform Miocene basalts and younger deposits of the Columbia Plateau in central Washington State. Geodesy implies ~2 mm/yr of NNE directed shortening across the folds, but until now the distribution and rates of Quaternary deformation among individual structures has been unclear. South of Ellensburg, Washington, the Yakima River cuts a ~600 m deep canyon across several Yakima folds, preserving gravel-mantled strath terraces that record progressive bedrock incision and related rock uplift. Here we integrate cosmogenic isochron burial dating of the strath terrace gravels with lidar analysis and field mapping to quantify rates of Quaternary differential incision and rock uplift across two folds transected by the Yakima River: Manastash and Umtanum Ridge. Isochron burial ages from in situ produced 26Al and 10Be at seven sites across the folds date episodes of strath terrace formation over the past ~2.9 Ma. Average bedrock incision rates across the Manastash (~88 m/Myr) and Umtanum Ridge (~46 m/Myr) anticlines are roughly 4 to 8 times higher than rates in the intervening syncline (~14 m/Myr) and outside the canyon (~10 m/Myr). These contrasting rates demonstrate differential bedrock incision driven by ongoing Quaternary rock uplift across the folds at rates corresponding to ~0.13 and ~0.06 mm/yr shortening across postulated master faults dipping 30 ± 10°S beneath the Manastash and Umtanum Ridge anticlines, respectively. The reported Quaternary shortening across the anticlines accounts for ~10% of the ~2 mm/yr geodetic budget, suggesting that other Yakima structures actively accommodate the remaining contemporary deformation.

  13. Pilot Study of Cartilage Repair in the Knee Joint with Multiply Incised Chondral Allograft

    PubMed Central

    Vancsodi, Jozsef; Farkas, Boglarka; Fazekas, Adam; Nagy, Szilvia Anett; Bogner, Peter; Vermes, Csaba; Than, Peter

    2015-01-01

    Background Focal cartilage lesions in the knee joint have limited capacity to heal. Current animal experiments show that incisions of the deep zone of a cartilage allograft allow acceptable integration for the graft. Questions/Purposes We performed this clinical study to determine (1) if the multiply incised cartilage graft is surgically applicable for focal cartilage lesions, (2) whether this allograft has a potential to integrate to the repair site, and (3) if patients show clinical improvement. Patients and Methods Seven patients with 8 chondral lesions were enrolled into the study. Symptomatic lesions between 2 and 8 cm2 were accepted. Additional injuries were allowed but were addressed simultaneously. Grafts were tailored to match and the deep zone of the cartilage was multiply incised to augment the basal integration before securing in place. Rigorous postoperative physiotherapy followed. At 12 and 24 months the patients’ satisfaction were measured and serial magnetic resonance imaging (MRI) was performed in 6 patients. Results Following the implantations no adverse reaction occurred. MRI evaluation postoperatively showed the graft in place in 5 out of 6 patients. In 1 patient, MRI suggested partial delamination at 1 year and graft degeneration at 2 years. Short Form–36 health survey and the Lysholm knee score demonstrated a significant improvement in the first year; however, by 2 years there was a noticeable drop in the scores. Conclusions. Multiply incised pure chondral allograft used for cartilage repair appears to be a relatively safe method. Further studies are necessary to assess its potential in cartilage repair before its clinical use. PMID:26069710

  14. Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population.

    PubMed

    Hugoson, A; Bergendal, T; Ekfeldt, A; Helkimo, M

    1988-10-01

    The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.

  15. Standardized technique for single-incision laparoscopic-assisted stoma creation.

    PubMed

    Miyoshi, Norikatsu; Fujino, Shiki; Ohue, Masayuki; Yasui, Masayoshi; Noura, Shingo; Wada, Yuma; Kimura, Ryuichiro; Sugimura, Keijiro; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Omori, Takeshi; Fujiwara, Yoshiyuki; Yano, Masahiko

    2016-08-10

    To describe the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade II (the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infections were cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions. PMID:27606046

  16. Postcataract endophthalmitis prophylaxis using irrigation, incision hydration, and eye pressurization with vancomycin

    PubMed Central

    Schelonka, Lee P; SaBell, Margaret A

    2015-01-01

    Purpose This study aimed to determine whether switching from balanced salt solution (BSS) to vancomycin 20 g/mL BSS for incision hydration and eye pressurization reduces the rate of postcataract endophthalmitis. Methods This was a patient safety/quality improvement project, including all patients undergoing cataract surgery at the Kaiser Permanente Colorado Ophthalmology Department from January 2002 to December 2014. Throughout the study, patients received vancomycin 20 μg/mL in the irrigating solution. During the baseline period from 2002 to 2005, surgeons pressurized eyes and hydrated incisions with plain BSS. During the intervention period from 2006 through 2014, surgeons switched from BSS to the vancomycin/BSS irrigating solution for eye pressurization and incision hydration. Results A total of 57,263 cataract operations were performed by 24 surgeons at seven surgical centers: 12,400 in the baseline period and 44,863 in the intervention period. The rate of post-cataract endophthalmitis declined significantly from 5/12,400 (rate: 0.4/1,000) in the baseline period to 1/44,863 (rate: 0.022/1,000) during the intervention period (odds ratio [OR]: 18.1, 95% confidence interval [CI]: 2.11–154.9; χ2=13.5, P=0.00024). Accounting for an estimated 2.05-fold risk reduction due to confounding variables, the risk reduction attributed to the intervention remained significant: (adjusted OR: 8.78, 95% CI: 1.73–44.5; χ2=10.06, P=0.0015). Since 2009, we have not experienced any cases of postcataract endophthalmitis after 32,753 operations. Conclusion We experienced a significant reduction in postcataract endophthalmitis when we switched from BSS to the vancomycin/BSS irrigating solution for incision hydration and eye pressurization. The pharmacokinetics profile indicates that this switch was important for effective prophylaxis. PMID:26229425

  17. Infilling and flooding of the Mekong River incised valley during deglacial sea-level rise

    NASA Astrophysics Data System (ADS)

    Tjallingii, Rik; Stattegger, Karl; Wetzel, Andreas; Van Phach, Phung

    2010-06-01

    The abrupt transition from fluvial to marine deposition of incised-valley-fill sediments retrieved from the southeast Vietnamese shelf, accurately records the postglacial transgression after 14 ka before present (BP). Valley-filling sediments consist of fluvial mud, whereas sedimentation after the transgression is characterized by shallow-marine carbonate sands. This change in sediment composition is accurately marked in high-resolution X-ray fluorescence (XRF) core scanning records. Rapid aggradation of fluvial sediments at the river mouth nearly completely filled the Mekong incised valley prior to flooding. However, accumulation rates strongly reduced in the valley after the river-mouth system flooded and stepped back. This also affected the sediment supply to deeper parts of the southeast Vietnamese shelf. Comparison of the Mekong valley-filling with the East Asian sea-level history of sub- and inter-tidal sediment records shows that the transgressive surface preserved in the incised-valley-fill records is a robust sea-level indicator. The valley was nearly completely filled with fluvial sediments between 13.0 and 9.5 ka BP when sea-level rose rather constantly with approximately 10 mm/yr, as indicated by the East Asian sea-level record. At shallower parts of the shelf, significant sediment reworking and the establishment of estuarine conditions at the final stage of infilling complicates accurate dating of the transgressive surface. Nevertheless, incised-valley-fill records and land-based drill sites indicate a vast and rapid flooding of the shelf from the location of the modern Vietnamese coastline to the Cambodian lowlands between 9.5 ka and 8.5 ka BP. Fast flooding of this part of the shelf is related with the low shelf gradient and a strong acceleration of the East Asian sea-level rise from 34 to 9 meter below modern sea level (mbsl) corresponding to the sea-level jump of melt water pulse (MWP) 1C.

  18. Relative strength of scleral corneal and clear corneal incisions constructed in cadaver eyes.

    PubMed

    Ernest, P H; Lavery, K T; Kiessling, L A

    1994-11-01

    Square scleral corneal, square clear corneal, and rectangular clear corneal incisions were constructed in six cadaver eyes that had no previous intraocular surgery. The 3.2 mm or smaller wounds had sutureless closures. To determine their relative abilities to resist leakage and iris prolapse, eyes were tested at external pressures of up to 525 pounds per square inch (psi) at one of two intraocular pressure (IOP) ranges: 10 to 15 mm Hg or 20 to 25 mm Hg. The square scleral corneal (3.2 mm x 3.2 mm) and square clear corneal wounds (3.2 mm x 3.2 mm, 2.0 mm x 2.0 mm, 1.0 mm x 1.0 mm) withstood external pressure without effect at both IOP ranges, up to the maximum 525 psi. This level of external pressure was far greater than pressures withstood by rectangular clear corneal wounds, especially the wound usually constructed in clinical practice (3.2 mm x 2.0 mm), which leaked and demonstrated iris prolapse at 13 psi at the lower IOP. The square clear corneal wounds that were stable at 525 psi, however, are either clinically impractical (visual axis encroachment from 3.2 mm x 3.2 mm wound) or not technologically feasible until the size of phacoemulsification tips and intraocular lenses can be further reduced. Thus, of the procedures for small incision cataract surgery presently in use, the square scleral corneal incision with 1.5 mm internal corneal lip appears to offer greater stability and safety than the conventional rectangular clear corneal incision (3.2 mm x 2.0 mm).

  19. Standardized technique for single-incision laparoscopic-assisted stoma creation.

    PubMed

    Miyoshi, Norikatsu; Fujino, Shiki; Ohue, Masayuki; Yasui, Masayoshi; Noura, Shingo; Wada, Yuma; Kimura, Ryuichiro; Sugimura, Keijiro; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Omori, Takeshi; Fujiwara, Yoshiyuki; Yano, Masahiko

    2016-08-10

    To describe the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade II (the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infections were cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

  20. Relaxation of vibrational degrees of freedom

    NASA Astrophysics Data System (ADS)

    Frohn, A.

    Shock tubes were used to measure relaxation times of the degrees of freedom in inelastic collisions of gas molecules. Design and construction of the experimental setup are described. For relaxation time measurements of vibrational degrees of freedom an initial pressure between 0.1 and 1 mbar is found to be optimal, and for dissociation between 1 and 10 mbar. The density gradients in the shock tube flow are measured with four differential laser interferometers and plotted with a transient recorder. A FORTRAN program was developed to determine the relaxation times. This measurement technique does not in general allow the degrees of freedom to be investigated separately.

  1. Relaxation time in disordered molecular systems

    SciTech Connect

    Rocha, Rodrigo P.; Freire, José A.

    2015-05-28

    Relaxation time is the typical time it takes for a closed physical system to attain thermal equilibrium. The equilibrium is brought about by the action of a thermal reservoir inducing changes in the system micro-states. The relaxation time is intuitively expected to increase with system disorder. We derive a simple analytical expression for this dependence in the context of electronic equilibration in an amorphous molecular system model. We find that the disorder dramatically enhances the relaxation time but does not affect its independence of the nature of the initial state.

  2. Collisionless Relaxation in Non-Neutral Plasmas

    SciTech Connect

    Levin, Yan; Pakter, Renato; Teles, Tarcisio N.

    2008-02-01

    A theoretical framework is presented which allows us to quantitatively predict the final stationary state achieved by a non-neutral plasma during a process of collisionless relaxation. As a specific application, the theory is used to study relaxation of charged-particle beams. It is shown that a fully matched beam relaxes to the Lynden-Bell distribution. However, when a mismatch is present and the beam oscillates, parametric resonances lead to a core-halo phase separation. The approach developed accounts for both the density and the velocity distributions in the final stationary state.

  3. Le Chatelier's principle with multiple relaxation channels

    NASA Astrophysics Data System (ADS)

    Gilmore, R.; Levine, R. D.

    1986-05-01

    Le Chatelier's principle is discussed within the constrained variational approach to thermodynamics. The formulation is general enough to encompass systems not in thermal (or chemical) equilibrium. Particular attention is given to systems with multiple constraints which can be relaxed. The moderation of the initial perturbation increases as additional constraints are removed. This result is studied in particular when the (coupled) relaxation channels have widely different time scales. A series of inequalities is derived which describes the successive moderation as each successive relaxation channel opens up. These inequalities are interpreted within the metric-geometry representation of thermodynamics.

  4. Requirements for muscle relaxation in Friedreich's ataxia.

    PubMed

    Mouloudi, H; Katsanoulas, C; Frantzeskos, G

    1998-02-01

    Friedreich's ataxia is an inherited disorder of the nervous system, requiring special care during anaesthesia, because of increased sensitivity to muscle relaxants. We report a case of Friedreich's ataxia in a 31-year-old woman, anaesthetised on two occasions, for tendinoplasty and pes cavus repair. Atracurium was used for neuromuscular blockade and monitored by a train-of-four twitch technique. The patient's response was normal. She returned to adequate spontaneous breathing within 20 min of the last dose of the muscle relaxant without need for anticholinesterase administration. When neuromuscular function is monitored, normal doses of muscle relaxant can safely be used in these patients.

  5. End-to-end test of spatial accuracy in Gamma Knife treatments for trigeminal neuralgia

    SciTech Connect

    Brezovich, Ivan A. Wu, Xingen; Duan, Jun; Popple, Richard A.; Shen, Sui; Benhabib, Sidi; Huang, Mi; Christian Dobelbower, M.; Fisher III, Winfield S.

    2014-11-01

    Purpose: Spatial accuracy is most crucial when small targets like the trigeminal nerve are treated. Although current quality assurance procedures typically verify that individual apparatus, like the MRI scanner, CT scanner, Gamma Knife, etc., are meeting specifications, the cumulative error of all equipment and procedures combined may exceed safe margins. This study uses an end-to-end approach to assess the overall targeting errors that may have occurred in individual patients previously treated for trigeminal neuralgia. Methods: The trigeminal nerve is simulated by a 3 mm long, 3.175 mm (1/8 in.) diameter MRI-contrast filled cavity embedded within a PMMA plastic capsule. The capsule is positioned within the head frame such that the location of the cavity matches the Gamma Knife coordinates of an arbitrarily chosen, previously treated patient. Gafchromic EBT2 film is placed at the center of the cavity in coronal and sagittal orientations. The films are marked with a pinprick to identify the cavity center. Treatments are planned for radiation delivery with 4 mm collimators according to MRI and CT scans using the clinical localizer boxes and acquisition protocols. Shots are planned so that the 50% isodose surface encompasses the cavity. Following irradiation, the films are scanned and analyzed. Targeting errors are defined as the distance between the pinprick, which represents the intended target, and the centroid of the 50% isodose line, which is the center of the radiation field that was actually delivered. Results: Averaged over ten patient simulations, targeting errors along the x, y, and z coordinates (patient’s left-to-right, posterior-to-anterior, and head-to-foot) were, respectively, −0.060 ± 0.363, −0.350 ± 0.253, and 0.348 ± 0.204 mm when MRI was used for treatment planning. Planning according to CT exhibited generally smaller errors, namely, 0.109 ± 0.167, −0.191 ± 0.144, and 0.211 ± 0.094 mm. The largest errors along individual axes in MRI

  6. Adjustable small-incision selective tenotomy and plication for correction of incomitant vertical strabismus and torsion

    PubMed Central

    Chang, Melinda Y.; Pineles, Stacy L.; Velez, Federico G.

    2015-01-01

    PURPOSE To evaluate the effectiveness of adjustable small-incision selective tenotomy and plication of vertical rectus muscles in correcting vertical strabismus incomitant in horizontal gaze positions and cyclotorsion. METHODS The medical records of all patients who underwent adjustable small-incision selective tenotomy or plication of a vertical rectus muscle for correction of horizontally incomitant vertical strabismus or cyclotorsion by a single surgeon at a single eye institute from July 2013 to September 2014 were retrospectively reviewed. Selective tenotomy and plication were performed on either the nasal or temporal side of vertical rectus muscles, based on the direction of cyclotorsion and incomitance of vertical strabismus. RESULTS Of 9 patients identified, 8 (89%) had successful correction of horizontally incomitant vertical strabismus, with postoperative vertical alignment within 4Δ of orthotropia in primary position, lateral gazes, and downgaze. Of the 8 patients with preoperative cyclotorsion, 4 (50%) were successfully corrected, with <5° of cyclotorsion postoperatively. Of the 4 patients in whom cyclotorsion did not improve, 3 had undergone prior strabismus surgery, and 2 had restrictive strabismus. Eight of the 9 patients (89%) reported postoperative resolution of diplopia. CONCLUSIONS Adjustable small-incision selective tenotomy and plication effectively treat horizontally incomitant vertical strabismus. These surgeries may be less effective for correcting cyclotorsion in patients with restriction or prior strabismus surgery. Advantages are that they may be performed in an adjustable manner and, in some cases, under topical anesthesia. PMID:26486021

  7. The versatility of lower eyelid blepharoplasty incision: In open reduction and fixation of zygomatic complex injuries

    PubMed Central

    Chandran, V. S. R.; Candamourty, R.; Thangavelu, A.

    2012-01-01

    Introduction: A zygomatic complex fracture includes disruption of the four articulating sutures: zygomaticofrontal, zygomaticotemporal, zygomaticomaxillary and zygomaticosphenoidal sutures. All zygomatic complex fractures involve the orbital floor and therefore an understanding of orbital anatomic features is essential for those treating these injuries. Aims and Objectives: To analyze the efficacy and shortcomings of this approach. To evaluate the adequacy, role of tarsorrhaphy, difficulties, role of steroid in postoperative edema control in lower lid blepharoplasty approach. Materials and Methods: A total number of six patients were included in this study and all the patients were treated surgically under general anesthesia. All the patients were approached through lower eyelid blepharoplasty incision. The first skin crease in the lower eyelid region is selected for this incision. Results: All patients were administered with steroid injection. Frost sutures were placed in four cases and tarsorrhaphy was done in two patients. Three cases encountered immediate mild edema and immediate scar formation. Late scar was present only in two patients with a follow up of three months. Conclusion: Lower eyelid blepharoplasty incision is an excellent, non complicated, simple procedure in the management of fractures in the infraorbital region, orbital floor, which occurs as a part of zygomatic complex fractures. PMID:23225979

  8. Double strand binding – single strand incision mechanism for human flap endonuclease: implications for the superfamily

    PubMed Central

    Tsutakawa, Susan E.; Tainer, John A.

    2012-01-01

    Detailed structural, mutational, and biochemical analyses of human FEN1/DNA complexes have revealed the mechanism for recognition of 5′ flaps formed during lagging strand replication and DNA repair. FEN1 processes 5′ flaps through a previously unknown, but structurally elegant double-stranded (ds) recognition/single stranded (ss) incision mechanism that both selects for 5′ flaps and selects against ss DNA or RNA, intact dsDNA, and 3′ flaps. Two major DNA binding interfaces, including a K+ bridge between the DNA and the H2TH motif, are spaced one helical turn apart and together select for substrates with dsDNA. A conserved helical gateway and a helical cap protects the two-metal active site and selects for ss flaps with free termini. Structures of substrate and product reveal an unusual step between binding substrate and incision that involves a double base unpairing with incision occurring in the resulting unpaired DNA or RNA. Ordering of the active site requires a disorder-to-order transition induced by binding of an unpaired 3′ flap, which ensures that the product is ligatable. Comparison with FEN superfamily members, including XPG, EXO1, and GEN1, identifies superfamily motifs such as the helical gateway that select for ss-dsDNA junctions and provides key biological insights into nuclease specificity and regulation. PMID:22244820

  9. Replication protein A safeguards genome integrity by controlling NER incision events

    PubMed Central

    Overmeer, René M.; Moser, Jill; Volker, Marcel; Kool, Hanneke; Tomkinson, Alan E.; van Zeeland, Albert A.

    2011-01-01

    Single-stranded DNA gaps that might arise by futile repair processes can lead to mutagenic events and challenge genome integrity. Nucleotide excision repair (NER) is an evolutionarily conserved repair mechanism, essential for removal of helix-distorting DNA lesions. In the currently prevailing model, NER operates through coordinated assembly of repair factors into pre- and post-incision complexes; however, its regulation in vivo is poorly understood. Notably, the transition from dual incision to repair synthesis should be rigidly synchronized as it might lead to accumulation of unprocessed repair intermediates. We monitored NER regulatory events in vivo using sequential UV irradiations. Under conditions that allow incision yet prevent completion of repair synthesis or ligation, preincision factors can reassociate with new damage sites. In contrast, replication protein A remains at the incomplete NER sites and regulates a feedback loop from completion of DNA repair synthesis to subsequent damage recognition, independently of ATR signaling. Our data reveal an important function for replication protein A in averting further generation of DNA strand breaks that could lead to mutagenic and recombinogenic events. PMID:21282463

  10. Chemical weathering as a mechanism for the climatic control of bedrock river incision.

    PubMed

    Murphy, Brendan P; Johnson, Joel P L; Gasparini, Nicole M; Sklar, Leonard S

    2016-04-14

    Feedbacks between climate, erosion and tectonics influence the rates of chemical weathering reactions, which can consume atmospheric CO2 and modulate global climate. However, quantitative predictions for the coupling of these feedbacks are limited because the specific mechanisms by which climate controls erosion are poorly understood. Here we show that climate-dependent chemical weathering controls the erodibility of bedrock-floored rivers across a rainfall gradient on the Big Island of Hawai'i. Field data demonstrate that the physical strength of bedrock in streambeds varies with the degree of chemical weathering, which increases systematically with local rainfall rate. We find that incorporating the quantified relationships between local rainfall and erodibility into a commonly used river incision model is necessary to predict the rates and patterns of downcutting of these rivers. In contrast to using only precipitation-dependent river discharge to explain the climatic control of bedrock river incision, the mechanism of chemical weathering can explain strong coupling between local climate and river incision.

  11. Nd:YAG laser incision of the vesical neck in obstructive BPH

    NASA Astrophysics Data System (ADS)

    Gilbert, Peter T. O.

    2003-06-01

    From February, 1995 through June, 2002, 68 patients underwent laser incision of the prostate at our clinic. By means of a 23 F cytoscope and a 600 micrometer lateral firing quartz fiber the vesical neck was incised at the 5 and 7 o'clock position at 60 W power. Total energy averaged 13648 J. Operative time did not exceed 15 minutes. General anesthesia was employed in all but one patient. 38 patients remained catheter-free whereas 30 patients were catheterized for two hours. Except for three cases, all patients were discharged on the same day, usually after the first micturition. Anti-inflammatory treatment was administered for two weeks, Cotrimoxazole for 5 days. No serious complications were encountered. Minor side effects included urinary retention (1 pat.), urinary infection (3 pat.) and retrograde ejaculation (1 pat.). Considering a mean follow-up of 21 months, the average Qmax improved enormously (25.4 ml/s versus 10.9 ml/s), as did residual urine volume (35 ml versus 95 ml) and IPSS (7.1 versus 20.5). Three patients required TUR-P 2-3 years after laser surgery and one patient underwent radical retropubic prostatectomy for prostate cancer 2 years later. In conclusion, Nd:YAG laser incision of the prostate is a simple, safe, reliable and cost-effective outpatient procedure.

  12. Distinction of infected and non-infected post-surgical incisions with In-111-WBC scintigraphy

    SciTech Connect

    Abdel-Nabi, H.; Hinkle, G.H.; Olsen, J.O.

    1985-05-01

    To determine if In-111-WBCs scintigraphy can distinguish between healing and infection in post-surgical wounds, a prospective study was performed in patients with 3-14 day old surgical incisions. Eighteen patients (11 males and 7 females) were scanned 24 hrs after injection of 0.5 mCi of In-111 labeled autologous leukocytes. The scan findings were correlated with blood and/wound cultures results and diagnosis at time of discharge. Incisional uptake of In-111-WBCs was noted in 9 patients with infected surgical wounds and was absent in those 9 patients with non-infected surgical wounds. The results of the authors' study show that In-111-WBCs do not accumulate in non-infected surgical incisions. This confirms their previous findings in rats. The high specificity of In-111 leukocytes imaging makes it a valuable study in the evaluation of post-operative patients with suspected surgical wound infections. In-111 WBCs scintigraphy can distinguish between normal healing and infection at the site of recent (3-14 days) surgical incisions.

  13. Uniportal and single-incision video-assisted thoracic surgery: the state of the art.

    PubMed

    Ng, Calvin S H; Rocco, Gaetano; Wong, Randolph H L; Lau, Rainbow W H; Yu, Simon C H; Yim, Anthony P C

    2014-10-01

    Over the past decade, uniportal video-assisted thoracic surgery (VATS) has evolved dramatically into a sophisticated technique capable of performing some of the most complex thoracic procedures. The idea of operating through fewer surgical incisions and, therefore, with potentially better cosmesis, less postoperative pain and paraesthesia, has led to uniportal VATS increasing in popularity worldwide. The uniportal approach demands instrument design to be better suited for operating with multiple instruments through a single small incision. Furthermore, the drive by surgeons and industry to develop novel, smaller, more specialized procedure-specific instruments for uniportal VATS to further allow reduction in incision size is relentless. Refinement of uniportal VATS instruments, angulated and narrower endostaplers, and improvements in video-camera systems, including 3D systems, and 120° articulating lens will make uniportal VATS major lung resection easier to perform and learn. In the future, we could see the development of subcostal or e-NOTES access, endorobotic arms that open and operate within the chest cavity, and cross-discipline imaging assistance for uniportal VATS procedures.

  14. Experimental evidence for climatically controlled changes between lateral erosion and incision of actively uplifting folds

    NASA Astrophysics Data System (ADS)

    Bufe, Aaron; Paola, Chris; Burbank, Douglas; Thompson, Jessica

    2016-04-01

    The understanding of the incision and lateral erosion of rivers provides key data for the interpretation of landscapes as recorders of climatic and tectonic processes. We present results from six physical experiments on the erosion of a simple growing fold by antecedent streams. By varying uplift rates, sediment flux, and the width of alluvial fans upstream of the uplift, we produced a range of morphologies from narrow canyons through the fold to erosion of the entire uplift. The fraction of the uplift that was beveled by the river can be predicted by a dimensionless parameter linking the mobility of channels (strongly dependent on the sediment flux) and the rock-uplift rate. We apply these findings to a series of active folds in the foreland of the Tian Shan in NW China. Whereas the folds are incised today, they preserve uplifted, kilometer-wide beveled platforms. In the light of the experimental results, lateral migration rates required to explain such extensive beveling are similar to the lateral mobility of alluvial streams in areas much wetter than the presently arid northwestern Tarim Basin and suggest that major changes in water and sediment influxes are the probable cause of switches between lateral erosion and incision of active uplifts in the foreland of the Tian Shan. This finding is supported by the clustering of ages of fluvial terrace and alluvial fan deposition in that region.

  15. Appendectomy and pregnancy: gestational age does not affect the position of the incision.

    PubMed

    de Moya, Marc A; Sideris, Antonios C; Choy, Garry; Chang, Yuchiao; Landman, Wendy B; Cropano, Catrina M; Cohn, Stephen M

    2015-03-01

    The position of the base of the appendix during advancing gestational age is based on inadequate data. Therefore, the proper location for an appendectomy incision during pregnancy is highly unclear. This study investigated the location of the appendix during pregnancy to determine the optimal location for an incision in pregnant patients with appendicitis relative to McBurney's point. Magnetic resonance images (MRIs) were reviewed independently by two fellowship-trained abdominal MRI radiologists blinded to the imaging report. The distance of the appendix from anatomic landmarks was measured in a total of 114 pregnant women with an abdominal or pelvic MRI who were admitted between 2001 and 2011 at a Level I trauma center. Patients with a history of appendectomy were excluded. The distance from the base of the appendix to McBurney's point changed over the course of the gestation by only 1.2 cm and which did not amount to a clinically or statistically significant change in position. Our data provide evidence that there is minimal upward or lateral displacement of the appendix during pregnancy, and therefore its distance from the McBurney's point remains essentially unchanged. These findings justify the use of the McBurney's incision for appendectomy during pregnancy regardless of the trimester.

  16. Active salt deformation and rapid, transient incision along the Colorado River near Moab, Utah

    NASA Astrophysics Data System (ADS)

    Jochems, Andrew P.; Pederson, Joel L.

    2015-04-01

    In certain settings, erosion is driven by and balanced with tectonic uplift, but the evolution of many landscapes is dominated by other factors such as geologic substrate, drainage history, and transient incision. The Colorado Plateau is an example where these controls are debated and where salt deformation is hypothesized to be locally active and driven by differential unloading, although this is unconfirmed and unquantified in most places. We use luminescence-dated Colorado River terraces upstream of Moab, Utah, to quantify rates of salt-driven subsidence and uplift at the local scale. Active deformation in the study area is also supported by patterns of concavity along tributary drainages crossing salt structures. Subsidence in Professor Valley at a time-averaged rate of ~500 m/Myr (meters/million years) is superimposed upon rapid bedrock incision rates that increase from ~600 to ~900 m/Myr upstream through the study area. Such high rates are unexpected given the absence of sources of regional tectonic uplift here. Instead, the incision rate pattern across the greater area is consistent with a transient signal, perhaps still from ancient drainage integration through Grand Canyon far downstream, and then amplified by unloading at both the broad regional scale and at the local canyon scale.

  17. The longitudinal epineural incision and complete nerve transection method for modeling sciatic nerve injury

    PubMed Central

    Cheng, Xing-long; Wang, Pei; Sun, Bo; Liu, Shi-bo; Gao, Yun-feng; He, Xin-ze; Yu, Chang-yu

    2015-01-01

    Injury severity, operative technique and nerve regeneration are important factors to consider when constructing a model of peripheral nerve injury. Here, we present a novel peripheral nerve injury model and compare it with the complete sciatic nerve transection method. In the experimental group, under a microscope, a 3-mm longitudinal incision was made in the epineurium of the sciatic nerve to reveal the nerve fibers, which were then transected. The small, longitudinal incision in the epineurium was then sutured closed, requiring no stump anastomosis. In the control group, the sciatic nerve was completely transected, and the epineurium was repaired by anastomosis. At 2 and 4 weeks after surgery, Wallerian degeneration was observed in both groups. In the experimental group, at 8 and 12 weeks after surgery, distinct medullary nerve fibers and axons were observed in the injured sciatic nerve. Regular, dense myelin sheaths were visible, as well as some scarring. By 12 weeks, the myelin sheaths were normal and intact, and a tight lamellar structure was observed. Functionally, limb movement and nerve conduction recovered in the injured region between 4 and 12 weeks. The present results demonstrate that longitudinal epineural incision with nerve transection can stably replicate a model of Sunderland grade IV peripheral nerve injury. Compared with the complete sciatic nerve transection model, our method reduced the difficulties of micromanipulation and surgery time, and resulted in good stump restoration, nerve regeneration, and functional recovery. PMID:26692866

  18. Relative strength of scleral tunnel incisions with internal corneal lips constructed in cadaver eyes.

    PubMed

    Ernest, P H; Lavery, K T; Kiessling, L A

    1993-07-01

    We constructed scleral tunnel wounds with internal corneal lips and sutureless closures in ten cadaver eyes without previous intraocular surgery. Each wound differed in width, total incision length, and internal corneal lip size. At a low and high range of initial intraocular pressure (IOP, 10 to 15 mm Hg or 20 to 25 mm Hg), we compared the wounds' resistance to leakage during application of external pressure. A square wound with a 4.0 mm width and 4.0 mm overall length, including a 1.5 mm corneal lip, had the optimum wound dimensions. These produced a stable incision that resisted leakage at external pressures up to 525 pounds per square inch equally well at both IOP ranges. Leakage occurred at lower external pressures for wounds with greater width, smaller corneal lips, or wound widths that were greater than wound lengths; such wounds were also more prone to leakage at the low IOP range. When constructed properly and adequately, the 4.0 mm wide scleral tunnel incision with 1.5 mm internal corneal lip is a strong and safe wound for sutureless cataract surgery.

  19. [Laparoscopic cholecystectomy with three-port and 25 millimeters long incision.

    PubMed

    Gómez Tagle-Morales, Enrique David

    2013-01-01

    Background: three-port and 25 mm total incision laparoscopic cholecystectomy has shown benefits compared to conventional laparoscopy. The aim was to examine the safety and feasibility of this technique. Methods: a three-port laparoscopic cholecystectomy trial was conducted through Cinvestav metasearcher, Seriunam and Rencis. The eligibility criteria were: three port laparoscopic cholecystectomy, 25 mm total incision, and score = 17 on Data Review System. Trials which employed instruments smaller than 5 mm in diameter were excluded. The comparative variables were documented and results obtained in the selected trials were described. Results: four trials were selected, comprising 1767 cases (1329 females and 438 males), average age was 44.3 years. Chronic cholecystitis was documented in 84.3 %, and acute cholecystitis in 14.7 %. Average surgical time was 54.5 minutes. An additional port was required in 4.8 % and 1.4 % was converted to open technique. Bile duct injury was presented in 0.11 %. The success rate was 94.9 %. Conclusions: three port and 25 mm total incision in laparoscopic cholecystectomy is safe and feasible.

  20. SU-E-T-542: Comparison of Stereotactic Radiosurgery (SRS) of Brain Lesions Using Gamma Knife, VMAT, IMRT, and Conformal Arcs

    SciTech Connect

    Li, S; Charpentier, P; Chan, P; Neicu, T; Miyamoto, C

    2014-06-01

    Purpose: To compare dose distributions in stereotactic radiation surgery of brain lesions using gamma Knife, VMAT, conformal arcs, and IMRT in order to provide an optimal treatment. Methods: Dose distributions from single shot of 4C model of Gamma Knife at the helmet collimation sizes of 4, 8, 14, and 18 mm in diameter were compared with full arcs with the square shapes of 4×4 (or 5×5), 8×8 (or 10×10), and spherical shapes of 16 or 20 mm in diameter using EDR3 films in the same gamma knife QA phantom. Plans for ten SRS cases with single and multiple lesions were created in gamma knife plans and Pinnacle plans. The external beam plans had enlarged field size by 2-mm and used single conformal full circle arc for solitary lesion and none coplanar arcs/beams for multiple lesions. Coverage, conformity index, dose to critical organs, and integral dose to the brain and nearby critical structures were compared on all plans. Structures and dose matrices were registered in a Velocity deformable image registration system. Results: Single full circle arc from Elekta beam-modulate MLC (4-mm leaf thickness) and agility MLC (5-mm leaf thickness) have larger penumbra and less flatness than that of Gamma Knife single shot. None-coplanar arcs or beams were required to achieve similar dose distribution. In general, Gamma Knife plans provided significant less integral dose than that of linac-based plans. Benefits of IMRT and VMAT versus gamma Knife and conformal arcs were not significant. Conclusion: Our dose measurement and treatment planning evaluation clearly demonstrated dose distribution differences amount current popular SRS modalities for small solitary and multiple brain lesions. The trend of using MLC shape beams or arcs to replace conventional cones should be revisited in order to keep lower integral dose if the late correlates with some radiation-induced side effects. Pilot grant from Elekta LLC.

  1. CyberKnife radiosurgery for brainstem metastases: Management and outcomes and a review of the literature.

    PubMed

    Liu, Szu-Hao; Murovic, Judith; Wallach, Jonathan; Cui, Guosheng; Soltys, Scott G; Gibbs, Iris C; Chang, Steven D

    2016-03-01

    To our knowledge this paper is the first to use recursive partitioning analysis (RPA) for brainstem metastasis (BSM) patient outcomes, after CyberKnife radiosurgery (CKRS; Accuray, Sunnyvale, CA, USA); nine similar previous publications used mainly Gamma Knife radiosurgery (Elekta AB, Stockholm, Sweden). Retrospective chart reviews from 2006-2013 of 949 CKRS-treated brain metastasis patients showed 54 BSM patients (5.7%): 35 RPA Class II (65%) and 19 Class III (35%). There were 30 women (56%) and 24 men (44%). The median age was 59 years (range 36-80) and median follow-up was 5 months (range 1-52). Twenty-three patients (43%) had lung carcinoma BSM and 12 (22%) had breast cancer BSM. Fifty-four RPA Class II and III BSM patients had a median overall survival (OS) of 5 months, and for each Class 8 and 2 months, respectively. Of 36 RPA Class II and III patients with available symptoms (n=31) and findings (n=33), improvement/stability occurred in the majority for symptoms (86%) and findings (92%). Of 35 cases, 28 (80%) achieved BSM local control (LC); 13/14 with breast histology (93%) and 10/13 with lung histology (77%). All six RPA Class II and III patients with controlled extracranial systemic disease (ESD) experienced LC. Median tumor volume was 0.14 cm(3); of 34 RPA Class II and III cases, 26 LC patients had a 0,13 cm(3) median tumor volume while it was 0.27 cm(3) in the eight local failures. Of 35 cases, single session equivalent dosages less than the median (n=13), at the 17.9 Gy median (n=5) and greater than the median (n=17) had BSM LC in 10 (77%), four (80%) and 14 cases (82%), respectively. Univariate analysis showed Karnofsky Performance Score, RPA Class and ESD-control predicted OS. CKRS is useful for RPA Class II and III BSM patients with effective clinical and local BSM control.

  2. SU-E-T-605: A New Design for a Rotating Gamma Knife. Monte Carlo Simulation

    SciTech Connect

    Mora, G; Chibani, O; Li, J; Ma, C

    2014-06-01

    Purpose: to determine the characteristics of the 60Co beam emerging from a new design of a rotating Gamma Knife system and to calculate 3D dose distributions at the isocenter for different source configurations and collimator openings. Methods: We employed the BEAM-Monte Carlo code to realistically model the geometry design, including 30 60Co source capsules, two circular primary collimators (diameter of 6.6mm and 6.1mm) and four different changeable collimators. The shielding of the head design was also simulated. The sources (2.8mm diameter) are distributed in six groups in the spherical geometry. Each source is individually collimated to obtained four different circular fields at the isocenter (3mm, 3.5mm, 6mm and 8mm).The phase-space particles reaching the scoring plane below the primary collimation assembly were recorded and the BEAMDP code was used to determine the fluence and energy spectra of the particles emerging from each source-collimator configuration. The dose distributions at the isocenter plane (397.6mm from the source) were calculated in a spherical component module for the circular field sizes studied. Results: The energy spectra below the head assembly and primary collimators have been obtained, which exhibited the typical 60Co peaks and a small low-energy tail due to scattered photons (from about 200keV to 1MeV). The scattered component of the spectra represents about 8 % of the total number of photons reaching the scoring plane. The radial photon fluence does not vary significantly inside the collimator openings. The spectra of particles from different source groups are compared. Conclusion: The 60Co beam emerging from each source configuration was characterized, which can be used to establish a generic source model for all the sources for fast MC dose calculation. Further investigations are needed to determine the dose variations as a result of partial switching on/off different groups of sources for advanced Gamma Knife SRS/SBRT planning.

  3. Impact of Millimeter-Level Margins on Peripheral Normal Brain Sparing for Gamma Knife Radiosurgery

    SciTech Connect

    Ma, Lijun; Sahgal, Arjun; Larson, David A.; Pinnaduwage, Dilini; Fogh, Shannon; Barani, Igor; Nakamura, Jean; McDermott, Michael; Sneed, Penny

    2014-05-01

    Purpose: To investigate how millimeter-level margins beyond the gross tumor volume (GTV) impact peripheral normal brain tissue sparing for Gamma Knife radiosurgery. Methods and Materials: A mathematical formula was derived to predict the peripheral isodose volume, such as the 12-Gy isodose volume, with increasing margins by millimeters. The empirical parameters of the formula were derived from a cohort of brain tumor and surgical tumor resection cavity cases (n=15) treated with the Gamma Knife Perfexion. This was done by first adding margins from 0.5 to 3.0 mm to each individual target and then creating for each expanded target a series of treatment plans of nearly identical quality as the original plan. Finally, the formula was integrated with a published logistic regression model to estimate the treatment-induced complication rate for stereotactic radiosurgery when millimeter-level margins are added. Results: Confirmatory correlation between the nominal target radius (ie, R{sub T}) and commonly used maximum target size was found for the studied cases, except for a few outliers. The peripheral isodose volume such as the 12-Gy volume was found to increase exponentially with increasing Δ/R{sub T}, where Δ is the margin size. Such a curve fitted the data (logarithmic regression, R{sup 2} >0.99), and the 12-Gy isodose volume was shown to increase steeply with a 0.5- to 3.0-mm margin applied to a target. For example, a 2-mm margin on average resulted in an increase of 55% ± 16% in the 12-Gy volume; this corresponded to an increase in the symptomatic necrosis rate of 6% to 25%, depending on the Δ/R{sub T} values for the target. Conclusions: Millimeter-level margins beyond the GTV significantly impact peripheral normal brain sparing and should be applied with caution. Our model provides a rapid estimate of such an effect, particularly for large and/or irregularly shaped targets.

  4. Target and peripheral dose during patient repositioning with the Gamma Knife automatic positioning system (APS) device.

    PubMed

    Tran, Tuan-Anh; Stanley, Thomas R; Malhotra, Harish K; De Boer, Steven F; Prasad, Dheerendra; Podgorsak, Matthew B

    2010-01-28

    The GammaPlan treatment planning system does not account for the leakage and scatter dose during APS repositioning. In this study, the dose delivered to the target site and its periphery from the defocus stage and intershot couch transit (couch motion from the focus to defocus position and back) associated with APS repositioning are measured for the Gamma Knife model 4C. A stereotactic head-frame was attached to a Leksell 16 cm diameter spherical phantom with a calibrated ion chamber at its center. Using a fiducial box, CT images of the phantom were acquired and registered in the GammaPlan treatment planning system to determine the coordinates of the target (center of the phantom). An absorbed dose of 10 Gy to the 50% isodose line was prescribed to the target site for all measurements. Plans were generated for the 8, 14 and 18 mm collimator helmets to determine the relationship of measured dose to the number of repositions of the APS system and to the helmet size. The target coordinate was identical throughout entire study and there was no movement of the APS between various shots. This allowed for measurement of intershot transit dose at the target site and its periphery. The couch was paused in the defocus position, allowing defocus dose measurements at the intracranial target and periphery. Measured dose increases with frequency of repositioning and with helmet collimator size. During couch transit, the target receives more dose than peripheral regions; however, in the defocus position, the greatest dose is superior to the target site. The automatic positioning system for the Leksell Gamma Knife model 4C results in an additional dose of up to 3.87 +/- 0.07%, 4.97 +/- 0.04%, and 5.71 +/- 0.07% to the target site; its periphery receives additional dose that varies depending on its position relative to the target. There is also dose contribution to the patient in the defocus position, where the APS repositions the patient from one treatment coordinate to another

  5. Assessment of absorbed dose to thyroid, parotid and ovaries in patients undergoing Gamma Knife radiosurgery

    NASA Astrophysics Data System (ADS)

    Hasanzadeh, H.; Sharafi, A.; Allah Verdi, M.; Nikoofar, A.

    2006-09-01

    Stereotactic radiosurgery was originally introduced by Lars Leksell in 1951. This treatment refers to the noninvasive destruction of an intracranial target localized stereotactically. The purpose of this study was to identify the dose delivered to the parotid, ovaries, testis and thyroid glands during the Gamma Knife radiosurgery procedure. A three-dimensional, anthropomorphic phantom was developed using natural human bone, paraffin and sodium chloride as the equivalent tissue. The phantom consisted of a thorax, head and neck and hip. In the natural places of the thyroid, parotid (bilateral sides) and ovaries (midline), some cavities were made to place TLDs. Three TLDs were inserted in a batch with 1 cm space between the TLDs and each batch was inserted into a single cavity. The final depth of TLDs was 3 cm from the surface for parotid and thyroid and was 15 cm for the ovaries. Similar batches were placed superficially on the phantom. The phantom was gamma irradiated using a Leksell model C Gamma Knife unit. Subsequently, the same batches were placed superficially over the thyroid, parotid, testis and ovaries in 30 patients (15 men and 15 women) who were undergoing radiosurgery treatment for brain tumours. The mean dosage for treating these patients was 14.48 ± 3.06 Gy (10.5-24 Gy) to a mean tumour volume of 12.30 ± 9.66 cc (0.27-42.4 cc) in the 50% isodose curve. There was no significant difference between the superficial and deep batches in the phantom studies (P-value < 0.05). The mean delivered doses to the parotid, thyroid, ovaries and testis in human subjects were 21.6 ± 15.1 cGy, 9.15 ± 3.89 cGy, 0.47 ± 0.3 cGy and 0.53 ± 0.31 cGy, respectively. The data can be used in making decisions for special clinical situations such as treating pregnant patients or young patients with benign lesions who need radiosurgery for eradication of brain tumours.

  6. Direct measures of mechanical energy for knife mill size reduction of switchgrass, wheat straw, and corn stover.

    PubMed

    Bitra, Venkata S P; Womac, Alvin R; Igathinathane, C; Miu, Petre I; Yang, Yuechuan T; Smith, David R; Chevanan, Nehru; Sokhansanj, Shahab

    2009-12-01

    Lengthy straw/stalk of biomass may not be directly fed into grinders such as hammer mills and disc refiners. Hence, biomass needs to be preprocessed using coarse grinders like a knife mill to allow for efficient feeding in refiner mills without bridging and choking. Size reduction mechanical energy was directly measured for switchgrass (Panicum virgatum L.), wheat straw (Triticum aestivum L.), and corn stover (Zea mays L.) in an instrumented knife mill. Direct power inputs were determined for different knife mill screen openings from 12.7 to 50.8 mm, rotor speeds between 250 and 500 rpm, and mass feed rates from 1 to 11 kg/min. Overall accuracy of power measurement was calculated to be +/-0.003 kW. Total specific energy (kWh/Mg) was defined as size reduction energy to operate mill with biomass. Effective specific energy was defined as the energy that can be assumed to reach the biomass. The difference is parasitic or no-load energy of mill. Total specific energy for switchgrass, wheat straw, and corn stover chopping increased with knife mill speed, whereas, effective specific energy decreased marginally for switchgrass and increased for wheat straw and corn stover. Total and effective specific energy decreased with an increase in screen size for all the crops studied. Total specific energy decreased with increase in mass feed rate, but effective specific energy increased for switchgrass and wheat straw, and decreased for corn stover at increased feed rate. For knife mill screen size of 25.4 mm and optimum speed of 250 rpm, optimum feed rates were 7.6, 5.8, and 4.5 kg/min for switchgrass, wheat straw, and corn stover, respectively, and the corresponding total specific energies were 7.57, 10.53, and 8.87 kWh/Mg and effective specific energies were 1.27, 1.50, and 0.24 kWh/Mg for switchgrass, wheat straw, and corn stover, respectively. Energy utilization ratios were calculated as 16.8%, 14.3%, and 2.8% for switchgrass, wheat straw, and corn stover, respectively. These

  7. A single-incision laparoscopic technique for retrieval and replacement of disconnected ventriculoperitoneal shunt tubing found in the peritoneum.

    PubMed

    Jackson, C C; Chwals, W J; Frim, D M

    2002-04-01

    A 7-year-old girl presented with signs and symptoms of increased intracranial pressure 2 years after insertion of a ventriculoperitoneal (VP) shunt. Evaluation revealed disconnection of the distal shunt catheter and migration into the peritoneal cavity. A single-incision laparoscopic procedure was performed to locate and remove the disconnected shunt tubing, and the new shunt catheter was inserted through the laparoscopic port site. Laparoscopy is being used more frequently for evaluation and repair of distal VP shunt malfunctions, but generally still requires multiple incisions for port placement and insertion of the new shunt catheter. The single-incision technique used here is technically feasible, allows excellent visualization of the peritoneal cavity and does not require any incisions beyond the previous one used for initial shunt insertion.

  8. DENITRIFICATION AND NITROGEN DYNAMICS IN SEDIMENTS OF A MID-ATLANTIC INCISED STREAM DEPOSITED WITH DEEP LEGACY SEDIMENTS.

    EPA Science Inventory

    Excess legacy sediments deposited in former impounded streams frequently bury Holocene pre-settlement wetlands, decrease in-situ nitrogen removal, and increase nitrogen transport downstream, particularly where deep incised channels limit sediment-water interactions. This has prom...

  9. Autogenic terraces and non-linear river incision rates under steady external forcing

    NASA Astrophysics Data System (ADS)

    Malatesta, Luca C.; Prancevic, Jeffrey P.; Avouac, Jean-Philippe

    2015-04-01

    Fluvial terraces are among the most commonly cited records of hydraulic changes and tectonic events, and researchers often use the timing of their abandonment to constrain regional climatic and tectonic forcings. However, it can be challenging to identify the cause of terrace abandonment, as the same first order signature results from multiple drivers: external forcings of tectonics and climate, and internal autogenic feedbacks. Misinterpretation of the origin of fluvial terraces carries important consequences, as they often are key evidences for geomorphological and tectonic studies. Using a numerical model we identify an autogenic mechanism in transport-limited rivers that produces accelerated incision rates and the abandonment of significant terraces under steady forcing conditions. We show that a 'bank-feedback' process controls the cross-sectional geometry of channel entrenchment through the rising cost of eroding higher banks. During a phase of incision under the forcing of regular discharges (e.g. bankfull floods), an incising alluvial river migrates in a floodplain bound by progressively higher banks. Consequently, the volume of sediment produced by a unit of lateral migration grows larger and eventually forms a talus that may persist for multiple flood events. The talus shields the toe of the bank and prevents lateral erosion while vertical erosion can continue unhindered. This bank-shielding mechanism becomes more effective as vertical erosion creates even higher banks, initiating a feedback that promotes dramatic vertical entrenchment and abandonment of wide terraces. We propose that such a 'bank-feedback' process also plays a large role in determining the source of bedload material by forcing the river to tap into deeper and older sedimentary strata. We compare the 'bank-feedback' mechanism with a well-studied case of the northern piedmont of the East Tian Shan. There, terrace ages documenting >200 m of Holocene river incision, record a fourfold

  10. Landscape evolution and bedrock incision in the northern Alpine Foreland since the last 2 Ma

    NASA Astrophysics Data System (ADS)

    Claude, Anne; Akçar, Naki; Schlunegger, Fritz; Ivy-Ochs, Susan; Kubik, Peter; Christl, Marcus; Vockenhuber, Christof; Dehnert, Andreas; Kuhlemann, Joachim; Rahn, Meinert; Schlüchter, Christian

    2016-04-01

    The landscape evolution of the Swiss Alpine Foreland since the early Pleistocene is of utmost importance for modelling the long-term safety of deep geological repositories for nuclear waste disposal in the northern Alpine Foreland. The oldest Quaternary sediments in the northern foreland are proximal glaciofluvial sediments lying unconformably on Tertiary Molasse or Mesozoic carbonate bedrock. These deposits form topographically distinct and discontinuous isolated plateaus. Terrace morphostratigraphy has a reversed stratigraphic relationship, i.e. today older sediments are located at higher altitudes and vice versa. In this study, we focus on the landscape evolution and long-term bedrock incision in the Swiss Alpine Foreland. We reconstruct the terrace chronology in the foreland at six key locations at different altitudes ranging from 433 m a.s.l. to 675 m a.s.l. by applying cosmogenic depth-profile and isochron-burial dating techniques. First results from these sites indicate that the gravels at studied sites were accumulated in the foreland between 1 and 2 Ma. Based on this reconstructed chronology, long-term bedrock incision rates between 0.1 and 0.2 mm/a were calculated. Thus, we inferred a landscape at that time that was most likely characterized by smoother hillslopes than at present. During the Mid-Pleistocene Revolution (ca. 0.95 Ma), a re-organization of the drainage systems occurred in the Alpine Foreland with a significant lowering of the base level of stream channels. Existing data suggest slightly increased incision rates after this drainage network re-organisation compared to our results. The reconstruction of the chronology at the remaining sites may allow quantifying a pronounced incision as well as the exact timing of the acceleration in the incision rates. REFERENCES Heuberger, S. & Naef, H. (2014). NAB 12-35: Regionale GIS-Kompilation und -Analyse der Deckenschotter-Vorkommen im nördlichen Alpenvorland. Nagra Arbeitsbericht. Kuhlemann, J. & Rahn

  11. Timing of European fluvial terrace formation and incision rates constrained by cosmogenic nuclide dating

    NASA Astrophysics Data System (ADS)

    Schaller, Mirjam; Ehlers, Todd A.; Stor, Tomas; Torrent, Jose; Lobato, Leonardo; Christl, Marcus; Vockenhuber, Christof

    2016-10-01

    Age constraints of late Cenozoic fluvial terraces are important for addressing surface process questions related to the incision rates of rivers, or tectonic and climate controls on denudation and sedimentation. Unfortunately, absolute age constraints of fluvial terraces are not always possible, and many previous studies have often dated terraces with relative age constraints that do not allow for robust interpretations of incision rates and timing of terrace formation. However, in situ-produced cosmogenic nuclides allow absolute age determination, and hence incision rates, of fluvial deposits back to 5 Ma. Here we present, cosmogenic depth profile dating and isochron burial dating of four different river systems in Europe spanning 12° of latitude. We do this to determine river incision rates and spatial variations in the timing of terrace formation. Isochron burial age constraints of four selected terraces from the Vltava river (Czech Republic) range between 1.00 ± 0.21 to 1.99 ± 0.45Ma. An isochron burial age derived for the Allier river (Central France) is 2.00 ± 0.17Ma. Five terrace levels from the Esla river (NW Spain) were dated between 0.08 + 0.04 / - 0.01Ma and 0.59 + 0.13 / - 0.20Ma with depth profile dating. The latter age agrees with an isochron burial age of 0.52 ± 0.20Ma. Two terrace levels from the Guadalquivir river (SW Spain) were dated by depth profile dating to 0.09 + 0.03 / - 0.02Ma and 0.09 + 0.04 / - 0.03Ma. The one terrace level from the Guadalquivir river dated by isochron burial dating resulted in an age of 1.79 ± 0.18Ma. Results indicate that the cosmogenic nuclide-based ages are generally older than ages derived from previous relative age constraints leading to a factor 2-3 lower incision rates than previous work. Furthermore, the timing of terrace formation over this latitudinal range is somewhat obscured by uncertainties associated with dating older terraces and not clearly synchronous with global climate variations.

  12. Protein dynamics from nuclear magnetic relaxation.

    PubMed

    Charlier, Cyril; Cousin, Samuel F; Ferrage, Fabien

    2016-05-01

    Nuclear magnetic resonance is a ubiquitous spectroscopic tool to explore molecules with atomic resolution. Nuclear magnetic relaxation is intimately connected to molecular motions. Many methods and models have been developed to measure and interpret the characteristic rates of nuclear magnetic relaxation in proteins. These approaches shed light on a rich and diverse range of motions covering timescales from picoseconds to seconds. Here, we introduce some of the basic concepts upon which these approaches are built and provide a series of illustrations.

  13. Relaxation techniques for children and young people.

    PubMed

    Hobbie, C

    1989-01-01

    The relaxation response, relaxation with mental imagery/self-hypnosis, and centering are techniques that can be used by the nurse practitioner in a variety of clinical situations to help children and young people manage stress. These approaches also can be used to treat certain common pediatric problems, such as headaches, enuresis, acute and chronic pain, and habit disorders. The techniques and their appropriate use are described. PMID:2647960

  14. METHOD OF HYPERBOLIC SYSTEMS WITH STIFF RELAXATION

    SciTech Connect

    R. B. LOWRIE; J. E. MOREL

    2001-03-01

    Three methods are analyzed for solving a linear hyperbolic system that contains stiff relaxation. We show that the semi-discrete discontinuous Galerkin method, with a linear basis, is accurate when the relaxation time is unresolved (asymptotically preserving--AP). A recently developed central method is shown to be non-AP. To discriminate between AP and non-AP methods, we argue that one must study problems that are diffusion dominated.

  15. Relaxation techniques for children and young people.

    PubMed

    Hobbie, C

    1989-01-01

    The relaxation response, relaxation with mental imagery/self-hypnosis, and centering are techniques that can be used by the nurse practitioner in a variety of clinical situations to help children and young people manage stress. These approaches also can be used to treat certain common pediatric problems, such as headaches, enuresis, acute and chronic pain, and habit disorders. The techniques and their appropriate use are described.

  16. Autogenic incision and terrace formation resulting from abrupt late-glacial base-level fall, lower Chippewa River, Wisconsin, USA

    NASA Astrophysics Data System (ADS)

    Faulkner, Douglas J.; Larson, Phillip H.; Jol, Harry M.; Running, Garry L.; Loope, Henry M.; Goble, Ronald J.

    2016-08-01

    A paucity of research exists regarding the millennial-scale response of inland alluvial streams to abrupt base-level fall. Studies of modern systems indicate that, over short time scales, the response is a diffusion-like process of upstream-propagating incision. In contrast, evidence from the lower Chippewa River (LCR), located in the upper Midwest of the USA, suggests that autogenic controls operating over time scales of several millennia can overwhelm diffusion, resulting in incision that is prolonged and episodic. During the Last Glacial Maximum, the LCR drained the Chippewa Lobe of the Laurentide Ice Sheet to the glacial upper Mississippi River (UMR). As a meltwater stream, it aggraded and filled its valley with glacial outwash, as did its largest tributaries, which were also meltwater streams. Its nonglacial tributaries aggraded, too, filling their valleys with locally derived sediment. During deglaciation, the UMR incised at least twice, abruptly lowering the LCR's base level - ~ 15 m at 16 ka or earlier and an additional 40 m at ca. 13.4 ka. Each of these base-level falls initiated incision of the LCR, led by upstream migrating knickpoints. The propagation of incision has, however, been a lengthy process. The optically stimulated luminescence (OSL) ages of terrace alluvium indicate that, by 13.5 ka, incision had advanced up the LCR only 15 km, and by 9 ka, only 55 km. The process has also been episodic, resulting in the formation of fill-cut terraces (inferred from GPR surveys and exposures of terrace alluvium) that are younger and more numerous in the upstream direction. Autogenic increases in sediment load and autogenic bed armoring, the result of periodic tributary-stream rejuvenation and preferential winnowing of fines by the incising river, may have periodically caused knickpoint migration and incision to slow and possibly stop, allowing lateral erosion and floodplain formation to dominate. A decline in sediment flux from stabilizing incised tributary

  17. KNIFE MILL COMMINUTION ENERGY ANALYSIS OF SWITCHGRASS, WHEAT STRAW, AND CORN STOVER AND CHARACTERIZATION OF PARTICLE SIZE DISTRIBUTIONS

    SciTech Connect

    Bitra, V.S.P.; Womac, A.R.; Sokhansanj, Shahabaddine; Igathinathane, C.

    2010-01-01

    Biomass preprocessing and pretreatment technologies such as size reduction and chemical preconditioning are aimed at reducing the cost of ethanol production from lignocellulosic biomass. Size reduction is an energy-intensive biomass preprocessing unit operation. In this study, switchgrass, wheat straw, and corn stover were chopped in an instrumented knife mill to evaluate size reduction energy and corresponding particle size distribution as determined with a standard forage sieve analyzer. Direct mechanical power inputs were determined using a dedicated data acquisition system for knife mill screen openings from 12.7 to 50.8 mm, rotor speeds between 250 and 500 rpm, and mass feed rates from 1 to 11 kg/min. A speed of 250 rpm gave optimum performance of the mill. Optimum feed rates for 25.4 mm screen and 250 rpm were 7.6, 5.8, and 4.5 kg/min for switchgrass, wheat straw, and corn stover, respectively. Total specific energy (MJ/Mg) was defined as the size reduction energy required to operate the knife mill plus that imparted to the biomass. Effective specific energy was defined as the energy imparted to the biomass. For these conditions, total specific energies were 27.3, 37.9, and 31.9 MJ/Mg and effective specific energies were 10.1, 15.5, and 3.2 MJ/Mg for switchgrass, wheat straw, and corn stover, respectively. These results demonstrated that biomass selection affects the size reduction energy, even for biomass with similar features. Second-order polynomial equations for the total specific energy requirement fitted well (R2 > 0.95) as a function of knife mill screen size, mass feed rate, and speed for biomass materials tested. The Rosin-Rammler equation fitted the cumulative undersize mass of switchgrass, wheat straw, and corn stover chop passed through ASABE sieves with high R2 (>0.983). Knife mill chopping of switchgrass, wheat straw, and corn stover resulted in particle size distributions classified as 'well-graded strongly fine-skewed mesokurtic', 'well

  18. Submarine Geomorphology of Incised Valleys on the Northern English Channel Shelf

    NASA Astrophysics Data System (ADS)

    Palmer-Felgate, A.; Gupta, S.; Collier, J.; Pye, J.; de Mol, B.; Dickinson, J.; Coakley, B.

    2003-12-01

    Late Quaternary sea-level fluctuations exposed large expanses of the English Channel shelf during glacial periods leading to the development of complex incised fluvial valley systems carved into the bedrock. These submerged remnants of the formerly extensive English Channel River provide a critical interface between the onshore fluvial systems of NW Europe and sediment sinks at the Celtic Sea shelf margin. Here we investigate the detailed morphology of the submerged River Arun, a tributary of the English Channel River, with a view to understanding the processes governing valley evolution. We conducted a high-resolution swath bathymetry survey of the Arun palaeovalley using a portable Reson 8101 240 kHz Multibeam Echosounder owned by the UK Universities High-Resolution Geophysics Consortium. An 8km x 17km area was surveyed in water depths ranging from 18m to 55m. The Reson 8101 was mobilised on a vessel of opportunity using an over-the-side pole mounting. Narrow focused beams (1.5° x 1.5° ) produced a footprint 0.5m2 to 3.5m2 and coverage over a 150° angular sector of seafloor. The sonar range resolution of 5cm combined with 2cm accuracy tidal measurements meant a very high vertical accuracy was achieved. DGPS positioning using a POS MV 220 was accurate to within 1m, and the system also provided satellite aided inertial heading and motion data. Co-registered acoustic backscatter data was merged with a Digital Elevation Model to aid in classifying the seabed. A dense grid of complementary commercial boomer profiles together with extensive cores have been used to constrain the subsurface stratigraphy. Our newly defined shelf morphology reveals a topographically complex submarine landscape comprising bedrock-incised valleys and embayments. The main Palaeo-Arun valley axis trends northwest to southeast and is bounded by bedrock on one margin and fluvial gravels on the other. The width of the valley narrows downstream from a maximum of 2km to 300m and the depth of

  19. Bedrock fluvial incision and longitudinal profile development over geologic time scales determined by fluvial terraces

    NASA Astrophysics Data System (ADS)

    Pazzaglia, Frank J.; Gardner, Thomas W.; Merritts, Dorothy J.

    Fluvial terraces preserve the history of river incision into bedrock over geologic time scales. In this paper we use terraces and a comparison of terrace longitudinal profiles to stream longitudinal profiles to develop a conceptual model of bedrock fluvial incision in diverse geologic, tectonic, and climatic settings. The conceptual model highlights a distinction between bedrock stream behavior in settings of relatively high versus relatively low tectonic activity. This distinction arises from the fundamentally different ways in which runoff is generated in these respective tectonic settings and the positive feedbacks that exist between topography and climate. The model allows for qualitative predictions of long profile shape that can be directly compared to the longitudinal profiles predicted by the stream power law. Our approach has the advantage of helping understand the geologic (and climatic) constraints on the wide variations in k, m, and n revealed in recent applications of the stream power law. We reconcile diverse longitudinal profile shapes and long-term rates of bedrock fluvial incision by considering how a drainage basin generates fluvial discharge and whether that discharge can produce the necessary stream power distributed across a valley bottom such that the long profile can rapidly accommodate changes in base level, climate, and/or rates of rock uplift. We propose that in tectonically active settings (Type I basins), the entire drainage basin experiences uplift which, in turn, builds steep slopes and concomitant increases in orographic precipitation that effectively generate the high peak discharges and fluvial-system wide stream power necessary to create and maintain concave-up long profiles and rates of incision equal and opposite to rates of rock uplift. Measured stream power for one of these basins is highly correlated to the width of the channel and valley bottom which argues for a conservation of energy along the profile and the apportionment

  20. Fluvial Bedrock Incision Rates in Taroko Gorge (Taiwan) From in Situ-Produced Cosmogenic Nuclides

    NASA Astrophysics Data System (ADS)

    Schaller, M.; Hovius, N.; Willett, S.; Ivy-Ochs, S.; Synal, H.

    2003-12-01

    Climate, through its influence on erosion, plays a key role in the tectonic evolution of the continental crust. Tectonics may in turn moderate both local and global climate, for example through the construction of mountain belts. Geodynamic modeling has yielded testable hypotheses concerning the feedbacks between climate, erosion and tectonics. The models, however, are not matched by an observational data base to test their predictions. This is primarily because erosion, the key parameter linking cause and consequence, has proved difficult to measure. Cosmogenic nuclide concentrations can be used to determine present and past rates of river incision, a key erosional process, and thus establish how bedrock rivers have responded to recent change of climate. The effects of such changes are recorded in fluvially sculpted landforms in mountain valleys. The age of these fluvially sculpted surfaces can be dated by cosmogenic nuclides. The concentration of cosmogenic nuclides in rocks exposed at the Earth's surface is proportional to the total duration of their exposure. The age of the surface and their absolute altitude above the active river channel is used to constrain valley lowering rates. We applied this approach in the Taroko gorge of the Liwu Chi river, Taiwan, an ideal natural laboratory for fluvial erosion studies because of its extreme, monsoonal climate and steady tectonic forcing, absence of significant glaciation, and availability of high-quality measurements of present day erosion. Fluvial incision rates between February 2000 and May 2002 are around 5 mm/yr (Hartshorn et al., 2002). Similar to these short-term incision rates are the long-term exhumation rates estimated from apatite fission tracks. However, 2.4 kyr old terrace deposits upstream of the Taroko gorge imply higher intermediate-term incision rates of 11 mm/yr (Liew, 1988). Minimum surface exposure ages derived from the concentration of in situ-produced 36Cl in marble, and corrected for topographic