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Sample records for sutured posterior chamber

  1. A new surgical technique using steel suture for trans-scleral fixation of posterior chamber intraocular lenses

    PubMed Central

    Ram, Jagat; Gupta, Nishant; Chaudhary, Manish; Verma, Neelam

    2013-01-01

    Background: A new emerging complication of trans-scleral fixation of posterior chamber (PC) intraocular lens (IOL) with polypropylene suture is high rates of spontaneous dislocation of the IOL due to disintegration or breakage of suture. Materials: We report a new surgical technique of trans-scleral fixation of posterior chamber intraocular lens (SF PCIOL) with steel suture to eliminate the complication of dislocation of IOL fixed with polypropylene suture in one adult and a child. Results: We successfully achieved stable fixation and good centration of IOL after SF PCIOL with steel suture in these patient having inadequate posterior capsular support. Both eyes achieved best corrected visual acuity 20/40 at 18 months follow-up. Conclusions: Steel suture is a viable option for trans-scleral fixation of posterior chamber intraocular lens. PMID:23619504

  2. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    PubMed Central

    Can, Ertuğrul; Koçak, Nurullah; Yücel, Özlem Eşki; Gül, Adem; Öztürk, Hilal Eser; Sayın, Osman

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes. PMID:27050346

  3. Long-term safety of polypropylene knots under scleral flaps for transsclerally sutured posterior chamber lenses.

    PubMed Central

    Van Meter, W S

    1997-01-01

    PURPOSE: To evaluate the safety of polypropylene knots used in TS-SPCL combined with PK and AV over time. METHOD: A retrospective review of 26 consecutive cases of TS-SPCL by one surgeon (WSVM) with at least 12 months follow-up (mean 26, range 12-62). All patients had a double strand polypropylene knot buried under partial thickness scleral flaps at 2 and 8 o'clock. Knots were rotated into the globe (R) in 10 cases, and could not be buried (N) in 13 cases, and in 3 cases 1 knot was buried. RESULTS: No cases of suture erosion occurred in R or N. One or more polypropylene sutures were visible in 17 patients (8 R, 9 T) at last exam. Twenty-three of 52 knots were rotated into the globe, and 70% of rotated knots were not even visible at the slit lamp at final visit. There was no evidence of conjunctival erosion in any patient. There was no lens dislocation and no endophthalmitis. CONCLUSION: The combination of partial thickness scleral flaps with double strand polypropylene knots reduces the incidence of suture erosion through the conjunctive if knots cannot be rotated into the globe. Images FIGURE 1 FIGURE 2 FIGURE 3 PMID:9440177

  4. [Endoscopically controlled optimization of trans-scleral suture fixation of posterior chamber lenses in the ciliary sulcus].

    PubMed

    Althaus, C; Sundmacher, R

    1993-08-01

    Two technical difficulties have to be overcome in transscleral suture fixation of posterior chamber intraocular lenses (PCL) in the ciliary sulcus: first, exact needle penetration through the sulcus, and second, exact positioning of the PCL haptics in the sulcus. Incongruence of the two may lead to long-term complications by compression or even strangulation of ciliary processes. Intraocular endoscopy was used intraoperatively to visualize the site of needle penetration and the final location of the haptics in patients. It turned out that with our previously described standard techniques the precision was far less than anticipated. Thus, new technical ways had to be sought to improve the precision of positioning. In secondary implantation without perforating keratoplasty we achieved the best results when the needle was passed ab externo before opening the eye and before anterior vitrectomy, taking advantage of a precisely prepared sclerocorneal zone. Passing the needle ab externo in an already hypotonic eyeball gives much less precise results. In combination with perforating keratoplasty with an open-sky approach, needle penetration ab interno is reliable. Correct positioning of the PCL haptics is at least as difficult as correct needle penetration, a fact which up to now has mostly been ignored. In 33 consecutively operated eyes the technique of implantation and PCL design was varied under endoscopical control.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Iris fixation of posterior chamber intraocular lenses.

    PubMed

    Yazdani-Abyaneh, Alireza; Djalilian, Ali R; Fard, Masoud Aghsaei

    2016-12-01

    We introduce a technique for iris fixation of a posterior chamber intraocular lens (IOL) in which most of the procedure is done outside the eye. This minimizes intraocular manipulation, maximizes corneal endothelial preservation, and avoids the risk for IOL drop into the vitreous cavity intraoperatively. The IOL is fixated to the most peripheral part of the iris, resulting in a rounder pupil. Sutures are placed at exact positions on the haptics, resulting in a well-centered IOL.

  6. [Macular threshold after ECCE and posterior chamber IOL implantation].

    PubMed

    Baltatzis, S; Georgopoulos, G; Andreanos, D

    1989-01-01

    In the present paper, the macular threshold after ECCE and posterior chamber intraocular lens implantation, was studied in an effort to determine the time period needed for full postoperative recovery of macular function. We evaluated 22 eyes in 20 patients who underwent extracapsular cataract extraction and posterior chamber IOL implantation. There were 12 men and 8 women between the ages of 40 and 62 years with mean age of 53 years. Postoperative visual field testing was performed within the central 4 degrees with an automated static perimeter (Humphrey Visual Field Analyser), using a macular threshold test pattern. It has been established that central retinal sensitivity in pseudophakia shows a postoperative decrease and consequently recovers to almost normal levels within one month. The exact cause of this reduction remains under discussion and further control mainly with fluorescein angiography is necessary.

  7. [Postoperative opacification of posterior chamber intraocular lenses - a review].

    PubMed

    Schmidbauer, J M; Werner, L; Apple, D J; Pandey, S K; Izak, A M; Trivedi, R H; Macky, T A; Auffarth, G U; Peng, Q; Arthur, S N; Escobar-Gomez, M; Ma, L; Vargas, L G

    2001-09-01

    Postoperative opacification of intraocular lenses (IOLs) is a very unpleasant complication for the ophthalmic surgeon and the patient. We report on our experiences with opacification of different foldable IOL designs and rigid poly (methyl methacrylate) (PMMA) posterior chamber lenses.1. Snowflake degeneration of PMMA IOLs: This condition is an unanticipated and surprising late postoperative finding 8 to 15 years after implantation. In our opinion, this complication is probably not related to the PMMA biomaterial itself, but rather it appears to represent a manufacturing problem that has affected a selected, albeit large number of lenses manufactured in the 1980s-mid 1990s.2. Degeneration of UV absorber material and calcium deposits within the optic of hydrophilic IOLs: Two years postoperatively degenerations of UV absorber material and calcium deposits within the optic of single piece hydrophilic acrylic lenses SC60B-OUV manufactured by MDR (Medical developmental research Inc. Clearwater FL, USA) can occur. Although the precise mechanism is not fully known, it was assumed that these opacifications are due to premature aging of the UV blocking agent incorporated in the lens biomaterial and calcification.3. Calcification on the surface of the Bausch & Lomb Hydroviewtrade mark IOLs: Twelve to 15 months postoperatively granular surface calcifications in Hydroviewtrade mark IOLs occured. The mechanism is not fully understood. According to Bausch and Lomb studies, part of the components of the packaging contained silicone, which may have come off the packaging onto the lens optic, where it then appears to be a catalyst for calcium precipitation. The manufacturer has correlated a change in packaging with the appearance of the opacification. The manufacturer now believes that this problem has been solved. However, final verification will require a careful 1 - 2 years clinical study.4. Glistenings in the hydrophobic acrylic AcrySoftrade mark IOLs: The time frame of

  8. [Capsulotomy through the pars plana in the eye with pseudophakia of the posterior chamber].

    PubMed

    Radian, A B; Mocanu, C

    1996-01-01

    It described one surgical technique for capsulotomy in the case of secondary cataract at an eye with pseudophakic by posterior chamber. The approaching makes with an simple instrument, through pars plana, the tearing of posterior capsule making under control with operator microscope, in area of visual axie, excluding any possibility to harm the lens, its luxation in vitreous or anothers complications.

  9. Safe suture anchor insertion for anterior and posterior hip labral repair

    PubMed Central

    Foster, Andrew D.; Ryan, John; Ellis, Thomas; Flom, James

    2015-01-01

    We sought to define bone thickness in relation to the chondral surface at various depths along the anterior and posterior acetabular rim and safe portals for anchor insertion in these regions. Six cadaveric pelvises were mounted on a custom jig. A custom guide was attached to simulate anterolateral (AL), mid-anterior (MA), distal anterolateral (DALA) and posterolateral (PL) arthroscopy portals. Anterior 3 o’clock and 4 o’clock positions were drilled using MA and DALA portals. Posterior 8 o’clock to 11 o’clock positions were drilled using a 1.4-mm drill bit from the PL portal. At depths of 5, 10 and 15 mm, the distance from the drill to the intra and extra-articular surfaces was measured using a custom caliper. Mean distance between drill hole and articular surface for anterior and posterior positions ranged from 1.61 to 2.75 mm at 5 mm. The smallest distance between the drill hole and articular surface and the largest width between drill hole and the extra-articular surface were at the 4 o’clock position. No difference between the MA and DALA portals were noted for the anterior positions. For the posterior rim positions, the distance on the articular side remained consistent throughout. For the posterior positions, only the PL portal was utilized. Both the MA or DALA portals can be utilized for safe drilling of the anterior rim positions. The posterior positions can all be safely drilled with a relatively good bone margin using the PL portal, but use of the MA or DALA portals resulted in extra-articular cortical perforation in all cases. PMID:27011835

  10. Safe suture anchor insertion for anterior and posterior hip labral repair.

    PubMed

    Foster, Andrew D; Ryan, John; Ellis, Thomas; Flom, James

    2015-07-01

    We sought to define bone thickness in relation to the chondral surface at various depths along the anterior and posterior acetabular rim and safe portals for anchor insertion in these regions. Six cadaveric pelvises were mounted on a custom jig. A custom guide was attached to simulate anterolateral (AL), mid-anterior (MA), distal anterolateral (DALA) and posterolateral (PL) arthroscopy portals. Anterior 3 o'clock and 4 o'clock positions were drilled using MA and DALA portals. Posterior 8 o'clock to 11 o'clock positions were drilled using a 1.4-mm drill bit from the PL portal. At depths of 5, 10 and 15 mm, the distance from the drill to the intra and extra-articular surfaces was measured using a custom caliper. Mean distance between drill hole and articular surface for anterior and posterior positions ranged from 1.61 to 2.75 mm at 5 mm. The smallest distance between the drill hole and articular surface and the largest width between drill hole and the extra-articular surface were at the 4 o'clock position. No difference between the MA and DALA portals were noted for the anterior positions. For the posterior rim positions, the distance on the articular side remained consistent throughout. For the posterior positions, only the PL portal was utilized. Both the MA or DALA portals can be utilized for safe drilling of the anterior rim positions. The posterior positions can all be safely drilled with a relatively good bone margin using the PL portal, but use of the MA or DALA portals resulted in extra-articular cortical perforation in all cases.

  11. Delayed pupillary capture and noninvasive repositioning of a posterior chamber intraocular lens after pupil dilation.

    PubMed

    Galvis, Virgilio; Tello, Alejandro; Montezuma, Sandra

    2002-10-01

    We present a case of pupillary capture of a posterior chamber intraocular lens after routine pupil dilation during a follow-up visit 6 years postoperatively. A noninvasive approach was used to resolve the capture. The possible causes and measures to avoid this complication are discussed.

  12. [Intraocular lenses for the correction of refraction errors. Part II. Phakic posterior chamber lenses and refractive lens exchange with posterior chamber lens implantation].

    PubMed

    Kohnen, T; Kasper, T; Terzi, E

    2005-11-01

    In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses which are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for posterior chamber lenses these are mainly cataract formation and pigment dispersion. RLE is preferable in cases of high ametropia in which the natural lens has lost its accommodative effect. The main complications for myopic RLA include retinal detachment, while hyperopic refractive lens exchange may be associated with surgical problems in the narrower anterior eye segment.

  13. Spontaneous fracture of an implanted posterior chamber polyimide intraocular lens haptic: a case report.

    PubMed

    Kang, Haemin; Han, Kyung Eun; Kim, Tae-im; Kim, Eung Kweon

    2014-03-01

    A 57-year-old male patient visited our clinic for decreased visual acuity in the right eye for 10 days. He denied any trauma history, but recalled that the symptom developed after straining. He had undergone uncomplicated phacoemulsification and posterior chamber intraocular lens (IOL) implantation in the bag of the right eye 11 years ago. The IOL was a three-piece silicone polyimide-haptics design. On slit-lamp examination, the IOL optic and proximal part of nasal fractured haptic were found in the anterior chamber. The distal part of fractured haptic was observed in the capsular bag. He underwent IOL exchange. The fracture site of the haptic was near the optic-haptic junction. This is the unique case report of a spontaneous fracture of an implanted posterior chamber polyimide IOL haptic, which implies the possibility of IOL haptic fracture in various haptic materials.

  14. Spontaneous dislocation of posterior chamber intraocular lenses (PC IOLs) in patients with retinitis pigmentosa – Case series

    PubMed Central

    Masket, Samuel; Bostanci Ceran, Basak; Fram, Nicole R.

    2011-01-01

    Purpose To report the outcomes of intraocular lens (IOL) dislocation management in 6 cases with Retinitis Pigmentosa (RP). Setting Private practice, Los Angeles, USA. Design Retrospective interventional case series. Methods The medical reports of six eyes of four RP patients with capsule bag fixated posterior chamber IOL dislocation were retrospectively reviewed. Pre-operative data included demographics, systemic or ocular disorders, history of trauma, previous intraocular surgery and pre-operative visual acuity. Outcome measures included the type of surgery, surgical complications, elevation of intraocular pressure (IOP), ocular inflammation, cystoid macular edema (CME) and IOL dislocation at 3 months or greater post-operatively. Results The medical records of six eyes of four patients operated on between December 2009 and May 2011 were evaluated. In four cases, dislocated PC IOL implants were sutured to the sclera. In two eyes of one patient anterior chamber IOLs (AC IOLs) were implanted after PC IOLs were explanted. One eye developed CME during the follow-up period. Despite modest tilt in one case and modest decentration in another, stability and centration of the IOLs was excellent during the follow-up period. No eyes had intraocular inflammation requiring long term medical treatment, new onset glaucoma or retinal detachment. Mean follow-up time was 6.9 months (range 3-20). Conclusions Cataract surgeons should be aware of the increased risk for decentration and malposition of PC IOLs in patients with RP. Satisfactory results can be achieved by fixation of the PC IOL or AC IOL implantation. PMID:23960970

  15. [Extracapsular cataract extraction (ECCE) with posterior chamber IOL implantation in the very elderly].

    PubMed

    Gao, Y; Zhang, Y Z

    1992-07-01

    A study of the operations of ECCE with posterior chamber IOL implantation in 30 eyes of 25 patients aged 75-86 years showed that the average postoperative corrected visual acuity was 18/20, the average corrective spherical lens power was -0.70D and those of cylindrical power 1.18D(AR) and 1.33D(WR). There was no difference in operative complications between these very old and general elderly patients. However, since the health state was often compromised in the very old, to ensure uneventful operations, the ophthalmic surgeon should solicit advice from geriatricians, in addition to his own meticulous perioperative and postoperative care.

  16. Ghost cell glaucoma following sutureless scleral-fixated posterior chamber intraocular lens placement.

    PubMed

    Thompson, Jordan M; Chang, Jonathan S; Bermudez-Magner, J Antonio; Dubovy, Sander R

    2015-01-01

    Secondary intraocular lens (IOL) placement in the absence of a capsular bag may result in several complications. The authors report the clinicopathologic features of a case of ghost cell glaucoma after the placement of a sutureless posterior chamber IOL. A 47-year-old male presented with a dislocated IOL and underwent lens exchange using a sutureless scleral-fixation technique. Over the following year, the patient developed recurrent vitreous hemorrhages and elevated intraocular pressure despite medical therapy, and an aqueous specimen disclosed ghost cells. Although uncommon, mechanical contact between the iris and a secondary IOL may produce persistent vitreous hemorrhage and elevated intraocular pressures with the formation of ghost cells.

  17. [Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens].

    PubMed

    Handzel, D M

    2012-04-01

    This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option.

  18. Long-Term Change in Intraocular Pressure after Extracapsular Cataract Extraction with Posterior Chamber Intraocular Lens Implantation Versus Phacoemulsification with Posterior Chamber Intraocular Lens Implantation in Indians

    PubMed Central

    Pal, Virendra K; Agrawal, Ajai; Suman, Suwarna; Pratap, V B

    2013-01-01

    Purpose: The purpose of the study is to evaluate the long-term changes in intraocular pressure (IOP) after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation versus phacoemulsification with PCIOL implantation in otherwise normal cataract patients in India. Materials and Methods: The study was conducted in the Department of Ophthalmology, King George's Medical College, Lucknow between August 2000 and August 2001. One hundred and seventeen eyes of 115 patients were included in the study. 84 patients were randomly selected for ECCE with PCIOL implantation (ECCE group) and 31 patients were selected for phacoemulsification with PCIOL implantation (Phaco group). IOP was measured pre-operatively and post-operatively, from the 1st month to the 12th month. Statistical significance was indicated by P > 0.05. Results: There was a mean fall in IOP of 2.70 mm Hg (19.74%) in the ECCE group and 2.74 mm Hg (20.57%) in the phaco group. The decrease in the mean post-operative IOP from baseline was statistically significant (P > 0.01) at the end of 2 months in both groups. There was no statistically significant difference in post-operative IOP at any visit between groups (P < 0.05, all post-operative visits). After 4th monthpost-operatively, the IOP was mostly stable, but it was significantly lower than the pre-operative IOP. Conclusion: Significant IOP reduction may be expected after cataract surgery with either ECCE or phacoemulsification with IOL implantation. The lowering of IOP became statistically significant at about 2 months post-operatively, but became almost stable after the 4th month. PMID:24339684

  19. Unilateral Scleral Fixation of Posterior Chamber Intraocular Lenses in Pediatric Complicated Traumatic Cataracts

    PubMed Central

    Hyun, Dong Won; Cho, Sung Won

    2009-01-01

    Purpose The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. Methods This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. Results The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. Conclusions Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases. PMID:19794939

  20. Phakic posterior chamber intraocular lens for unilateral high myopic amblyopia in Chinese pediatric patients

    PubMed Central

    Zhang, Jing; Li, Jin-Rong; Chen, Zi-Dong; Yu, Min-Bin; Yu, Ke-Ming

    2016-01-01

    AIM To assess the outcomes of posterior chamber implantable collamer lens (ICL) implantation in Chinese pediatric patients with unilateral high myopic amblyopia. METHODS Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL (model V4, Staar Surgical Inc.) implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure (IOP), vaulting, corneal endothelial cell count and complications were evaluated. Patients completed follow-up at 3d, 1, 3mo and the last follow-up time (mean 8.18±2.82mo) after surgery. RESULTS The mean myopic anisometropia was -13.70±3.25 D preoperatively and +0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity (CDVA) of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks postoperatively. CONCLUSION This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery. PMID:28003981

  1. Comparison of outcomes of primary and secondary implantation of scleral fixated posterior chamber intraocular lens

    PubMed Central

    Lee, V Y W; Yuen, H K L; Kwok, A K H

    2003-01-01

    Aim: To assess and compare the results of primary and secondary implantation of scleral fixated posterior chamber intraocular lens (SFIOL). Methods: The medical records of a consecutive series of 55 eyes of 55 patients with SFIOLs implanted during (group 1) or after (group 2) complicated senile cataract surgery were retrospectively reviewed and analysed. Results: There were 30 and 25 eyes in group 1 and 2, respectively. Follow up was from 6 to 36 months. Mean logMAR postoperative best corrected visual acuity in group 1 was not significantly different (0.50 (SD 0.36)) from that of group 2 (0.36 (0.21)) (p = 0.109). Postoperative best corrected visual acuity of 6/12 or better was achieved in 58.6% and 76.0% in group 1 and 2, respectively. The difference was not statistically significant (p = 0.177). In group 1, 25 (83.3%) eyes had a total of 55 early complications, while in group 2, 16 (64%) eyes had 26 early complications (p = 0.028). The difference in early complication was statistically significant. For late complication after 1 month, 21 (70.0%) eyes had a total of 37 complications in group 1, while 13 eyes (52.0%) had 19 complications in group 2 (p = 0.077). The difference in late complication was not statistically significant. Conclusion: Secondary implantation of SFIOL after cataract extraction seems to have a lower early complication rate than primary implantation in complicated cataract extraction although the final visual acuity and late complication rate are not significantly different. PMID:14660452

  2. Growth of mitral annulus in the pediatric patient after suture annuloplasty of the entire posterior mitral annulus.

    PubMed

    Komoda, Takeshi; Huebler, Michael; Berger, Felix; Hetzer, Roland

    2009-08-01

    When mitral annuloplasty is performed in small children, room for annular growth should be allowed. However, it has not been reported how the valve develops after mitral annuloplasty of the entire posterior annulus. We report a case showing traces of annular growth at redo surgery. A female patient suffering from mitral valve insufficiency due to annular dilatation underwent modified Paneth plasty with Kay-Wooler commissural plication annuloplasty at the age of two years one month. In redo surgery 8.4 years after initial repair, enlargement of the commissural portion of the posterior annulus in addition to enlargement of the anterior leaflet and anterior annulus was observed. Modified Paneth plasty reinforced with a pericardial strip and Kay-Wooler annuloplasty of the posteromedial commissure were performed. Mitral orifice size measured with the Hegar dilator was 18 mm after the re-repair, increasing from 16 mm after the initial repair. Taking into account the normal mitral annulus diameter related to body surface area (BSA) of 16 mm at initial operation and 20 mm at redo surgery, the increase in mitral orifice size from 16 mm to 18 mm in this patient may be regarded as the annular growth in 8.4 years.

  3. Ultrasound biomicroscopy in pupillary block glaucoma secondary to ophthalmic viscosurgical device remnants in the posterior chamber after anterior chamber phakic intraocular lens implantation.

    PubMed

    Sun, Chuan-Bin; Liu, Zhe; Yao, Ke

    2010-12-01

    A 25-year-old woman developed pupillary block glaucoma in the right eye after implantation of an angle-supported phakic intraocular lens despite a preexisting moderate-sized iridectomy. Ultrasound biomicroscopy (UBM) showed ophthalmic viscosurgical device retention in the posterior chamber and a full-thickness, patent-appearing iridectomy at 12 o'clock. The intraocular pressure gradually decreased to normal after a neodymium:YAG laser iridotomy was performed midperipherally at 9 o'clock. To our knowledge, this is the first report of UBM findings of this complication.

  4. Trabeculectomy combined with deep sclerectomy and scleral flap suture tension adjustment under an anterior chamber maintainer: a new modification of trabeculectomy.

    PubMed

    Kayikcioglu, Ozcan R; Emre, Sinan; Kaya, Ziya

    2010-06-01

    The objective of this study was to investigate the efficacy and safety of trabeculectomy combined with deep sclerectomy in patients with primary open angled glaucoma (POAG) and to compare the results with those from conventional trabeculectomy. In the study 12 eyes of 10 patients operated with trabeculectomy combined with deep sclerectomy (Group I) and 16 eyes of 16 patients operated with conventional trabeculectomy surgery (Group II) were included. In the described form of combined deep sclerectomy with the trabeculectomy technique the superficial scleral flap was sutured with 10/0 monofilament, the number and tension of sutures were adjusted according to the outflow dynamics, under the scleral flap, of balanced salt solution (BSS) provided by an anterior chamber maintainer. In groups I and II all the patients were male POAG cases with mean ages of 60.0 +/- 19.4 and 67.0 +/- 7.1 years, respectively. The mean follow-up periods were 8.3 +/- 3.5 months for group I and 16.6 +/- 7.0 months for group II. Preoperative mean IOP were 29.7 +/- 8.3 and 29.1 +/- 12.8 mmHg mmHg, and average topical antiglaucomatous medications were 2.9 +/- 0.7 and 2.7 +/- 1.1 for groups I and II, respectively. Postoperatively mean IOP measurements were reduced in groups I and II to 10.5 +/- 2.9 vs. 9.6 +/- 4.8 mmHg at 1 week, 13.7 +/- 5.6 vs. 16.0 +/- 9.8 at 1st month, 12.3 +/- 6.4 vs. 17.3 +/- 8.0 at 3rd month, 11.0 +/- 4.1 vs. 15.3 +/- 5.8 at 6th month, 10.8 +/- 1.6 vs. 16.1 +/- 4.4 at 12th month, and 11.0 +/- 1.0 vs. 16.7 +/- 5.0 at 18th month. Statistical analysis revealed that mean postoperative IOP measurements for group I were significantly lower than for group II for all measurements except the first week (P < 0.05). At 12th month, the complete (IOP <22 mmHg without medication) and qualified (IOP <22 mmHg with medication) success rates were 83.3 and 100% for group I and 63.6 and 90.9% for group II. Postoperatively at 12th month, the mean number of antiglaucoma medications had fallen to

  5. Quilting sutures for nasal septum.

    PubMed

    Hari, C; Marnane, C; Wormald, P J

    2008-05-01

    Suturing of the nasal septum after septal surgery is a commonly performed procedure designed to prevent complications such as septal haematoma and bleeding. It is also useful for closing any inadvertent tears of the septal mucosa and providing additional support for the cartilage pieces retained in septoplasty. In addition, the suture can be placed through the middle turbinates, stabilising them during the healing process. Placing knots for interrupted sutures in the posterior and middle part of the nasal septum can be technically difficult. We describe a continuous suturing technique for approximating the mucosal flaps following septal surgery.

  6. Anterior Chamber Angle Evaluation following Phakic Posterior Chamber Collamer Lens with CentraFLOW and Its Correlation with ICL Vault and Intraocular Pressure

    PubMed Central

    El-Deeb, Mohamed W. A.

    2016-01-01

    Purpose. To assess intraocular pressure (IOP), lens vaulting, and anterior chamber (AC) angle width, following V4C implantable Collamer lens (ICL) procedure for myopic refractive error. Methods. A prospective case series that enrolled 54 eyes of 27 patients that were evaluated before and after V4C phakic posterior chamber Collamer lens implantation for correction of myopic refractive error. Preoperative measurement of IOP was done using Goldmann applanation tonometer and anterior chamber angle width using both Van Herick slit lamp grading system and Scheimpflug tomography imaging (Oculus Pentacam). Follow-up of the aforementioned variables was at 1, 6, and 18 months postoperatively, together with ICL vault measurements. Results. The mean baseline IOP of 11.69 ± 2.15 showed a statistically significant (P = 0.002) increase after 1 month that remained unchanged at 6 and 18 months postoperatively, with mean value of 16.07 ± 4.12, 16.07 ± 4.10, and 16.07 ± 4.13, respectively. Pentacam AC angle width showed a statistically significant decrease at 1 (P = 0.025), 6 (P = 0.016), and 18 (P = 0.010) months postoperatively, with mean preoperative value of 40.14 ± 5.49 that decreased to 25.28 ± 5.33, 25.46 ± 5.44, and 25.49 ± 5.38, at 1, 6, and 18 months, respectively. Mean ICL vault showed moderate correlation with Pentacam AC angle width at 1 (r = −0.435) and 6 (r = −0.424) months. Conclusion. V4C ICL implantation resulted in decrease in AC angle width and increase in IOP, within acceptable physiological values at all time points. PMID:28053776

  7. Posterior C1-C2 Fixation Using Absorbable Suture for Type II Odontoid Fracture in 2-Year-Old Child: Description of a New Technique and Literature Review.

    PubMed

    Labbe, Jean L; Peres, Olivier; Leclair, Olivier; Goulon, Renaud; Scemama, Patrice; Jourdel, François; Bertrou, Véronique; Murgier, Jerome

    2016-12-01

    Odontoid synchondrosis fractures are rare in children, even though they are the more common cervical fracture in children less than 7 years old. Nonoperative treatment with external orthosis immobilization is the treatment of choice for stable undisplaced or minimally displaced injuries. In unstable fractures, when reduction cannot be achieved or maintained, surgical fixation is recommended. We report a 2-year-old boy with an unstable fracture of the odontoid treated surgically using an absorbable monofilament suture for C1-C2 interlaminar fixation without bone grafting. This suture was strong enough to provide the stability necessary to allow healing of the synchondrosis and the delayed resorption of the suture was followed by complete restoration of the mobility between C1 and C2. This case illustrates that surgical stabilization using an absorbable suture in young children with an unstable odontoid fracture is a safe and effective alternative to other surgical techniques.

  8. Visual Function after Primary Posterior Chamber Intraocular Lens Implantation in Pediatric Unilateral Cataract: Stereopsis and Visual Acuity

    PubMed Central

    Park, Jung Hyun; Kim, Jeong Hun; Kim, Seong Joon; Choung, Ho Kyung

    2007-01-01

    Purpose To investigate the association between binocular function and vision after cataract removal and primary posterior chamber intraocular lens (PC-IOL) implantation in children with unilateral cataract and to identify visual function differences according cataract type. Methods Clinical records of 2- to 6-year-old patients with unilateral cataract removal and primary PC-IOL implantation were reviewed retrospectively. Visual acuity and ocular alignment were measured. Sensory fusion was assessed with the Worth 4-dot test, and stereoacuity with the Titmus stereo test. Cataracts were classified according to cause, lens opacity location, age at onset, and presence of strabismus. Clinical characteristics of patients who obtained good visual function were identified. Results Forty-seven patients were included. Among 22 (46.8%) with good vision (20/40 or better), only 6 (27.3%) achieved good binocular function (the presence of fusion and 100 seconds of arc or better of stereoacuity). Visual acuity was better in eyes with good binocular function (p=0.002). No other variables were significant for achieving good binocular function. Conclusions The removal of unilateral cataract in a visually immature child can result in a combination of good visual acuity and binocular function. Good binocular function is closely related to good visual acuity. PMID:18063882

  9. Etiology and Management of Raised Intraocular Pressure following Posterior Chamber Phakic Intraocular Lens Implantation in Myopic Eyes

    PubMed Central

    Senthil, Sirisha; Choudhari, Nikhil S.; Vaddavalli, Pravin K.; Murthy, Somasheila; Reddy, Jagadesh; Garudadri, Chandra S.

    2016-01-01

    Aim To evaluate the etiology and management of elevated intraocular pressure (IOP) following posterior chamber phakic implantable collamer lens (ICL) surgery. Methods Between 2009 and 2015, 638 eyes of 359 subjects with refractive myopia, underwent V4b and V4c (CentraFLOW) model ICL implantation. Ocular hypertension (OHT) was defined as IOP of ≥ 22 mm Hg on two separate occasions and elevated IOP with corresponding optic disc or visual field damage was defined as glaucoma. Results Elevated IOP ≥ 22 mm Hg was noted in 33 eyes of 30 subjects (33/638; 5.17%). Median age of subjects with raised IOP was 26 years (Inter quartile range (IQR):22, 29) and median refarctive error was -16 diopters (-19.5, -13). The median follow up was 7.8 months (IQR:0.3, 17.6) and median time for postoperative IOP rise was 12 days, (IQR:2, 24). The various etiologies for elevated IOP were steroid response in 21 eyes (64%; 10 eyes with V4b, 11 eyes with V4c), retained viscoelastic in 5 eyes (15%) (3 with V4b, 2 with V4c), pupillary block in four eyes (12%; 3 with V4b, 1 with V4c), malignant glaucoma in one eye (3%, V4b), and missed pre-existing Juvenile open angle glaucoma (JOAG) in two eyes (6% with V4b). Elevated IOP in 31 eyes resolved with conservative management. One eye (centraFLOW design) with central aquaport block by viscoelastic, needed AC wash and one eye with malignant glaucoma needed parsplana vitrectomy and hyaloidotomy. Ten eyes required longterm (>2 months) antiglaucoma medications (AGM) for IOP control. Except the two eyes with JOAG, none had disc and field damage. Conclusion In our series, OHT was seen in 4.85% and glaucoma in 0.3% eyes that underwent V4b and V4c model ICL implantation. Multiple etiologies were noted and steroid induced ocular hypertension was the most common cause of elevated IOP followed by retained viscoelastic and pupillary block. One third of these eyes required longterm AGM for IOP control. PMID:27855172

  10. Ectocranial suture fusion in primates: pattern and phylogeny.

    PubMed

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

    2014-03-01

    Patterns of ectocranial suture fusion among Primates are subject to species-specific variation. In this study, we used Guttman Scaling to compare modal progression of ectocranial suture fusion among Hominidae (Homo, Pan, Gorilla, and Pongo), Hylobates, and Cercopithecidae (Macaca and Papio) groups. Our hypothesis is that suture fusion patterns should reflect their evolutionary relationship. For the lateral-anterior suture sites there appear to be three major patterns of fusion, one shared by Homo-Pan-Gorilla, anterior to posterior; one shared by Pongo and Hylobates, superior to inferior; and one shared by Cercopithecidae, posterior to anterior. For the vault suture pattern, the Hominidae groups reflect the known phylogeny. The data for Hylobates and Cercopithecidae groups is less clear. The vault suture site termination pattern of Papio is similar to that reported for Gorilla and Pongo. Thus, it may be that some suture sites are under larger genetic influence for patterns of fusion, while others are influenced by environmental/biomechanic influences.

  11. A Surprising Cause for Corneal Edema after Cataract Surgery: A Missed Posterior Chamber Intraocular Lens Haptic Remnant.

    PubMed

    Elyashiv, Sivan; Barequet, Irina

    2015-01-01

    We present a case of retained intraocular lens (IOL) haptic segment in the anterior chamber, diagnosed seven months following a reportedly uneventful cataract surgery due to manifestation of inferior corneal edema. Specular microscopy revealed low endothelial counts of 513/mm(2). Upon diagnosis, prompt surgical removal of the IOL haptic segment resulted in rapid resolution of the corneal edema within a week. Despite the clearing of the cornea, no improvement in the visual acuity occurred and cystoid macular edema was diagnosed and treated with topical anti-inflammatory agents and two intra-vitreal anti-VEGF injections, followed by complete resolution of ocular findings and improvement of the visual acuity.

  12. The hidden X suture: a technical note on a novel suture technique for alveolar ridge preservation

    PubMed Central

    2016-01-01

    Purpose The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by 1.56±0.90 mm in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by 0.25±0.66 mm. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). Conclusions Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP. PMID:28050319

  13. Posterior fixation suture and convergence excess esotropia.

    PubMed

    Steffen; Auffarth; Kolling

    1998-09-01

    The present study investigates the results of Cuppers' 'Fadenoperation' in patients with non-accommodative convergence excess esotropia. Particular attention is given to postoperative eye alignment at distance fixation. Group 1 (n=96) included patients with a 'normal' convergence excess. The manifest near angles (mean ET 16.73 degrees +/- 6.33 degrees, range 4 degrees -33 degrees ) were roughly twice the size of the distance angles (mean ET 6.50 degrees +/- 3.62 degrees, range 0 degrees -14 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti without additional eye muscle surgery. Three months after surgery, the mean postoperative angles were XT 0.5 degrees +/- 3.3 degrees (range XT 11 degrees -ET 5 degrees ) for distance fixation, and ET 2.7 degrees +/- 3.6 degrees (range XT 5 degrees -ET 14 degrees ) for near fixation, respectively. Postoperative convergent angles at near fixation >ET 10 degrees were present in two patients (1.9%). Group 2 (n=21) included patients with a mean preoperative distance angle of ET 9.2 degrees +/- 3.7 degrees (range 6 degrees -16 degrees ) and a mean preoperative near angle of ET 23.4 degrees +/- 3.1 degrees (range 16 degrees -31 degrees ). These patients were operated on with a bilateral fadenoperation of the medial recti and a simultaneous recession of one or both medial rectus muscles. Mean postoperative angles were XT 0.5 degrees +/- 4.6 degrees (range XT 12 degrees -ET 7 degrees ) for distance fixation and ET 1.4 degrees +/- 4.5 degrees (range XT 8 degrees -ET 13 degrees ) for near fixation, respectively. In this group, 2 patients (10.6%) had a postoperative exotropia >XT 5 degrees at distance fixation, and two patients had residual esotropia>ET 10 degrees at near fixation. Group 3 (n=17) included patients with a pronounced non-accommodative convergence excess. Near angle values (mean of 17.8 degrees +/- 5.3 degrees, range ET 7 degrees -26 degrees ) were several times higher than the distance angle values (mean ET 1.9 degrees +/- 4.2 degrees, range XT 3 degrees -ET 6 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti and a simultaneous resection of one or both medial rectus muscles. Mean postoperative angles were ET 0.2 degrees +/- 4.7 degrees (range XT 8 degrees -ET 6 degrees ) for distance fixation and 5.3 degrees +/- 6.1 degrees (range XT 3 degrees -ET 12 degrees ) for near fixation, respectively. One patient had a postoperative distance angle >XT 5 degrees, whereas two patients displayed postoperative convergent angles >ET 5 degrees at near fixation.

  14. Achondroplasia with synostosis of multiple sutures.

    PubMed

    Georgoulis, George; Alexiou, George; Prodromou, Neofytos

    2011-08-01

    We report for the second time on a case of achondroplasia with synostosis of multiple sutures. The most common mutation for achondroplasia (FGFR3 Gly380Arg, resulting in 1138G>A) was identified. Imaging studies disclosed complex craniosynostosis and neurosurgical intervention was carried out, particularly for posterior plagiocephaly.

  15. Cranial suture biology of the Aleutian Island inhabitants.

    PubMed

    Cray, James; Mooney, Mark P; Siegel, Michael I

    2011-04-01

    Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations.

  16. Safety pin suture for management of atonic postpartum hemorrhage.

    PubMed

    Mostfa, Ali Abdelhamed M; Zaitoun, Mostafa M

    2012-01-01

    Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.

  17. The double loop mattress suture

    PubMed Central

    Biddlestone, John; Samuel, Madan; Creagh, Terry; Ahmad, Tariq

    2014-01-01

    An interrupted stitch type with favorable tissue characteristics will reduce local wound complications. We describe a novel high-strength, low-tension repair for the interrupted closure of skin, cartilage, and muscle, the double loop mattress stitch, and compare it experimentally with other interrupted closure methods. The performance of the double loop mattress technique in porcine cartilage and skeletal muscle is compared with the simple, mattress, and loop mattress interrupted sutures in both a novel porcine loading chamber and mechanical model. Wound apposition is assessed by electron microscopy. The performance of the double loop mattress in vivo was confirmed using a series of 805 pediatric laparotomies/laparoscopies. The double loop mattress suture is 3.5 times stronger than the loop mattress in muscle and 1.6 times stronger in cartilage (p ≤ 0.001). Additionally, the double loop mattress reduces tissue tension by 66% compared with just 53% for the loop mattress (p ≤ 0.001). Wound gapping is equal, and wound eversion appears significantly improved (p ≤ 0.001) compared with the loop mattress in vitro. In vivo, the double loop mattress performs as well as the loop mattress and significantly better than the mattress stitch in assessments of wound eversion and dehiscence. There were no episodes of stitch extrusion in our series of patients. The mechanical advantage of its intrinsic pulley arrangement gives the double loop mattress its favorable properties. Wound dehiscence is reduced because this stitch type is stronger and exerts less tension on the tissue than the mattress stitch. We advocate the use of this novel stitch wherever a high-strength, low-tension repair is required. These properties will enhance wound repair, and its application will be useful to surgeons of all disciplines. PMID:24698436

  18. Craniofacial clefting and sutural dystopia.

    PubMed

    Moore, M H; Edwards, T J; David, D J

    1991-07-01

    Sutural anomalies in conjunction with craniofacial clefting are unusual. A case of median frontal clefting is presented in which there was an absence of a normal metopic suture and replacement by paramedian frontal sutures. The association of an underlying brain anomaly, with attendant surgical difficulties, is noted, as are the radiological techniques of preoperative diagnosis.

  19. [Surgical sutures. Principles and materials].

    PubMed

    Mousques, T; Levavasseur, F

    1989-06-01

    This article begins by a brief review of the advantages and modalities of the sutures. Then, the choice of the instrumentation (needle-holders, pliers and scissors) will be discussed. The suture material by itself (needles, threads) is studied. A description of the physical and biological properties of the different threads allows their comparison. The author's choice is the conclusion of this paper.

  20. Flow chamber

    SciTech Connect

    Morozov, Victor

    2011-01-18

    A flow chamber having a vacuum chamber and a specimen chamber. The specimen chamber may have an opening through which a fluid may be introduced and an opening through which the fluid may exit. The vacuum chamber may have an opening through which contents of the vacuum chamber may be evacuated. A portion of the flow chamber may be flexible, and a vacuum may be used to hold the components of the flow chamber together.

  1. Ectocranial suture closure in Pan troglodytes and Gorilla gorilla: pattern and phylogeny.

    PubMed

    Cray, James; Meindl, Richard S; Sherwood, Chet C; Lovejoy, C Owen

    2008-08-01

    The order in which ectocranial sutures undergo fusion displays species-specific variation among primates. However, the precise relationship between suture closure and phylogenetic affinities is poorly understood. In this study, we used Guttman Scaling to determine if the modal progression of suture closure differs among Homo sapiens, Pan troglodytes, and Gorilla gorilla. Because DNA sequence homologies strongly suggest that P. troglodytes and Homo sapiens share a more recent common ancestor than either does with G. gorilla, we hypothesized that this phylogenetic relationship would be reflected in the suture closure patterns of these three taxa. Results indicated that while all three species do share a similar lateral-anterior closure pattern, G. gorilla exhibits a unique vault pattern, which, unlike humans and P. troglodytes, follows a strong posterior-to-anterior gradient. P. troglodytes is therefore more like Homo sapiens in suture synostosis.

  2. Force Sensing in Surgical Sutures

    PubMed Central

    Horeman, Tim; Meijer, Evert-jan; Harlaar, Joris J.; Lange, Johan F.; van den Dobbelsteen, John J.; Dankelman, Jenny

    2013-01-01

    The tension in a suture is an important factor in the process of wound healing. If there is too much tension in the suture, the blood flow is restricted and necrosis can occur. If the tension is too low, the incision opens up and cannot heal properly. The purpose of this paper is to describe the design and evaluation of the Stitch Force (SF) sensor and the Hook-In Force (HIF) sensor. These sensors were developed to measure the force on a tensioned suture inside a closed incision and to measure the pulling force used to close the incision. The accuracy of both sensors is high enough to determine the relation between the force in the thread of a stitch and the pulling force applied on the suture by the physician. In a pilot study, a continuous suture of 7 stitches was applied on the fascia of the abdominal wall of multiple pigs to study this relationship. The results show that the max force in the thread of the second stitch drops from 3 (SD 1.2) to 1 (SD 0.3) newton after the 4th stitch was placed. During placement of the 5th, 6th and 7th stitch, the force in the 2nd stitch was not influenced anymore. This study indicates that in a continuous suture the force in the thread remains constant up to more than 3 stiches away from the pulled loose end of the suture. When a force feedback tool is developed specially for suturing in surgery on patients, the proposed sensors can be used to determine safety threshold for different types of tissue and sutures. PMID:24376812

  3. Accuracy of Suture Passage During Arthroscopic Remplissage—What Anatomic Landmarks Can Improve It?

    PubMed Central

    Garcia, Grant H.; Degen, Ryan M.; Liu, Joseph N.; Kahlenberg, Cynthia A.; Dines, Joshua S.

    2016-01-01

    Background: Recent data suggest that inaccurate suture passage during remplissage may contribute to a loss of external rotation, with the potential to cause posterior shoulder pain because of the proximity to the musculotendinous junction. Purpose: To evaluate the accuracy of suture passage during remplissage and identify surface landmarks to improve accuracy. Study Design: Descriptive laboratory study. Methods: Arthroscopic remplissage was performed on 6 cadaveric shoulder specimens. Two single-loaded suture anchors were used for each remplissage. After suture passage, position was recorded in reference to the posterolateral acromion (PLA), with entry perpendicular to the humeral surface. After these measurements, the location of posterior cuff penetration was identified by careful surgical dissection. Results: Twenty-four sutures were passed in 6 specimens: 6 sutures (25.0%) were correctly passed through the infraspinatus tendon, 12 (50%) were through the infraspinatus muscle or musculotendinous junction (MTJ), and 6 (25%) were through the teres minor. Suture passage through the infraspinatus were on average 25 ± 5.4 mm inferior to the PLA, while sutures passing through the teres minor were on average 35.8 ± 5.7 mm inferior to the PLA. There was an odds ratio of 25 (95% CI, 2.1-298.3; P < .001) that the suture would be through the infraspinatus if the passes were less than 3 cm inferior to the PLA. Sutures passing through muscle and the MTJ were significantly more medial than those passing through tendon, measuring on average 8.1 ± 5.1 mm lateral to the PLA compared with 14.5 ± 5.5 mm (P < .02). If suture passes were greater than 1 cm lateral to the PLA, it was significantly more likely to be in tendon (P = .013). Conclusion: We found remplissage suture passage was inaccurate, with only 25% of sutures penetrating the infraspinatus tendon. Passing sutures 1 cm lateral and within 3 cm inferior of the PLA improves the odds of successful infraspinatus tenodesis

  4. Bakeout Chamber Within Vacuum Chamber

    NASA Technical Reports Server (NTRS)

    Taylor, Daniel M.; Soules, David M.; Barengoltz, Jack B.

    1995-01-01

    Vacuum-bakeout apparatus for decontaminating and measuring outgassing from pieces of equipment constructed by mounting bakeout chamber within conventional vacuum chamber. Upgrade cost effective: fabrication and installation of bakeout chamber simple, installation performed quickly and without major changes in older vacuum chamber, and provides quantitative data on outgassing from pieces of equipment placed in bakeout chamber.

  5. Bone Plug Versus Suture-Only Fixation of Meniscal Grafts

    PubMed Central

    Wang, Hongsheng; Gee, Albert O.; Hutchinson, Ian D.; Stoner, Kirsten; Warren, Russell F.; Chen, Tony O.; Maher, Suzanne A.

    2014-01-01

    Background Meniscus allograft transplantation (MAT) is primarily undertaken to relieve the symptoms associated with meniscal deficiencies. However, its ability to restore normal knee joint contact mechanics under physiological loads is still unclear. Purpose To quantify the dynamic contact mechanics associated with 2 commonly used fixation techniques in MAT of the medial compartment: transosseous suture fixation via bone plugs and suture-only fixation at the horns. Study Design Controlled laboratory study. Methods Physiological loads to mimic gait were applied across 7 human cadaveric knees on a simulator. A sensor placed on the medial tibial plateau recorded dynamic contact stresses under the following conditions: (1) intact meniscus, (2) MAT using transosseous suture fixation via bone plugs at the anterior and posterior horns, (3) MAT using suture-only fixation, and (4) total medial meniscectomy. A “remove-replace” procedure was performed to place the same autograft for both MAT conditions to minimize the variability in graft size, geometry, and material property and to isolate the effects of the fixation technique. Contact stress, contact area, and weighted center of contact stress (WCoCS) were quantified on the medial plateau throughout the stance phase. Results Knee joint contact mechanics were sensitive to the meniscal condition primarily during the first half of the gait cycle. After meniscectomy, the mean peak contact stress increased from 4.2 ± 1.2 MPa to 6.2 ± 1.0 MPa (P = .04), and the mean contact area decreased from 546 ± 132 mm2 to 192 ± 122 mm2 (P = .01) compared with the intact meniscus during early stance (14% of the gait cycle). After MAT, the mean contact stress significantly decreased with bone plug fixation (5.0 ± 0.7 MPa) but not with suture-only fixation (5.9 ± 0.7 MPa). Both fixation techniques partially restored the contact area, but bone plug fixation restored it closer to the intact condition. The location of WCoCS in the

  6. Endoscopic posterior interhemispheric complete corpus callosotomy.

    PubMed

    Sood, Sandeep; Asano, Eishi; Altinok, Deniz; Luat, Aimee

    2016-12-01

    Traditionally corpus callosotomy is done through a craniotomy centered at the coronal suture, with the aid of a microscope. This involves dissecting through the interhemispheric fissure below the falx to reach the corpus callosum. The authors describe a posterior interhemispheric approach to complete corpus callosotomy with an endoscope, which bypasses the need to perform interhemispheric dissection because the falx is generally close to the corpus callosum in this region.

  7. Internal morphology of the nonsyndromic prematurely fused sagittal suture in the human skull--A preliminary micro-CT study.

    PubMed

    Nowaczewska, W; Ziółkowski, G; Dybała, B

    2015-10-01

    Although nonsyndromic craniosynostosis (NSC) of the sagittal suture is a well-known type of craniosynostosis, little is currently known about the internal morphology of this prematurely fused suture in modern humans. Recently, micro-computed tomography (micro-CT) has been applied as a new tool for the quantitative evaluation of cranial suture morphology. However, so far there are only a small number of reports concerning studies of the internal morphology of prematurely fused sagittal suture in humans using micro-CT. The primary aim of this study was to examine the internal morphology of a completely obliterated sagittal suture in NSC. Two modern human skulls were used in this study: a skull of a child (aged 10 ± 2.5 years) displaying NSC of the sagittal suture and a skull of an adult showing non-prematurely completely obliterated sagittal suture. Quantitative variables of the sagittal sutures were assessed using method proposed by the authors. Porosity, and relative thickness of three bone layers in two examined skulls (inner cortical, diploë and outer cortical) were analysed using micro-CT in three equal sections of the sagittal suture. In the case of the prematurely fused suture, there were statistically significant differences mainly in the mean values of the porosity, thickness and relative thickness of the diploë between the anterior part and the two other parts (central and posterior) of this suture. Significant differences were also observed in some of the analysed variables between the sections of the sagittal suture of the skull with NSC and the normal skull.

  8. Exposure chamber

    DOEpatents

    Moss, Owen R.; Briant, James K.

    1983-01-01

    An exposure chamber includes an imperforate casing having a fluid inlet at the top and an outlet at the bottom. A single vertical series of imperforate trays is provided. Each tray is spaced on all sides from the chamber walls. Baffles adjacent some of the trays restrict and direct the flow to give partial flow back and forth across the chambers and downward flow past the lowermost pan adjacent a central plane of the chamber.

  9. Effects of rapid maxillary expansion on the cranial and circummaxillary sutures

    PubMed Central

    Ghoneima, Ahmed; Abdel-Fattah, Ezzat; Hartsfield, James; El-Bedwehi, Ashraf; Kamel, Ayman; Kula, Katherine

    2016-01-01

    Introduction The aim of this study was to determine whether the orthopedic forces of rapid maxillary expansion cause significant quantitative changes in the cranial and the circummaxillary sutures. Methods Twenty patients (mean age, 12.3 ± 1.9 years) who required rapid maxillary expansion as a part of their comprehensive orthodontic treatment had preexpansion and postexpansion computed tomography scans. Ten cranial and circummaxillary sutures were located and measured on one of the axial, coronal, or sagittal sections of each patient’s preexpansion and postexpansion computed tomography scans. Quantitative variables between the 2 measurements were compared by using the Wilcoxon signed rank test. A P value less than 0.05 was considered statistically significant. Results Rapid maxillary expansion produced significant width increases in the intermaxillary, internasal, maxillonasal, frontomaxillary, and frontonasal sutures, whereas the frontozygomatic, zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures showed nonsignificant changes. The greatest increase in width was recorded for the intermaxillary suture (1.7 ± 0.9 mm), followed by the internasal suture (0.6 ± 0.3 mm), and the maxillonasal suture (0.4 ± 0.2 mm). The midpalatal suture showed the greatest increase in width at the central incisor level (1.6 ± 0.8 mm) followed by the increases in width at the canine level (1.5 ± 0.8 mm) and the first molar level (1.2 ± 0.6 mm). Conclusions Forces elicited by rapid maxillary expansion affect primarily the anterior sutures (intermaxillary and maxillary frontal nasal interfaces) compared with the posterior (zygomatic interface) craniofacial structures. PMID:21967938

  10. Comparing Skin Staples to Sutures

    PubMed Central

    Shuster, Michael

    1989-01-01

    In a prospective randomized study, 52 lacerations requiring closure in the emergency department were either stapled or sutured. Six participating emergency physicians closed the wounds and recorded data about the laceration and the treatment provided. Patients visited their own family physicians for removal of the closures. Forty family physicians removed closures from 44 lacerations and reported follow-up data on discomfort levels, ease of closure removal, and cosmetic results. Lacerations were closed 2.7 times faster by the staple method (p<0.001), and there were no clinically significant differences between the two methods with respect to discomfort, infection rates, cosmetic result, or ease of removal. The staple device we used was more expensive than sutures. We concluded that the staple method of closure is safe, comfortable, and effective in the emergency department setting, and that the method's speed offsets its greater expense in some circumstances. PMID:21248986

  11. Iris mattress suture: a technique for sectoral iris defect repair.

    PubMed

    Tsao, Sean W; Holz, Huck A

    2015-03-01

    Achieving a cosmetic and functional outcome from iris defect repair is a surgical challenge. We describe an adaptation of techniques to address a case of 2.5 clock hours of sectoral iris tissue defect. Our method combines Siepser's modified closed-chamber sliding knot technique with the placement of a double-armed iris mattress suture to approximate iris tissue to the scleral wall and thereby create a pseudo-iris root. This technique reduces glare and achieves a cosmetic outcome for the patient.

  12. Posterior ventricular anchoring neochordal repair of degenerative mitral regurgitation efficiently remodels and repositions posterior leaflet prolapse†

    PubMed Central

    Woo, Y. Joseph; MacArthur, John W.

    2013-01-01

    OBJECTIVES Mitral valve repair techniques for degenerative disease typically entail leaflet resection or neochordal construction, which may require extensive resection, leaflet detachment/reattachment, reliance on diseased native chords or precise neochordal measuring. Occasionally, impaired leaflet mobility, reduced coaptation surface and systolic anterior motion (SAM) may result. We describe a novel technique for addressing posterior leaflet prolapse/flail, which both simplifies repair and addresses these issues. METHODS Fifty-four patients (age 62 ± 11 years) with degenerative MR underwent this new repair, 36 of whom minimally-invasively. A CV5 Gore-Tex suture was placed into the posterior left ventricular myocardium underneath the prolapsing segment as an anchor. This suture was then used to imbricate a portion of the prolapsed segment into the ventricle, creating a smooth, broad, non-prolapsed coapting surface on a leaflet with preserved mobility, additional neochordal support and posteriorly positioned enough to preclude SAM. RESULTS Repair was successful in all patients. The mean MR grade was reduced from +3.8 to +0.1 with 50 of 54 patients having zero MR and 4 of the 54 having trace or mild MR. All patients had proper antero-posterior location of the coaptation line of a mean length of 10.2 mm, and preserved posterior leaflet mobility. No patients had SAM or mitral stenosis. All patients were discharged and are currently doing well. CONCLUSION This new technique facilitated efficient single-suture repair of the prolapsed posterior leaflet mitral regurgitation without the need for resection or sliding annuloplasty. It precluded the need for precise neochordal measurement and preserved the leaflet coaptation surface. PMID:23449863

  13. Exposure chamber

    DOEpatents

    Moss, Owen R.

    1980-01-01

    A chamber for exposing animals, plants, or materials to air containing gases or aerosols is so constructed that catch pans for animal excrement, for example, serve to aid the uniform distribution of air throughout the chamber instead of constituting obstacles as has been the case in prior animal exposure chambers. The chamber comprises the usual imperforate top, bottom and side walls. Within the chamber, cages and their associated pans are arranged in two columns. The pans are spaced horizontally from the walls of the chamber in all directions. Corresponding pans of the two columns are also spaced horizontally from each other. Preferably the pans of one column are also spaced vertically from corresponding pans of the other column. Air is introduced into the top of the chamber and withdrawn from the bottom. The general flow of air is therefore vertical. The effect of the horizontal pans is based on the fact that a gas flowing past the edge of a flat plate that is perpendicular to the flow forms a wave on the upstream side of the plate. Air flows downwardly between the chamber walls and the outer edges of the pan. It also flows downwardly between the inner edges of the pans of the two columns. It has been found that when the air carries aerosol particles, these particles are substantially uniformly distributed throughout the chamber.

  14. Wire chamber

    DOEpatents

    Atac, Muzaffer

    1989-01-01

    A wire chamber or proportional counter device, such as Geiger-Mueller tube or drift chamber, improved with a gas mixture providing a stable drift velocity while eliminating wire aging caused by prior art gas mixtures. The new gas mixture is comprised of equal parts argon and ethane gas and having approximately 0.25% isopropyl alcohol vapor.

  15. IONIZATION CHAMBER

    DOEpatents

    Redman, W.C.; Shonka, F.R.

    1958-02-18

    This patent describes a novel ionization chamber which is well suited to measuring the radioactivity of the various portions of a wire as the wire is moved at a uniform speed, in order to produce the neutron flux traverse pattern of a reactor in which the wire was previously exposed to neutron radiation. The ionization chamber of the present invention is characterized by the construction wherein the wire is passed through a tubular, straight electrode and radiation shielding material is disposed along the wire except at an intermediate, narrow area where the second electrode of the chamber is located.

  16. Mesh Sutured Repairs of Abdominal Wall Defects

    PubMed Central

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

  17. Mesenchymal stem cell-coated sutures enhance collagen depositions in sutured tissues.

    PubMed

    Casado, Javier G; Blazquez, Rebeca; Jorge, Inmaculada; Alvarez, Veronica; Gomez-Mauricio, Guadalupe; Ortega-Muñoz, Mariano; Vazquez, Jesus; Sanchez-Margallo, Francisco M

    2014-01-01

    Sutures are commonly used for surgical procedures and new sutures are being developed to improve wound healing. In the past decade, it has been extensively shown that mesenchymal stem cells (MSCs) have a wound healing potential. To benefit the overall wound healing process, we aimed to analyze the usage of pretreated sutures for improving the implantation of MSCs in the tissues. Our results firstly showed that suture pretreatments with gelatin, poly-L-lysine, and NaOH improved the adhesive strength of MSCs to sutures. These cells remained surrounding the sutured tissue and no significant phenotypic changes were found in those cells cultured onto pretreated sutures. In vivo experiments showed that the implantation of MSCs by suturing increases the collagen content in the sutured tissue. Moreover, proteomics analysis of secreted proteins showed that collagen alpha-1(I) chain was the most abundant collagen found. To our knowledge, this is the first report that aimed to improve the implantation of MSCs in tissue by suture pretreatments. Moreover, in vivo experiments suggest that MSC-coated sutures may enhance wound healing and tissue remodeling through the release of different collagen types being applicable for those patients that tend to have difficulty healing.

  18. Total knee arthroplasty closure with barbed sutures.

    PubMed

    Eickmann, Tom; Quane, Erika

    2010-09-01

    Bidirectional barbed sutures, which do not require the tying of knots, have the potential to reduce closure times of total knee arthroplasty (TKA) wounds without adverse effect to wound security, cosmesis, or infection risk. In this retrospective study, data were reviewed from TKAs performed between January 2007 and September 2008. For 88 of these procedures, conventional absorbable sutures were used for interrupted closure of the retinacular and subcutaneous layers and for running closure of the subcuticular layer. For 90 procedures, bidirectional barbed absorbable sutures were used for running closure of the retinacular and subcutaneous layers. Surgeries performed with barbed sutures were significantly faster than those performed with conventional sutures (mean times of 74.3 minutes and 85.8 minutes, respectively, p < 0.001) with no detrimental clinical effects.

  19. Ancient suture zones within continents.

    PubMed

    Moores, E M

    1981-07-03

    Ancient suture belts within continents are deformed regions which contain the remnants of former ocean basins. They form when two continents or island arcs that earlier were separated by an ocean basin converge and collide during plate tectonic activity. These belts provide the only record we have of deep oceanic crust and of ancient sea-floor processes for the first 94 percent of the earth's history, that is, prior to the oldest preserved crust in the oceans. Ten criteria for the recognition and interpretation of these ancient belts are discussed. A comprehensive program for the study of these belts should have great scientific and economic benefit for the United States and would be relatively cheap compared to other large national scientific efforts.

  20. Ionization chamber

    DOEpatents

    Walenta, Albert H.

    1981-01-01

    An ionization chamber has separate drift and detection regions electrically isolated from each other by a fine wire grid. A relatively weak electric field can be maintained in the drift region when the grid and another electrode in the chamber are connected to a high voltage source. A much stronger electric field can be provided in the detection region by connecting wire electrodes therein to another high voltage source. The detection region can thus be operated in a proportional mode when a suitable gas is contained in the chamber. High resolution output pulse waveforms are provided across a resistor connected to the detection region anode, after ionizing radiation enters the drift region and ionize the gas.

  1. Fuchs's heterochromic cyclitis and posterior capsulotomy.

    PubMed Central

    Roussel, T J; Coster, D J

    1985-01-01

    We report a case of intractable glaucoma following an uncomplicated secondary posterior capsulotomy in a 48-year-old male with Fuchs's heterochromic cyclitis. The patient had been free of inflammation and glaucoma since cataract extraction 27 years previously. We also report the results of phenotypic analysis of lymphocytes removed from the anterior chamber. Images PMID:3859323

  2. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis.

    PubMed

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y

    2016-05-01

    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  3. An analysis of flexible anterior chamber lenses with special reference to the normalized rate of lens explantation.

    PubMed

    Lim, E S; Apple, D J; Tsai, J C; Morgan, R C; Wasserman, D; Assia, E I

    1991-02-01

    A survey of 1204 closed-loop anterior chamber intraocular lenses (AC-IOLs) and 310 open-loop AC-IOLs accessioned between November 1982 and January 1990 was conducted at the Center for Intraocular Lens Research. An analysis of complication rates was done after normalization of data with respect to market share totals. The results establish that an unacceptable complication rate is associated with the closed-loop design when compared with either the tripod or quadripod lens styles. Furthermore, the closed-loop designs, while comprising an estimated 45% of the total number of AC-IOLs estimated to be implanted in the United States (n = 674,000), were responsible for 80% of the AC-IOLs explanted after complications and accessioned at the authors' center. A rethinking of the extreme condemnation of all anterior chamber IOLs that has surfaced in recent years is warranted. This is particularly true with respect to indications for use of sutured posterior chamber (PC) IOLs as well as with regard to possible use of open-loop AC-IOLs in less-industrialized nations.

  4. Strength of different meniscus suturing techniques.

    PubMed

    Aşik, M; Sener, N; Akpinar, S; Durmaz, H; Göksan, A

    1997-01-01

    We measured and compared the primary stabilities of five different meniscal suturing techniques. The techniques tested were horizontal mattress, vertical mattress, knot-end, vertical, and vertical loop. Twenty bovine medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of the five suture techniques. Then the two parts of the meniscus were pulled using the Instron Tensometer until failure occurred. Knot-end techniques gave inferior results (mean ultimate failure strength 64 +/- 5 N) compared with the other techniques. Vertical mattress failed at 130 +/- 3 N, vertical loop at 128 +/- 4.5 N, horizontal mattress at 98 +/- 5 N and vertical suturing at 136 +/- 2.7 N. This study shows the superior mechanical characteristic of the vertical suturing technique.

  5. 21 CFR 878.4495 - Stainless steel suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  6. 21 CFR 878.4495 - Stainless steel suture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  7. 21 CFR 878.4495 - Stainless steel suture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  8. 21 CFR 878.4495 - Stainless steel suture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  9. 21 CFR 878.4495 - Stainless steel suture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  10. Successful repair of recurrent rectovaginal fistula by stratified suture using transanal endoscopic microsurgery

    PubMed Central

    Chen, Weijie; Chen, Xin; Lin, Guole; Qiu, Huizhong

    2016-01-01

    Abstract Background: Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina. Although many surgical approaches to correct them have been attempted, management of RVFs still remains a challenge, especially for recurrent RVFs. Methods: In the present study, we report a case in a 22-year-old female with a chief complaint of obvious passages of flatus or stool through the vagina for 10 years. She had suffered a vaginal trauma from a violent accident 10 years prior, and gradually noticed the uncontrollable passage of gas or feces from the vagina 2 weeks later. The patient underwent a transvaginal direct repair surgery at local hospital 9 years ago, but the symptoms recurred 1 month after the surgery. After 2-years monitoring, the patient underwent another transvaginal repair surgery (fistulectomy followed by direct suture) at another hospital, but the fistula recurred again. We initially performed a temporary protective transversostomy upon admission. After 8-months of observation, a methylene blue test was conducted and the diagnosis of recurrent RVF was confirmed. Subsequently, we performed a successful repair by stratified suture using transanal endoscopic microsurgery (TEM). The scar tissue on the posterior wall of the vagina and the anterior wall of the rectum were meticulously excised until the margin of the excisional line showed healthy tissue. In addition, the fistulous tract was completely removed. The edges of the fistula on the posterior wall of the vagina were closed by simple continuous suturing, and the rectal anterior wall was sutured in the same manner. Results: During a 1-year follow-up period, the fistulae were not recurrent and no complication such as incontinences or rectal bleeding were found. The latest Wexner score was 3. Conclusion: We present a case of successful treatment with stratified suture using TEM throughout the procedure. We strongly recommend this efficient and minimally invasive procedure for recurrent

  11. Biomechanical Comparison of Parallel and Crossed Suture Repair for Longitudinal Meniscus Tears

    PubMed Central

    Milchteim, Charles; Branch, Eric A.; Maughon, Ty; Hughey, Jay; Anz, Adam W.

    2016-01-01

    Background: Longitudinal meniscus tears are commonly encountered in clinical practice. Meniscus repair devices have been previously tested and presented; however, prior studies have not evaluated repair construct designs head to head. This study compared a new-generation meniscus repair device, SpeedCinch, with a similar established device, Fast-Fix 360, and a parallel repair construct to a crossed construct. Both devices utilize self-adjusting No. 2-0 ultra–high molecular weight polyethylene (UHMWPE) and 2 polyether ether ketone (PEEK) anchors. Hypothesis: Crossed suture repair constructs have higher failure loads and stiffness compared with simple parallel constructs. The newer repair device would exhibit similar performance to an established device. Study Design: Controlled laboratory study. Methods: Sutures were placed in an open fashion into the body and posterior horn regions of the medial and lateral menisci in 16 cadaveric knees. Evaluation of 2 repair devices and 2 repair constructs created 4 groups: 2 parallel vertical sutures created with the Fast-Fix 360 (2PFF), 2 crossed vertical sutures created with the Fast-Fix 360 (2XFF), 2 parallel vertical sutures created with the SpeedCinch (2PSC), and 2 crossed vertical sutures created with the SpeedCinch (2XSC). After open placement of the repair construct, each meniscus was explanted and tested to failure on a uniaxial material testing machine. All data were checked for normality of distribution, and 1-way analysis of variance by ranks was chosen to evaluate for statistical significance of maximum failure load and stiffness between groups. Statistical significance was defined as P < .05. Results: The mean maximum failure loads ± 95% CI (range) were 89.6 ± 16.3 N (125.7-47.8 N) (2PFF), 72.1 ± 11.7 N (103.4-47.6 N) (2XFF), 71.9 ± 15.5 N (109.4-41.3 N) (2PSC), and 79.5 ± 25.4 N (119.1-30.9 N) (2XSC). Interconstruct comparison revealed no statistical difference between all 4 constructs regarding maximum

  12. Management of Cerebrospinal Fluid Leak following Posterior Cranial Fossa Surgery

    PubMed Central

    Altaf, Imran; Vohra, Anjum Habib; Shams, Shahzad

    2016-01-01

    Objective: Cerebrospinal fluid leakage remains a significant cause of morbidity following posterior fossa surgery, and its treatment remains a difficult problem. The aim of the study was to propose a treatment algorithm for its management. Methods: A retrospective, single-center study was conducted on 147 patients who underwent elective posterior fossa surgery for a variety of diseases. Patients with post operative CSF leakage had either been treated initially with conservative measures including re-suturing of the wound, with CSF lumbar drainage to be employed in case the CSF leakage didn’t stop, or the initial intervention was the institution of CSF lumbar drainage simultaneously with conservative measures. VP (ventriculo-peritoneal) shunt was done in patients with gross hydrocephalus on postoperative CT brain. Results: There were 25 (17%) cases of CSF leakage, including 24 incisional CSF leaks and one case of CSF otorrhea. In eight patients with incisional CSF leakage treated initially with conservative measures including re-suturing of the wound, CSF leakage stopped in only two cases. CSF lumbar drainage instituted later on in six cases with persistent leakage stopped the CSF leakage. In fourteen patients managed initially with re-suturing of the wound and concomitant CSF lumbar drainage, CSF leakage settled in all the cases. Two patients with gross hydrocephalus on post operative CT were managed successfully with VP shunt. Re-suturing of the wound with concomitant CSF lumbar drainage was found to be significantly associated (p=0.003) with the stoppage of CSF leakage, and the settlement of meningitis (p= 0.014). Conclusion: Incisional CSF leaks after posterior fossa surgery should be managed with re-suturing of the wound and concomitant CSF lumbar drainage, instead of an initial trial of conservative therapy alone. PMID:28083041

  13. Shear lag sutures: Improved suture repair through the use of adhesives.

    PubMed

    Linderman, Stephen W; Kormpakis, Ioannis; Gelberman, Richard H; Birman, Victor; Wegst, Ulrike G K; Genin, Guy M; Thomopoulos, Stavros

    2015-09-01

    Suture materials and surgical knot tying techniques have improved dramatically since their first use over five millennia ago. However, the approach remains limited by the ability of the suture to transfer load to tissue at suture anchor points. Here, we predict that adhesive-coated sutures can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize the strength of the adhesive-coated suture repair construct. To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine). As a clinically relevant proof-of-concept, cyanoacrylate-coated sutures were then used to perform a clinically relevant flexor digitorum tendon repair in cadaver tissue. The repair performed with adhesive-coated suture had significantly higher strength compared to the standard repair without adhesive. Notably, cyanoacrylate provides strong adhesion with high stiffness and brittle behavior, and is therefore not an ideal adhesive for enhancing suture repair. Nevertheless, the improvement in repair properties in a clinically relevant setting, even using a non-ideal adhesive, demonstrates the potential for the proposed approach to improve outcomes for treatments requiring suture fixation. Further study is necessary to develop a strongly adherent, compliant adhesive within the optimal design space described by the model.

  14. Shear lag sutures: Improved suture repair through the use of adhesives

    PubMed Central

    Linderman, Stephen W.; Kormpakis, Ioannis; Gelberman, Richard H.; Birman, Victor; Wegst, Ulrike G. K.; Genin, Guy M.; Thomopoulos, Stavros

    2015-01-01

    Suture materials and surgical knot tying techniques have improved dramatically since their first use over five millennia ago. However, the approach remains limited by the ability of the suture to transfer load to tissue at suture anchor points. Here, we predict that adhesive-coated sutures can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize the strength of the adhesive-coated suture repair construct. To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine). As a clinically relevant proof-of-concept, cyanoacrylate-coated sutures were then used to perform a clinically relevant flexor digitorum tendon repair in cadaver tissue. The repair performed with adhesive-coated suture had significantly higher strength compared to the standard repair without adhesive. Notably, cyanoacrylate provides strong adhesion with high stiffness and brittle behavior, and is therefore not an ideal adhesive for enhancing suture repair. Nevertheless, the improvement in repair properties in a clinically relevant setting, even using a non-ideal adhesive, demonstrates the potential for the proposed approach to improve outcomes for treatments requiring suture fixation. Further study is necessary to develop a strongly adherent, compliant adhesive within the optimal design space described by the model. PMID:26022966

  15. Functional implications of squamosal suture size in paranthropus boisei.

    PubMed

    Dzialo, Christine; Wood, Sarah A; Berthaume, Michael; Smith, Amanda; Dumont, Elizabeth R; Benazzi, Stefano; Weber, Gerhard W; Strait, David S; Grosse, Ian R

    2014-02-01

    It has been hypothesized that the extensively overlapping temporal and parietal bones of the squamosal sutures in Paranthropus boisei are adaptations for withstanding loads associated with feeding. Finite element analysis (FEA) was used to investigate the biomechanical effects of suture size (i.e., the area of overlap between the temporal and parietal bones) on stress, strain energy, and strain ratio in the squamosal sutures of Pan troglodytes and P. boisei (specimen OH 5) during biting. Finite element models (FEMs) of OH 5 and a P. troglodytes cranium were constructed from CT scans. These models contain sutures that approximate the actual suture sizes preserved in both crania. The FEM of Pan was then modified to create two additional FEMs with squamosal sutures that are 50% smaller and 25% larger than those in the original model. Comparisons among the models test the effect of suture size on the structural integrity of the squamosal suture as the temporal squama and parietal bone move relative to each other during simulated premolar biting. Results indicate that with increasing suture size there is a decreased risk of suture failure, and that maximum stress values in the OH 5 suture were favorable compared to values in the Pan model with the normal suture size. Strain ratios suggest that shear is an important strain regime in the squamosal suture. This study is consistent with the hypothesis that larger sutures help reduce the likelihood of suture failure under high biting loads.

  16. Double triangular resection for a widely prolapsed posterior mitral leaflet†

    PubMed Central

    Sawazaki, Masaru; Tomari, Shiro; Tsunekawa, Tomohiro; Izawa, Naoto

    2013-01-01

    A wide and redundant prolapse of the posterior mitral leaflet in active infective endocarditis cannot be easily repaired. A sliding plasty can be attempted, but the range of annular plication is often too large. Chordal replacement is another option, but is prone to long-term degeneration because the redundant leaflet still exists. Here, we describe a simple resection technique that utilizes only two small triangular resections. The resections are sutured with no need to shorten the annulus. The leaflet tissue between the two triangular resections must be preserved to make an appropriately shaped posterior leaflet. PMID:23223672

  17. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures.

    PubMed

    Ji, Jong-Hun; Kim, Weon-Yoo; Ra, Ki-Hang

    2007-10-01

    In cases of displaced greater tuberosity fractures, treatments by arthroscopic-assisted reduction and percutaneous screw fixation have been reported. However, in cases in which there is a comminuted fracture or a minimally displaced fracture combined with concomitant lesions such as rotator cuff tear or labral pathology, it is difficult to reduce the fracture and to treat other pathologies by use of a percutaneous screw. Recently, many surgeons have used the double-row repair method in rotator cuff repair, which provides a tendon-bone interface better suited for biologic healing and restoring normal anatomy. In accordance with this method, we used the arthroscopic technique of double-row suture anchor fixation for a minimally displaced greater tuberosity fracture without additional incision. Initially, debridement was performed on the fracture surface by use of a shaver, and the medial-row anchor was inserted through the anterior portal or the intact cuff. Two lateral-row anchors were inserted just anterior and posterior to the lower margin of the fractured fragment under C-arm guidance. The medial-row sutures and lateral-row sutures were then placed. Arthroscopic double-row suture anchor fixation of a displaced greater tuberosity fracture restores the original footprint of the rotator cuff and normal tendon-bone interface of the displaced greater tuberosity fracture.

  18. The history and evolution of sutures in pelvic surgery

    PubMed Central

    Muffly, Tyler M; Tizzano, Anthony P; Walters, Mark D

    2011-01-01

    Summary The purpose of the study is to review the history and innovations of sutures used in pelvic surgery. Based on a review of the literature using electronic- and hand-searched databases we identified appropriate articles and gynaecology surgical textbooks regarding suture for wound closure. The first documented uses of suture are explored and then the article focuses on the use of knotted materials in pelvic surgery. The development of suture of natural materials is followed chronologically until the present time where synthetic suture is implanted during countless surgeries every day. This millennial history of suture contains an appreciation of the early work of Susruta, Celsus, Paré and Lister, including a survey of some significant developments of suture methods over the last 100 years. Most surgeons know little about the history and science of sutures. A retrospective view of suture is critical to the appreciation of the current work and development of this common tool. PMID:21357979

  19. Fourier technique for studying ammonoid sutures

    SciTech Connect

    Gildner, R.F.; Ackerly, S.C.

    1985-01-01

    Suture patterns have long been recognized as being of primary importance in the study of ammonoids. The authors have developed a technique to use Fourier analysis to study these structures by using a simple transformation: x-y data of a digitized suture are transformed to angle of slope versus position along the suture's length. A Fast Fourier Transform applied to the data produces a power spectrum (amplitude versus wave number) providing a precise and accurate measure of suture shape. The authors have applied this technique to the analysis of ontogenetic change in suture morphology. In goniatitic, ceratitic and preadult ammonitic patterns most of the change is exhibited in the amplitudes of the lowest ten wave numbers. Their Fourier coefficients clearly show trends not readily apparent by visual inspection. The more complex ammonitic patterns are reflected in increased amplitudes of higher wave numbers (a broader peak of the power spectrum) and their analysis is necessarily more complex. The Fourier approach presents the opportunity to quantitatively measure and describe the tempo and mode of evolution in the Ammonoidea. Potential applications of the new technique, as well as limitations, are discussed with special attention to investigations of ammonoid ontogeny and phylogeny.

  20. The cell biology of suturing tendons

    PubMed Central

    Wong, J.K.F.; Alyouha, S.; Kadler, K.E.; Ferguson, M.W.J.; McGrouther, D.A.

    2010-01-01

    Trauma by suturing tendon form areas devoid of cells termed “acellular zones” in the matrix. This study aimed to characterise the cellular insult of suturing and acellular zone formation in mouse tendon. Acellular zone formation was evaluated using single grasping sutures placed using flexor tendons with time lapse cell viability imaging for a period of 12 h. Both tension and injury were required to induce cell death and cell movement in the formation of the acellular zone. DNA fragmentation studies and transmission electron microscopy indicated that cells necrosed. Parallel in vivo studies showed that cell-to-cell contacts were disrupted following grasping by the suture in tensioned tendon. Without tension, cell death was lessened and cell-to-cell contacts remained intact. Quantitative immunohistochemistry and 3D cellular profile mapping of wound healing markers over a one year time course showed that acellular zones arise rapidly and showed no evidence of healing whilst the wound healing response occurred in the surrounding tissues. The acellular zones were also evident in a standard modified “Kessler” clinical repair. In conclusion, the suture repair of injured tendons produces acellular zones, which may potentially cause early tendon failure. PMID:20600895

  1. Percutaneous Posterior Calcaneal Osteotomy.

    PubMed

    Lui, Tun Hing

    2015-01-01

    Different types of posterior calcaneal osteotomy are used for calcaneal realignment in the management of hindfoot deformity. We describe a percutaneous technique of posterior calcaneal osteotomy that can be either a Dwyer-type closing wedge osteotomy or displacement osteotomy.

  2. Retro iris suture fixation of a rigid intraocular lens.

    PubMed

    Haripriya, Aravind; Sharma, Sankalp S

    2016-11-01

    We present an iris suture fixation technique for a rigid poly(methyl methacrylate) (PMMA) intraocular lens (IOL). A 10-0 polypropylene suture on a long curved needle is used to preplace 2 iris suture bites 180 degrees apart. The suture loops below the iris are retracted through the main scleral tunnel using a Kuglen hook and a McPherson forceps. The 2 suture loops are twirled twice around the corresponding haptics of a standard 3-piece PMMA IOL, and the IOL is placed in the sulcus. After it is confirmed that the loop surrounds the haptic, the suture knot is tied to secure the IOL to the iris.

  3. [Predictable tip suture techniques in rhinoplasty].

    PubMed

    Papel, I D

    2010-09-01

    Recontouring the nasal tip in rhinoplastic procedures has generated a wide range of surgical techniques. These range from aggressive cartilage resection, division, grafting, or suture methods. Each of these categories contains many variations described in hundreds of publications. The goal of this communication is to describe a predictable, reproducible technique that can be used in a wide variety of rhinoplasty operations. Based on pre-existing anatomy variations of this technique can be adopted. The author described the basic technique in 2004 [1].The cornerstone of the technique is a predictable method of narrowing the interdomal space utilizing a suture technique. This procedure employs a pair of permanent sutures designed to minimize distortion, valve impingement and overcorrection. It can be performed through intranasal or external approaches. This paper will define the wide interdomal space, describe the technique, and demonstrate the efficacy of the technique in 250 rhinoplasty procedures. In addition, variations of the technique for specific goals will be shown.

  4. Childhood recurrent pneumonia caused by endobronchial sutures

    PubMed Central

    Zan, Yiheng; Liu, Hanmin; Zhong, Lin; Qiu, Li; Tao, Qingfen; Chen, Lina

    2017-01-01

    Abstract Background: Recurrent pneumonia is defined as more than two episodes of pneumonia in one year or three or more episodes anytime in life. Common clinical scenarios leading to recurrent pneumonia include anatomical abnormalities of respiratory tract, immunodeficiency, congenital heart diseases, primary ciliary dyskinesia, etc. Case report: A school-aged girl suffered from 1-2 episodes of pneumonia each year after trachea connection and lung repair operation resulted from an accident of car crash. Bronchoscopy revealed the sutures twisted with granulation in the left main bronchus and the patient's symptoms relieved after removal of the sutures. Here we report for the first time that surgical suture was the cause of recurrent pneumonia. Conclusions: This case indicates that children with late and recurrent onset of pneumonia should undergo detailed evaluation including bronchoscopy. PMID:28121955

  5. Polypropylene suture--is it safe?

    PubMed

    Calhoun, T R; Kitten, C M

    1986-07-01

    Polypropylene suture has steadily gained popularity for use in vascular and cardiac surgical procedures because of its long-term tensile strength and minimal tissue trauma. However, recently some questions have arisen concerning its safety. We recently had two cases of polypropylene fracture, one occurring early and the other late after operation. Comparison and collation of these two cases with other reports leads to the conclusion that polypropylene suture is safe in most situations, but care must be taken to avoid instrumentation trauma and kinking stresses at knots, which probably explain most of the reported cases of polypropylene failure. In addition, polypropylene probably should not be used in graft-to-graft anastomoses in which the continual sawing stresses of two rigid structures appears to lead to an excessive incidence of late suture fracture with resultant false aneurysm formation.

  6. Achondroplasia with multiple-suture craniosynostosis: a report of a new case of this rare association.

    PubMed

    Bessenyei, Beáta; Nagy, Andrea; Balogh, Erzsébet; Novák, László; Bognár, László; Knegt, Alida C; Oláh, Eva

    2013-10-01

    We report on a female patient with an exceedingly rare combination of achondroplasia and multiple-suture craniosynostosis. Besides the specific features of achondroplasia, synostosis of the metopic, coronal, lambdoid, and squamosal sutures was found. Series of neurosurgical interventions were carried out, principally for acrocephaly and posterior plagiocephaly. The most common achondroplasia mutation, a p.Gly380Arg in the fibroblast growth factor receptor 3 (FGFR3) gene, was detected. Cytogenetic and array CGH analyses, as well as molecular genetic testing of FGFR1, 2, 3 and TWIST1 genes failed to identify any additional genetic alteration. It is suggested that this unusual phenotype is a result of variable expressivity of the common achondroplasia mutation.

  7. Optimal Suturing Technique and Number of Sutures for Surgical Implantation of Acoustic Transmitters in Juvenile Salmonids

    SciTech Connect

    Deters, Katherine A.; Brown, Richard S.; Boyd, James W.; Eppard, M. B.; Seaburg, Adam

    2012-01-02

    The size reduction of acoustic transmitters has led to a reduction in the length of incision needed to implant a transmitter. Smaller suture knot profiles and fewer sutures may be adequate for closing an incision used to surgically implant an acoustic microtransmitter. As a result, faster surgery times and reduced tissue trauma could lead to increased survival and decreased infection for implanted fish. The objective of this study was to assess the effects of five suturing techniques on mortality, tag and suture retention, incision openness, ulceration, and redness in juvenile Chinook salmon Oncorhynchus tshawytscha implanted with acoustic microtransmitters. Suturing was performed by three surgeons, and study fish were held at two water temperatures (12°C and 17°C). Mortality was low and tag retention was high for all treatments on all examination days (7, 14, 21, and 28 days post-surgery). Because there was surgeon variation in suture retention among treatments, further analyses included only the one surgeon who received feedback training in all suturing techniques. Incision openness and tissue redness did not differ among treatments. The only difference observed among treatments was in tissue ulceration. Incisions closed with a horizontal mattress pattern had more ulceration than other treatments among fish held for 28 days at 17°C. Results from this study suggest that one simple interrupted 1 × 1 × 1 × 1 suture is adequate for closing incisions on fish under most circumstances. However, in dynamic environments, two simple interrupted 1 × 1 × 1 × 1 sutures should provide adequate incision closure. Reducing bias in survival and behavior tagging studies is important when making comparisons to the migrating salmon population. Therefore, by minimizing the effects of tagging on juvenile salmon (reduced tissue trauma and reduced surgery time), researchers can more accurately estimate survival and behavior.

  8. A Reduction Method for All-Inside Posterior Horn Meniscal Repair

    PubMed Central

    M. Thompson, Simon; A. Pinczewski, Leo

    2015-01-01

    Obtaining, and maintaining, optimal reduction of a displaced posterior horn can be a difficult and time-consuming procedure. There are many different ways to repair a tear of the meniscus; we describe a quick and simple technique using a readily available meniscal suturing device. PMID:26697298

  9. Surgical time for graft preparation using different suture techniques

    PubMed Central

    Camarda, Lawrence; Giambartino, Sebastian; Lauria, Michele; Saporito, Michele; Triolo, Vito; D’Arienzo, Michele

    2016-01-01

    Summary Background The purpose of the present study was to compare the operative time for graft preparation using different techniques for graft suturing. Material and methods Flexor profundus tendons were harvested from fresh pig hind-leg trotters. Three different suture techniques were investigated: the Krackow stitch (K), the Whipstitch (W), and the Modified Finger-Trap suture (MFT). Tendons were sutured starting at 10 mm from the distal free end of the tendon. The suture configurations of the Krackow stitch and Whipstitch were completed with five suture throws. According to the MFT technique, the suture was wrapped five times around the tendon over a distance of 30 mm. The time required to perform a complete suture on each tendon was measured. Five independent examiners of different levels of training measured the time required for graft preparation during 3 separate occasions to determine intraobserver repeatability and interobserver reproducibility. Results The mean time required for graft preparation following the Krackow technique was 69.1 seconds ± 18.3 SD (range 31.8–120). The Whipstitch technique took an average of 59.9 seconds ± 21.2 SD (range 27–93). The MFT suture required a mean of 29.3 seconds ± 11.4 SD for completing the suture (range 21.6–33). In all examiners the time required to complete the MFT suture was significantly less than the other suture techniques (p < 0.05). Intraobserver intraclass correlation coefficients for each examiner ranged from 0.72 to 0.83. Conclusion Low graft preparation time is required to complete a MFT suture in a porcine tendon model. Further, time required for graft preparation using the MFT was shorter than other suturing techniques such as the Krackow and Whipstitch techniques. Clinical relevance The MFT suture could be used for graft set-up with the main advantage of reducing the time required in comparison with other suture techniques. PMID:27900298

  10. The role of sutures and fibrin sealant in wound healing.

    PubMed

    Spotnitz, W D; Falstrom, J K; Rodeheaver, G T

    1997-06-01

    Sutures and fibrin sealant are important surgical aids for facilitating wound closure and creating an optimal setting for wound healing. Most commonly, sutures are used to close wounds because suture material provides the mechanical support necessary to sustain closure. A wide variety of suturing material is available, and the surgeon can choose among sutures with a range of attributes to find the one best suited to his or her needs. Considerations when choosing an appropriate suture for wound closure and healing include strength of suture, holding power of tissue, absorbability, risk of infection, and inflammatory reaction associated with the suture material. Other factors to be considered include type of incision, suturing technique, and appearance of wound site. Fibrin sealant, in contrast, is a biologic tissue adhesive that can function as a useful adjunct to sutures. Fibrin sealant can be used in conjunction with sutures or tape to promote optimal wound integrity, or it can be used independently to seal wound sites where sutures cannot control bleeding or would aggravate bleeding. This adhesive can effectively seal tissue planes and eliminate potential spaces. Fibrin sealant has been used clinically in many surgical applications, although an FDA-approved commercially available product does not yet exist in the United States. Clinically, fibrin sealant has resulted in a low rate of infection and has promoted healing. Further study is needed to determine the best fibrin sealant mixtures both to achieve hemostasis and to encourage healing. It may even be desirable to use different sealant formulations for particular clinical situations.

  11. The Morphogenesis of Cranial Sutures in Zebrafish

    PubMed Central

    Topczewska, Jolanta M.; Shoela, Ramy A.; Tomaszewski, Joanna P.; Mirmira, Rupa B.; Gosain, Arun K.

    2016-01-01

    Using morphological, histological, and TEM analyses of the cranium, we provide a detailed description of bone and suture growth in zebrafish. Based on expression patterns and localization, we identified osteoblasts at different degrees of maturation. Our data confirm that, unlike in humans, zebrafish cranial sutures maintain lifelong patency to sustain skull growth. The cranial vault develops in a coordinated manner resulting in a structure that protects the brain. The zebrafish cranial roof parallels that of higher vertebrates and contains five major bones: one pair of frontal bones, one pair of parietal bones, and the supraoccipital bone. Parietal and frontal bones are formed by intramembranous ossification within a layer of mesenchyme positioned between the dermal mesenchyme and meninges surrounding the brain. The supraoccipital bone has an endochondral origin. Cranial bones are separated by connective tissue with a distinctive architecture of osteogenic cells and collagen fibrils. Here we show RNA in situ hybridization for col1a1a, col2a1a, col10a1, bglap/osteocalcin, fgfr1a, fgfr1b, fgfr2, fgfr3, foxq1, twist2, twist3, runx2a, runx2b, sp7/osterix, and spp1/ osteopontin, indicating that the expression of genes involved in suture development in mammals is preserved in zebrafish. We also present methods for examining the cranium and its sutures, which permit the study of the mechanisms involved in suture patency as well as their pathological obliteration. The model we develop has implications for the study of human disorders, including craniosynostosis, which affects 1 in 2,500 live births. PMID:27829009

  12. Recycling Suture Limbs from Knotless Suture Anchors for Arthroscopic Shoulder Stabilization.

    PubMed

    Johnson, Timothy S; DiPompeo, Christine M; Ismaeli, Zahra C; Porter, Polly A; Nicholson, Shannon L; Johnson, David C

    2014-06-01

    Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second suture pass. This technique (1) creates a more cost- and time-efficient surgical procedure than using multiple single-loaded anchors or double-loaded anchors, (2) decreases the known risk of glenoid fracture from the stress riser at the implant tips of multi-anchor repairs by reducing the number of anchors required for stabilization, (3) decreases the surgical time compared with the use of double-loaded anchors through simpler suture management and less knot tying, (4) allows for the secure reapproximation of the labrum to the glenoid while offering a convenient option for capsulorrhaphy without the need to insert another anchor, and (5) yields more points of soft-tissue fixation with fewer anchors drilled into the glenoid.

  13. A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients

    PubMed Central

    Aliano, Kristen; Fromm, Indira Michelle; Dagum, Alexander; Khan, Sami; Bui, Duc

    2016-01-01

    Cosmesis is a vital concern for patients undergoing plastic and reconstructive surgery. Many variations in wound closure are employed when attempting to minimize a surgical scar's appearance. Barbed sutures are one potential method of achieving improved wound cosmesis and are more common in recent years. To determine if barbed sutures differ from nonbarbed in wound cosmesis, we conducted a single-blinded, randomized, controlled trial of 18 patients undergoing bilateral reduction mammoplasty or panniculectomy. Patients were their own controls, receiving barbed sutures on one side and standard sutures on the contralateral side. Surgical scars were evaluated postoperatively by patient preference self-assessment and an observer. Ten patients were evaluated at 3 months postoperatively, yielding a mean Stony Brook Scar Evaluation Scale (SBSES) rating of 4.4 for barbed suture and 3.5 for regular suture (p = 0.15). At 6 months, 8 patients performed self-assessment to determine their preference; 4 preferred the barbed sutures, 1 preferred the regular sutures, and 3 had no preference. Further research with larger sample sizes is needed to determine if barbed sutures convey any advantage over standard sutures in wound healing. However, our results suggest that barbed sutures are a reasonable alternative to standard sutures particularly with regard to wound cosmesis. PMID:28025622

  14. Effect of suture material on platelet deposition onto prosthetic material

    SciTech Connect

    Connolly, R.; McEnroe, C.S.; Li, S.; Coleman, J.; Callow, A.D.

    1988-07-01

    Previous studies have demonstrated the importance of employing prosthetic material with minimal thrombogenicity. However, the role of different suture materials in early thrombotic events on prosthetic materials has not been examined. Experiments were designed to analyze the effects of suture on platelet graft interaction using an in vivo baboon hemocompatability screen. Indium labeled, autologous platelet deposition was determined on expanded polytetrafluoroethylene (ePTFE) containing suture lines of polypropylene (Prolene), polybutester (Novafil), and ePTFE (Gore-Tex). A significant increase in platelet deposition was noted not only at the suture line, but proximal and distal to it as well. The results were different for each of the sutures employed and suggest that the suture line may influence early platelet deposition in the perianastomotic region, not only at the suture line, but proximally and distally as well.

  15. Achondroplasia and multiple-suture craniosynostosis.

    PubMed

    Albino, Frank P; Wood, Benjamin C; Oluigbo, Chima O; Lee, Angela C; Oh, Albert K; Rogers, Gary F

    2015-01-01

    Genetic mutations in the fibroblast growth factor receptor 3 gene may lead to achondroplasia or syndromic forms of craniosynostosis. Despite sharing a common genetic basis, craniosynostosis has rarely been described in cases of confirmed achondroplasia. We report an infant with achondroplasia who developed progressive multiple-suture craniosynostosis to discuss the genetic link between these clinical entities and to describe the technical challenges associated with the operative management.

  16. Suture-induced right coronary artery stenosis.

    PubMed

    Seltmann, Martin; Achenbach, Stephan; Muschiol, Gerd; Feyrer, Richard

    2010-01-01

    An 82-year-old patient developed right heart failure in the days after surgical aortic valve replacement. Coronary CT angiography showed a high-grade stenosis of the mid-right coronary artery. Adjacent suture material seen on noncontrast CT suggested that the lesion was related to surgical closure of the right atrial cannulation site. Invasive angiography confirmed the stenosis, and percutaneous intervention was successfully performed.

  17. Skin tension related to tension reduction sutures.

    PubMed

    Hwang, Kun; Kim, Han Joon; Kim, Kyung Yong; Han, Seung Ho; Hwang, Se Jin

    2015-01-01

    The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer.The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures.

  18. Deployment and testing of a second prototype expandable surgical chamber in microgravity

    NASA Technical Reports Server (NTRS)

    Markham, Sanford M.; Rock, John A.

    1991-01-01

    During microgravity exposure, two separate expandable surgical chambers were tested. Both chambers had been modified to fit the microgravity work station without extending over the sides of the table. Both chambers were attached to a portable laminar flow generator which served two purposes: to keep the chambers expanded during use; and to provide an operative area environment free of contamination. During the tests, the chambers were placed on various parts of a total body moulage to simulate management of several types of trauma. The tests consisted of cleansing contusions, debridement of burns, and suturing of lacerations. Also, indigo carmine dye was deliberately injected into the chamber during the tests to determine the ease of cleansing the chamber walls after contamination by escaping fluids. Upon completion of the tests, the expandable surgical chambers were deflated, folded, and placed in a flattened state back into their original containers for storage and later disposal. Results are briefly discussed.

  19. Portable Hyperbaric Chamber

    NASA Technical Reports Server (NTRS)

    Schneider, William C. (Inventor); Locke, James P. (Inventor); DeLaFuente, Horacio (Inventor)

    2001-01-01

    A portable, collapsible hyperbaric chamber was developed. A toroidal inflatable skeleton provides initial structural support for the chamber, allowing the attendant and/or patient to enter the chamber. Oval hatches mate against bulkhead rings, and the hyperbaric chamber is pressurized. The hatches seal against an o-ring, and the internal pressure of the chamber provides the required pressure against the hatch to maintain an airtight seal. In the preferred embodiment, the hyperbaric chamber has an airlock to allow the attendant to enter and exit the patient chamber during treatment. Visual communication is provided through portholes in the patient and/or airlock chamber. Life monitoring and support systems are in communication with the interior of the hyperbaric chamber and/or airlock chamber through conduits and/or sealed feed-through connectors into the hyperbaric chamber.

  20. Fiber from ramie plant (Boehmeria nivea): A novel suture biomaterial.

    PubMed

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Devi, Dipali; Kalita, Dhaneswar; Kalita, Kasturi; Dash, Suvakanta; Kotoky, Jibon

    2016-05-01

    The quest for developing an ideal suture material prompted our interest to develop a novel suture with advantageous characters to market available ones. From natural origin only silk, cotton and linen fibers are presently available in market as non-absorbable suture biomaterials. In this study, we have developed a novel, cost-effective, and biocompatible suture biomaterial from ramie plant, Boehmeria nivea fiber. Field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and thermo gravimetric analysis (TGA) results revealed the physicochemical properties of raw and degummed ramie fiber, where the former one showed desirable characteristics for suture preparation. The braided multifilament ramie suture prepared from degummed fiber exhibited excellent tensile strength. The suture found to be biocompatible towards human erythrocytes and nontoxic to mammalian cells. The fabricated ramie suture exhibited significant antibacterial activity against Escherichia coli, Bacillus subtilis and Staphylococcus aureus; which can be attributed to the inherent bacteriostatic ability of ramie plant fiber. In vivo wound closure efficacy was evaluated in adult male wister rats by suturing the superficial wound incisions. Within seven days of surgery the wound got completely healed leaving no rash and scar. The role of the ramie suture in complete wound healing was supported by the reduced levels of serum inflammatory mediators. Histopathology studies confirmed the wound healing ability of ramie suture, as rapid synthesis of collagen, connective tissue and other skin adnexal structures were observed within seven days of surgery. Tensile properties, biocompatibility and wound closure efficacy of the ramie suture were comparable with market available BMSF suture. The outcome of this study can drive tremendous possibility for the utilization of ramie plant fiber for

  1. Management of the posterior capsule during pediatric intraocular lens implantation.

    PubMed

    Buckley, E G; Klombers, L A; Seaber, J H; Scalise-Gordy, A; Minzter, R

    1993-06-15

    One of the major obstacles in pediatric intraocular lens implantation has been the subsequent dense opacification of the posterior capsule. We used a modification of the standard pediatric cataract surgical procedure, which involved endocapsular cataract extraction, posterior chamber intraocular lens implantation, pars plana posterior capsulotomy, and pars plana anterior vitrectomy in 20 consecutive patients with unilateral traumatic, radiation-induced, and developmental cataracts. Visual axes were rapidly restored in all patients without further intervention for posterior capsule opacification. Visual acuity returned to 20/40 or better in all patients and 75% of all patients (15 patients) reached maximum improvement by five weeks. No complications attributed to intraoperative removal of the posterior capsule occurred.

  2. Posterior Cruciate Ligament Injury

    MedlinePlus

    ... ACL connect your thighbone (femur) to your shinbone (tibia). If either ligament is torn, it might cause ... ligaments connect the thighbone (femur) to the shinbone (tibia). The anterior and posterior cruciate ligaments form an " ...

  3. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases.

  4. The Use of Barbed Sutures in Obstetrics and Gynecology

    PubMed Central

    Greenberg, James A

    2010-01-01

    Despite the multitude of different procedures performed with a host of different wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations. In recent years, a new class of suture material—barbed suture—has been introduced into the surgeon’s armamentarium. This review focuses on barbed suture to better understand the role of this newer material in obstetrics and gynecology. PMID:21364859

  5. Needle Path Planning for Autonomous Robotic Surgical Suturing

    PubMed Central

    Jackson, Russell C.; Çavuşoğlu, M. Cenk

    2013-01-01

    This paper develops a path plan for suture needles used with solid tissue volumes in endoscopic surgery. The path trajectory is based on the best practices that are used by surgeons. The path attempts to minimize the interaction forces between the tissue and the needle. Using surgical guides as a basis, two different techniques for driving a suture needle are developed. The two techniques are compared in hardware experiments by robotically driving the suture needle using both of the motion plans. PMID:24683500

  6. Needle Path Planning for Autonomous Robotic Surgical Suturing.

    PubMed

    Jackson, Russell C; Cavuşoğlu, M Cenk

    2013-12-31

    This paper develops a path plan for suture needles used with solid tissue volumes in endoscopic surgery. The path trajectory is based on the best practices that are used by surgeons. The path attempts to minimize the interaction forces between the tissue and the needle. Using surgical guides as a basis, two different techniques for driving a suture needle are developed. The two techniques are compared in hardware experiments by robotically driving the suture needle using both of the motion plans.

  7. Reversing the antilock braking system theory for suture removal.

    PubMed

    Mangus, D J

    1987-06-01

    A simple and extremely practical technique for removal of long subcuticular sutures is possible by simply interposing a rubber band between the suture and the traction source. We have likened the technique in a reverse manner to the pulsing application of brakes in the antilock braking system now commonly found in modern automobiles. We also suggest with this paper that Prolene at this time be tried as the suture of choice in pullout repairs of all types.

  8. The “excluding” suture technique for surgical closure of ventricular septal defects: A retrospective study comparing the standard technique

    PubMed Central

    Varghese, Roy; Saheed, Sanni; Ravi, Amrutha K; Sherrif, Ejaz Ahmed; Agarwal, Ravi; Kothandam, Sivakumar

    2016-01-01

    Background: Conventional methods of closure of ventricular septal defects involve placement of sutures 4-5 mm from the posterior inferior margin. This study compares the conventional method with an alternative technique wherein sutures are placed along the edge of the defect thereby “excluding” the conduction system and the tensor apparatus of the tricuspid valve from the suture line. Materials and Methods: Between January 2013 and January 2016, 409 consecutive patients were retrospectively reviewed and divided into two matched groups. Group A (n = 174) underwent closure using the alternative technique and Group B (n = 235) with the conventional technique. Patients with isolated ventricular septal defects (VSDs) (n = 136) were separately analyzed as were infants within this subset. Results: Immediate postoperative results were similar with no statistically significant differences in either group in terms of incidence of residual defects or postoperative tricuspid regurgitation. There was however a significantly increased incidence of post operative complete heart block (CHB) among patients in the conventional group (P = 0.02). Incidence of temporary heart block that reverted to sinus rhythm was also more in the conventional method group (Group B) (P = 0.03) as was right bundle branch block (P ≤ 0.05) in all the subsets of patients analyzed. Conclusion: Surgical closure of VSDs can be accomplished by placing sutures along the margins or away with comparable results. The incidence of CHB, however, seems to be less when the “excluding” technique is employed. PMID:27625520

  9. Heterochrony and patterns of cranial suture closure in hystricognath rodents

    PubMed Central

    Wilson, Laura A B; Sánchez-Villagra, Marcelo R

    2009-01-01

    Sutures, joints that allow one bone to articulate with another through intervening fibrous connective tissue, serve as major sites of bone expansion during postnatal craniofacial growth in the vertebrate skull and represent an aspect of cranial ontogeny which may exhibit functional and phylogenetic correlates. Suture evolution among hystricognath rodents, an ecologically diverse group represented here by 26 species, is examined using sequence heterochrony methods, i.e. event pairing and parsimov. Although minor nuances in suture closure sequence exist between species, the overall sequence was found to be conserved both across the hystricognath group and, to an increasing degree, within selected clades. At species level, suture closure pattern exhibited a significant positive correlation with patterns previously reported for hominoids. Patterns for most clades revealed the first sutures to close are those contacting the exoccipital, interparietal, and palatine bones. Heterochronic shifts were found along 19 of 35 branches within the hystricognath phylogeny. The number of shifts per node ranged from one to seven events and, overall, involved 21 of 34 suture sites. The topology generated by parsimony analyses of the event pair matrix yielded only one grouping that was congruent with the evolutionary relationships, compiled from morphological and molecular studies, taken as framework. Sutures contacting the exoccipital displayed the highest levels of most complete closure across all species. Level of suture closure is negatively correlated with cranial length (P < 0.05). Differing life history and locomotory strategies are coupled in part with differing suture closure patterns among several species. PMID:19245501

  10. Visual measurement of suture strain for robotic surgery.

    PubMed

    Martell, John; Elmer, Thomas; Gopalsami, Nachappa; Park, Young Soo

    2011-01-01

    Minimally invasive surgical procedures offer advantages of smaller incisions, decreased hospital length of stay, and rapid postoperative recovery to the patient. Surgical robots improve access and visualization intraoperatively and have expanded the indications for minimally invasive procedures. A limitation of the DaVinci surgical robot is a lack of sensory feedback to the operative surgeon. Experienced robotic surgeons use visual interpretation of tissue and suture deformation as a surrogate for tactile feedback. A difficulty encountered during robotic surgery is maintaining adequate suture tension while tying knots or following a running anastomotic suture. Displaying suture strain in real time has potential to decrease the learning curve and improve the performance and safety of robotic surgical procedures. Conventional strain measurement methods involve installation of complex sensors on the robotic instruments. This paper presents a noninvasive video processing-based method to determine strain in surgical sutures. The method accurately calculates strain in suture by processing video from the existing surgical camera, making implementation uncomplicated. The video analysis method was developed and validated using video of suture strain standards on a servohydraulic testing system. The video-based suture strain algorithm is shown capable of measuring suture strains of 0.2% with subpixel resolution and proven reliability under various conditions.

  11. Does UV disinfection compromise sutures? An evaluation of tissue response and suture retention in salmon surgically implanted with transmitters

    SciTech Connect

    Walker, Ricardo W.; Brown, Richard S.; Deters, Katherine A.; Eppard, M. B.; Cooke, Steven J.

    2013-10-01

    Ultraviolet radiation (UVR) can be used as a tool to disinfect surgery tools used for implanting transmitters into fish. However, the use of UVR could possibly degrade monofilament suture material used to close surgical incisions. This research examined the effect of UVR on monofilament sutures to determine if they were compromised and negatively influenced tag and suture retention, incision openness, or tissue reaction. Eighty juvenile Chinook salmon Oncorhynchus tshawytscha were surgically implanted with an acoustic transmitter and a passive integrated transponder. The incision was closed with a single stitch of either a suture exposed to 20 doses of UV radiation (5 minute duration per dose) or a new, sterile suture. Fish were then held for 28 d and examined under a microscope at day 7, 14, 21 and 28 for incision openness, ulceration, redness, and the presence of water mold. There was no significant difference between treatments for incision openness, redness, ulceration or the presence of water mold on any examination day. On day 28 post-surgery, there were no lost sutures; however, 2 fish lost their transmitters (one from each treatment). The results of this study do not show any differences in negative influences such as tissue response, suture retention or tag retention between a new sterile suture and a suture disinfected with UVR.

  12. New suture materials for midline laparotomy closure: an experimental study

    PubMed Central

    2014-01-01

    Background Midline laparotomy closure carries a significant risk of incisional hernia. This study examines the behavior of two new suture materials, an elastic material, polyurethane (PUe), and a barbed polydioxanone (PDXb) suture thread in a rabbit model of midline incision closure. Methods Three 2-cm midline incisions were made in 68 New Zealand White rabbits. The incisions were closed by running suture using four 3/0 threads: polypropylene (PP) (Surgipro®, Covidien), PUe (Assuplus®, Assut Europe), PDX (Assufil®, Assut Europe) or PDXb (Filbloc®, Assut Europe). Animals in each suture group were euthanized 3 weeks and 6 months after surgery. Histological sections of the tissue-embedded sutures were subjected to morphological, collagen expression, macrophage response and uniaxial tensiometry studies. Results No signs of wound dehiscence or complications were observed. At 3 weeks, all sutures were surrounded by connective tissue composed mainly of collagen III. PUe showed greater collagen I expression than the other sutures. All sutures elicited a macrophage response that diminished from 3 weeks to 6 months (p < 0.001). This response was similar for the non-reabsorbable sutures (PP and PUe) yet PDXb showed a significantly greater response than the other reabsorbable suture (PDX) at 3 weeks (p < 0.01). At this early time point, the tensile strength of PUe was similar to that of control intact tissue (p > 0.05). Conclusion Three weeks after surgery, PUe revealed more collagen I deposition than the remaining materials and this translated to a similar biomechanical behavior to linea alba, that could avoid the appearance of short term dehiscences and thus reduce the incidence of incisional hernia. PDXb provides no additional advantages in their behavior regarding PDX suture. PMID:25231161

  13. The tibialis posterior tendon.

    PubMed

    Lhoste-Trouilloud, A

    2012-02-01

    The tibialis posterior tendon is the largest and anteriormost tendon in the medial ankle. It produces plantar flexion and supination of the ankle and stabilizes the plantar vault. Sonographic assessment of this tendon is done with high-frequency, linear-array transducers; an optimal examination requires transverse retromalleolar, longitudinal retromalleolar, and distal longitudinal scans, as well as dynamic studies. Disorders of the posterior tibial tendon include chronic tendinopathy with progressive rupture, tenosynovitis, acute rupture, dislocation and instability, enthesopathies. The most common lesion is a progressive "chewing gum" lesion that develops in a setting of chronic tendinopathy; it is usually seen in overweight women over 50 years of age with valgus flat feet. Medial ankle pain must also be carefully investigated, and the presence of instability assessed with dynamic maneuvers (forced inversion, or dorsiflexion) of the foot. Sonography plays an important role in the investigation of disorders involving the posterior tibial tendon.

  14. The influence of scleral flap thickness, shape, and sutures on intraocular pressure (IOP) and aqueous humor flow direction in a trabeculectomy model

    PubMed Central

    Samsudin, Amir; Eames, Ian; Brocchini, Steve; Khaw, Peng Tee

    2015-01-01

    Purpose IOP and aqueous humor flow direction determined by the scleral flap immediately after trabeculectomy are critical determinants of the surgical outcome. We used a large-scale model to objectively measure the influence of flap thickness and shape, and suture number and position on pressure difference across the flap and flow of fluid underneath it. Methods The model exploits the principle of dynamic and geometric similarity, so while dimensions were up to 30× greater than actual, the flow had similar properties. Scleral flaps were represented by transparent 0.8 and 1.6 mm thick silicone sheets on an acrylic plate. Dyed 98% glycerine, representing the aqueous humor was pumped between the sheet and plate, and the equilibrium pressure measured with a pressure transducer. Image analysis based on the principle of dye dilution was performed using MATLAB software. Results The pressure drop across the flap was larger with thinner flaps, due to reduced rigidity and resistance. Doubling the surface area of flaps and reducing the number of sutures from 5 to 3 or 2 also resulted in larger pressure drops. Flow direction was affected mainly by suture number and position, it was less towards the sutures and more towards the nearest free edge of the flap. Posterior flow of aqueous humor was promoted by placing sutures along the sides while leaving the posterior edge free. Conclusion We demonstrate a new physical model which shows how changes in scleral flap thickness and shape, and suture number and position affect pressure and flow in a trabeculectomy. PMID:26561421

  15. Posterior Fossa Tumors.

    PubMed

    Brandão, Lara A; Young Poussaint, Tina

    2017-02-01

    Pediatric brain tumors are the leading cause of death from solid tumors in childhood. The most common posterior fossa tumors in children are medulloblastoma, atypical teratoid/rhabdoid tumor, cerebellar pilocytic astrocytoma, ependymoma, and brainstem glioma. Location, and imaging findings on computed tomography (CT) and conventional MR (cMR) imaging may provide important clues to the most likely diagnosis. Moreover, information obtained from advanced MR imaging techniques increase diagnostic confidence and help distinguish between different histologic tumor types. Here we discuss the most common posterior fossa tumors in children, including typical imaging findings on CT, cMR imaging, and advanced MR imaging studies.

  16. Posterior crossbites in children.

    PubMed

    Zhu, J F; Crevoisier, R; King, D L; Henry, R; Mills, C M

    1996-11-01

    Posterior crossbite, the most common malocclusion in young children, can be caused by a variety of skeletal, muscular, or dental factors. This condition produces insufficient maxillary arch width and is frequently associated with various oral sucking and postural habits. If left untreated, this problem can result in adverse skeletal growth changes. Various mechanical treatment modalities designed to expand the posterior maxillary arch width are available to correct this problem. The appropriate treatment method depends on the patient's age and level of cooperation as well as the determined etiology of the constriction.

  17. Interdomal Suture through a Nondelivery Endonasal Approach: A New Technique

    PubMed Central

    Leibou, Lior

    2016-01-01

    Background: The use of interdomal sutures for tip refinement is common in open rhinoplasty and in endonasal rhinoplasty using a delivery technique, but there is paucity of reports in the literature regarding the use of interdomal suturing techniques when the nondelivery endonasal approach is chosen. Objective: The authors describe a technique designed to refine the nasal tip with an interdomal suture placed through a nondelivery endonasal approach. Methods: In this study, the authors retrospectively review the cases of 45 patients who underwent endonasal rhinoplasty with the authors’ interdomal suturing technique between the years 2011 and 2013. The average age of the patients was 25.3 years. Intercrural sutures (PDS 4.0 straight needle, Cincinnati, Ohio) were placed as mattress-like suture in the tip region, with the knot buried between both alar cartilages. The suture is tightened progressively according to the tip definition and narrowing sought. Results: The patients were followed for 12 months. All of the patients demonstrated a significant reduction in lobule and tip widths. This series had only 1 complication of tip asymmetry that was revised 1 year after the initial operation. There were no cases of infection, allergic reaction, or extrusion of the suture. Conclusions: Despite the lack of a large volume of patients, our study confirms that this technique is indeed an attractive and highly predictable option for achieving adequate tip refinement and definition when using a nondelivery endonasal rhinoplasty. PMID:27622086

  18. Structural grafts and suture techniques in functional and aesthetic rhinoplasty

    PubMed Central

    Gassner, Holger G.

    2011-01-01

    Rhinoplasty has undergone important changes. With the advent of the open structure approach, requirements for structural grafting and direct manipulation of the cartilaginous skeleton through suture techniques have increased substantially. The present review analyzes the current literature on frequently referenced structural grafts and suture techniques. Individual techniques are described and their utility is discussed in light of available studies and data. PMID:22073105

  19. Cataract Section Across Temporary Stainless-Steel Sutures

    PubMed Central

    MacDonald, R. Keith

    1965-01-01

    The purpose of the technique described was to combine the advantages of a cleanedged Graefe-knife incision with those of safety and near-perfect apposition offered by preplaced sutures: a preliminary to cataract extraction. Uncuttable preplaced 2-mm. stainless steel sutures were finally replaced after completion of the incision by attached braided silk for closure purposes. PMID:14291461

  20. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture...

  1. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture...

  2. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture...

  3. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture...

  4. 21 CFR 882.4650 - Neurosurgical suture needle.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical suture needle. 882.4650 Section 882.4650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture...

  5. Nose tip refinement using interdomal suture in caucasian nose

    PubMed Central

    Pasinato, Rogério; Mocelin, Marcos; Berger, Cezar Augusto Sarraf

    2012-01-01

    Summary Introduction: Refinement of the nose tip can be accomplished by a variety of techniques, but currently, the use of sutures in the nasal tip with conservative resection of the alar cartilage is the most frequently recommended approach. Objective: To classify the nasal tip and to demonstrate the interdomal suture applied to nasal tip refinement in the Caucasian nose, as well as to provide a simple and practical presentation of the surgical steps. Method: Development of surgical algorithm for nasal tip surgery: 1. Interdomal suture (double binding suture), 2. Interdomal suture with alar cartilage weakening (cross-hatching), 3. Interdomal suture with cephalic removal of the alar cartilage (McIndoe technique) based on the nasal tip type classification. This classification assesses the interdomal distance (angle of domal divergence and intercrural distance), domal arch width, cartilage consistency, and skin type. Interdomal suture is performed through endonasal rhinoplasty by basic technique without delivery (Converse-Diamond technique) under local anesthesia. Conclusion: This classification is simple and facilitates the approach of surgical treatment of the nasal tip through interdomal suture, systematizing and standardizing surgical maneuvers for better refinement of the Caucasian nose. PMID:25991963

  6. 21 CFR 878.4930 - Suture retention device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention...

  7. 21 CFR 878.4930 - Suture retention device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention...

  8. 21 CFR 878.4930 - Suture retention device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention...

  9. 21 CFR 878.4930 - Suture retention device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention...

  10. 21 CFR 878.4930 - Suture retention device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention...

  11. Biomechanical evaluation of tibial eminence fractures using suture fixation.

    PubMed

    Aoki, Stephen K; Curtis, Stuart H

    2011-12-06

    This study evaluates the initial fixation strength of tibial eminence fracture repair using 1, 2, 3, and 4 sutures to determine the optimal number of sutures required to adequately secure the avulsed fragment to the tibia. Sixteen skeletally immature porcine knees were stripped of all soft tissues, isolating the femur-anterior cruciate ligament (ACL)-tibia complex. Type III tibial eminence fractures were simulated in the specimens, and each specimen was randomly assigned to a repair group using 1, 2, 3, or 4 #2 FiberWire sutures (Arthrex, Inc, Naples, Florida). Initial fixation strength of the repair was measured by single cycle pull to failure testing using a materials testing machine (Instron, Norwood, Massachusetts). The mean ultimate failure force during anterior tibial translation was 389±128, 627±66, 703±77, and 802±29 N for 1, 2, 3, and 4 sutures, respectively. The lower limit of the 95% confidence interval was >500 N (estimated force of native ACL during activities of daily living) for each group with ≥2 sutures. In this study, at least 2 high-strength sutures were needed for tibial eminence fracture repairs to withstand potential forces seen across the ACL in the postoperative period. Suture fixation of tibial eminence fractures is a reproducible method requiring a minimum of 2 high-strength polyester sutures to resist forces seen during early rehabilitation.

  12. Tibialis Posterior Tendon Entrapment Within Posterior Malleolar Fracture Fragment.

    PubMed

    Fantry, Amanda; Lareau, Craig; Vopat, Bryan; Blankenhorn, Brad

    2016-01-01

    Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. In this article, we report a case of tibialis posterior tendon entrapment within a posterior malleolus fracture, as identified by arthroscopy and managed with open reduction. Tibialis posterior tendon entrapment within a posterior malleolus has not been previously reported. Ankle arthroscopy for posterior malleolus fractures provides an opportunity to identify soft-tissue or tendinous entrapment, articular surface reduction, and articular cartilage injuries unlikely to be identified with fluoroscopy alone and should be considered in reduction and fixation of posterior malleolus fractures.

  13. CONTINUOUS ROTATION SCATTERING CHAMBER

    DOEpatents

    Verba, J.W.; Hawrylak, R.A.

    1963-08-01

    An evacuated scattering chamber for use in observing nuclear reaction products produced therein over a wide range of scattering angles from an incoming horizontal beam that bombards a target in the chamber is described. A helically moving member that couples the chamber to a detector permits a rapid and broad change of observation angles without breaching the vacuum in the chamber. Also, small inlet and outlet openings are provided whose size remains substantially constant. (auth)

  14. Two chamber reaction furnace

    DOEpatents

    Blaugher, Richard D.

    1998-05-05

    A vertical two chamber reaction furnace. The furnace comprises a lower chamber having an independently operable first heating means for heating the lower chamber and a gas inlet means for admitting a gas to create an ambient atmosphere, and an upper chamber disposed above the lower chamber and having an independently operable second heating means for heating the upper chamber. Disposed between the lower chamber and the upper chamber is a vapor permeable diffusion partition. The upper chamber has a conveyor means for conveying a reactant there through. Of particular importance is the thallinating of long-length thallium-barium-calcium-copper oxide (TBCCO) or barium-calcium-copper oxide (BCCO) precursor tapes or wires conveyed through the upper chamber to thereby effectuate the deposition of vaporized thallium (being so vaporized as the first reactant in the lower chamber at a temperature between about 700.degree. and 800.degree. C.) on TBCCO or BCCO tape or wire (the second reactant) at its simultaneous annealing temperature in the upper chamber of about 800.degree. to 950.degree. C. to thereby replace thallium oxide lost from TBCCO tape or wire because of the high annealing temperature or to deposit thallium on BCCO tape or wire. Continuously moving the tape or wire provides a single-step process that effectuates production of long-length TBCCO superconducting product.

  15. Two chamber reaction furnace

    DOEpatents

    Blaugher, R.D.

    1998-05-05

    A vertical two chamber reaction furnace is described. The furnace comprises a lower chamber having an independently operable first heating means for heating the lower chamber and a gas inlet means for admitting a gas to create an ambient atmosphere, and an upper chamber disposed above the lower chamber and having an independently operable second heating means for heating the upper chamber. Disposed between the lower chamber and the upper chamber is a vapor permeable diffusion partition. The upper chamber has a conveyor means for conveying a reactant there through. Of particular importance is the thallinating of long-length thallium-barium-calcium-copper oxide (TBCCO) or barium-calcium-copper oxide (BCCO) precursor tapes or wires conveyed through the upper chamber to thereby effectuate the deposition of vaporized thallium (being so vaporized as the first reactant in the lower chamber at a temperature between about 700 C and 800 C) on TBCCO or BCCO tape or wire (the second reactant) at its simultaneous annealing temperature in the upper chamber of about 800 to 950 C to thereby replace thallium oxide lost from TBCCO tape or wire because of the high annealing temperature or to deposit thallium on BCCO tape or wire. Continuously moving the tape or wire provides a single-step process that effectuates production of long-length TBCCO superconducting product. 2 figs.

  16. Development of Absorbable, Antibiotic-Eluting Sutures for Ophthalmic Surgery

    PubMed Central

    Kashiwabuchi, Fabiana; Parikh, Kunal S.; Omiadze, Revaz; Zhang, Shuming; Luo, Lixia; Patel, Himatkumar V.; Xu, Qingguo; Ensign, Laura M.; Mao, Hai-Quan; Hanes, Justin; McDonnell, Peter J.

    2017-01-01

    Purpose To develop and evaluate an antibiotic-eluting suture for ophthalmic surgery. Methods Wet electrospinning was used to manufacture sutures composed of poly(L-lactide), polyethylene glycol (PEG), and levofloxacin. Size, morphology, and mechanical strength were evaluated via scanning electron microscopy and tensile strength, respectively. In vitro drug release was quantified using high performance liquid chromatography. In vitro suture activity against Staphylococcus epidermidis was investigated through bacterial inhibition studies. Biocompatibility was determined via histological analysis of tissue sections surrounding sutures implanted into Sprague-Dawley rat corneas. Results Sutures manufactured via wet electrospinning were 45.1 ± 7.7 μm in diameter and 0.099 ± 0.007 newtons (N) in breaking strength. The antibiotic release profile demonstrated a burst followed by sustained release for greater than 60 days. Increasing PEG in the polymer formulation, from 1% to 4% by weight, improved drug release without negatively affecting tensile strength. Sutures maintained a bacterial zone of inhibition for at least 1 week in vitro and elicited an in vivo tissue reaction comparable to a nylon suture. Conclusions There is a need for local, postoperative delivery of antibiotics following ophthalmic procedures. Wet electrospinning provides a suitable platform for the development of sutures that meet size requirements for ophthalmic surgery and are capable of sustained drug release; however, tensile strength must be improved prior to clinical use. Translational Relevance No antibiotic-eluting suture exists for ophthalmic surgery. A biocompatible, high strength suture capable of sustained antibiotic release could prevent ocular infection and preclude compliance issues with topical eye drops. PMID:28083445

  17. Strain in the Braincase and Its Sutures During Function

    PubMed Central

    Herring, Susan W.; Teng, Shengyi

    2010-01-01

    The skull is distinguished from other parts of the skeleton by its composite construction. The sutures between bony elements provide for interstitial growth of the cranium, but at the same time they alter the transmission of stress and strain through the skull. Strain gages were bonded to the frontal and parietal bones of miniature pigs and across the interfrontal, interparietal and coronal sutures. Strains were recorded 1) during natural mastication in conjunction with electromyographic activity from the jaw muscles and 2) during stimulation of various cranial muscles in anesthetized animals. Vault sutures exhibited vastly higher strains than did the adjoining bones. Further, bone strain primarily reflected torsion of the braincase set up by asymmetrical muscle contraction; the tensile axis alternated between +45° and −45° depending on which diagonal masseter/temporalis pair was most active. However, suture strains were not related to overall torsion but instead were responses to local muscle actions. Only the coronal suture showed significant strain (tension) during jaw opening; this was caused by the contraction of neck muscles. All sutures showed strain during jaw closing, but polarity depended on the pattern of muscle usage. For example, masseter contraction tensed the coronal suture and the anterior part of the interfrontal suture, whereas the temporalis caused compression in these locations. Peak tensile strains were larger than peak compressive strains. Histology suggested that the skull is bent at the sutures, with the ectocranial surface tensed and the endocranial surface predominantly compressed. Collectively, these results indicate that skulls with patent sutures should be analyzed as complexes of independent parts rather than solid structures. PMID:10918130

  18. Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography

    PubMed Central

    SALGUEIRO, Daniel Gomes; RODRIGUES, Vitor Hugo Leite de Oliveira; TIEGHI, Victor; de MENEZES, Carolina Carmo; GONÇALES, Eduardo Sanches; FERREIRA, Osny

    2015-01-01

    Surgically assisted rapid maxillary expansion (SARME) is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial. Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME) through cone beam computed tomography (CBCT). Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days) through CBCT. Results Type I opening pattern (from anterior to posterior nasal spine) occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture) occurred in 2 individuals. The 180-day postoperative mean (PO 180) of bone density value was 49.9% of the preoperative mean (Pre) value. Conclusions The opening pattern of midpalatal suture is more related to patients’ age (23.9 years in type I and 33.5 years in type II) and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days). PMID:26398512

  19. Pars plana suture fixation for intraocular lenses dislocated into the vitreous cavity using a closed-eye cow-hitch technique.

    PubMed

    Nakashizuka, Hiroyuki; Shimada, Hiroyuki; Iwasaki, Yutaka; Matsumoto, Yoko; Sato, Yukihiro

    2004-02-01

    We describe a modified intraocular cow-hitch technique for pars plana suture fixation of intraocular lenses (IOLs) that dislocated into the vitreous cavity in 3 patients who had a 3-port vitrectomy and IOL implantation because of retinal disease. To reposition the dislocated IOL after the residual vitreous was removed, 2 additional sclerotomies for suture fixation were made 3.0 mm posterior to the limbus. A loop (cow-hitch knot) was made with 10-0 polypropylene for suture fixation. After the neck of the cow-hitch loop was grasped with an intraocular forceps, the loop was used to lasso a haptic of the dislocated IOL, which was then pulled forward to the sclerotomy. The same procedure was used for the other haptic, and both sutures were secured to the sclera under scleral flaps. In all patients, the dislocated IOLs were repositioned without the need for extraction. The procedures were uneventful. Pars plana suture fixation with the intraocular cow-hitch technique can be used to reposition an IOL that has dislocated into the vitreous cavity.

  20. Microbiological Evaluation of Suture Items Before Radiation Sterilization

    PubMed Central

    Österberg, Bertil O.

    1973-01-01

    Microbiological contamination levels of suture samples taken at various stages of the manufacturing process in a new hygienically controlled plant were determined by employing a membrane filturation technique. Both raw material and materials handled manually in the production process were tested to assess the effect of manual handling on the product contamination level. Evaluation of the efficacy of contamination control, however, was directed primarily to the finished, packaged products, just prior to the processing with cobalt 60. The suture material for testing was divided into two groups, namely, wet and dry products, the wet being packaged in a special „tubing” fluid consisting mainly of isopropyl alcohol. Initial contamination results are reported as the average of values obtained on the test day and the preceding 9 consecutive production days. A total of 1,787 suture samples tested in the dry group showed daily averages varying between 2.1 and 14.8 contaminants per suture. The 2,980 wet-packaged suture samples tested gave daily averages varying from 0.7 to 4.2 contaminants per suture. The highest values obtained for an individual suture were 400 for the dry and 89 for the wet. Identification studies of the contaminants revealed that fungi predominated. Most of the bacterial contaminants proved to be spore-forming rods. PMID:4751791

  1. Interlocking circumareolar suture with undyed polyamide thread: a personal experience.

    PubMed

    Salgarello, Marzia; Visconti, Giuseppe; Barone-Adesi, Liliana

    2013-10-01

    In plastic breast surgery, the interlocking areolar suture has gained wide popularity since its introduction in 2007 by Hammond and colleagues. The interlocking circumareolar suture plays its role in the setting of circumareolar excisions to achieve a durable areola shaping and to prevent scar widening/hypertrophy and areola spreading/distortion. This study retrospectively reviewed 49 breasts that underwent interlocking suture after July 2011 for both aesthetic and reconstructive indications. For the suturing, 3-0 undyed polyamide thread with a straight cutting needle (Dafilon; B. Braun Melsungen AG, Melsungen, Germany) was used. This suture material was preferred to Gore-Tex reported by Hammond and colleagues because it is undyed without any microporous configuration, more wieldy, and less expensive. All 49 breasts showed good results in terms of areola shaping and diameter control as well as good scar quality during a mean follow-up period of 12 months (range 2-18 months) (Fig. 2). No infection, suture extrusion, skin fistula, or granuloma were experienced. The suture was not visible at all, and the patients did not report its palpability. However, at careful examination, the thread resulted slightly palpable.

  2. Barbed suture for gastrointestinal closure: a randomized control trial.

    PubMed

    Demyttenaere, Sebastian V; Nau, Peter; Henn, Matthew; Beck, Catherine; Zaruby, Jeffrey; Primavera, Michael; Kirsch, David; Miller, Jeffrey; Liu, James J; Bellizzi, Andrew; Melvin, W Scott

    2009-09-01

    In an effort to make laparoscopic suturing more efficient, the V-Loc advanced wound closure device (Covidien, Mansfield, MA) has been produced. This device is a self-anchoring barbed suture that obviates the need for knot tying. The goal of this initial feasibility study was to investigate the use of the barbed suture in gastrointestinal enterotomy closure. A randomized study of 12 pigs comparing enterotomy closure with barbed versus a nonbarbed suture of similar tensile strength was performed. To this end, 25 mm enterotomies were made in the stomach (1 control, 1 treatment), jejunum (2 controls, 2 treatments), and descending colon (1 control, 1 treatment). Animals were killed at 3, 7, and 14 days postoperatively (4 each group) and their gastrointestinal tracts harvested; 6 of the 8 enterotomies from each pig underwent burst strength testing. The remaining 2 were fixed in formalin and sent for histological examination. All 12 pigs survived until they were killed without any major complications. Enterotomy closure with barbed suture revealed adhesion scores, burst strength pressures, and histology scores that were similar to those for the control. Jejunal closures resulted in 6 failures at 7 days (3 control, 3 barbed) and 4 failures at 14 days (2 control, 2 barbed). The barbed suture significantly reduced suturing time in the stomach, jejunum, and colon. The V-Loc wound closure device appears to offer comparable gastrointestinal closure to 3-0 Maxon while being significantly faster. Further studies with V-Loc are required to assess its use in laparoscopic surgery.

  3. No mortality or pancreatic fistula after full-thickness suture pancreaticogastrostomy in 39 patients who underwent pancreaticoduodenectomy.

    PubMed

    Fatih, Ozdemir; Adil, Baskiran; Cengiz, Ara; Mustafa, Ates; Sagir, Kahraman Ayşegul; Maras, Ozdemir Zeynep; Sezai, Yilmaz

    2015-02-01

    Pancreaticoduodenectomy is considered the standard operation for periampullary tumors. Despite major advances in pancreatic surgery, pancreatic fistula is still an important cause of morbidity and mortality after pancreaticoduodenectomy. Meticulous surgical technique and proper reconstruction of the pancreas are essential to prevent pancreatic fistula. Pancreaticogastrostomy is a safe method for reconstruction of the pancreas after pancreaticoduodenectomy. Regardless of pancreatic texture or duct diameter, the reconstruction is performed by passing full-thickness sutures through both the anterior and posterior sides of the pancreas. In this study, we report 39 cases of reconstruction with pancreaticogastrostomy after pancreaticoduodenectomy without mortality or pancreatic fistula.

  4. Early weightbearing using Achilles suture bridge technique for insertional Achilles tendinosis: a review of 43 patients.

    PubMed

    Rigby, Ryan B; Cottom, James M; Vora, Anand

    2013-01-01

    Posterior heel pain caused by insertional Achilles tendinosis can necessitate surgical intervention when recalcitrant to conservative care. Surgical treatment can necessitate near complete detachment of the Achilles tendon to fully eradicate the offending pathologic features and, consequently, result in long periods of non-weightbearing. A suture bridge technique using bone anchors is available for reattachment of the Achilles tendon. This provides restoration of the Achilles footprint on the calcaneus, including not only contact, but also actual pressure between the tendon and bone. We performed a review of 43 patients who underwent surgical treatment of insertional Achilles tendinosis with reattachment of the Achilles tendon using the suture bridge technique. The mean age was 53 (range 29 to 87) years. The mean follow-up period was 24 (range 13 to 52) months. The mean postoperative American Orthopaedic Foot and Ankle Society score was 90 (range 65 to 100). The mean preoperative visual analog scale pain score was 6.8 (range 2 to 10) and the mean postoperative visual analog scale pain score was 1.3 (range 0 to 6). The mean interval to weightbearing was 10 (range 0 to 28) days. No postoperative ruptures occurred. Of the 43 patients, 42 (97.6%) successfully performed the single heel rise test at the final postoperative visit. Concomitant procedures were performed in 35 patients, including 33 (77%) requiring open gastrocnemius recession and 2 (5%) requiring flexor hallucis longus tendon transfer. A total of 42 patients (97.6%) returned to regular shoe gear, and 42 (97.6%) returned to their activities of daily living, including running for 20 athletic patients (100%). Complications included postoperative wound dehiscense requiring surgical debridement in 2 patients (5%) and soft tissue infection requiring antibiotics and surgical debridement in 1 (2%) patient. Our findings support using the Achilles tendon suture bridge for reattachment of the Achilles tendon in the

  5. Effects of BMP-12-Releasing Sutures on Achilles Tendon Healing

    PubMed Central

    Chamberlain, Connie S.; Lee, Jae-Sung; Leiferman, Ellen M.; Maassen, Nicholas X.; Baer, Geoffrey S.

    2015-01-01

    Tendon healing is a complex coordinated event orchestrated by numerous biologically active proteins. Unfortunately, tendons have limited regenerative potential and as a result, repair may be protracted months to years. Current treatment strategies do not offer localized delivery of biologically active proteins, which may result in reduced therapeutic efficacy. Surgical sutures coated with nanostructured minerals may provide a potentially universal tool to efficiently incorporate and deliver biologically active proteins directly to the wound. Additionally, previous reports indicated that treatment with bone morphogenetic protein-12 (BMP-12) improved tendon healing. Based on this information, we hypothesized that mineral-coated surgical sutures may be an effective platform for localized BMP-12 delivery to an injured tendon. The objective of this study was, therefore, to elucidate the healing effects of mineral-coated sutures releasing BMP-12 using a rat Achilles healing model. The effects of BMP-12-releasing sutures were also compared with standard BMP-12 delivery methods, including delivery of BMP-12 through collagen sponge or direct injection. Rat Achilles tendons were unilaterally transected and repaired using BMP-12-releasing suture (0, 0.15, 1.5, or 3.0 μg), collagen sponge (0 or 1.5 μg BMP-12), or direct injection (0 or 1.5 μg). By 14 days postinjury, repair with BMP-12-releasing sutures reduced the appearance of adhesions to the tendon and decreased total cell numbers. BMP-12 released from sutures and collagen sponge also tended to improve collagen organization when compared with BMP-12 delivered through injection. Based on these results, the release of a protein from sutures was able to elicit a biological response. Furthermore, BMP-12-releasing sutures modulated tendon healing, and the delivery method dictated the response of the healing tissue to BMP-12. PMID:25354567

  6. Posterior Circulation Ischemic Stroke.

    PubMed

    Go, Steven

    2015-01-01

    Approximately 20-25% of all acute strokes occur in the posterior circulation. These strokes can be rather difficult to diagnose because they present in such diverse ways, and can easily be mistaken for more benign entities. A fastidious history, physical exam, high clinical suspicion, and appropriate use of imaging are essential for the emergency physician to properly diagnose and treat these patients. Expert stroke neurologist consultation should be utilized liberally.

  7. A Case of Intraocular Erosion and Intrusion by an Arruga Suture

    PubMed Central

    Kitagaki, Takakuni; Morishita, Seita; Kohmoto, Ryohsuke; Fukumoto, Masanori; Suzuki, Hiroyuki; Sato, Takaki; Kobayashi, Takatoshi; Kida, Teruyo; Nakajima, Masayuki; Ikeda, Tsunehiko

    2016-01-01

    Purpose To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs. PMID:27099609

  8. The Paleotethys suture in Central Iran

    NASA Astrophysics Data System (ADS)

    Bagheri, S.; Stampfli, G. M.

    2003-04-01

    The Triassic rocks of the Nakhlak area have been used to justify the hypothesis of the rotation of the Central-East Iranian microplate, mainly based on paleomagnetic data. Davoudzadeh and his coworkers (1981) pointed out the existing contrast between the Nakhlakh succession and the time-equivalent lithostratigraphic units exposed in the surrounding regions and compared them with the Triassic rocks of the Aghdarband area on the southern edge of the Turan plate. We recently gathered evidences that this part of central Iran effectively belongs to the Northern Iranian Paleo-Tethys suture zone and related Variscan terrains of the Turan plate. This is the case for the northwestern part of central Iran, where the Anarak-Khur belt (Anarak schists and their thick Cretaceous-Paleocene sedimentary cover) presents all the elements of an orogenic zone such as dismembered ophiolites and silisiclastics, calcareous and volcanic cover which has been deformed and metamorphosed. This belt is separated to the northwest from the Alborz microcontinent by the Great Kavir fault and Cretaceous ophiolite mélanges. To the southeast it is bounded by the Biabanak fault and serpentinites and the Biabanak block, part of the central-east Iranian plate. The later zone is formed by Proterozoic metamorphic basement and marine sedimentary cover, nearly continuous from the Ordovician to the Triassic, at the uppermost part upper Triassic-lower Jurassic bauxites and silisiclastics are observed. Excepted the Ordovician angular unconformities and the boundary between lower Jurassic and younger layers, this sequence displays no significant main unconformities and can be attributed to the Cimmerian super-terrain. Thus, this sequences represents the classical evolution of the southern Paleo-Tethys passive margin, as found in the Alborz microcontinent or the Band-e Bayan zone of Afghanistan and is the witness of large scale duplication of the Paleo-Tethys suture zone through major Alpine strike-slip faults

  9. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures.

    PubMed

    Dhom, Jonas; Bloes, Dominik A; Peschel, Andreas; Hofmann, Ulf Krister

    2016-05-21

    Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (P <.001), but 1.4 times larger than on Ethilon II (P <.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. This article is protected by copyright. All rights reserved.

  10. Cranial Osteogenesis and Suture Morphology in Xenopus laevis: A Unique Model System for Studying Craniofacial Development

    PubMed Central

    Slater, Bethany J.; Liu, Karen J.; Kwan, Matthew D.; Quarto, Natalina; Longaker, Michael T.

    2009-01-01

    Background The tremendous diversity in vertebrate skull formation illustrates the range of forms and functions generated by varying genetic programs. Understanding the molecular basis for this variety may provide us with insights into mechanisms underlying human craniofacial anomalies. In this study, we provide evidence that the anuran Xenopus laevis can be developed as a simplified model system for the study of cranial ossification and suture patterning. The head structures of Xenopus undergo dramatic remodelling during metamorphosis; as a result, tadpole morphology differs greatly from the adult bony skull. Because of the extended larval period in Xenopus, the molecular basis of these alterations has not been well studied. Methodology/Principal Findings We examined late larval, metamorphosing, and post-metamorphosis froglet stages in intact and sectioned animals. Using micro-computed tomography (μCT) and tissue staining of the frontoparietal bone and surrounding cartilage, we observed that bone formation initiates from lateral ossification centers, proceeding from posterior-to-anterior. Histological analyses revealed midline abutting and posterior overlapping sutures. To determine the mechanisms underlying the large-scale cranial changes, we examined proliferation, apoptosis, and proteinase activity during remodelling of the skull roof. We found that tissue turnover during metamorphosis could be accounted for by abundant matrix metalloproteinase (MMP) activity, at least in part by MMP-1 and -13. Conclusion A better understanding of the dramatic transformation from cartilaginous head structures to bony skull during Xenopus metamorphosis may provide insights into tissue remodelling and regeneration in other systems. Our studies provide some new molecular insights into this process. PMID:19156194

  11. Suture-Only Repair Versus Suture Anchor–Augmented Repair for Achilles Tendon Ruptures With a Short Distal Stump

    PubMed Central

    Boin, Michael A.; Dorweiler, Matthew A.; McMellen, Christopher J.; Gould, Gregory C.; Laughlin, Richard T.

    2017-01-01

    Background: Chronic noninsertional Achilles tendinosis can result in an acute Achilles tendon rupture with a short distal stump. In such tendon ruptures, there is a limited amount of adequate tissue that can hold suture, thus presenting a challenge for surgeons who elect to treat the rupture operatively. Hypothesis: Adding suture anchors to the repair construct may result in biomechanically stronger repairs compared with a suture-only technique. Study Design: Controlled laboratory study. Methods: Nine paired Achilles-calcaneus complexes were harvested from cadavers. An artificial Achilles rupture was created 2 cm proximal to the insertion on the calcaneus. One specimen from each cadaver was assigned to a suture-only or a suture anchor–augmented repair. The contralateral specimen of the same cadaver received the opposing repair. Cyclic testing was then performed at 10 to 100 N for 2000 cycles, and load-to-failure testing was performed at 0.2 mm/s. This was followed by analysis of repair displacement, gapping at repair site, peak load to failure, and failure mode. Results: The suture anchor–augmented repair exhibited a 116% lower displacement compared with the suture-only repair (mean ± SD, 1.54 ± 1.13 vs 3.33 ± 1.47 mm, respectively; P < .03). The suture anchor–augmented repair also exhibited a 45% greater load to failure compared with the suture-only repair (303.50 ± 102.81 vs 209.09 ± 48.12 N, respectively; P < .04). Conclusion: Suture anchor–augmented repairs performed on acute Achilles tendon ruptures with a short distal stump are biomechanically stronger than suture-only repairs. Clinical Relevance: Our results support the use of suture anchor–augmented repairs for a biomechanically stronger construct in Achilles tendon ruptures with a short distal stump. Biomechanically stronger repairs may lead to less tendon repair gapping and failure, increasing the ability to start early active rehabilitation protocols and thus improving patient outcomes

  12. Posterior capsule opacification and neovascularization treated with intravitreal bevacizumab and Nd:YAG capsulotomy

    PubMed Central

    Sánchez-Castro, Grimelda Yuriana; Hitos-Fájer, Alejandra; Mendoza-Schuster, Erick; Velez-Montoya, Raul; Velasco-Barona, Cecilio Francisco

    2008-01-01

    We reported a 75-year-old diabetic man, who developed opacification and neovascularization of the posterior capsule after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient was treated with two injections of 2.5 mg of intravitreal bevacizumab. The treatment produced an important regression of the posterior capsular new vessels, allowing us to perform a successful Nd:YAG capsulotomy, clearing the visual axis and improving the visualization of the posterior pole. Even though, best corrected visual acuity was 20/200 due to diabetic macular edema. PMID:19668770

  13. Modeling of Needle-Tissue Interaction Forces During Surgical Suturing

    PubMed Central

    Jackson, Russell C.; Çavuşoğlu, M. Cenk

    2013-01-01

    This paper presents a model of needle tissue interaction forces that a rigid suture needle experiences during surgical suturing. The needle-tissue interaction forces are modeled as the sum of lumped parameters. The model has three main components; friction, tissue compression, and cutting forces. The tissue compression force uses the area that the needle sweeps out during a suture to estimate both the force magnitude and force direction. The area that the needle sweeps out is a direct result of driving the needle in a way that does not follow the natural curve of the needle. The friction force is approximated as a static friction force along the shaft of the needle. The cutting force acts only on the needle tip. The resulting force and torque model is experimentally validated using a tissue phantom. These results indicate that the proposed lumped parameter model is capable of accurately modeling the forces experienced during a suture. PMID:24683499

  14. Use of absorbable sutures in canine carotid arteries.

    PubMed

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

    1990-01-01

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

  15. Corneoscleral abscess resulting from a broken suture after cataract surgery.

    PubMed

    Cameron, J A; Huaman, A

    1994-01-01

    An 82-year-old man had pain and decreased vision in his right eye 15 months after uncomplicated cataract surgery. Examination revealed a large corneoscleral abscess with a 2 mm x 1 mm area of fluorescein staining at the base of a broken protruding 10-0 nylon suture. Streptococcus pneumoniae was isolated from both the suture and base of the ulcer. Despite intensive topical, subconjunctival, and systemic antibiotics, a large corneal perforation developed, necessitating a 10 mm tectonic penetrating keratoplasty. Long-term follow-up of patients after cataract surgery is important and should include an inspection of the limbal wound and removal of loose or broken exposed sutures. Suture-related complications will be eliminated if clinical studies prove the safety and efficacy of sutureless cataract surgery.

  16. [Pilot study on facial palsy correction with suture suspension].

    PubMed

    Navarrete Álvaro, María Luisa; Knäpper, Jennifer; Boemo, Rafael; Torrent, Lluisa

    2011-01-01

    We present a pilot study to evaluate the benefit of static facial suspension with Silhouette sutures. We operated on a female patient with complete facial palsy secondary to otic tuberculosis. The patient has currently achieved satisfactory facial symmetry, mastication and speech production. As a result, self-esteem and social interaction have also been recovered. Static facial suspension with Silhouette sutures is an alternative to dynamic techniques in patients who do not wish to or cannot undergo those more complex surgeries.

  17. Bacterial Adherence to High Tensile-Strength Sutures.

    DTIC Science & Technology

    2011-06-01

    system. In addition, suture an- chors are typically preloaded with No. 2 sutures. Bioluminescent Bacteria The bacterial broth prepared for this... bacteria strain are genetically engineered to emit photons, allowing for quantification with a photon-counting camera sys- tem. Bioluminescent bacteria ... bioluminescent in vitro model. Methods: Eleven strands each of No. 2 MaxBraid (Arthrotek [Biomet], Warsaw, IN), FiberWire (Arthrex, Naples, FL), Ethibond

  18. Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives.

    PubMed

    Günaydın, Rıza Önder; Aygenc, Erdinc; Karakullukcu, Selma; Fidan, Fatih; Celikkanat, Serdar

    2011-08-01

    The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores, follow-up times in post-anaesthesia care unit (PACU), pain scores, and postoperative complications. Two hundred patients who underwent septoplasty from January 2009 to October 2009 were randomly assigned either to have nasal packs (n: 100) or transeptal sutures (n: 100). In the transseptal suture group, extubation was easier and PACU follow-up times were shorter, when compared to the nasal packing group (p < 0.001). Patients with nasal packing had significantly higher pain scores (p < 0.001). Minor bleeding was significantly higher in the transseptal group with seven cases, compared to the nasal packing group without any bleeding cases (p = 0.014). There were two patients who had postoperative major bleeding, and two patients who had septal hematoma in the transseptal suture group. One patient with nasal packing had postoperative infection. Septal perforation was not seen in any of the cases. While patients in both groups experienced postoperative crusting, patients in the transseptal suture group also complained about foreign body sensation. Extubation was more comfortable; post-anaesthesia monitorization duration was shorter, and postoperative pain was less, but minor bleeding was seen more with transseptal sutures. There was no significant difference in terms of major bleeding, hematoma, infection or perforation. Foreign body sensation was the main cause of postoperative discomfort in the transseptal suture group. Transseptal suturing might be a significantly comfortable, cost-effective and reliable alternative to nasal packing.

  19. New Pattern of Sutural Synostosis Associated With TWIST Gene Mutation and Saethre-Chotzen Syndrome: Peace Sign Synostosis.

    PubMed

    Tahiri, Youssef; Bastidas, Nicholas; McDonald-McGinn, Donna M; Birgfeld, Craig; Zackai, Elaine H; Taylor, Jesse; Bartlett, Scott P

    2015-07-01

    The authors present a new and unique pattern of sutural fusion "peace sign synostosis" (PSS) characterized by synostosis of the metopic, bicoronal, and sagittal sutures and associated with abnormalities of the TWIST1 gene known to be associated with Saethre-Chotzen syndrome (SCS). To do so, we performed a retrospective review of patients with bicoronal, metopic, and at least partial anterior sagittal synostoses at the Children's Hospital of Philadelphia and Seattle Children's Hospital. Patients' demographics, genetic analysis, perioperative and clinic notes were reviewed. Five patients were identified with PSS and abnormalities of TWIST1 consistent with SCS. One patient, with the longest follow-up of 7 years, underwent 5 intracranial procedures and required a ventriculoperitoneal (VP) shunt. The remaining 4 patients underwent posterior cranial vault distraction as the initial procedure, followed by anterior cranial vault remodeling. Two patients required a VP shunt. To conclude, synostosis of the metopic, bicoronal, and sagittal sutures (PSS) appears to be associated with SCS and produces a characteristic skull morphology that can be readily identified on physical examination. Early data suggest a high rate of reoperation, increased necessity for a VP shunt, and potential complications. Of note, this novel phenotype had not been previously observed at our respective institutions, reported in the literature, or observed in association with TWIST1 abnormalities as described in association with SCS.

  20. Posterior interosseous neuropathy

    PubMed Central

    Kele, Henrich; Xia, Annie; Weiler, Markus; Schwarz, Daniel; Bendszus, Martin; Pham, Mirko

    2016-01-01

    Objective: To investigate the spatial pattern of lesion dispersion in posterior interosseous neuropathy syndrome (PINS) by high-resolution magnetic resonance neurography. Methods: This prospective study was approved by the local ethics committee and written informed consent was obtained from all patients. In 19 patients with PINS and 20 healthy controls, a standardized magnetic resonance neurography protocol at 3-tesla was performed with coverage of the upper arm and elbow (T2-weighted fat-saturated: echo time/repetition time 52/7,020 milliseconds, in-plane resolution 0.27 × 0.27 mm2). Lesion classification of the radial nerve trunk and its deep branch (which becomes the posterior interosseous nerve) was performed by visual rating and additional quantitative analysis of normalized T2 signal of radial nerve voxels. Results: Of 19 patients with PINS, only 3 (16%) had a focal neuropathy at the entry of the radial nerve deep branch into the supinator muscle at elbow/forearm level. The other 16 (84%) had proximal radial nerve lesions at the upper arm level with a predominant lesion focus 8.3 ± 4.6 cm proximal to the humeroradial joint. Most of these lesions (75%) followed a specific somatotopic pattern, involving only those fascicles that would form the posterior interosseous nerve more distally. Conclusions: PINS is not necessarily caused by focal compression at the supinator muscle but is instead frequently a consequence of partial fascicular lesions of the radial nerve trunk at the upper arm level. Neuroimaging should be considered as a complementary diagnostic method in PINS. PMID:27683851

  1. A new design of a Nitinol ring-like wire for suturing in deep surgical field.

    PubMed

    Nespoli, Adelaide; Dallolio, Villiam; Villa, Elena; Passaretti, Francesca

    2015-11-01

    The present work proposes a new suturing procedure based on self-accommodating suture points. Each suture point is made of a commercial NiTi wire hot-shaped in a single loop ring; a standard suture needle is then fixed at one end of the NiTi suture. According to this simple geometry, several NiTi suture stitches have been prepared and tested by tensile test to verify the closing force in comparison to that of commercial sutures. Further experimental tests have also been performed on anatomic samples from animals to verify the handiness of the NiTi suture. Moreover, surface quality of sutures has been carefully investigated via microscopy. Results show that the NiTi suture expresses high stiffness and a good surface quality. In addition, the absence of manual knotting allows for a simple, fast and safe procedure.

  2. Dietary consistency and the midline sutures in growing pigs

    PubMed Central

    Burn, AK; Herring, SW; Hubbard, R; Zink, K; Rafferty, K; Lieberman, DE

    2010-01-01

    Objectives The purpose of this study was to investigate the effects of reduced masticatory function on midline suture growth and morphology in growing pigs. Setting and Sample Population The sample was 20 pigs separated into 2 dietary groups, and raised at the Department of Antrhopology, Harvard University. Midline suture specimes were analyzed at the Department of Orthodontics, University of Washington. Materials and Methods Ten farm pigs and 10 minipigs, all male, were randomly assigned to hard (n=9) and soft diet (n=11) groups. Fluorochromic mineral labels were administered to document bone apposition, and the animals were sacrificed after 12 weeks. Undecalcified sections of the interfrontal, interparietal, internasal and intermaxillary sutures were evaluated for bone quantity and sutural thickness, interdigitation ratio and growth rate. Results Soft diet pigs were characterized by a slower rate of weight gain, and less bone than their hard diet counterparts. Even after correction for weight gain, soft diet pigs had reduced suture growth rate and thickness. However, no difference in interdigitation ratio was detected between dietary groups. Conclusion Restriction to a soft diet reduces midline suture growth and bone apposition in the growing pig. PMID:20477970

  3. First investigation of spider silk as a braided microsurgical suture.

    PubMed

    Kuhbier, Joern W; Reimers, Kerstin; Kasper, Cornelia; Allmeling, Christina; Hillmer, Anja; Menger, Björn; Vogt, Peter M; Radtke, Christine

    2011-05-01

    Inhibition of axonal outgrowth accompanied by neuroma formation appears in microsurgical nerve repair as reaction to common microsuture materials like silk, nylon, or polyglycolic acid. In contrast, recent findings revealed advantages of spider silk fibers in guiding Schwann cells in nerve regeneration. Here, we asked if we could braid microsutures from native spider silk fibers. Microsutures braided of native spider dragline silk were manufactured, containing either 2 × 15 or 3 × 10 single fibres strands. Morphologic appearance was studied and tensile strength and stress-strain ratio (SSR) were calculated. The constructed spider silk sutures showed a median thickness of 25 μm, matching the USP definition of 10-0. Maximum load and tensile strength for both spider silk microsutures were significantly more than 2-fold higher than for nylon suture; SSR was 1.5-fold higher. All values except elasticity were higher in 3 × 10 strand sutures compared to 2 × 15 strand sutures, but not significantly. In this pilot study, we demonstrate the successful manufacture of microsutures from spider silk. With regards to the mechanical properties, these sutures were superior to nylon sutures. As spider silk displays high biocompatibility in nerve regeneration, its usage in microsurgical nerve repair should be considered.

  4. Structural brain differences in school-age children with and without single-suture craniosynostosis.

    PubMed

    Aldridge, Kristina; Collett, Brent R; Wallace, Erin R; Birgfeld, Craig; Austin, Jordan R; Yeh, Regina; Feil, Madison; Kapp-Simon, Kathleen A; Aylward, Elizabeth H; Cunningham, Michael L; Speltz, Matthew L

    2017-04-01

    OBJECTIVE Single-suture craniosynostosis (SSC), the premature fusion of a cranial suture, is characterized by dysmorphology of the craniofacial skeleton. Evidence to suggest that children with SSC are at an elevated risk of mild to moderate developmental delays and neurocognitive deficits is mounting, but the associations among premature suture fusion, neuroanatomy, and neurocognition are unexplained. The goals of this study were to determine 1) whether differences in the brain are present in young children with the 2 most common forms of SSC (sagittal and metopic) several years following surgical correction, and 2) whether the pattern of differences varies by affected suture (sagittal or metopic). Examination of differences in the brains of children with SSC several years after surgery may illuminate the growth trajectory of the brain after the potential constraint of the dysmorphic cranium has been relieved. METHODS The authors compared quantitative measures of the brain acquired from MR images obtained from children with sagittal or metopic craniosynostosis (n = 36) at 7 years of age to those obtained from a group of unaffected controls (n = 27) at the same age. The authors measured the volumes of the whole brain, cerebral cortex, cerebral white matter, cerebral cortex by lobe, and ventricles. Additionally, they measured the midsagittal area of the corpus callosum and its segments and of the cerebellar vermis and its component lobules. Measurements obtained from children with SSC and controls were compared using linear regression models. RESULTS No volume measures of the cerebrum or of the whole brain differed significantly between patients with SSC and controls (p > 0.05). However, ventricle volume was significantly increased in patients with SSC (p = 0.001), particularly in those with sagittal craniosynostosis (p < 0.001). In contrast, the area of the corpus callosum was significantly reduced in patients with metopic synostosis (p = 0.04), particularly in the

  5. Posterior Urethral Strictures

    PubMed Central

    Gelman, Joel; Wisenbaugh, Eric S.

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  6. Symptomatic posterior mediastinal angioleiomyoma.

    PubMed

    I, Hoseok; Jeong, Yeon Joo; Choi, Kyung Un; Kim, Yeong-Dae

    2008-08-30

    We report a case of a symptomatic angioleiomyoma in the left posterior mediastinum. A 66-year-old woman presented with left back and flank pain for 6 months. Chest computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-circumscribed 4.3 cm round mass. The mass was initially diagnosed as nerve sheath tumor, because of her symptoms and its close location to the sympathetic trunk and intercostal nerve. It was uneventfully removed through video-assisted thoracoscopic surgery. The pathology revealed an angioleiomyoma.

  7. The Mobile Chamber

    NASA Technical Reports Server (NTRS)

    Scharfstein, Gregory; Cox, Russell

    2012-01-01

    A document discusses a simulation chamber that represents a shift from the thermal-vacuum chamber stereotype. This innovation, currently in development, combines the capabilities of space simulation chambers, the user-friendliness of modern-day electronics, and the modularity of plug-and-play computing. The Mobile Chamber is a customized test chamber that can be deployed with great ease, and is capable of bringing payloads at temperatures down to 20 K, in high vacuum, and with the desired metrology instruments integrated to the systems control. Flexure plans to lease Mobile Chambers, making them affordable for smaller budgets and available to a larger customer base. A key feature of this design will be an Apple iPad-like user interface that allows someone with minimal training to control the environment inside the chamber, and to simulate the required extreme environments. The feedback of thermal, pressure, and other measurements is delivered in a 3D CAD model of the chamber's payload and support hardware. This GUI will provide the user with a better understanding of the payload than any existing thermal-vacuum system.

  8. High resolution drift chambers

    SciTech Connect

    Va'vra, J.

    1985-07-01

    High precision drift chambers capable of achieving less than or equal to 50 ..mu..m resolutions are discussed. In particular, we compare so called cool and hot gases, various charge collection geometries, several timing techniques and we also discuss some systematic problems. We also present what we would consider an ''ultimate'' design of the vertex chamber. 50 refs., 36 figs., 6 tabs.

  9. Target chambers for gammashpere

    SciTech Connect

    Carpenter, M.P.; Falout, J.W.; Nardi, B.G.

    1995-08-01

    One of our responsibilities for Gammasphere, was designing and constructing two target chambers and associated beamlines to be used with the spectrometer. The first chamber was used with the early implementation phase of Gammasphere, and consisted of two spun-Al hemispheres welded together giving a wall thickness of 0.063 inches and a diameter of 12 inches.

  10. A soundproof pressure chamber.

    PubMed

    Kitahara, M; Kodama, A; Ozawa, H; Inoue, S

    1994-01-01

    For neurotological research we designed a soundproof pressure chamber in which pressure can be adjusted +/- 1000 mmH2O at the rate of less than 100 mmH2O per second. Noise in the chamber can be maintained under 30-35 dB while pressure is kept at a given level.

  11. Static diffusion cloud chambers

    NASA Technical Reports Server (NTRS)

    Ayers, G.

    1981-01-01

    The chamber geometry and optical arrangement are described. The supersaturation range is given and consists of readings taken at five fixed points: 0.25%, 0.5%, 0.75%, 1.0%, and 1.25%. The detection system is described including light source, cameras, and photocell detectors. The temperature control and the calibration of the chamber are discussed.

  12. [The invention and application of the vaginal suturing-aid apparatus].

    PubMed

    Cheng, Yu-ping

    2002-07-01

    We have invented a barrel-shape suturing-aid apparatus with a light source on one side and a trapzoid cranny for suturing on the other side. There are many advantages proved by clinical practices in applying the suturing-aid apparatus: 1. to increase the suturing speed and relieve the pains of patients; 2. to avoid the infection of HBV by blood and crossinfection; 3. to improve the illumination condition and avoid no suturing of the hurt tissue.

  13. Posterior Cortical Atrophy

    PubMed Central

    Crutch, Sebastian J; Lehmann, Manja; Schott, Jonathan M; Rabinovici, Gil D; Rossor, Martin N; Fox, Nick C

    2013-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by a progressive decline in visuospatial, visuoperceptual, literacy and praxic skills. The progressive neurodegeneration affecting parietal, occipital and occipito-temporal cortices which underlies PCA is attributable to Alzheimer's disease (AD) in the majority of patients. However, alternative underlying aetiologies including Dementia with Lewy Bodies (DLB), corticobasal degeneration (CBD) and prion disease have also been identified, and not all PCA patients have atrophy on clinical imaging. This heterogeneity has led to diagnostic and terminological inconsistencies, caused difficulty comparing studies from different centres, and limited the generalizability of clinical trials and investigations of factors driving phenotypic variability. Significant challenges remain in identifying the factors associated with both the selective vulnerability of posterior cortical regions and the young age of onset seen in PCA. Greater awareness of the syndrome and agreement over the correspondence between syndrome-and disease-level classifications are required in order to improve diagnostic accuracy, research study design and clinical management. PMID:22265212

  14. Posterior Fossa Meningioma

    PubMed Central

    Saleh, Essam A.; Taibah, Abdel Kader; Achilli, Vittorio; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

    1994-01-01

    Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5 cases (12%), the suboccipital in 4 cases (10%), the petro-occipital trassigmoid transcervical in 2 cases (5%), the petro-occipital transsigmoid transtentorial in 1 case (2%), and a subtemporal transtentorial for another case (2%). Facial nerve anatomical integrity was preserved in 87% of procedures but was interrupted in 5 cases, with 4 of the latter subsequently repaired. Total tumor removal was accomplished in 38 cases. A second-stage total tumor removal is planned for the remaining case. There was only one case of perioperative death and no cases of radiological recurrence so far. ImagesFigure 1Figure 2Figure 3Figure 4p206-bFigure 5p207-bFigure 5 PMID:17171173

  15. [Pre- and postoperative corneal topography after combined single suture and running suture in ECCE. An analysis using the video keratoscope].

    PubMed

    Schickel, B; Holschbach, A; Strobel, J

    1993-12-01

    In a prospective study with 45 patients undergoing extracapsular cataract extraction (ECCE) with implantation of posterior chamber lens, curvature measurements of the cornea by means of computerized videokeratoscope were taken postoperatively. Analysis of the corneal shape on color-coded topographic maps of astigmatism showed an hourglass-shaped formation in all patients with a main axis in the sense of general astigmatism. Within a 3-mm zone (optical zone) the steepest meridian in all eyes was 96.1 +/- 13.3 degrees with an astigmatism of +4.4 +/- 2.1 D (1st postoperative day). Postoperatively we found that 35.6% of the patients examined had irregular astigmatism that could not be corroborated by the readings from the Javal ophthalmometer. An irregular astigmatism, corneal topographic analysis reveals regions peripheral to the center with a peak corneal refractive power of +43.8 +/- 1.4 D. In contrast to the conventional methods (for example, Javal ophthalmometer, autokeratometer), computerized videokeratoscope analysis provides additional and useful information on the corneal topography after intraocular operations.

  16. Diminished suture strength after robotic needle driver manipulation.

    PubMed

    Ricchiuti, Daniel; Cerone, Jeffrey; Shie, Scott; Jetley, Ajay; Noe, Donald; Kovacik, Mark

    2010-09-01

    Robot-assisted minimally invasive surgery has become a routine surgical option for the treatment of prostate cancer. Despite its technical advancements, the da Vinci(®) Surgical System still lacks haptic feedback to the surgeon, resulting in a maximally applied compressive force by the robotic needle driver during every grasping maneuver. Without this perceptional sense of touch and grip control, repetitive robotic needle driver manipulation may unknowingly lead to irreparable damage to fine sutures used during delicate anastomotic repairs. For robotic prostatectomy, any such loss of integrity can potentially lead to premature breakdown of the urethrovesical anastomosis and urine extravasation, especially important for a less-than-perfectly fashioned anastomotic repair. Although it has already been established that overhandling of sutures using handheld laparoscopic instruments can lead to reduced suture strength, it has not been established to what extent this may occur after robotic surgical procedures. We present analytical data and analyses concerning the failure strength of fine sutures commonly used for urethrovesical anastomotic repair during robotic prostatectomy, after repetitive robotic needle driver manipulation. When compared with noncompromised monofilament suture controls, the average maximal failure force after repetitive robotic manipulation was significantly reduced by 35% (p < 0.0001). Similarly, the average maximal failure force of braided sutures was significantly reduced after repetitive robotic manipulation by 3% (p = 0.009). This work demonstrates that significant reductions in monofilament and braided suture strength integrity can occur after customary repetitive manipulation by robotic needle drivers in an ex vivo model, with further research warranted in the in vivo setting.

  17. Novel posterior fixation keratoprosthesis

    NASA Astrophysics Data System (ADS)

    Lacombe, Emmanuel

    1992-08-01

    The keratoprosthesis is the last solution for corneally blind patients that cannot benefit from corneal transplants. Keratoprostheses that have been designed to be affixed anteriorly usually necessitate multi-step surgical procedures and are continuously subjected to the extrusion forces generated by the positive intraocular pressure; therefore, clinical results in patients prove inconsistent. We proposed a novel keratoprosthesis concept that utilizes posterior corneal fixation which `a priori' minimizes the risk of aqueous leakage and expulsion. This prosthesis is implanted in a single procedure thereby reducing the number of surgical complications normally associated with anterior fixation devices. In addition, its novel design makes this keratoprosthesis implantable in phakic eyes. With an average follow-up of 13 months (range 3 to 25 months), our results on 21 cases are encouraging. Half of the keratoprostheses were implanted in severe burn cases, with the remainder in cases of pseudo- pemphigus. Good visual results and cosmetic appearance were obtained in 14 of 21 eyes.

  18. Posterior pole tumor update.

    PubMed

    Ou, Judy I; Wheeler, Sharon M; O'Brien, Joan M

    2002-12-01

    This chapter focuses on the diagnosis and management of choroidal melanoma in light of recent findings from the COMS. Retinoblastoma is emphasized to describe recent trends in primary treatment away from EBRT and toward chemoreduction with local therapy. In addition, vascular and glial tumors of the retina and tumors of the retinal pigment epithelium are described because of the association between these lesions and systemic disease. Recent advances in treatment and genetic testing for these diseases are discussed. Finally, ocular metastasis, intraocular lymphoid tumors, and intraocular leukemia are included because of their importance in determining systemic treatment and prognosis. The chapter gives an overview of important posterior pole tumors and highlights recent developments in the management of each intraocular disease process.

  19. Large Vertical Axis Rotations along Neotethyan Sutures in TURKEY

    NASA Astrophysics Data System (ADS)

    Ozkaptan, M.; Gulyuz, E.; Kaymakci, N.; Langereis, C. G.; Ozacar, A. A.; Lefebvre, C.

    2014-12-01

    Two Neotethyan Sutures,Izmir-Ankara and Intra-Tauride suture zones meet around Ankara region appx. at right angles.The northerly located Izmir-Ankara Suture zone follows approximately E-W trend and it makes a sharp approximately 90° bend at the east along the western margin of the Çankiri Basin.The Intra-Tauride suture follows approximately the Tuzgölü Fault Zone and trends NW-SE and seems to be overprinted by the structures related to the Izmir-Ankara suture zone. These two sutures meet southeastern corner of the Haymana Basin where the basin makes major eastwards counterclockwise bend.From west to East, the Haymana, Tuzgölü and Çankiri Basins straddle these suture zones and are developed in relation to the subduction and collision processes in the region, making them the perfect sites to unravel deformation history and paleogeography of the Neotethyan suture zones in the region. In order to accomplish this, the tectono-stratigraphic evolution of the basin and its paleogeographical positions, in different time slices, constructed by conducting a very detailed study on the Late Cretaceous to Recent infill of the Haymana, Tuzgölü, and Çankiri Basins. We collected more than 4500 sedimentary paleomagnetic samples for paleomagnetic purposes from 112 different locations within 250 km diameter area.Before the demagnetization process, nearly 3000 core specimens were measured for anisotropy of magnetic susceptibility (AMS) in order to understand deformation amounts and kinematics.The paleomagnetic results show that the region underwent strong clockwise and counterclockwise rotations more than 90° in places, resulting in the present geometry of the suture zones. The central part of the Haymana basin rotated as high as 90° counterclockwise while its northern part together with the southwestern part of the Çankiri basin and northern part of the Tuzgölü basin rotated approximately 30° clockwise contrary to almost all published paleomagnetic data from the region

  20. Recognizing surgeon's actions during suture operations from video sequences

    NASA Astrophysics Data System (ADS)

    Li, Ye; Ohya, Jun; Chiba, Toshio; Xu, Rong; Yamashita, Hiromasa

    2014-03-01

    Because of the shortage of nurses in the world, the realization of a robotic nurse that can support surgeries autonomously is very important. More specifically, the robotic nurse should be able to autonomously recognize different situations of surgeries so that the robotic nurse can pass necessary surgical tools to the medical doctors in a timely manner. This paper proposes and explores methods that can classify suture and tying actions during suture operations from the video sequence that observes the surgery scene that includes the surgeon's hands. First, the proposed method uses skin pixel detection and foreground extraction to detect the hand area. Then, interest points are randomly chosen from the hand area so that their 3D SIFT descriptors are computed. A word vocabulary is built by applying hierarchical K-means to these descriptors, and the words' frequency histogram, which corresponds to the feature space, is computed. Finally, to classify the actions, either SVM (Support Vector Machine), Nearest Neighbor rule (NN) for the feature space or a method that combines "sliding window" with NN is performed. We collect 53 suture videos and 53 tying videos to build the training set and to test the proposed method experimentally. It turns out that the NN gives higher than 90% accuracies, which are better recognition than SVM. Negative actions, which are different from either suture or tying action, are recognized with quite good accuracies, while "Sliding window" did not show significant improvements for suture and tying and cannot recognize negative actions.

  1. Quantitative evaluation of midpalatal suture maturation via fractal analysis

    PubMed Central

    Kwak, Kyoung Ho; Kim, Yong-Il; Kim, Yong-Deok

    2016-01-01

    Objective The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. Methods The study included 131 subjects aged over 18 years of age (range 18.1–53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. Results The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (−0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. Conclusions There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation. PMID:27668195

  2. Mechanical Behavior of Bio-inspired Model Suture Joints

    NASA Astrophysics Data System (ADS)

    Li, Yaning; Lin, Erica; Ortiz, Christine; Boyce, Mary

    2012-02-01

    Suture joints of varying degrees of geometric complexity are prevalent throughout nature as a means of joining structural elements while providing locally tailored mechanical performance. Here, micromechanical models of general trapezoidal waveforms of varying hierarchy are formulated to reveal the role of geometric complexity in governing stiffness, strength, toughness and corresponding deformation and failure mechanisms. Physical constructs of model composite suture systems are fabricated via multi-material 3D printing (Object Connex500). Tensile tests are conducted on samples covering a range in geometry, thus providing quantitative measures of stiffness, strength, and failure. The experiments include direct visualization of the deformation and failure mechanisms and their progression, as well as their dependence on suture geometry, showing the interplay between shear and tension/compression of the interfacial layers and tension of the skeletal teeth and the transition in failure modes with geometry. The results provide quantitative guidelines for the design and tailoring of suture geometry to achieve the desired mechanical properties and also facilitate understanding of suture growth and fusion, and evolutionary phenotype.

  3. Biomechanical Study of Two Peripheral Suture Methods on Repaired Tendons

    PubMed Central

    Qiu, Zhenling

    2015-01-01

    Flexor digitorum tendon injuries are challenging conditions to manage to ensure optimal patient outcomes. While several surgical approaches with high success rates have been developed, there remains no gold standard for suture technique for the repair of flexor tendon injuries. In this study, we compared two distinct peripheral suture methods on the strength of repaired tendons. Pig flexor digitorum profundus tendons were used in biomechanical studies and the biomechanical influence on tendon repair of continuous running peripheral suture (CRPS) and continuous locking peripheral suture (CLPS), were compared, using stitch length ranging from 1mm to 5mm. In CRPS, the 1mm stitch length group displayed the highest maximum load and breaking power, which was 1.57 fold higher than the 2mm stitch length group. Pairwise comparison revealed that the 1 and 2mm groups were statistically different from the 3, 4, and 5mm stitch length groups while comparison among the latter groups was not statistically significant. For CLPS, the 1mm group exhibited consistently the highest maximum load strength and breaking power, which was twice the strength displayed by the 2mm group. Pairwise comparisons between groups showed statistical significance. For future repairs of flexor tendon injuries, 1mm stitch length is highly recommended for simple peripheral suture.

  4. Failure strength of repair devices versus meniscus suturing techniques.

    PubMed

    Aşík, Mehmet; Sener, Nadir

    2002-01-01

    The purpose of this study was to compare the load to failure of different common suturing techniques with repair devices. Seventy-one calf medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of 13 repair techniques. The two parts of the meniscus were pulled using the Instron tensometer until failure occurred. The techniques and repair devices tested were vertical (0 PDS, 2-0 PDS, 2-0 Ethibond), horizontal (0 PDS, 2-0 PDS, 2-0 Ethibond) suturing, T-fix, Mitek, Clearfix screw, Clearfix dart, Biostinger, S-D-sorb, and Artrex dart. The strongest repair method in our study was the vertical sutures with 0 PDS. In this study the mean failure strength of all meniscal repair devices was lower than that of the vertical and horizontal suturing techniques. All meniscus repair devices except T-fix and in some the Arthrex dart (40% broken up) pulled out of the menisci. Devices which had only horizontally placed barbs had lower mean failure strength. Failure strength of T-fix was similar to horizontal sutures with 2-0 Ethibond and 2-0 PDS. In conclusion, because all meniscal repair devices had inferior results, when such devices are used, postoperative rehabilitation should not be hastened, and their inferior primary stability should be kept in mind.

  5. The Mars Chamber

    NASA Video Gallery

    The Mars chamber is a box about the size of a refrigerator that re-creates the temperatures, pressures, and atmosphere of the Martian surface, essentially creating a Mars environment on Earth! Scie...

  6. The efficacy of a single continuous nylon suture for control of post keratoplasty astigmatism.

    PubMed Central

    Van Meter, W

    1996-01-01

    PURPOSE: Post operative adjustment of a single continuous suture is an effective means of reducing post keratoplasty astigmatism. This study evaluates post keratoplasty keratometry following suture adjustment with an adjusted suture in place and after the suture is removed. METHODS: Average keratometric astigmatism was measured over 24 months time in 26 patients with an adjusted continuous suture and 24 patients with a continuous suture that was not adjusted. Average keratometry in 43 patients with an adjusted continuous suture was compared with 37 patients with combined continuous and interrupted sutures. Finally, suture out astigmatism in 19 adjusted patients was compared to six patients with no adjustment. RESULTS: There was an increase in average corneal astigmatism over two years of 2.2 diopters in the adjusted group and 1.7 diopters in the non-adjusted group with sutures in place. One year following surgery, average keratometry flattened from 47.5 to 42.9 diopters in the adjusted continuous group and from 47.0 to 46.0 diopters in the group with combined continuous and interrupted sutures. Following suture removal, average astigmatism in patients who had suture adjustment was 4.4 diopters +/- 2.5 diopters (range 1-10 diopters), and 6.01 diopters (range 4-7) in the non-adjusted group. CONCLUSIONS: Average post keratoplasty astigmatism increases after a continuous suture is adjusted but the increase is comparable to patients with acceptable astigmatism who do not require adjustment. More progressive corneal flattening over 12 months time is seen with a continuous suture than which combined sutures. Average suture out astigmatism was 4.0 diopters following suture adjustment, compared to an average of 8.4 diopters prior to adjustment. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 7A FIGURE 7B PMID:8981721

  7. Sleeve reaction chamber system

    DOEpatents

    Northrup, M. Allen; Beeman, Barton V.; Benett, William J.; Hadley, Dean R.; Landre, Phoebe; Lehew, Stacy L.; Krulevitch, Peter A.

    2009-08-25

    A chemical reaction chamber system that combines devices such as doped polysilicon for heating, bulk silicon for convective cooling, and thermoelectric (TE) coolers to augment the heating and cooling rates of the reaction chamber or chambers. In addition the system includes non-silicon-based reaction chambers such as any high thermal conductivity material used in combination with a thermoelectric cooling mechanism (i.e., Peltier device). The heat contained in the thermally conductive part of the system can be used/reused to heat the device, thereby conserving energy and expediting the heating/cooling rates. The system combines a micromachined silicon reaction chamber, for example, with an additional module/device for augmented heating/cooling using the Peltier effect. This additional module is particularly useful in extreme environments (very hot or extremely cold) where augmented heating/cooling would be useful to speed up the thermal cycling rates. The chemical reaction chamber system has various applications for synthesis or processing of organic, inorganic, or biochemical reactions, including the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction.

  8. Mixing processes in the vitreous chamber induced by eye rotations

    NASA Astrophysics Data System (ADS)

    Stocchino, Alessandro; Repetto, Rodolfo; Siggers, Jennifer H.

    2010-01-01

    In this paper, we study a model of flow in the vitreous humour in the posterior chamber of the human eye, induced by saccadic eye rotations. We concentrate on the effect of the shape of the chamber upon the mixing properties of the induced flows. We make particle image velocimetry measurements of the fluid velocity in a transparent plastic (Perspex) model of the posterior chamber during sinusoidal torsional oscillations about a vertical axis. We use a Newtonian fluid to model the vitreous humour, which is most realistic when either the vitreous humour is liquefied or has been replaced by purely viscous tamponade fluids. The model of the posterior chamber is a sphere with an indentation, representing the effect of the lens. In spite of the purely periodic forcing, a steady streaming flow is generated, which plays a fundamental role in the mixing processes in the domain. The streaming flow differs markedly from that in a perfect sphere, and its topological characteristics change substantially as the frequency of oscillation varies. We discuss the flow characteristics in detail and show that, for physiological parameter values, the Péclet number (based on a suitable measure of the steady streaming velocity) is large, suggesting that advection strongly dominates over diffusion for mass transport phenomena. We also compute particle trajectories based on the streaming velocity and use these to investigate the stirring properties of the flow.

  9. Ureteric Suture Urolithiasis Following Open Emergency Ureteric Repair

    PubMed Central

    Sarmah, Piyush B.; Kelly, Brian D.; Devarajan, Raghuram

    2016-01-01

    Suture urolithiasis is an unusual but recognised phenomenon following surgery on the urinary tract. We report a case in a 30-year-old man who sustained a gunshot injury to the left ureter in Burundi and underwent open ureteric repair in a regional hospital. He migrated to the UK and presented one year later with left loin pain. An intravenous urogram revealed two foci of calcification to the left of L3, within a peri-ureteric position. The patient underwent left-sided ureteroscopy where two calculi each formed around a nylon suture were discovered within a ureteric pseudo-diverticulum, and basketed. This is the first reported case of suture urolithiasis occurring following ureteric surgery. PMID:26989371

  10. Is the Kapuskasing structure the site of a cryptic suture

    NASA Technical Reports Server (NTRS)

    Burke, K.

    1983-01-01

    The demonstration that the Kapuskasing structure involves substantial thrusting of deep continental crustal rocks over shallower continental rocks calls into question an earlier suggestion (by Wilson) that the Circum-Ungaua suture zone continued through the Kapuskasing to join the Penokean fold belt (implying that the Kapuskasing marked the site of what has since come to be called a cryptic suture). Problems are discussed which arose in attempting to reconcile Wilson's idea with data from more recent studies: whether the Kapuskasing and the Thompson belt both mark sutures of about 1700 Ma age; why there is no age difference across the Kapuskasing if it does mark the site of continental collision, and why there is no offset of Superior subprovinces across the Kapuskasing.

  11. Force-Induced Craniosynostosis in the Murine Sagittal Suture

    PubMed Central

    Oppenheimer, Adam J.; Rhee, Samuel T.; Goldstein, Steven A.; Buchman, Steven R.

    2010-01-01

    BACKGROUND The etiology of non-syndromic craniosynostosis remains elusive. While compressive forces have been implicated in premature suture fusion, conclusive evidence of force-induced craniosynostosis is lacking. The purpose of this study was to determine if cyclical loading of the murine calvarium could induce suture fusion. METHODS Calvarial coupons from post-natal day 21, B6CBA wild-type mice (n = 18) were harvested and cultured. A custom appliance capable of delivering controlled, cyclical, compressive loads was applied perpendicular to the sagittal suture within the coupon in vitro. Nine coupons were subjected to 0.3g of force for 30 minutes each day for a total of 14 days. A control group of nine coupons was clamped in the appliance without loading. Analysis of suture phenotype was performed using alkaline phosphatase and H&E staining techniques, as well as in situ hybridization analysis using Bone Sialoprotein (BSP). RESULTS Control group sagittal sutures—which normally remain patent in mice—showed their customary histological appearance. In contradistinction, sagittal sutures subjected to cyclic loading showed histological evidence of premature fusion (craniosynostosis). In addition, alkaline phosphatase activity and BSP expression was observed to be increased in the experimental group when compared to matched controls. CONCLUSIONS An in vitro model of forced-induced craniosynostosis has been devised. Premature fusion of the murine sagittal suture was induced with the application of controlled, cyclical, compressive loads. These results implicate abnormal forces in the development of non-syndromic craniosynostosis, which supports our global hypothesis that epigenetic phenomena have a crucial role in the pathogenesis of craniosynostosis. PMID:19952640

  12. Influence of metopic suture fusion associated with sagittal synostosis.

    PubMed

    Domeshek, Leahthan F; Das, Rajesh R; Van Aalst, John A; Mukundan, Srinivasan; Marcus, Jeffrey R

    2011-01-01

    Some patients with sagittal synostosis present with a fused metopic suture. We hypothesize that premature metopic suture fusion consistently and identifiably alters form associated with sagittal synostosis. We previously validated three-dimensional vector analysis as a tool for the study of cranial morphology and used it herein to distinguish between dysmorphologies of isolated sagittal synostosis (ISS) and combined sagittal-metopic synostosis (CSM). Preoperative computed tomographic scans for patients with ISS and CSM were compared with matched normative counterparts. Premature metopic suture fusion was defined by established radiographic criteria. Color-coded point clouds were created for each scan, with color gradient based on patient deviation from normal across the dysmorphic skull. Standard deviation data were evaluated in 7 cranial regions and compared between ISS and CSM. Mean ISS and CSM point clouds were evaluated. Using three-dimensional vector analysis, standard anthropometric data/indices were determined and compared between the 2 groups. Differences in ISS and CSM regional deviations and index measurements were not statistically significant. Mean ISS and CSM representations depicted similar overall morphology. Using accepted criteria for identification of metopic synostosis in CSM, only subtle differences appear between the 2 populations on average. Expected morphologic changes associated with metopic synostosis are present in only a small number of patients with CSM, arguing against our hypothesis, and calling into question the criteria used to identify premature metopic suture fusion. Normal metopic suture fusion occurs for a continuum of time. Our findings suggest that the normal continuum may begin earlier than the literature suggests. In the setting of sagittal synostosis, the influence of metopic suture fusion and treatment is best determined by individual morphologic analysis.

  13. Posterior Reversible Encephalopathy Syndrome

    PubMed Central

    Algahtani, Abdulhadi; Aldarmahi, Ahmad; Hmoud, Mohammed; Marzuk, Yousef; Shirah, Bader

    2016-01-01

    Objectives: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, altered mental status, seizures, or loss of vision. In this study, we report the largest series of PRES coming from Saudi Arabia and explore the etiology, clinical presentation, and outcome. We also report new imaging findings associated with this condition. Methods: We performed a retrospective study of all cases of PRES admitted to King Abdulaziz Medical City, Jeddah, Saudi Arabia, between the years 2005 and 2015. A neurologist reviewed all charts and analyzed the clinical presentations, etiological factors, and outcomes, and a neuroradiologist reviewed the imaging studies. Only patients with clinical and imaging features consistent with PRES were included in the study. Results: We collected 31 patients who had clinical and radiological features consistent with PRES. Females were more affected than males (18 females and 13 males), and patients’ age ranged from 6 to 95 years, with a mean of 38.3 years. Patients were treated by removing the precipitating causes and treating the underlying conditions. Resolution of neurologic signs occurred within 2 to 3 weeks in all patients. Conclusion: In our opinion, PRES itself is usually a benign condition with complete recovery if the condition is recognized early and managed appropriately. Although clinical signs are nonspecific, the constellation of symptoms including headache, visual problems, seizures, and altered level of consciousness should suggest the possibility of PRES, especially in high-risk group. Abnormalities on magnetic resonance imaging are often characteristic and may be the first clue to the diagnosis. PMID:28042366

  14. A reusable suture anchor for arthroscopy psychomotor skills training.

    PubMed

    Tillett, Edward D; Rogers, Rainie; Nyland, John

    2003-03-01

    For residents to adequately develop the early arthroscopy psychomotor skills required to better learn how to manage the improvisational situations they will encounter during actual patient cases, they need to experience sufficient practice repetitions within a contextually relevant environment. Unfortunately, the cost of suture anchors can be a practice repetition-limiting factor in learning arthroscopic knot-tying techniques. We describe a technique for creating inexpensive reusable suture anchors and provide an example of their application to repair the anterior glenoid labrum during an arthroscopy psychomotor skills laboratory training session.

  15. Familial idiopathic hypertrophic osteoarthropathy and cranial suture defects in children

    SciTech Connect

    Reginato, A.J.; Schiapachasse, V.; Guerrero, R.

    1982-05-01

    Three children with idiopathic hypertrophic osteoarthropathy and cranial suture defects are reported. The syndrome was recognized after birth and in the two oldest siblings, the cranial defects and subperiosteal bone formation resolved almost completely by age 4 and 6 years. The joint swelling and clubbing persisted and mild bone reabsorption of the distal phalanges became apparent at an older age. Two siblings and both parents had normal bone X-rays and no clubbing. This study confirms the association of cranial sutural defects and familial idopathic hypertrophic osteoarthropathy.

  16. Preparation of scaffolds based on bulky sutures for cell therapy

    NASA Astrophysics Data System (ADS)

    Park, Young Hwan; Chun, Heung Jae; Kim, Sung Jin

    2012-04-01

    Scaffold for cell therapy was prepared with poly (lactide-co-glicolide, PLA/PGA (10:90). By using melt-spinning and draw texturing process, we could prepare microfibrous bulky suture which had heterogeneous macropore. Microfibrous structure has great potentiality as biomimicking architecture for cell growth and maintaining cell functions. The result of cell seeding showed that pore size, pore distribution, and fiber fineness of sutures were suitable as a biocompatible scaffold in vitro for NIH 3T3 Fibroblast cell. Also, we expect that prepared scaffold for cell-therapy will provide numerous benefits as a noninvasive alternative for tissue engineering applications.

  17. Preparation of scaffolds based on bulky sutures for cell therapy

    NASA Astrophysics Data System (ADS)

    Park, Young Hwan; Chun, Heung Jae; Kim, Sung Jin

    2011-11-01

    Scaffold for cell therapy was prepared with poly (lactide-co-glicolide, PLA/PGA (10:90). By using melt-spinning and draw texturing process, we could prepare microfibrous bulky suture which had heterogeneous macropore. Microfibrous structure has great potentiality as biomimicking architecture for cell growth and maintaining cell functions. The result of cell seeding showed that pore size, pore distribution, and fiber fineness of sutures were suitable as a biocompatible scaffold in vitro for NIH 3T3 Fibroblast cell. Also, we expect that prepared scaffold for cell-therapy will provide numerous benefits as a noninvasive alternative for tissue engineering applications.

  18. Endotracheal tube fixation methods for optimal stability: a comparison of adhesive tape, suture, and tape-suture fixation.

    PubMed

    Farbod, Frank; Tuli, Puneet; Robertson, Bernard F; Jackson, Ian T

    2010-07-01

    Accidental extubation of an intubated patient is a serious consideration in the surgical patient. Adequate fixation in the intubated patient is essential to prevent potentially life-threatening complications. Several methods of endotracheal tube fixation have been described in the literature. In this study, we examine 3 common methods of fixation: adhesive tape alone, suture, and tape-suture. Testing occurred in a laboratory setting with 2 fresh cadavers. Endotracheal tubes were inserted, using the methods of fixation in question. We subjected each fixation technique to progressively increasing weight to determine which technique is most resistant to accidental removal. We found that fixation of the tube by combining tape around the tube with a suture through the tape is the best noninvasive technique of the 3 methods evaluated in cases where movement of the head is anticipated.

  19. Target Chamber Manipulator

    NASA Astrophysics Data System (ADS)

    Tantillo, Anthony; Watson, Matthew

    2015-11-01

    A system has been developed to allow remote actuation of sensors in a high vacuum target chamber used with a particle accelerator. Typically, sensors of various types are placed into the target chamber at specific radial and angular positions relative to the beam line and target. The chamber is then evacuated and the experiments are performed for those sensor positions. Then, the chamber is opened, the sensors are repositioned to new angles or radii, and the process is repeated, with a separate pump-down cycle for each set of sensor positions. The new sensor positioning system allows scientists to pre-set the radii of up to a dozen sensors, and then remotely actuate their angular positions without breaking the vacuum of the target chamber. This reduces the time required to reposition sensors from 6 hours to 1 minute. The sensors are placed into one of two tracks that are separately actuated using vacuum-grade stepping motors. The positions of the sensors are verified using absolute optical rotary encoders, and the positions are accurate to 0.5 degrees. The positions of the sensors are electronically recorded and time-stamped after every change. User control is through a GUI using LabVIEW.

  20. Thrust chamber life prediction

    NASA Technical Reports Server (NTRS)

    Kasper, H. J.

    1985-01-01

    The reusable life of the Space Shuttle main engine (SSME) is influenced by the cyclic life of the regeneratively liquid cooled main combustion chamber (MCC). During an operational duty cycle the MCC liner is subjected to a large transient thermal gradient that imparts a high thermal cyclic strain to the liner hot gas wall. Life predictions of such chambers have usually been based on low cycle fatigue (LCF) evaluations. Hot-fire testing, however, has shown significant mid-channel wall deformation and thinning during accrued cyclic testing. This phenomenon is termed cyclic creep and appears to be significantly accelerated at elevated temperatures. An analytical method that models the cyclic creep phenomenon and its application to thrust chamber life prediction is presented. The chamber finite element geometry is updated periodically to account for accrued wall thinning and distortion. Failure is based on the tensile instability failure criterion. Cyclic life results for several chamber life enhancing coolant channel designs are compared to the typically used LCF analysis that neglects cyclic creep. The results show that the usable cyclic creep life is approximately 30 to 50% of the commonly used LCF life.

  1. Improved Rhenium Thrust Chambers

    NASA Technical Reports Server (NTRS)

    O'Dell, John Scott

    2015-01-01

    Radiation-cooled bipropellant thrust chambers are being considered for ascent/ descent engines and reaction control systems on various NASA missions and spacecraft, such as the Mars Sample Return and Orion Multi-Purpose Crew Vehicle (MPCV). Currently, iridium (Ir)-lined rhenium (Re) combustion chambers are the state of the art for in-space engines. NASA's Advanced Materials Bipropellant Rocket (AMBR) engine, a 150-lbf Ir-Re chamber produced by Plasma Processes and Aerojet Rocketdyne, recently set a hydrazine specific impulse record of 333.5 seconds. To withstand the high loads during terrestrial launch, Re chambers with improved mechanical properties are needed. Recent electrochemical forming (EL-Form"TM") results have shown considerable promise for improving Re's mechanical properties by producing a multilayered deposit composed of a tailored microstructure (i.e., Engineered Re). The Engineered Re processing techniques were optimized, and detailed characterization and mechanical properties tests were performed. The most promising techniques were selected and used to produce an Engineered Re AMBR-sized combustion chamber for testing at Aerojet Rocketdyne.

  2. Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair.

    PubMed

    Wu, ZiYing; Zhang, Chong; Zhang, Peng; Chen, TianWu; Chen, ShiYi; Chen, JiWu

    2016-01-01

    Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB), the medially Untied Suture Bridge (USB), and the Modified Suture Bridge (MSB). Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6 ± 78.0 N, P = 0.04 for KSB group; P < 0.001 for USB group), stiffness (58.0 ± 10.7 N/mm, P = 0.005 for KSB group; P < 0.001 for USB group), and lowest elongation (1.49 ± 0.39 mm, P = 0.009 for KSB group; P = 0.001 for USB group) among 3 groups. The KSB repair had significantly higher ultimate load (443.5 ± 65.0 N) than USB repair (363.5 ± 52.3 N, P = 0.024). However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P = 0.396 for stiffness and P = 0.242 for elongation, resp.). The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB) may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

  3. Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

    PubMed Central

    Zhang, Peng; Chen, TianWu; Chen, ShiYi

    2016-01-01

    Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB), the medially Untied Suture Bridge (USB), and the Modified Suture Bridge (MSB). Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6 ± 78.0 N, P = 0.04 for KSB group; P < 0.001 for USB group), stiffness (58.0 ± 10.7 N/mm, P = 0.005 for KSB group; P < 0.001 for USB group), and lowest elongation (1.49 ± 0.39 mm, P = 0.009 for KSB group; P = 0.001 for USB group) among 3 groups. The KSB repair had significantly higher ultimate load (443.5 ± 65.0 N) than USB repair (363.5 ± 52.3 N, P = 0.024). However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P = 0.396 for stiffness and P = 0.242 for elongation, resp.). The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB) may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair. PMID:27975065

  4. Revascularization alone or combined with suture annuloplasty for ischemic mitral regurgitation. Evaluation by color Doppler echocardiography.

    PubMed Central

    Czer, L S; Maurer, G; Bolger, A F; DeRobertis, M; Chaux, A; Matloff, J M

    1996-01-01

    To determine the effectiveness of revascularization alone or combined with mitral valve repair for ischemic mitral regurgitation, we performed color Doppler echocardiography intraoperatively before and after cardiopulmonary bypass in 49 patients (mean age, 70 +/- 9 years) with concomitant mitral regurgitation and coronary artery disease (triple vessel or left main in 88%; prior infarction in 90%). After revascularization alone (n = 25), the mitral annulus diameter (2.88 +/- 0.44 cm vs 2.88 +/- 0.44 cm), leaflet-to-annulus ratio (1.44 +/- 0.30 vs 1.44 +/- 0.29), and mitral regurgitation grade (1.7 +/- 0.9 vs 1.8 +/- 0.7) remained unchanged (p = NS, postpump vs prepump); mitral regurgitation decreased by 2 grades in only 1 patient (4%). After combined revascularization and mitral valve suture annuloplasty (Kay-Zubiate; n = 24), the annulus diameter decreased (to 2.57 +/- 0.45 cm from 3.11 +/- 0.43 cm), the leaflet-to-annulus ratio increased (to 1.46 +/- 0.25 from 1.20 +/- 0.21), and the mitral regurgitation grade decreased significantly (to 0.9 +/- 0.9 from 2.8 +/- 1.0) (p < 0.01); mitral regurgitation decreased by 2 grades or more (successful repair) in 75%. The origin of the jet correlated with the site of prior infarction (p < 0.05), being inferior in cases of posterior or inferior infarction (67%), and central or broad in cases of combined anterior and inferior infarction (70%). Despite a slightly higher 30-day mortality in the repair group (p = 0.10), there was no significant difference in survival between the 2 surgical groups at 5 years or 8 years. Therefore, in this study of patients with mitral regurgitation and coronary artery disease, reduction in regurgitation grade with revascularization alone was infrequent. Concomitant suture annuloplasty significantly reduced regurgitation by reestablishing a more normal relationship between the leaflet and annulus sizes. The failure rate after suture annuloplasty was 25%; alternative repair techniques such as ring

  5. Automated Electrostatics Environmental Chamber

    NASA Technical Reports Server (NTRS)

    Calle, Carlos; Lewis, Dean C.; Buchanan, Randy K.; Buchanan, Aubri

    2005-01-01

    The Mars Electrostatics Chamber (MEC) is an environmental chamber designed primarily to create atmospheric conditions like those at the surface of Mars to support experiments on electrostatic effects in the Martian environment. The chamber is equipped with a vacuum system, a cryogenic cooling system, an atmospheric-gas replenishing and analysis system, and a computerized control system that can be programmed by the user and that provides both automation and options for manual control. The control system can be set to maintain steady Mars-like conditions or to impose temperature and pressure variations of a Mars diurnal cycle at any given season and latitude. In addition, the MEC can be used in other areas of research because it can create steady or varying atmospheric conditions anywhere within the wide temperature, pressure, and composition ranges between the extremes of Mars-like and Earth-like conditions.

  6. Antipollution combustion chamber

    SciTech Connect

    Caruel, J.E.; Gastebois, P.M.

    1981-01-27

    The invention concerns a combustion chamber for turbojet engines. The combustion chamber is of the annular type and consists of two coaxial flame tubes opening into a common dilution and mixing zone. The inner tube is designed for low operating ratings of the engine, the outer tube for high ratings. Air is injected as far upstream as possible into the dilution zone, to enhance the homogenization of the gaseous flow issuing from the two tubes prior to their passage into the turbine and to assure the optimum radial distribution of temperatures. The combustion chamber according to the invention finds application in a particularly advantageous manner in turbojet engines used in aircraft propulsion because of the reduced emission of pollutants it affords.

  7. Posterior sampling with improved efficiency

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.

    1998-12-01

    The Markov Chain Monte Carlo (MCMC) technique provides a means to generate a random sequence of model realizations that sample the posterior probability distribution of a Bayesian analysis. That sequence may be used to make inferences about the model uncertainties that derive from measurement uncertainties. This paper presents an approach to improving the efficiency of the Metropolis approach to MCMC by incorporating an approximation to the covariance matrix of the posterior distribution. The covariance matrix is approximated using the update formula from the BFGS quasi-Newton optimization algorithm. Examples are given for uncorrelated and correlated multidimensional Gaussian posterior distributions.

  8. Filament wound rocket motor chambers

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The design, analysis, fabrication and testing of a Kevlar-49/HBRF-55A filament wound chamber is reported. The chamber was fabricated and successfully tested to 80% of the design burst pressure. Results of the data reduction and analysis from the hydrotest indicate that the chamber design and fabrication techniques used for the chamber were adequate and the chamber should perform adequately in a static test.

  9. Automated soil gas monitoring chamber

    DOEpatents

    Edwards, Nelson T.; Riggs, Jeffery S.

    2003-07-29

    A chamber for trapping soil gases as they evolve from the soil without disturbance to the soil and to the natural microclimate within the chamber has been invented. The chamber opens between measurements and therefore does not alter the metabolic processes that influence soil gas efflux rates. A multiple chamber system provides for repetitive multi-point sampling, undisturbed metabolic soil processes between sampling, and an essentially airtight sampling chamber operating at ambient pressure.

  10. Electrostatic Levitator Vacuum Chamber

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Optical ports ring the Electrostatic Levitator (ESL) vacuum chamber to admit light from the heating laser (beam passes through the window at left), positioning lasers (one port is at center), and lamps to allow diagnostic instruments to view the sample. The ESL uses static electricity to suspend an object (about 2-3 mm in diameter) inside a vacuum chamber while a laser heats the sample until it melts. This lets scientists record a wide range of physical properties without the sample contacting the container or any instruments, conditions that would alter the readings. The Electrostatic Levitator is one of several tools used in NASA's microgravity materials science program.

  11. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nonabsorbable polypropylene surgical suture. 878.5010 Section 878.5010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... a monofilament, nonabsorbable, sterile, flexible thread prepared from long-chain polyolefin...

  12. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section 878.5020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., sterile, flexible thread prepared from long-chain aliphatic polymers Nylon 6 and Nylon 6,6 and...

  13. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonabsorbable polypropylene surgical suture. 878.5010 Section 878.5010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... a monofilament, nonabsorbable, sterile, flexible thread prepared from long-chain polyolefin...

  14. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section 878.5020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., sterile, flexible thread prepared from long-chain aliphatic polymers Nylon 6 and Nylon 6,6 and...

  15. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nonabsorbable polypropylene surgical suture. 878.5010 Section 878.5010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... a monofilament, nonabsorbable, sterile, flexible thread prepared from long-chain polyolefin...

  16. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonabsorbable polypropylene surgical suture. 878.5010 Section 878.5010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... a monofilament, nonabsorbable, sterile, flexible thread prepared from long-chain polyolefin...

  17. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section 878.5020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., sterile, flexible thread prepared from long-chain aliphatic polymers Nylon 6 and Nylon 6,6 and...

  18. Use of Absorbable Sutures in Canine Carotid Arteries

    PubMed Central

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

    1990-01-01

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

  19. [Making easier what is difficult: continuous suture in intracorporeal anastomosis].

    PubMed

    Ferrer-Márquez, Manuel; Belda-Lozano, Ricardo; Solvas-Salmerón, María José; Ferrer-Ayza, Manuel

    2014-01-01

    Bariatric surgery requires a high level of training and detailed knowledge of advanced laparoscopy, especially when carrying out intracorporeal anastomosis. The following presentation shows two examples used by our group, which consists of slipknots done at the beginning and the end of the thread that allows us to do the suture quickly and securely.

  20. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section 878.5020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., sterile, flexible thread prepared from long-chain aliphatic polymers Nylon 6 and Nylon 6,6 and...

  1. 21 CFR 870.3460 - Endovascular Suturing System.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endovascular Suturing System. 870.3460 Section 870.3460 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3460 Endovascular...

  2. 21 CFR 870.3460 - Endovascular Suturing System.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endovascular Suturing System. 870.3460 Section 870.3460 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3460 Endovascular...

  3. 21 CFR 870.3460 - Endovascular Suturing System.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endovascular Suturing System. 870.3460 Section 870.3460 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3460 Endovascular...

  4. Modified Margin Convergence: Over-Under Lacing Suture Technique

    PubMed Central

    Métais, Pierre; Lanzone, Roberto; Lim, Chauncey Kester; Albino, Paolo; Carbone, Stefano

    2015-01-01

    The principle of margin convergence can be applied to rotator cuff repair to enhance the security of fixation by decreasing the mechanical strain at the margins of the tear. We describe a suture technique, over-under lacing, that reproduces the same margin convergence, with equal tissue tension across the entire surface area of the cuff. A consecutive series of patients affected by massive U-shaped rotator cuff tears were treated by this repair technique. Preoperative diagnosis, tear assessment, and grading of fatty infiltration of the cuff muscles were based on arthro–computed tomography evaluation. The technique passes 2 sutures from the medial to lateral margin of the tear, with a knotless suture anchor for tendon-to-bone fixation. The proposed technique seems to reduce tensile strain on the repaired tendon, can reconstruct the rotator cuff cable, and can attain the balanced pull of the tendon in a medial-to-lateral fashion. The over-under lacing suture technique is both simple and reproducible. This technique may achieve the goals of margin convergence with satisfactory preliminary clinical results for patients with massive rotator cuff tears. PMID:26697304

  5. Hyperammonemic encephalopathy due to suture line breakdown after bladder operation.

    PubMed

    Boogerd, W; Zoetmulder, F A; Moffie, D

    1990-01-01

    A patient is described with a severe encephalopathy and hyperammonemia in absence of liver dysfunction, attributed to urine absorption into the systemic circulation due to suture line breakdown after bladder dome resection. At autopsy characteristic Alzheimer type II astrocytes were found in the basal ganglia.

  6. Angiogenesis and osteogenesis in an orthopedically expanded suture

    NASA Technical Reports Server (NTRS)

    Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.

    1997-01-01

    The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.

  7. Single-Suture Neochorda-Folding Plasty for Mitral Regurgitation

    PubMed Central

    Park, Jong Myung; Je, Hyung Gon; Lee, Sang Kwon

    2016-01-01

    The single-suture neochorda-folding plasty technique is a modification of existing mitral valve repair techniques. In the authors’ experience, its simplicity, reliability, and versatility make it a useful technique for mitral valve repair, especially when a minimally invasive approach is used. PMID:26889453

  8. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nonabsorbable polypropylene surgical suture. 878.5010 Section 878.5010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  9. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Natural nonabsorbable silk surgical suture. 878.5030 Section 878.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  10. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Natural nonabsorbable silk surgical suture. 878.5030 Section 878.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  11. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Natural nonabsorbable silk surgical suture. 878.5030 Section 878.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  12. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Natural nonabsorbable silk surgical suture. 878.5030 Section 878.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  13. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Natural nonabsorbable silk surgical suture. 878.5030 Section 878.5030 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...

  14. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section 878.5020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.5020...

  15. Cystoscopic suture removal by Holmium-YAG laser after Burch procedure.

    PubMed

    Karaşahin, Emre Kazım; Esin, Sertaç; Alanbay, Ibrahim; Ercan, Mutlu Cihangir; Mutlu, Erol; Başer, Iskender; Basal, Seref

    2011-01-01

    Burch colposuspension remains one of the successful operations performed for stress incontinence. Accidental suturing of the bladder wall during the procedure or subsequent erosion may lead to lower urinary tract symptoms. Diagnosis and management of these sutures indicate precise evaluation for which a 70 degree cystoscope is used. In selected cases, Holmium-YAG laser may enable us to manage long-standing, encrustated neglected sutures. Here we would like to report successful removal of intravesical sutures using the Holmium-YAG laser.

  16. Mechanical force-induced midpalatal suture remodeling in mice

    PubMed Central

    Hou, Bo; Fukai, Naomi; Olsen, Bjorn R.

    2007-01-01

    Mechanical stress is an important epigenetic factor for regulating skeletal remodeling, and application of force can lead to remodeling of both bone and cartilage. Chondrocytes, osteoblasts and osteoclasts all participate and interact with each other in this remodeling process. To study cellular responses to mechanical stimuli in a system that can be genetically manipulated, we used mouse midpalatal suture expansion in vivo. 6-weeks-old male C57BL/6 mice were subjected to palatal suture expansion by opening loops with an initial force of 0.56N for periods of 1, 3, 7, 14 or 28 days. Periosteal cells in expanding sutures showed increased proliferation, with Ki67 positive cells representing 1.8±0.1% to 4.5±0.4% of total suture cells in control groups and 12.0±2.6% to 19.9±1.2% in experimental/expansion groups (p<0.05). Starting at day 1, cells expressing alkaline phosphatase and type I collagen were seen. New cartilage and bone formation was observed at the oral edges of the palatal bones at day 7; at the nasal edges only bone formation without cartilage appeared to occur. An increase in osteoclast numbers suggested increased bone remodeling, ranging from 60 to 160% throughout the experimental period. Decreased Saffranin O staining after day 3 suggested decreased proteoglycan content in the secondary cartilage. MicroCT showed a significant increase in maxillary width at days 14 and 28 (from 2334±4μm to 2485±3μm at day 14 and from 2383±5μm to 2574±7μm at day 28, p<0.001). The suture width was increased at days 14 and 28, except in the oral third region at day 28 (from 48±5μm to 36±4μm, p<0.05). Bone volume/total volume was significantly reduced at days 14 and 28 (50.2±0.7% vs. 68.0±3.7% and 56.5±1.0%vs. 60.9±1.3%, respectively, p<0.05), indicative of increased bone marrow space. These findings demonstrate that expansion forces across the midpalatal suture promote bone resorption through activation of osteoclasts and bone and cartilage formation via

  17. Accelerated biodegradation of silk sutures through matrix metalloproteinase activation by incorporating 4-hexylresorcinol

    PubMed Central

    Jo, You-Young; Kweon, HaeYong; Kim, Dae-Won; Kim, Min-Keun; Kim, Seong-Gon; Kim, Jwa-Young; Chae, Weon-Sik; Hong, Sam-Pyo; Park, Young-Hwan; Lee, Si Young; Choi, Je-Yong

    2017-01-01

    Silk suture material is primarily composed of silk fibroin and regarded as a non-resorbable material. It is slowly degraded by proteolysis when it is implanted into the body. 4-Hexylresorcinol (4HR) is a well-known antiseptic. In this study, the biodegradability of 4HR-incorporated silk sutures were compared to that of untreated silk sutures and polyglactin 910 sutures, a commercially available resorbable suture. 4HR-incorporated silk sutures exhibited anti-microbial properties. Matrix metalloproteinase (MMP) can digest a wide spectrum of proteins. 4HR increased MMP-2, -3, and -9 expression in RAW264.7 cells. MMP-2, -3, and -9 were able to digest not only silk fibroin but also silk sutures. Consequently, 59.5% of the 4HR-incorporated silk suture material remained at 11 weeks after grafting, which was similar to that of polyglactin 910 degradation (56.4% remained). The residual amount of bare silk suture material at 11 weeks after grafting was 91.5%. The expression levels of MMP-2, -3 and -9 were high in the 4HR-incorporated silk suture-implanted site 12 weeks after implantation. In conclusion, 4HR-treated silk sutures exhibited anti-microbial properties and a similar level of bio-degradation to polyglactin 910 sutures and induced higher expression of MMP-2, -3, and -9 in macrophages. PMID:28205580

  18. Liquid Wall Chambers

    SciTech Connect

    Meier, W R

    2011-02-24

    The key feature of liquid wall chambers is the use of a renewable liquid layer to protect chamber structures from target emissions. Two primary options have been proposed and studied: wetted wall chambers and thick liquid wall (TLW) chambers. With wetted wall designs, a thin layer of liquid shields the structural first wall from short ranged target emissions (x-rays, ions and debris) but not neutrons. Various schemes have been proposed to establish and renew the liquid layer between shots including flow-guiding porous fabrics (e.g., Osiris, HIBALL), porous rigid structures (Prometheus) and thin film flows (KOYO). The thin liquid layer can be the tritium breeding material (e.g., flibe, PbLi, or Li) or another liquid metal such as Pb. TLWs use liquid jets injected by stationary or oscillating nozzles to form a neutronically thick layer (typically with an effective thickness of {approx}50 cm) of liquid between the target and first structural wall. In addition to absorbing short ranged emissions, the thick liquid layer degrades the neutron flux and energy reaching the first wall, typically by {approx}10 x x, so that steel walls can survive for the life of the plant ({approx}30-60 yrs). The thick liquid serves as the primary coolant and tritium breeding material (most recent designs use flibe, but the earliest concepts used Li). In essence, the TLW places the fusion blanket inside the first wall instead of behind the first wall.

  19. Metabolic simulation chamber

    NASA Technical Reports Server (NTRS)

    Bartlett, R. G.; Hendricks, C. M.

    1972-01-01

    Metabolic simulation combustion chamber was developed as subsystem for breathing metabolic simulator. Entire system is used for evaluation of life support and resuscitation equipment. Metabolism subsystem simulates a human by consuming oxygen and producing carbon dioxide. Basic function is to simulate human metabolic range from rest to hard work.

  20. Improved wire chamber

    DOEpatents

    Atac, M.

    1987-05-12

    An improved gas mixture for use with proportional counter devices, such as Geiger-Mueller tubes and drift chambers. The improved gas mixture provides a stable drift velocity while eliminating wire aging caused by prior art gas mixtures. The new gas mixture is comprised of equal parts argon and ethane gas and having approximately 0.25% isopropyl alcohol vapor. 2 figs.

  1. In vitro characteristics of a bioabsorbable suspension screw and suture system for endoscopic brow lift surgery.

    PubMed

    Pietrzak, William S; Eppley, Barry L

    2007-03-01

    The time requirement for endoscopic subperiosteal brow lift fixation is as little as 10-14 days. Many types of bioabsorbable fixation have been applied to this procedure, including bioabsorbable suture coupled with a bioabsorbable bone anchor, with excellent outcomes. Typically, the anchor and suture materials differ, each having their own hydrolytic strength loss profile. The dynamic relationship between the instantaneous state of degradation of the bone anchor and the suture components can affect fixation strength and failure mode, a poorly understood phenomenon. We examined the use of 2x5 mm PLLA-PGA (82:18) copolymer screws containing a suture eyelet in the head, paired with one of four types of bioabsorbable suture (2-0 and 3-0 Vicryl and 2-0 and 3-0 PDS-II), in a model system designed to mimic brow lift fixation. Constructs were inserted into a synthetic bone substrate and incubated in pH 7.4 buffer at 37 degrees C for up to 3 weeks, then loaded to failure. Initial failure loads were dependent upon suture size but not suture material, with 2-0 suture constructs (63-70N) failing at twice the load of the 3-0 suture constructs (30-35N). The following 3 week strength retentions were obtained: 40-55% for 2-0 and 3-0 Vicryl suture, 100% for 3-0 PDS-II suture, and 58% for 2-0 PDS-II suture constructs. The predominant failure mode was suture breakage at the knot, with the later intervals utilizing 2-0 PDS-II suture including some screw head failures. This suspension screw, when coupled with an appropriate suture, appears to have suitable mechanical properties for endoscopic brow lift fixation.

  2. Combustor with fuel preparation chambers

    NASA Technical Reports Server (NTRS)

    Zelina, Joseph (Inventor); Myers, Geoffrey D. (Inventor); Srinivasan, Ram (Inventor); Reynolds, Robert S. (Inventor)

    2001-01-01

    An annular combustor having fuel preparation chambers mounted in the dome of the combustor. The fuel preparation chamber comprises an annular wall extending axially from an inlet to an exit that defines a mixing chamber. Mounted to the inlet are an air swirler and a fuel atomizer. The air swirler provides swirled air to the mixing chamber while the atomizer provides a fuel spray. On the downstream side of the exit, the fuel preparation chamber has an inwardly extending conical wall that compresses the swirling mixture of fuel and air exiting the mixing chamber.

  3. Multi-chamber deposition system

    DOEpatents

    Jacobson, Richard L.; Jeffrey, Frank R.; Westerberg, Roger K.

    1989-10-17

    A system for the simultaneous deposition of different coatings onto a thin web within a large volume vacuum chamber is disclosed which chamber is provided with a plurality of deposition chambers in which the different layers are deposited onto the film as its moves from a supply roll to a finished take-up roll of coated web. The deposition chambers provided within the large vacuum chamber are provided with separate seals which minimize back diffusion of any dopant gas from adjacent deposition chambers.

  4. Multi-chamber deposition system

    DOEpatents

    Jacobson, Richard L.; Jeffrey, Frank R.; Westerberg, Roger K.

    1989-06-27

    A system for the simultaneous deposition of different coatings onto a thin web within a large volume vacuum chamber is disclosed which chamber is provided with a plurality of deposition chambers in which the different layers are deposited onto the film as its moves from a supply roll to a finished take-up roll of coated web. The deposition chambers provided within the large vacuum chamber are provided with separate seals which minimize back diffusion of any dopant gas from adjacent deposition chambers.

  5. 72. VISITOR'S CENTER, MODEL OF BOILER CHAMBER, AUXILIARY CHAMBER, REACTOR ...

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

    72. VISITOR'S CENTER, MODEL OF BOILER CHAMBER, AUXILIARY CHAMBER, REACTOR AND CANAL (LOCATION T) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

  6. Manual Suture Less Small Incision Cataract Surgery in Patients with Uveitic Cataract

    PubMed Central

    Bhargava, Rahul; Kumar, Prachi; Bashir, Hafsa; Sharma, Shiv Kumar; Mishra, Anurag

    2014-01-01

    Purpose: The purpose of this study is to evaluate the outcome of manual small incision cataract surgery (SICS) in eyes with uveitic cataract. Setting: Medical college hospital of the subcontinent. Design: Retrospective case series. Materials and Methods: In this retrospective study, patients who underwent SICS with posterior chamber intraocular lens implantation for uveitic cataract from 2006 to 2009 were evaluated. Patients with less than 3 months follow-up were excluded. Post-operative vision and complications were analyzed. Results: A total of 54 patients completed the study. The mean age was 52.3 ± 9.3 years. The mean follow-up was 11.53 ± 5.05 months. The mean surgical time was (10.2 ± 3.8 min). Etiological diagnosis was possible in 31.41% (17/54) of patients. There was a statistically significant improvement in vision after surgery (P < 0.001). When uveitis was well-controlled, pre-operative corticosteroids did not change post-operative inflammation (P = 0.796). However, pre-operative corticosteroids were statistically significantly associated to final best corrected visual acuity (BCVA) (P = 0.010). Conclusion: SICS with posterior chamber intraocular lens implantation is safe in most cataracts due to uveitis and improves BCVA at 6 months. Inflammation should be well-controlled pre-operatively for at least 3 months. Posterior capsule opacification, macular edema and persistent uveitis were the main factors affecting visual outcome. SICS requires minimal instrumentation, surgical time is short and can also be performed in rural clinics and eye-camps, where phacoemulsification machines are unavailable. SICS may be a more practical and cost-effective technique for uveitic cataract, in such circumstances. PMID:24669151

  7. An intuitive method of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy: use of one-step circumferential interrupted sutures

    PubMed Central

    Kim, Moonwhan; Shin, Woo Young; Ahn, Seung-Ik

    2017-01-01

    Pancreaticoenteric anastomosis is the origin of postoperative pancreatic fistula (POPF). Although a variety of methods have been proposed to decrease the POPF rate, randomized controlled trials performed so far have failed to demonstrate superiority of any particular method to the others. Cattell-Warren duct-to-mucosa pancreaticojejunostomy (PJ) is a widely practiced procedure. Their method is challenging, especially when the pancreatic duct is small. We assumed that the difficulty resides in the pancreatic duct becoming difficult to access when the posterior row is tied before suturing the anterior row. We have modified the duct-to-mucosa PJ so that the entire circumference of the inner layer can be sutured and tied in one-step by anchoring and retracting the anterior row. The jejunal roux-limb and pancreatic stump are positioned spatially apart, allowing enough space for free needle work. During a 13-year period, 151 patients underwent pancreaticoduodenectomy with this method, and the cumulative POPF and mortality rates were 37.1% and 4.6%, respectively. These rates were stable throughout the study period, implicating a relative independence from surgeons' experience. We believe that our method is intuitive, easy to grasp, and can be readily adopted even by surgeons not accustomed to pancreaticoduodenectomy. PMID:28317044

  8. Three chamber negative ion source

    DOEpatents

    Leung, Ka-Ngo; Ehlers, Kenneth W.; Hiskes, John R.

    1985-01-01

    A negative ion vessel is divided into an excitation chamber, a negative ionization chamber and an extraction chamber by two magnetic filters. Input means introduces neutral molecules into a first chamber where a first electron discharge means vibrationally excites the molecules which migrate to a second chamber. In the second chamber a second electron discharge means ionizes the molecules, producing negative ions which are extracted into or by a third chamber. A first magnetic filter prevents high energy electrons from entering the negative ionization chamber from the excitation chamber. A second magnetic filter prevents high energy electrons from entering the extraction chamber from the negative ionizing chamber. An extraction grid at the end of the negative ion vessel attracts negative ions into the third chamber and accelerates them. Another grid, located adjacent to the extraction grid, carries a small positive voltage in order to inhibit positive ions from migrating into the extraction chamber and contour the plasma potential. Additional electrons can be suppressed from the output flux using ExB forces provided by magnetic field means and the extractor grid electric potential.

  9. Surgical treatment of an acetabular fracture and labral tear with suture anchors in a 10-year-old child.

    PubMed

    Mormor, Meir; Matityahu, Amir

    2009-11-01

    This article presents a case of a 10-year-old boy with a right acetabular fracture secondary to a direct blow to the pelvis and back. He sustained a right hip dislocation and transverse with posterior wall acetabular fracture with a nonconcentric hip joint after reduction. The fracture was treated with right labral and articular segment absorbable suture tie-down and relocation of the right hip into an anatomical position. At 32-month follow-up, the patient had returned to activities of daily living, he had a normal and symmetric gait pattern, and no pain on hip adduction, flexion, or internal rotation. This technique reduced the fracture and labrum, relocated the hip joint, and obviated the need for hardware removal that is typically needed in the pediatric population. This case is distinctive due to the patient's young age and treatment method, which has not been described previously for the treatment of this rare pediatric fracture.

  10. Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery

    PubMed Central

    Heymanns, Verena; Oseni, Abidemi W.; Alyeldien, Ameer; Maslehaty, Homajoun; Parvin, Richard; Scholz, Martin

    2016-01-01

    Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature. PMID:27478578

  11. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    PubMed

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.

  12. Timing of ectocranial suture activity in Gorilla gorilla as related to cranial volume and dental eruption.

    PubMed

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

    2011-05-01

    Research has shown that Pan and Homo have similar ectocranial suture synostosis patterns and a similar suture ontogeny (relative timing of suture fusion during the species ontogeny). This ontogeny includes patency during and after neurocranial expansion with a delayed bony response associated with adaptation to biomechanical forces generated by mastication. Here we investigate these relationships for Gorilla by examining the association among ectocranial suture morphology, cranial volume (as a proxy for neurocranial expansion) and dental development (as a proxy for the length of time that it has been masticating hard foods and exerting such strains on the cranial vault) in a large sample of Gorilla gorilla skulls. Two-hundred and fifty-five Gorilla gorilla skulls were examined for ectocranial suture closure status, cranial volume and dental eruption. Regression models were calculated for cranial volumes by suture activity, and Kendall's tau (a non-parametric measure of association) was calculated for dental eruption status by suture activity. Results suggest that, as reported for Pan and Homo, neurocranial expansion precedes suture synostosis activity. Here, Gorilla was shown to have a strong relationship between dental development and suture activity (synostosis). These data are suggestive of suture fusion extending further into ontogeny than brain expansion, similar to Homo and Pan. This finding allows for the possibility that masticatory forces influence ectocranial suture morphology.

  13. Vitrectomy and translocation of the anterior chamber intraocular lens to the sulcus: a closed microsurgical technique for the UGH syndrome.

    PubMed

    Gualtieri, William; Rossini, Paolo; Forlini, Cesare

    2008-01-01

    This interventional case report presents an anterior chamber intraocular lens (AC-IOL) translocation technique to manage a case of uveitis-glaucoma-hyphema (UGH) syndrome associated with posterior dislocation of nuclear fragments and vitreitis as a consequence of capsule rupture during cataract surgery. Pars plana vitrectomy followed by an AC-IOL translocation from the anterior chamber to the sulcus without additional surgical corneal incision was performed. At 12 months' follow-up, the original AC-IOL was in stable position in the posterior chamber, with binocular refractive balance and no further astigmatism and resolution of the UGH syndrome.

  14. Cranial sutures work collectively to distribute strain throughout the reptile skull

    PubMed Central

    Curtis, Neil; Jones, M. E. H.; Evans, S. E.; O'Higgins, P.; Fagan, M. J.

    2013-01-01

    The skull is composed of many bones that come together at sutures. These sutures are important sites of growth, and as growth ceases some become fused while others remain patent. Their mechanical behaviour and how they interact with changing form and loadings to ensure balanced craniofacial development is still poorly understood. Early suture fusion often leads to disfiguring syndromes, thus is it imperative that we understand the function of sutures more clearly. By applying advanced engineering modelling techniques, we reveal for the first time that patent sutures generate a more widely distributed, high level of strain throughout the reptile skull. Without patent sutures, large regions of the skull are only subjected to infrequent low-level strains that could weaken the bone and result in abnormal development. Sutures are therefore not only sites of bone growth, but could also be essential for the modulation of strains necessary for normal growth and development in reptiles. PMID:23804444

  15. Multiwire proportional chamber development

    NASA Technical Reports Server (NTRS)

    Doolittle, R. F.; Pollvogt, U.; Eskovitz, A. J.

    1973-01-01

    The development of large area multiwire proportional chambers, to be used as high resolution spatial detectors in cosmic ray experiments is described. A readout system was developed which uses a directly coupled, lumped element delay-line whose characteristics are independent of the MWPC design. A complete analysis of the delay-line and the readout electronic system shows that a spatial resolution of about 0.1 mm can be reached with the MWPC operating in the strictly proportional region. This was confirmed by measurements with a small MWPC and Fe-55 X-rays. A simplified analysis was carried out to estimate the theoretical limit of spatial resolution due to delta-rays, spread of the discharge along the anode wire, and inclined trajectories. To calculate the gas gain of MWPC's of different geometrical configurations a method was developed which is based on the knowledge of the first Townsend coefficient of the chamber gas.

  16. Crystals in magma chambers

    NASA Astrophysics Data System (ADS)

    Higgins, M.

    2011-12-01

    Differentiation processes in igneous systems are one way in which the diversity of igneous rocks is produced. Traditionally, magmatic diversity is considered as variations in the overall chemical composition, such as basalt and rhyolite, but I want to extend this definition to include textural diversity. Such textural variations can be manifested as differences in the amount of crystalline (and immiscible liquid) phases and in the origin and identity of such phases. One important differentiation process is crystal-liquid separation by floatation or decantation, which clearly necessitates crystals in the magma. Hence, it is important to determine if magmas in chambers (sensu lato) have crystals. The following discussion is framed in generalities - many exceptions occur. Diabase (dolerite) dykes are a common, widespread result of regional mafic magmatism. The rims of most diabase dykes have few or no phenocrysts and crystals in the cores are commonly thought to have crystallized in place. Hence, this major mafic magmatic source did not have crystals, although compositional diversity of these dykes is commonly explained by crystal-liquid separation. This can be resolved if crystallisation was on the walls on the magma chamber. Similarly, most flood basalts are low in crystals and separation of those that are present cannot always explain the observed compositional diversity. Crystal-rich flows do occur, for example the 'Giant Plagioclase Basalts' of the Deccan series, but the crystals are thought to form or accumulate in a crystal-rich zone beneath the roof of the chamber - the rest of the chamber probably has few crystals. Some magmas from Hawaii contain significant amounts of olivine crystals, but most of these are deformed and cannot have crystallised in the chamber. In this case the crystals are thought to grow as the magma passes through a decollement zone. They may have grown on the walls or been trapped by filters. Basaltic andesite ignimbrites generally have

  17. Combustion chamber noise suppressor

    SciTech Connect

    Livingston, A.M.

    1986-08-19

    A combustion chamber is described for a hot fog generating machine comprising a hollow cylindrical combustion chamber shell having a closure plate at one end and outlet means at the opposite end for directing hot combustion gasses to a fogging nozzle, air inlet means disposed adjacent the outlet means, fuel inlet means and ignition means mounted in the closure plate and liner means disposed concentrically within the cylindrical combustion chamber for controlling the flow of air and combustion gasses within the shell. The liner means includes a liner base having a frustroconical configuration with the smaller diameter end thereof disposed in communication with the outlet means and with the larger diameter end thereof disposed in spaced relation to the shell, circumferentially spaced, longitudinally extending fins extending outwardly from the liner base intermediate the liner base and the shell, a cylindrical liner midsection having circumferentially spaced fins extending outwardly therefrom between the midsection and the shell with the fins supporting the midsection on the larger diameter end of the liner base.

  18. [Low colorectal anastomosis: a comparison of manual and mechanical sutures].

    PubMed

    Del Gaudio, A; Boschi, L; Petrin, C; Berardi, M; Accorsi, D

    1993-01-01

    Sixty-three carcinomas of the lower third of the rectum operated of anterior resection with low colorectal or coloanal anastomosis are presented. Handsewn anastomoses were performed in 33 patients, while staplers were used in 30 cases. The average distance of the tumor from the anal verge is 10.8 cm. in hand sutured anastomoses and 7.8 cm. in stapled ones. Dehiscences, stenosis and temporary incontinence are observed more frequently after stapled anastomosis, while the incidence of neoplastic recurrences is higher in sutured anastomosis; hospital stay and mortality are similar in the two series. Our results and literature review show that both techniques are comparable though maintaining their own specific identity and precise indication.

  19. Vertical two chamber reaction furnace

    DOEpatents

    Blaugher, R.D.

    1999-03-16

    A vertical two chamber reaction furnace is disclosed. The furnace comprises a lower chamber having an independently operable first heating means for heating the lower chamber and a gas inlet means for admitting a gas to create an ambient atmosphere, and an upper chamber disposed above the lower chamber and having an independently operable second heating means for heating the upper chamber. Disposed between the lower chamber and the upper chamber is a vapor permeable diffusion partition. The upper chamber has a conveyor means for conveying a reactant there through. Of particular importance is the thallinating of long-length thallium-barium-calcium copper oxide (TBCCO) or barium-calcium-copper oxide (BCCO) precursor tapes or wires conveyed through the upper chamber to thereby effectuate the deposition of vaporized thallium (being so vaporized as the first reactant in the lower chamber at a temperature between about 700 and 800 C) on TBCCO or BCCO tape or wire (the second reactant) at its simultaneous annealing temperature in the upper chamber of about 800 to 950 C to thereby replace thallium oxide lost from TBCCO tape or wire because of the high annealing temperature or to deposit thallium on BCCO tape or wire. Continuously moving the tape or wire provides a single-step process that effectuates production of long-length TBCCO superconducting product. 2 figs.

  20. Vertical two chamber reaction furnace

    DOEpatents

    Blaugher, Richard D.

    1999-03-16

    A vertical two chamber reaction furnace. The furnace comprises a lower chamber having an independently operable first heating means for heating the lower chamber and a gas inlet means for admitting a gas to create an ambient atmosphere, and an upper chamber disposed above the lower chamber and having an independently operable second heating means for heating the upper chamber. Disposed between the lower chamber and the upper chamber is a vapor permeable diffusion partition. The upper chamber has a conveyor means for conveying a reactant there through. Of particular importance is the thallinating of long-length thallium-barium-calcium-copper oxide (TBCCO) or barium-calcium-copper oxide (BCCO) precursor tapes or wires conveyed through the upper chamber to thereby effectuate the deposition of vaporized thallium (being so vaporized as the first reactant in the lower chamber at a temperature between about 700.degree. and 800.degree. C.) on TBCCO or BCCO tape or wire (the second reactant) at its simultaneous annealing temperature in the upper chamber of about 800.degree. to 950.degree. C. to thereby replace thallium oxide lost from TBCCO tape or wire because of the high annealing temperature or to deposit thallium on BCCO tape or wire. Continuously moving the tape or wire provides a single-step process that effectuates production of long-length TBCCO superconducting product.

  1. Syneture stainless STEEL suture. A collective review of its performance in surgical wound closure.

    PubMed

    Edlich, Richard F; Drake, David B; Rodeheaver, George T; Winters, Kathryne L; Greene, Jill A; Gubler, K Dean; Long, William B; Britt, L D; Winters, Samuel P; Scott, Christine C; Lin, Kant Y

    2006-01-01

    Syneture (division of U.S. Surgical, division of Tyco Healthcare, Norwalk, Connecticut, USA) STEEL sutures are monofilament stainless steel sutures composed of 316L stainless steel conforming to ASTM Standard F138 grade 2 (" Stainless steel bar and wire for surgical implant"). STEEL sutures meet all requirements established by the United States Pharmacopeia (USP) for nonabsorbable surgical sutures. Steel sutures are for use in abdominal wound closure, intestinal anastomosis, hernia repair, sternal closure, and skin closure. They are attached to the following types of surgical needles: Roto-Grip Needles and SCC Needle. The sutures and needles are packaged in a Mylar/Tyvek outer envelope. The purposes of this clinical review are two fold. First, we will report the performance of the Syneture STEEL suture product in the largest studies of suture performance ever reported in the literature. In addition, we will provide comprehensive information from the surgical literature that highlights the unique benefits of stainless steel sutures for the following wound closure techniques: sternal fixation, abdominal wound repair, inguinal hernia repair, and skin wound closure. Consorta Inc. (Rolling Meadows, Illinois), a leading healthcare resource management group purchasing organization, and Syneture, jointly with a clinician task force, designed a reproducible surgical evaluation program for needles and sutures in a large cooperative of healthcare systems. Because of the subjective nature of the more commonly used suture selection techniques, a nonexperimental observational study approach was designed to replace perception of performance characteristics with actual clinical experience. In a report involving 19 Consorta shareholder hospitals, they discussed the preliminary part (Phase I) of a large nonexperimental observational study of the clinical performance of surgical needles and sutures. Performance characteristics of the sutures and needles produced by Syneture that were

  2. Rethinking "posterior" tongue-tie.

    PubMed

    Douglas, Pamela Sylvia

    2013-12-01

    Currently, many clinicians who help with breastfeeding problems are diagnosing "posterior" tongue-tie in infants and performing or referring for frenotomy. In this "Speaking Out" article, I argue that the diagnosis of "posterior" tongue-tie has successfully raised awareness of the importance of impaired tongue function in breastfeeding difficulty. However, the diagnosis of "posterior" tongue-tie also applies a reductionist, medicalized theoretical frame to the complex problem of impaired tongue function, risking unintended outcomes. Impaired tongue function arises out of multiple interacting and co-evolving factors, including the interplay between social behaviors concerning breastfeeding and mother-infant biology. Consideration of theoretical frames is vital if we are to build an evidence base through efficient use of the scarce resources available for clinical breastfeeding research and minimize unintended outcomes.

  3. The south Zagros suture zone in teleseismic images

    NASA Astrophysics Data System (ADS)

    Motaghi, K.; Shabanian, E.; Tatar, M.; Cuffaro, M.; Doglioni, C.

    2017-01-01

    The geometry of intra-continental lithosphere boundaries along the Zagros orogenic belt in the Arabia-Eurasia collision is investigated by means of teleseismic data. The data are gathered over a seismic linear profile extending across south Zagros, the Sanandaj-Sirjan metamorphic zone, the Urumieh-Dokhtar magmatic arc, Central Iran, and the Kopeh Dagh - Binalud mountains. We exploit the P and S receiver functions leading to map the geometry of the crustal and subcrustal interfaces. The migrated depth sections reveal an abrupt crustal thickening and a gentle crustal thinning 60 km north and 30 km south of the Zagros suture, respectively. Associated to the buckled antiformal Moho south of the suture, a deeper synform in the lithospheric lid of the lower Arabia plate is shown by migrated depth sections affecting the lithospheric mantle of the Arabia plate beneath the suture zone. This geometry implies an unexpected intra-lid decoupling. These features imply that the Central Iran lithosphere acts as a relatively strong backstop producing significant internal deformation expressed by shortening and thickening at the edge of the Arabian lithosphere. The 410 km and 660 km transition zones are imaged by P to S converted phases and showed lateral continuity implying an originally low dip angle subduction of the oceanic Arabian plate beneath Central Iran.

  4. Arthroscopic Direct Repair for a Complete Radial Tear of the Posterior Root of the Medial Meniscus

    PubMed Central

    Wang, Kook Hyun; Hwang, Dae Hee; Cho, Jin Ho; Changale, Sachin D.; Woo, Sung Jong

    2011-01-01

    We report here on a new arthroscopic direct repair technique for a radial tear of the posterior root of the medial meniscus (PRMM) using a posterior trans-septal portal. Radial tears of the PRMM are commonly observed in the elderly population of Korea and Japan, and the life style of these people requires squatting and kneeling down in daily life. A radial tear of the PRMM results in the loss of hoop tension and this accelerates degenerative changes in the knee joint and causes early osteoarthritis. Several reports in the medical literature have focused on various repair techniques for these tears by using pull out sutures. These techniques result in nonanatomic fixation of the meniscus, which may lead to disturbed meniscal excursion and failure to restore hoop tension. Arthroscopic direct repair may contribute to restoring hoop tension and preventing accelerated degenerative changes in the knee joint of these patients. PMID:22162797

  5. A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery.

    PubMed

    Osunde, O D; Adebola, R A; Saheeb, B D

    2012-10-01

    The aim of this prospective randomized study was to evaluate the effect of not using sutures on postoperative pain, swelling and trismus after lower third molar surgery. 80 patients with impacted lower third molars were referred for surgical extraction (42 males; 38 females; aged 18-38 years). The patients were randomly divided into two equal groups (sutures n=40; suture-less n=40). In the experimental group, the flaps were replaced without suturing. The control group was selected using the same criteria and treated under the same surgical protocol as the experimental group, except that the flaps were apposed using multiple sutures. Pain, swelling and trismus were evaluated at 24 h, 48 h and 1 week postoperatively in both groups. The operation time was found to be significantly longer in the multiple sutures group (p<0.05). There was significantly less pain, swelling and trismus at 24 h and 48 h, respectively, in the suture-less group (p<0.05). There was no significant difference between the two treatment groups in terms of pain, swelling and trismus, at 1 week postoperatively (p>0.05). There is less postoperative pain, swelling and trismus with the suture-less technique in third molar surgery.

  6. The posterior border of the sphenoid greater wing and its phylogenetic usefulness in human evolution.

    PubMed

    Braga, J; Crubézy, E; Elyaqtine, M

    1998-12-01

    The elucidation of patterns of cranial skeletal maturation and growth in fossil hominids is possible not only through dental studies but also by mapping different aspects of ossification in both extant African apes and humans. However, knowledge of normal skeletal development in large samples of extant great apes is flimsy. To remedy this situation, this paper offers an extensive survey and thorough discussion of the ossification of the posterior border of the sphenoid greater wing. Indeed, this area provides much information about basicranial skeletal maturation. We investigate three variants: the absence of the foramen spinosum and the position of both the foramen spinosum and the foramen ovale in relation to the sphenosquamosal suture. Providing original data about humans and 1,425 extant great ape skulls and using a sample of 64 fossil hominids, this study aimed to test whether different ossification patterns occurred during the course of human evolution. The incidence of three derived morphologies located on the posterior border of the sphenoid greater wing increases during human evolution at different geological periods. The evolutionary polarity of these three derived morphologies is assessed by outgroup comparison and ontogenetic methods. During human evolution, there is a clear trend for the foramen spinosum to be present and wholly located on the posterior area of the sphenoid greater wing. Moreover, in all the great ape species and in Australopithecus afarensis, the sphenosquamosal suture may split the foramen ovale. Inversely, the foramen ovale always lies wholly within the sphenoid greater wing in Australopithecus africanus, robust australopithecines, early Homo, H. erectus (and/or H. ergaster), and Homo sapiens. From ontogenetic studies in humans, we conclude that, during human evolution, the ossification of the posterior area of the sphenoid greater wing progressively surrounded the middle meningeal artery (passing through the foramen spinosum) and

  7. Fabrication and feasibility study of an absorbable diacetyl chitin surgical suture for wound healing.

    PubMed

    Shao, Kai; Han, Baoqin; Gao, Jinning; Jiang, Zhiwen; Liu, Weizhi; Liu, Wanshun; Liang, Ye

    2016-01-01

    Diacetyl chitin (DAC) is an acidylated chitin obtained using acetic anhydride mixed perchloric acid system. By wet spinning and weaving technique, DAC has been successfully developed into a novel absorbable surgical suture. Thanks to the unique properties of chitins, the potential application of this novel monocomponent multifilament DAC suture may break the monopoly of synthetic polymer sutures in wound closure area. In this study, DAC was synthesized and characterized by multiple approaches including elemental analysis, Fourier transform infrared spectrometry (FTIR), and X-ray diffraction (XRD). In addition, we performed the feasibility assessment of DAC suture (USP 2-0) as absorbable suture for wound healing. Several lines of evidences suggested that DAC suture had comparable mechanical properties as synthetic polymer sutures. Moreover, DAC suture retained approximately 63% of the original strength at 14 days and completely absorbed in 42 days with no remarkable tissue reaction in vivo. Most important of all, DAC suture significantly promoted skin regeneration with faster tissue reconstruction and higher wound breaking strength on a linear incisional wound model. All these results demonstrated the potential use of DAC suture in short- or middle-term wound healing, such as epithelial and connective tissue.

  8. Bending and abrasion fatigue of common suture materials used in arthroscopic and open orthopedic surgery.

    PubMed

    Savage, Earle; Hurren, Christopher J; Slader, Simon; Khan, Lukman A K; Sutti, Alessandra; Page, Richard S

    2013-01-01

    In orthopedic surgery, the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow time for healing at the tendon-bone interface. The suture, not rigidly restrained within the anchor eyelet, is free to move during surgery and potentially after surgery with limb motion. During such movement, the suture is subjected to bending and frictional forces that can lead to fatigue-induced failure. We investigated some common contemporary commercial number-two-grade suture materials and evaluated their resistance to bending abrasion fatigue and the consequent failure. Sutures were oscillated over a stainless steel wire at low frequency under load. Number of abrasion cycles to failure, changes in suture morphology, and fatigue-failure method was recorded for each material. Suture structure had a significant effect on abrasion resistance, with braided sutures containing large numbers of fine high tenacity core filaments performing 15-20 times better than other braided suture structures. Ultra high molecular weight polyethylene (UHMWPE) core filaments resisted bending abrasion failure better than other core materials due to the load spreading and abrasion resistance of these filaments. Sutures with UHMWPE cores also had high resistance to tensile failure. Limited correlation was observed between tensile strength and abrasion resistance.

  9. Ionization chamber dosimeter

    DOEpatents

    Renner, Tim R.; Nyman, Mark A.; Stradtner, Ronald

    1991-01-01

    A method for fabricating an ion chamber dosimeter collecting array of the type utilizing plural discrete elements formed on a uniform collecting surface which includes forming a thin insulating layer over an aperture in a frame having surfaces, forming a predetermined pattern of through holes in the layer, plating both surfaces of the layer and simultaneously tilting and rotating the frame for uniform plate-through of the holes between surfaces. Aligned masking and patterned etching of the surfaces provides interconnects between the through holes and copper leads provided to external circuitry.

  10. The APS ceramic chambers

    SciTech Connect

    Milton, S.; Warner, D.

    1994-07-01

    Ceramics chambers are used in the Advanced Photon Source (APS) machines at the locations of the pulsed kicker and bumper magnets. The ceramic will be coated internally with a resistive paste. The resistance is chosen to allow the low frequency pulsed magnet field to penetrate but not the high frequency components of the circulating beam. Another design goal was to keep the power density experienced by the resistive coating to a minimum. These ceramics, their associated hardware, the coating process, and our recent experiences with them are described.

  11. Children's Understanding of Posterior Probability

    ERIC Educational Resources Information Center

    Girotto, Vittorio; Gonzalez, Michael

    2008-01-01

    Do young children have a basic intuition of posterior probability? Do they update their decisions and judgments in the light of new evidence? We hypothesized that they can do so extensionally, by considering and counting the various ways in which an event may or may not occur. The results reported in this paper showed that from the age of five,…

  12. Stereolithography for Posterior Fossa Cranioplasty

    PubMed Central

    Agner, Celso; Dujovny, Manuel; Evenhouse, Raymond; Charbel, Fady T.; Sadler, Lewis

    1998-01-01

    Posterior fossa cranioplasty has been suggested for improvement of neurological symptoms following craniectomy. However, there is no particular recommendation in the literature about techniques for prosthesis manufacture and implantation. We report our experience using rapid prototyping technology and stereolithography for pre-surgical implant design and production of cranioplasties. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17171056

  13. Bundles of Spider Silk, Braided into Sutures, Resist Basic Cyclic Tests: Potential Use for Flexor Tendon Repair

    PubMed Central

    Hennecke, Kathleen; Redeker, Joern; Kuhbier, Joern W.; Strauss, Sarah; Allmeling, Christina; Kasper, Cornelia; Reimers, Kerstin; Vogt, Peter M.

    2013-01-01

    Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials. PMID:23613793

  14. Drug delivery to the posterior segment of the eye for pharmacologic therapy

    PubMed Central

    Shah, Shalin S; Denham, Lori Vidal; Elison, Jasmine R; Bhattacharjee, Partha S; Clement, Christian; Huq, Tashfin; Hill, James M

    2010-01-01

    Treatment of diseases of the posterior segment of the eye, such as age-related macular degeneration, cytomegalovirus retinitis, diabetic retinopathy, posterior uveitis and retinitis pigmentosa, requires novel drug delivery systems that can overcome the many barriers for efficacious delivery of therapeutic drug concentrations. This challenge has prompted the development of biodegradable and nonbiodegradable sustained-release systems for injection or transplantation into the vitreous as well as drug-loaded nanoparticles, microspheres and liposomes. These drug delivery systems utilize topical, systemic, subconjunctival, intravitreal, transscleral and iontophoretic routes of administration. The focus of research has been the development of methods that will increase the efficacy of spatiotemporal drug application, resulting in more successful therapy for patients with posterior segment diseases. This article summarizes recent advances in the research and development of drug delivery methods of the posterior chamber of the eye, with an emphasis on the use of implantable devices as well as micro- and nanoparticles. PMID:20305803

  15. Central posterior capsule pigmentation in a patient with pigment dispersion and previous ocular trauma: a case report.

    PubMed

    Al-Mezaine, Hani S

    2010-01-01

    We report a 55-year-old man with unusually dense, unilateral central posterior capsule pigmentation associated with the characteristic clinical features of pigment dispersion syndrome, including a Krukenberg's spindle and dense trabecular pigmentation in both eyes. A history of an old blunt ocular trauma probably caused separation of the anterior hyaloid from the back of the lens, thereby creating an avenue by which pigment could reach the potential space of Berger's from the posterior chamber.

  16. Orientation of late Precambrian sutures in the Arabian-Nubian shield

    NASA Astrophysics Data System (ADS)

    Stern, Robert J.; Nielsen, Kent C.; Best, Eric; Sultan, Mohamed; Arvidson, Raymond E.

    1990-11-01

    Recent tectonic models have resulted in conflicting descriptions of how the late Precambrian sutures of the Arabian-Nubian shield extend into northeast Africa. The Hamisana shear zone in northeastern Sudan is critical to this discussion because it truncates and disrupts two sutures, the Allaqi-Heiani and the Onib-Sol Hamed. Analysis of field structural data, Thematic Mapper imagery, and Rb-Sr and U-Pb geochronology suggests that the Allaqi-Heiani suture is the western extension of the Onib-Sol Hamed suture and that both make up the exposed parts of a far-traveled, polydeformed ophiolitic nappe complex. Subsequent deformation localized in the Hamisana shear zone disrupted this nappe and displaced the suture between 660 and 550 Ma during regional deformation associated with the Najd fault system. These results indicate that at least one suture extends westward into the interior of northern Africa.

  17. [Developments in suture techniques of hand flexor tendon injuries during the last fifteen years].

    PubMed

    Bíró, Vilmos

    2016-02-07

    In the reconstruction of hand flexor tendon injuries it is fundamental to select the best suture technique, which makes possible early, active postoperative mobilization and achievement of the best results. The author reviews the development of suture techniques of the flexor tendon injuries during the last fifteen years, and discusses experimental tendon reconstruction results as well as clinical outcomes. The author describes the importance of different tendon suture materials, the significance of the pulley system of the fingers, the stretching between the sutured tendon ends by tendon sutures and, finally, the importance of the moving course in the reconstructed tendon. He states, that the wide-range adoption of the discussed modern tendon sutures would be necessary for better postoperative results.

  18. Orientation of late Precambrian sutures in the Arabian-Nubian shield

    NASA Technical Reports Server (NTRS)

    Stern, Robert J.; Nielsen, Kent C.; Best, Eric; Sultan, Mohamed; Arvidson, Raymond E.

    1990-01-01

    Recent tectonic models have resulted in conflicting descriptions of how the late Precambrian sutures of the Arabian-Nubian shield extend into northeast Africa. The Hamisana shear zone in northeastern Sudan is critical to this discussion because it truncates and disrupts two sutures, the Allaqi-Heiani and the Onib-Sol Hamed. Analysis of field structural data, Thematic Mapper imagery, and Rb-Sr and U-Pb geochronology suggests that the Allaqi-Heiani suture is the western extension of the Onib-Sol Hamed suture and that both make up the exposed parts of a far-traveled, polydeformed ophiolitic nappe complex. Subsequent deformation localized in the Hamisana shear zone disrupted this nappe and displaced the suture between 660 and 550 Ma during regional deformation associated with the Najd fault system. These results indicate that at least one suture extends westward into the interior of northern Africa.

  19. Utility of the frontonasal suture for estimating age at death in human skeletal remains.

    PubMed

    Alesbury, Helen S; Ubelaker, Douglas H; Bernstein, Robin

    2013-01-01

    This project evaluated the utility of the frontonasal suture for estimating age at death. Utilizing human remains of known age at death with varying degrees of fusion, curated at the American Museum of Natural History in New York City and the Smithsonian Institution's National Museum of Natural History in Washington, DC, data were collected from the ectocranial surface of 522 crania; 68 of these were sagittally sectioned, allowing collection of internal data and observation of suture closure through the bone. Degree of ectocranial suture closure does not significantly predict age, even when sex and ancestry are accounted for. Suture closure progression data were converted into a Hershkovitz ratio (sum of the measurement of open portion divided by the total suture length), and regression models demonstrate that the effect of age accounts for only 13% of variation in suture closure.

  20. [Effect of abrasion on three types of sutures in a metallic anchor].

    PubMed

    Acosta Rodríguez, Eduardo; Almazán Díaz, Arturo

    2007-01-01

    It is necessary to slide the suture into the articulation in the arthroscopic techniques, this produce friction and abrasion of the suture, this is the principal cause of failure in the union of anchor-suture. We used a Fastak 2.4 anchor, Sawbones, No 2 Ethibond, No 2 Fiberwire and No 2 Herculine. Each suture was introduce to the anchor eyelet and was cycled in four times with 40N. The angles of traction were 0 degrees and 45 degrees at the same direction of the anchor eyelet and 45 degrees with different direction of the anchor eyelet. Five sutures were used in every test. We performed the Kolmogorov-Smirnof and "t" Student tests. In all the tests there were a significant differences. The strength of the suture is affected by the abrasion in the anchor eyelet.

  1. Anterior Chamber Iris Claw Lens for the Treatment of Aphakia in a Patient with Megalocornea

    PubMed Central

    Saffra, Norman; Rakhamimov, Aleksandr; Masini, Robert; Rosenthal, Kenneth J.

    2015-01-01

    Megalocornea in isolation is a rare congenital enlargement of the cornea greater than 13 mm in diameter. Patients with megalocornea are prone to cataract formation, crystalline lens subluxation, zonular deficiencies and dislocation of the posterior chamber intraocular lens (PCIOL) within the capsular bag. A 55-year-old male with megalocornea in isolation developed subluxation of the capsular bag and PCIOL. The PCIOL and capsular bag were explanted, and the patient was subsequently implanted with an anterior chamber iris claw lens. An anterior chamber iris claw lens is an effective option for the correction of aphakia in patients with megalocornea. PMID:26120314

  2. Sequential lift and suture technique for post-LASIK corneal striae.

    PubMed

    Mackool, Richard J; Monsanto, Vivian R

    2003-04-01

    We describe a surgical technique to manage persistent corneal striae after laser in situ keratomileusis (LASIK). The sequential lift and suture technique reduces the time required for LASIK, eliminates the need to fixate the flap with forceps during suturing, and increases the accuracy of suture placement. The results in 10 eyes (9 patients) showed complete resolution of striae with improvement in subjective symptoms (glare and blurred vision) and best corrected visual acuity.

  3. Quantitative physical and handling characteristics of novel antibacterial braided silk suture materials.

    PubMed

    Chen, Xiaojie; Hou, Dandan; Tang, Xiaoqi; Wang, Lu

    2015-10-01

    Surgical braided silk sutures have been widely used because these materials exhibit good handling characteristics, ease of use, and ideal knot security. However, surgical silk sutures likely cause surgical site infections because these sutures are composed of natural protein materials with a braided structure. As such, antibacterial silk sutures for clinical wound closure should be developed. Braided silk suture could be treated and modified with antibacterial agent, provided that excellent physical and handling characteristics of this material should maximize maintained. This study aimed to quantitatively investigate the effect of antibacterial treatment with different parameters on physical and handling characteristics of novel antibacterial braided silk sutures. Physical and handling characteristics, including appearance, knot-pull tensile strength, pullout friction resistance, tissue drag friction resistance, and bending stiffness, were evaluated. After physical and handling tests were conducted, images showed morphological characteristics were obtained and evaluated to investigate the relationship between antibacterial treatment and physical and handling properties. Results showed that suture diameter increased and reached the nearest thick size specification; knot-pull tensile strength decreased but remained higher than the standard value by at least 40.73%. Fracture asynchronism during knot-pull tensile strength test suggested that the fineness ratio of shell and core strands may enhance knot-pull tensile strength. Static and dynamic frictions of suture-to-suture friction behavior were slightly affected by antibacterial treatment, and changed to less than 16.07% and 32.77%, respectively. Suture-to-tissue friction and bending stiffness increased by approximately 50%; the bending stiffness of the proposed suture remained efficient compared with that of synthetic sutures. Therefore, good physical and handling characteristics can be maintained by selecting

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

    PubMed

    Kapustin, B B; Sysoev, S V

    2010-01-01

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

  5. Metallurgically bonded needle holder jaws. A technique to enhance needle holding security without sutural damage.

    PubMed

    Abidin, M R; Dunlapp, J A; Towler, M A; Becker, D G; Thacker, J G; McGregor, W; Edlich, R F

    1990-10-01

    A new needle holder jaw face has been specifically designed and developed to increase needle holding security without sutural damage. Tungsten carbide particles have been metallurgically bonded into the stainless steel jaw to create a fine granular surface. This bonded jaw enhances needle holding security by limiting either twisting or rotation of the clamped needle. In addition, compression of the monofilament synthetic sutures by the bonded jaws does not reduce suture breaking strength.

  6. A new, removable, sliding noose for adjustable-suture strabismus surgery.

    PubMed

    Deschler, Emily K; Irsch, Kristina; Guyton, Kristina L; Guyton, David L

    2013-10-01

    We describe a new removable sliding polyglactin 910 suture noose for postoperative suture adjustment following extraocular muscle surgery. No excess suture material remains after adjustment has been completed, helping to reduce discomfort, inflammation, and scarring. We have used this noose with the cul-de-sac conjunctival incision in approximately 360 patients over a period of 18 months. This report details how to fashion, use, and remove the noose.

  7. An accessory skull suture mimicking a skull fracture.

    PubMed

    Wiedijk, J E F; Soerdjbalie-Maikoe, V; Maat, G J R; Maes, A; van Rijn, R R; de Boer, H H

    2016-03-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of the parietal bone. Originally this was interpreted as a skull fracture, but autopsy indicated no signs of mechanical trauma. Instead the defect was defined as a unilateral accessory suture of the parietal bone. The initial erroneous diagnosis had severe adverse consequences and thus every health care professional or forensic specialist dealing with paediatric mechanical traumas should be cautious of this rare anomaly.

  8. Effectivity of intraoperative adjustable suture technique in horizontal strabismus

    PubMed Central

    Altintas, Ayse Gul Kocak; Arifoglu, Hasan Basri; Midillioglu, Inci Kocak; Gungor, Elif Damar; Simsek, Saban

    2013-01-01

    AIM To compare the long-term effectivity of intraoperative adjustable suture technique with traditional non-adjustable strabismus surgery. METHODS Two hundred and thirty-three patients, who underwent strabismus surgery either with traditional procedures or one-stage intraoperative adjustable suture technique, were included in our long-term follow-up study. One hundred and eighteen patients were evaluated in traditional surgery group (TSG) and 115 who underwent adjustable suture were in the one-stage intraoperative adjustable surgery group (ASG). In this group 9 patients had paralytic strabismus and 16 had reoperations, 2 patients had restrictive strabismus related to thyroid eye disease. The mean follow up in the TSG was 26.2 months and it was 24.8 months in the ASG group. RESULTS In patients with exotropia (XT) the mean correction of deviation for near fixation in ASG (32.4±13.2PD) and in TSG (26.4±8.2PD) were similar (P=0.112). The correction for distant fixation in ASG (33.2±11.4PD) and TSG (30.9±7.2PD) were not significantly different (P=0.321). In patients with esotropia (ET) even the mean correction of deviation for both near (31±12PD) and distant (30.6±12.8PD) fixations were higher in ASG than in TSG, for both near (28.27±14.2PD) and distant (28.9±12.9PD) fixations, the differences were not significant (P=0.346, 0.824 respectively). The overall success rate of XT patient was 78.9% in TSG and 78.78% in ASG, the difference was not significant (P=0.629). The success rates were 78.75% in TSG and 75.51% in ASG in ET patient, which was also not significantly different (P=0.821). CONCLUSION Although patients in ASG had more complex deviation such as paralysis, reoperations and restrictive strabismus, success rates of this tecnique was as high as TSG which did not contain complicated deviation. One-stage intraoperative adjustable suture technique is a safe and effective method for cooperative patient who has complex deviation. PMID:23991385

  9. Mush Column Magma Chambers

    NASA Astrophysics Data System (ADS)

    Marsh, B. D.

    2002-12-01

    Magma chambers are a necessary concept in understanding the chemical and physical evolution of magma. The concept may well be similar to a transfer function in circuit or time series analysis. It does what needs to be done to transform source magma into eruptible magma. In gravity and geodetic interpretations the causative body is (usually of necessity) geometrically simple and of limited vertical extent; it is clearly difficult to `see' through the uppermost manifestation of the concentrated magma. The presence of plutons in the upper crust has reinforced the view that magma chambers are large pots of magma, but as in the physical representation of a transfer function, actual magma chambers are clearly distinct from virtual magma chambers. Two key features to understanding magmatic systems are that they are vertically integrated over large distances (e.g., 30-100 km), and that all local magmatic processes are controlled by solidification fronts. Heat transfer considerations show that any viable volcanic system must be supported by a vertically extensive plumbing system. Field and geophysical studies point to a common theme of an interconnected stack of sill-like structures extending to great depth. This is a magmatic Mush Column. The large-scale (10s of km) structure resembles the vertical structure inferred at large volcanic centers like Hawaii (e.g., Ryan et al.), and the fine scale (10s to 100s of m) structure is exemplified by ophiolites and deeply eroded sill complexes like the Ferrar dolerites of the McMurdo Dry Valleys, Antarctica. The local length scales of the sill reservoirs and interconnecting conduits produce a rich spectrum of crystallization environments with distinct solidification time scales. Extensive horizontal and vertical mushy walls provide conditions conducive to specific processes of differentiation from solidification front instability to sidewall porous flow and wall rock slumping. The size, strength, and time series of eruptive behavior

  10. Diogene pictorial drift chamber

    SciTech Connect

    Gosset, J.

    1984-01-01

    A pictorial drift chamber, called DIOGENE, has been installed at Saturne in order to study central collisions of high energy heavy ions. It has been adapted from the JADE internal detector, with two major differences to be taken into account. First, the center-of-mass of these collisions is not identical to the laboratory reference frame. Second, the energy loss and the momentum ranges of the particles to be detected are different from the ones in JADE. It was also tried to keep the cost as small as possible, hence the choice of minimum size and minimum number of sensitive wires. Moreover the wire planes are shifted from the beam axis: this trick helps very much to quickly reject the bad tracks caused by the ambiguity of measuring drift distances (positive or negative) through times (always positive).

  11. Patterns and implications of extensive heterochrony in carnivoran cranial suture closure

    PubMed Central

    Goswami, A; Foley, L; Weisbecker, V

    2013-01-01

    Heterochronic changes in the rate or timing of development underpin many evolutionary transformations. In particular, the onset and rate of bone development have been the focus of many studies across large clades. In contrast, the termination of bone growth, as estimated by suture closure, has been studied far less frequently, although a few recent studies have shown this to represent a variable, although poorly understood, aspect of developmental evolution. Here, we examine suture closure patterns across 25 species of carnivoran mammals, ranging from social-insectivores to hypercarnivores, to assess variation in suture closure across taxa, identify heterochronic shifts in a phylogenetic framework and elucidate the relationship between suture closure timing and ecology. Our results show that heterochronic shifts in suture closure are widespread across Carnivora, with several shifts identified for most major clades. Carnivorans differ from patterns identified for other mammalian clades in showing high variability of palatal suture closure, no correlation between size and level of suture closure, and little phylogenetic signal outside of musteloids. Results further suggest a strong influence of feeding ecology on suture closure pattern. Most of the species with high numbers of heterochronic shifts, such as the walrus and the aardwolf, feed on invertebrates, and these taxa also showed high frequency of closure of the mandibular symphysis, a state that is relatively rare among mammals. Overall, caniforms displayed more heterochronic shifts than feliforms, suggesting that evolutionary changes in suture closure may reflect the lower diversity of cranial morphology in feliforms. PMID:23530892

  12. Recent advances in biodegradable metals for medical sutures: a critical review.

    PubMed

    Seitz, Jan-Marten; Durisin, Martin; Goldman, Jeremy; Drelich, Jaroslaw W

    2015-09-16

    Sutures that biodegrade and dissolve over a period of several weeks are in great demand to stitch wounds and surgical incisions. These new materials are receiving increased acceptance across surgical procedures whenever permanent sutures and long-term care are not needed. Unfortunately, both inflammatory responses and adverse local tissue reactions in the close-to-stitching environment are often reported for biodegradable polymeric sutures currently used by the medical community. While bioabsorbable metals are predominantly investigated and tested for vascular stent or osteosynthesis applications, they also appear to possess adequate bio-compatibility, mechanical properties, and corrosion stability to replace biodegradable polymeric sutures. In this Review, biodegradable alloys made of iron, magnesium, and zinc are critically evaluated as potential materials for the manufacturing of soft and hard tissue sutures. In the case of soft tissue closing and stitching, these metals have to compete against currently available degradable polymers. In the case of hard tissue closing and stitching, biodegradable sternal wires could replace the permanent sutures made of stainless steel or titanium alloys. This Review discusses the specific materials and degradation properties required by all suture materials, summarizes current suture testing protocols and provides a well-grounded direction for the potential future development of biodegradable metal based sutures.

  13. Effects of suture position on left ventricular fluid mechanics under mitral valve edge-to-edge repair.

    PubMed

    Du, Dongxing; Jiang, Song; Wang, Ze; Hu, Yingying; He, Zhaoming

    2014-01-01

    Mitral valve (MV) edge-to-edge repair (ETER) is a surgical procedure for the correction of mitral valve regurgitation by suturing the free edge of the leaflets. The leaflets are often sutured at three different positions: central, lateral and commissural portions. To study the effects of position of suture on left ventricular (LV) fluid mechanics under mitral valve ETER, a parametric model of MV-LV system during diastole was developed. The distribution and development of vortex and atrio-ventricular pressure under different suture position were investigated. Results show that the MV sutured at central and lateral in ETER creates two vortex rings around two jets, compared with single vortex ring around one jet of the MV sutured at commissure. Smaller total orifices lead to a higher pressure difference across the atrio-ventricular leaflets in diastole. The central suture generates smaller wall shear stresses than the lateral suture, while the commissural suture generated the minimum wall shear stresses in ETER.

  14. Distortions of posterior visual space.

    PubMed

    Phillips, Flip; Voshell, Martin G

    2009-01-01

    The study of spatial vision is a long and well traveled road (which, of course, converges to a vanishing point at the horizon). Its various distortions have been widely investigated empirically, and most concentrate, pragmatically, on the space anterior to the observer. The visual world behind the observer has received relatively less attention and it is this perspective the current experiments address. Our results show systematic perceptual distortions in the posterior visual world when viewed statically. Under static viewing conditions, observer's perceptual representation was consistently 'spread' in a hyperbolic fashion. Directions to distant, peripheral locations were consistently overestimated by about 11 degrees from the ground truth and this variability increased as the target was moved toward the center of the observer's back. The perceptual representation of posterior visual space is, no doubt, secondary to the more immediate needs of the anterior visual world. Still, it is important in some domains including certain sports, such as rowing, and in vehicular navigation.

  15. HATCH CONNECTING TEMPERED AIR CHAMBER AND HOT AIR CHAMBER OF ...

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

    HATCH CONNECTING TEMPERED AIR CHAMBER AND HOT AIR CHAMBER OF PLENUM WITH ATTACHED DRAFT REGULATOR. - Hot Springs National Park, Bathhouse Row, Superior Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  16. Outcome of repair of chronic tear of the pectoralis major using corkscrew suture anchors by box suture sliding technique

    PubMed Central

    Joshi, Deepak; Jain, Jitesh Kumar; Chaudhary, Deepak; Singh, Utkarsh; Jain, Vineet; Lal, Ajay

    2016-01-01

    AIM To assess the functional and clinical results of repair of chronic tears of pectoralis major using corkscrew and sliding suture technique. METHODS In this retrospective study, we reviewed the results of pectoralis major repair in 11 chronic cases (> 6 wk) done between September 2011 and December 2014 at our institute. In all cases repair was done by same surgeon using corkscrew suture anchors and box suture sliding technique. At 6 mo, after surgery magnetic resonance imaging was done to see the integrity of the repair. Functional evaluation was done using Penn and ASES scores. Pre and postoperative Isokinetic strength was measured. RESULTS Average follow-up was 48.27 ± 21.0 mo. The Wilcoxon signed rank test was used to evaluate the outcome scores. The average ASES score increased from an average of 54.63 ± 13.0 preoperatively to 95.09 ± 2.60 after surgery at their last follow-up. The average Penn score also increased from 5.72 ± 0.78, 2.81 ± 1.32 and 45.81 ± 1.72 to 9.36 ± 0.80, 8.27 ± 0.90 and 59 ± 1.34 for pain, satisfaction and function respectively. Follow up magnetic resonance imaging (MRI) (at 6 mo) showed continuity and the bulk of pectoralis major muscle in all cases. Average isokinetic strength deficiency in horizontal adduction at 60° was 13.63% ± 6.93% and at 120° was 10.18% ± 4.93% and in flexion at 60° was 10.72% ± 5.08% and at 120° was 6.63% + 3.74%. Results showed that both ASES and Penn score improved significantly (2 tailed P value = 0.0036). CONCLUSION We could conclude from this series that pectoralis major repair even in chronic cases using 5.5 mm corkscrew anchors give excellent functional and cosmetic results. In chronic cases the repairable length of the tendon is not available and sliding suture technique allows for fixation of worn out tendomuscular junction to bone without letting cutting through the muscle. PMID:27795949

  17. Suturing and extensional reactivation in the Grenville orogen, Canada

    NASA Astrophysics Data System (ADS)

    Busch, Jay P.; Mezger, Klaus; van der Pluijm, Ben A.

    1997-06-01

    Sutures are zones of weakness within orogenic belts that have the potential to become reactivated during orogenic evolution. The Robertson Lake shear zone marks a major tectonic boundary in the southeastern Grenville orogen of Canada that has been intermittently active for at least 130 m.y. The shear zone played a major role in the compressional stage of the orogenic cycle as well as during postorogenic collapse. The zone separates the Elzevir terrane to the west and the Frontenac terrane to the east. Sphene ages (U-Pb) indicate that these two terranes have distinct tectonothermal histories and that the shear zone represents a “cryptic suture.” In its current state, the shear zone is a low angle (30°ESE dip) plastic to brittle extensional shear zone that separates the Mazinaw (footwall) and Sharbot Lake (hanging wall) domains. Integration of structural, metamorphic, and chronologic data leads to a model that describes the complete evolution of this fundamental tectonic boundary that evolved from an early compressional zone (ca. 1030 Ma) to a late extensional zone (until at least 900 Ma).

  18. Assessing suturing techniques using a virtual reality surgical simulator.

    PubMed

    Kazemi, Hamed; Rappel, James K; Poston, Timothy; Hai Lim, Beng; Burdet, Etienne; Leong Teo, Chee

    2010-09-01

    Advantages of virtual-reality simulators surgical skill assessment and training include more training time, no risk to patient, repeatable difficulty level, reliable feedback, without the resource demands, and ethical issues of animal-based training. We tested this for a key subtask and showed a strong link between skill in the simulator and in reality. Suturing performance was assessed for four groups of participants, including experienced surgeons and naive subjects, on a custom-made virtual-reality simulator. Each subject tried the experiment 30 times using five different types of needles to perform a standardized suture placement task. Traditional metrics of performance as well as new metrics enabled by our system were proposed, and the data indicate difference between trained and untrained performance. In all traditional parameters such as time, number of attempts, and motion quantity, the medical surgeons outperformed the other three groups, though differences were not significant. However, motion smoothness, penetration and exit angles, tear size areas, and orientation change were statistically significant in the trained group when compared with untrained group. This suggests that these parameters can be used in virtual microsurgery training.

  19. Stapler suture of the pharynx after total laryngectomy.

    PubMed

    Dedivitis, R A; Aires, F T; Pfuetzenreiter, E G; Castro, M A F; Guimarães, A V

    2014-04-01

    The use of a stapler for pharyngeal closure during total laryngectomy was first described in 1971. It provides rapid watertight closure without surgical field contamination. The objective of our study was to compare the incidence of pharyngocutaneous fistula after total laryngectomy with manual and mechanical closures of the pharynx. This was a non-randomised, prospective clinical study conducted at two tertiary medical centres from 1996 to 2011 including consecutive patients with laryngeal tumours who underwent total laryngectomy. We compared the incidence of pharyngocutaneous fistula between two groups of patients: in 20 patients, 75 mm linear stapler closure was applied, whereas in 67 patients a manual suture was used. Clinical data were compared between groups. The groups were statistically similar in terms of gender, age, diabetes mellitus, smoking and alcohol consumption and tumour site. The group of patients who underwent stapler-assisted pharyngeal closure had a higher number of patients with previous tracheotomy (p < 0.001) and previous chemoradiation (p < 0.001). The incidence of pharyngocutaneous fistula was 30% in the mechanical closure group and 20.9% in the manual suture group (p = 0.42). In conclusion the use of the stapler does not increase the rate of fistulae.

  20. Antibacterial Surgical Silk Sutures Using a High-Performance Slow-Release Carrier Coating System.

    PubMed

    Chen, Xiaojie; Hou, Dandan; Wang, Lu; Zhang, Qian; Zou, Jiahan; Sun, Gang

    2015-10-14

    Sutures are a vital part for surgical operation, and suture-associated surgical site infections are an important issue of postoperative care. Antibacterial sutures have been proved to reduce challenging complications caused by bacterial infections. In recent decades, triclosan-free sutures have been on their way to commercialization. Alternative antibacterial substances are becoming relevant to processing surgical suture materials. Most of the antibacterial substances are loaded directly on sutures by dipping or coating methods. The aim of this study was to optimize novel antibacterial braided silk sutures based on levofloxacin hydrochloride and poly(ε-caprolactone) by two different processing sequences, to achieve suture materials with slow-release antibacterial efficacy and ideal physical and handling properties. Silk strands were processed into sutures on a circular braiding machine, and antibacterial treatment was introduced alternatively before or after braiding by two-dipping-two-rolling method (M1 group and M2 group). The antibacterial activity and durability against Staphylococcus aureus and Escherichia coli were tested. Drug release profiles were measured in phosphate buffer with different pH values, and release kinetics model was built to analyze the sustained drug release mechanism between the interface of biomaterials and the in vitro aqueous environment. Knot-pull tensile strength, thread-to-thread friction, and bending stiffness were determined to evaluate physical and handling properties of sutures. All coated sutures showed continuous antibacterial efficacy and slow drug release features for more than 5 days. Besides, treated sutures fulfilled U.S. Pharmacopoeia required knot-pull tensile strength. The thread-to-thread friction and bending stiffness for the M1 group changed slightly when compared with those of uncoated ones. However, physical and handling characteristics of the M2 group tend to approach those of monofilament ones. The novel suture

  1. An "in vitro" tensile strength study on suturing technique and material.

    PubMed

    González-Barnadas, Albert; Camps-Font, Octavi; Espanya-Grifol, Dunia; España-Tost, Antoni; Figueiredo, Rui; Valmaseda-Castellón, Eduard

    2017-03-16

    Suture technique and materials are important in preventing complications like wound dehiscences. The purpose of this study was to determine the tensile strength of different suturing techniques, comparing several materials with different diameters. One hundred and sixty sutures were performed using silk, e-PTFE and two types of polyamide (monofilament and Supramid®). Ten simple, 10 horizontal mattress and 10 combinations of the two stitches were performed with the 4-0 gauge of each material. Additionally, 10 simple sutures were performed with the 5-0 gauge of each material. The maximum tensile force resisted by each suture was recorded. When 5mm of traction were applied, the polyamide monofilament resisted significantly better without untying or breaking compared with Supramid® or silk, while e-PTFE was superior to all the others. However, the force when the e-PTFE 4-0 sutures untied or broke was lower than for either type of polyamide. The combined technique withstood a significantly higher tensile force before unknotting or breaking than the simple and mattress stitches. The 5-0 gauges of silk and both types of polyamide showed lower tensile strengths than the 4-0 materials. Among the 5-0 sutures, Supramid® showed a higher tensile strength than silk. The combined suture technique possesses greater tensile strength than a simple or a horizontal mattress suture and e-PTFE 4-0 withstands more traction without untying or breaking than all the other materials, although at a lower tensile force. With the exception of e-PTFE, 4-0 sutures have greater tensile strength than 5-0 sutures.

  2. Revisiting the Variscan transpressional tectonics in the Southwestern Iberian suture

    NASA Astrophysics Data System (ADS)

    Pérez Cáceres, Irene; Martínez Poyatos, David; Simancas, José Fernando; Azor, Antonio

    2014-05-01

    The boundary between the Ossa-Morena Zone (OMZ) and the South Portuguese Zone (SPZ) in southwest Iberia is a Variscan collisional suture with transpressive left-lateral kinematics, contrasting with the dextral component that characterizes most of the Variscan convergence in other regions of the Orogen. Recent work including new structural and radiometric data has improved our knowledge on the geometry and timing of deformations affecting the OMZ/SPZ suture, which can be summarized as follows: Closure of the Rheic Ocean in Late Devonian time is attested by high-pressure and ophiolitic thin allochthonous units emplaced on the southern border of the OMZ. The kinematic interpretation of early stretching lineations and tectonic fabrics indicate that these units were emplaced in a tectonic regime of oblique left-lateral convergence. Transient transtension in Early Carboniferous time gave way to a narrow aisle of newly-formed oceanic-like crust just over the foregoing Rheic Ocean suture, accompanied by mafic magmatism intruded/extruded at both continental sides. Radiometric dating has yielded the same age of around 340 Ma for the oceanic-like mafic protholiths and their granulite/amphibolite facies tectonic fabric, thus indicating the very ephemeral life of the oceanic-like strip. Oblique convergence was resumed immediately after transtension, first causing northward obduction of the oceanic-like unit and north-verging folding in metasedimentary units of the southern border of the suture. Later on, a south-vergent regional fold was developed synchronous with left-lateral granulite-amphibolite facies shearing. Finally, shear deformation gave way to a low pitch stretching lineation, thrusting the OMZ over SPZ, concentrated on the southern limb of this regional fold and constituting a complex ductile 2-3 km-thick shear band evolving from amphibolite to greenschist facies, developing: (i) high-temperature greenschists at the southern border of the mafic oceanic-like unit

  3. Tendoscopy in stage I posterior tibial tendon dysfunction.

    PubMed

    Khazen, Gabriel; Khazen, Cesar

    2012-09-01

    Stage I PTTD was defined by Johnson and Strom as tenosynovitis or tendinitis whereby tendon length remains normal, there is no hindfoot deformity, and diagnosis is basically clinical, characterized by swelling and tenderness posterior to the medial malleolus. The PTT has a hypovascular zone 40 mm proximal to the insertion of the tendon and 14 mm in length. Pain often is localized to this portion of the tendon. Tendon power might be normal, and the patient can perform single heel rise, sometimes with slight discomfort. This condition is often misdiagnosed as ankle sprain, which delays correct diagnosis and early treatment that may improve symptoms, stop the disease process, and prevent the development of adult acquired flatfoot deformity. Ultrasonography is a valuable adjunctive diagnostic tool for stage I PTTD, but the authors always indicate MRI for accurate diagnosis in such patients. Patients with stage I PTTD are first treated nonoperatively with nonsteroidal anti-inflammatory drugs for 5 days, cryotherapy, local ultrasound, and a PTTD airlift brace (Aircast) for 3 to 6 months. If symptoms persist, surgical debridement and synovectomy has been suggested. PTT tendoscopic synovectomy is a minimally invasive and effective surgical procedure to treat patients with stage I PTTD. It has the advantages of less wound pain, and fewer scar and wound problems. If tendon tear is observed during tendoscopy, it must be repaired with nonabsorbable sutures using a 3- or 4-cm incision.

  4. LRL 25-inch Bubble Chamber

    DOE R&D Accomplishments Database

    Alvarez, L. W.; Gow, J. D.; Barrera, F.; Eckman, G.; Shand, J.; Watt, R.; Norgren, D.; Hernandez, H. P.

    1964-07-08

    The recently completed 25-inch hydrogen bubble chamber combines excellent picture quality with a fast operating cycle. The chamber has a unique optical system and is designed to take several pictures each Bevatron pulse, in conjunction with the Bevatron rapid beam ejection system.

  5. Characterization of a Reverberation Chamber

    DTIC Science & Technology

    2015-10-01

    electromagnetic susceptibility and immunity of a device under test because of its repeatability and measurement speed. A reverberation chamber is...devices or unmanned aircraft systems has led to a baseline characterization of the reverberation chamber at the US Army Research Laboratory (ARL). A...

  6. Small rocket flowfield diagnostic chambers

    NASA Technical Reports Server (NTRS)

    Morren, Sybil; Reed, Brian

    1993-01-01

    Instrumented and optically-accessible rocket chambers are being developed to be used for diagnostics of small rocket (less than 440 N thrust level) flowfields. These chambers are being tested to gather local fluid dynamic and thermodynamic flowfield data over a range of test conditions. This flowfield database is being used to better understand mixing and heat transfer phenomena in small rockets, influence the numerical modeling of small rocket flowfields, and characterize small rocket components. The diagnostic chamber designs include: a chamber design for gathering wall temperature profiles to be used as boundary conditions in a finite element heat flux model; a chamber design for gathering inner wall temperature and static pressure profiles; and optically-accessible chamber designs, to be used with a suite of laser-based diagnostics for gathering local species concentration, temperature, density, and velocity profiles. These chambers were run with gaseous hydrogen/gaseous oxygen (GH2/GO2) propellants, while subsequent versions will be run on liquid oxygen/hydrocarbon (LOX/HC) propellants. The purpose, design, and initial test results of these small rocket flowfield diagnostic chambers are summarized.

  7. Fast-response cloud chamber

    NASA Technical Reports Server (NTRS)

    Fogal, G. L.

    1977-01-01

    Wall structure keeps chambers at constant, uniform temperature, yet allows them to be cooled rapidly if necessary. Wall structure, used in fast-response cloud chamber, has surface heater and coolant shell separated by foam insulation. It is lightweight and requires relatively little power.

  8. National Ignition Facility Target Chamber

    SciTech Connect

    Wavrik, R W; Cox, J R; Fleming, P J

    2000-10-05

    On June 11, 1999 the Department of Energy dedicated the single largest piece of the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) in Livermore, California. The ten (10) meter diameter aluminum target high vacuum chamber will serve as the working end of the largest laser in the world. The output of 192 laser beams will converge at the precise center of the chamber. The laser beams will enter the chamber in two by two arrays to illuminate 10 millimeter long gold cylinders called hohlraums enclosing 2 millimeter capsule containing deuterium, tritium and isotopes of hydrogen. The two isotopes will fuse, thereby creating temperatures and pressures resembling those found only inside stars and in detonated nuclear weapons, but on a minute scale. The NIF Project will serve as an essential facility to insure safety and reliability of our nation's nuclear arsenal as well as demonstrating inertial fusion's contribution to creating electrical power. The paper will discuss the requirements that had to be addressed during the design, fabrication and testing of the target chamber. A team from Sandia National Laboratories (SNL) and LLNL with input from industry performed the configuration and basic design of the target chamber. The method of fabrication and construction of the aluminum target chamber was devised by Pitt-Des Moines, Inc. (PDM). PDM also participated in the design of the chamber in areas such as the Target Chamber Realignment and Adjustment System, which would allow realignment of the sphere laser beams in the event of earth settlement or movement from a seismic event. During the fabrication of the target chamber the sphericity tolerances had to be addressed for the individual plates. Procedures were developed for forming, edge preparation and welding of individual plates. Construction plans were developed to allow the field construction of the target chamber to occur parallel to other NIF construction activities. This was

  9. Ion chamber based neutron detectors

    DOEpatents

    Derzon, Mark S; Galambos, Paul C; Renzi, Ronald F

    2014-12-16

    A neutron detector with monolithically integrated readout circuitry, including: a bonded semiconductor die; an ion chamber formed in the bonded semiconductor die; a first electrode and a second electrode formed in the ion chamber; a neutron absorbing material filling the ion chamber; and the readout circuitry which is electrically coupled to the first and second electrodes. The bonded semiconductor die includes an etched semiconductor substrate bonded to an active semiconductor substrate. The readout circuitry is formed in a portion of the active semiconductor substrate. The ion chamber has a substantially planar first surface on which the first electrode is formed and a substantially planar second surface, parallel to the first surface, on which the second electrode is formed. The distance between the first electrode and the second electrode may be equal to or less than the 50% attenuation length for neutrons in the neutron absorbing material filling the ion chamber.

  10. Posterior commissure of the human larynx revisited.

    PubMed

    Tucker, John A; Tucker, Sean T

    2010-05-01

    The existence of the posterior commissure (PC) of the human larynx has been disputed (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). "The term posterior commissure has no relevance to anatomical structure. The term commissure means a joining together. The bilateral vocal folds never join at their posterior ends. The posterior aspect of the glottis is a wall. The posterior lateral aspect of the posterior glottis is also the lateral wall of the posterior glottis" (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). This study is intended to clarify the development of anatomical and morphological aspects of the PC in conjunction with a clinical classification of the larynx in sagittal view. This study uses human embryo and fetal laryngeal sections from the Carnegie Collection of Human Embryos (the world standard) and whole organ laryngeal sections from the Tucker Laryngeal Fetal Collection. Correlation of histologic and gross anatomical structure is made with the Hirano et al atlas, the Vidić Photographic Atlas of the Human Body, and the O'Rahilly Embryonic Atlas. Embryologic data clearly describe and illustrate the posterior union of the cricoid cartilage with formation of the PC. The anatomical functional aspects of the posterior lateral cricoid lamina as the supporting buttress of the articulating arytenoid cartilages are illustrated.

  11. Rac1 GTPase-deficient mouse lens exhibits defects in shape, suture formation, fiber cell migration and survival.

    PubMed

    Maddala, Rupalatha; Chauhan, Bharesh K; Walker, Christopher; Zheng, Yi; Robinson, Michael L; Lang, Richard A; Rao, Ponugoti V

    2011-12-01

    Morphogenesis and shape of the ocular lens depend on epithelial cell elongation and differentiation into fiber cells, followed by the symmetric and compact organization of fiber cells within an enclosed extracellular matrix-enriched elastic capsule. The cellular mechanisms orchestrating these different events however, remain obscure. We investigated the role of the Rac1 GTPase in these processes by targeted deletion of expression using the conditional gene knockout (cKO) approach. Rac1 cKO mice were derived from two different Cre (Le-Cre and MLR-10) transgenic mice in which lens-specific Cre expression starts at embryonic day 8.75 and 10.5, respectively, in both the lens epithelium and fiber cells. The Le-Cre/Rac1 cKO mice exhibited an early-onset (E12.5) and severe lens phenotype compared to the MLR-10/Rac1 cKO (E15.5) mice. While the Le-Cre/Rac1 cKO lenses displayed delayed primary fiber cell elongation, lenses from both Rac1 cKO strains were characterized by abnormal shape, impaired secondary fiber cell migration, sutural defects and thinning of the posterior capsule which often led to rupture. Lens fiber cell N-cadherin/β-catenin/Rap1/Nectin-based cell-cell junction formation and WAVE-2/Abi-2/Nap1-regulated actin polymerization were impaired in the Rac1 deficient mice. Additionally, the Rac1 cKO lenses were characterized by a shortened epithelial sheet, reduced levels of extracellular matrix (ECM) proteins and increased apoptosis. Taken together, these data uncover the essential role of Rac1 GTPase activity in establishment and maintenance of lens shape, suture formation and capsule integrity, and in fiber cell migration, adhesion and survival, via regulation of actin cytoskeletal dynamics, cell adhesive interactions and ECM turnover.

  12. Interactive Virtual Suturing Simulations: Enhancement of Student Learning in Veterinary Medicine

    ERIC Educational Resources Information Center

    Staton, Amy J.; Boyd, Christine B.

    2013-01-01

    This capstone addresses an instructional gap in the Morehead State University Veterinary Technology Program and in other similar programs around the globe. Students do not retain the knowledge needed to proficiently complete suture patterns nor do students receive sufficient instructional time during the year to master each suture pattern that is…

  13. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology. 878.4494 Section 878.4494 Food and Drugs FOOD AND DRUG... recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is...

  14. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology. 878.4494 Section 878.4494 Food and Drugs FOOD AND DRUG... recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is...

  15. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology. 878.4494 Section 878.4494 Food and Drugs FOOD AND DRUG... recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is...

  16. Barbed Suture: A Review of the Technology and Clinical Uses in Obstetrics and Gynecology

    PubMed Central

    Greenberg, James A; Goldman, Randi H

    2013-01-01

    Surgical knots are simply a necessary evil needed to anchor smooth suture to allow it to function in its role in tissue reapproximation. Surgical knots reduce the tensile strength of all sutures by thinning and stretching the material. The tying of surgical knots introduces the potential of human error and interuser variability. Knot-secured smooth suture must create an uneven distribution of tension across the wound with the higher tension burdens placed at the knots. Given the excessive relative wound tension on the knot and the reasonable concerns of surgeons for suture failure due to knot slippage, there is a natural tendency toward overcoming these concerns by over-tightening knots; however, tighter knots may be worse for wound healing and strength than looser knots. In minimally invasive laparoscopic surgeries, the ability to quickly and properly tie surgical knots presents a new challenge. In cases in which knot tying is difficult, the use of knotless barbed suture can securely reapproximate tissues with less time, cost, and aggravation. This article reviews the technology behind barbed sutures with a focus on understanding how they differ from traditional smooth sutures and how barbed sutures have performed in in vitro and animal model testing, as well as in human clinical trials. PMID:24920976

  17. Skull sutures: Changing morphology during preadolescent growth and its implications in forensic identification.

    PubMed

    Jayaprakash, Paul T; Srinivasan, G J

    2013-06-10

    Forensic identification of juvenile skulls is a problem area. Although the skull suture patterns have been suggested for use in individualizing human remains by comparing antemortem and postmortem radiographs, the age at which such patterns stabilize and can be useful for identification had been indicated as 7 years. Subsequent researchers have also concurred that antemortem and postmortem radiographs taken after the 7th year would be sufficient to meet the Daubert standard criteria for identifying skulls using radiographs. The suggestions regarding the lower age limit for stabilization of suture patterns have not been verified so far. In this research, the patterns of the sutures in the ectocranial and endocranial surfaces of the lambdoid region in 22 juvenile skulls (age range 1-10 years) and 100 adult skulls (age range 17-70 years) were studied for the relative incidence of different types of suture patterns. The radiographic recordings of the suture patterns in the juvenile skulls were also compared with the patterns seen in the ectocranial and endocranial surfaces. The findings of this study support the proposition that the suture patterns are plastic during the juvenile stage and that they undergo significant remodeling during growth into adulthood. Indicating the possibility of growth related alterations in the sutural morphology, the onset of adulthood is suggested as the age for stabilization of suture patterns in the context of prescribing standards for such criteria as those relating to Daubert.

  18. A mathematical model for mechanotransduction at the early steps of suture formation

    PubMed Central

    Khonsari, R. H.; Olivier, J.; Vigneaux, P.; Sanchez, S.; Tafforeau, P.; Ahlberg, P. E.; Di Rocco, F.; Bresch, D.; Corre, P.; Ohazama, A.; Sharpe, P. T.; Calvez, V.

    2013-01-01

    Growth and patterning of craniofacial sutures is subjected to the effects of mechanical stress. Mechanotransduction processes occurring at the margins of the sutures are not precisely understood. Here, we propose a simple theoretical model based on the orientation of collagen fibres within the suture in response to local stress. We demonstrate that fibre alignment generates an instability leading to the emergence of interdigitations. We confirm the appearance of this instability both analytically and numerically. To support our model, we use histology and synchrotron X-ray microtomography and reveal the fine structure of fibres within the sutural mesenchyme and their insertion into the bone. Furthermore, using a mouse model with impaired mechanotransduction, we show that the architecture of sutures is disturbed when forces are not interpreted properly. Finally, by studying the structure of sutures in the mouse, the rat, an actinopterygian (Polypterus bichir) and a placoderm (Compagopiscis croucheri), we show that bone deposition patterns during dermal bone growth are conserved within jawed vertebrates. In total, these results support the role of mechanical constraints in the growth and patterning of craniofacial sutures, a process that was probably effective at the emergence of gnathostomes, and provide new directions for the understanding of normal and pathological suture fusion. PMID:23516237

  19. Sutural loosening and skeletal flexibility during growth: determination of drop-like shapes in sea urchins.

    PubMed

    Johnson, Amy S; Ellers, Olaf; Lemire, Jim; Minor, Melissa; Leddy, Holly A

    2002-02-07

    The shape of sea urchins may be determined mechanically by patterns of force analogous to those that determine the shape of a water droplet. This mechanical analogy implies skeletal flexibility at the time of growth. Although comprised of many rigid calcite plates, sutural collagenous ligaments could confer such flexibility if the sutures between plates loosened and acted as joints at the time of growth. We present experimental evidence of such flexibility associated with weight gain and growth. Over 13-, 4-, and 2-week periods, fed urchins (Strongylocentrotus droebachiensis) gained weight and developed looser sutures than unfed urchins that maintained or lost weight. Further, skeletons of fed urchins force-relaxed more than did those of unfed urchins and urchins with loose sutures force-relaxed more than those with tight sutures. Urchins (Strongylocentrotus franciscanus) fed for two and a half weeks, gained weight, also had looser skeletons and deposited calcite at sutural margins, whereas unfed ones did not. In field populations of S. droebachiensis the percentage having loose sutures varied with urchin diameter and reflected their size-specific growth rate. The association between feeding, weight gain, calcite deposition, force relaxation and sutural looseness supports the hypothesis that urchins deform flexibly while growing, thus determining their drop-like shapes.

  20. Sutural loosening and skeletal flexibility during growth: determination of drop-like shapes in sea urchins.

    PubMed Central

    Johnson, Amy S; Ellers, Olaf; Lemire, Jim; Minor, Melissa; Leddy, Holly A

    2002-01-01

    The shape of sea urchins may be determined mechanically by patterns of force analogous to those that determine the shape of a water droplet. This mechanical analogy implies skeletal flexibility at the time of growth. Although comprised of many rigid calcite plates, sutural collagenous ligaments could confer such flexibility if the sutures between plates loosened and acted as joints at the time of growth. We present experimental evidence of such flexibility associated with weight gain and growth. Over 13-, 4-, and 2-week periods, fed urchins (Strongylocentrotus droebachiensis) gained weight and developed looser sutures than unfed urchins that maintained or lost weight. Further, skeletons of fed urchins force-relaxed more than did those of unfed urchins and urchins with loose sutures force-relaxed more than those with tight sutures. Urchins (Strongylocentrotus franciscanus) fed for two and a half weeks, gained weight, also had looser skeletons and deposited calcite at sutural margins, whereas unfed ones did not. In field populations of S. droebachiensis the percentage having loose sutures varied with urchin diameter and reflected their size-specific growth rate. The association between feeding, weight gain, calcite deposition, force relaxation and sutural looseness supports the hypothesis that urchins deform flexibly while growing, thus determining their drop-like shapes. PMID:11839189

  1. Medical treatment of craniosynostosis: Recombinant Noggin inhibits coronal suture closure in the rat craniosynostosis model

    PubMed Central

    Shen, K; Krakora, SM; Cunningham, M; Singh, M; Wang, X; Hu, FZ; Post, JC; Ehrlich, GD

    2009-01-01

    Introduction The mechanisms underlying craniosynostosis remains unknown. However, mutations in FGFR2 are associated with craniosynostotic syndromes. We previously compared gene expression patterns of patent and synostosing coronal sutures in the nude rat and demonstrated down regulation of Noggin in synostosing sutures. Noggin expression is also suppressed by FGF2 and constitutive FGFR2 signaling.(1–2) Thus, we therefore hypothesized that the addition of rhNoggin to prematurely fusing sutures should prevent synostosis. Materials and Methods Cohorts of nude rats were subjected to: 1) surgical elevation of the coronal suture (shams); 2) surgical elevation and placement of normal or FGFR2 mutant human osteoblasts onto the underlying dura (xenotranplants); or 3) xenotransplantation with co-application of heparin acrylic beads soaked with recombinant human (rh) Noggin. Eleven days post surgery the sutures were harvested, stained, and histologically examined. Results Animals that received control osteoblasts, sham surgery, or no surgery demonstrated normal skull growth and coronal suture histology, whereas animals transplanted only with FGFR2 mutant osteoblasts showed evidence of bridging synostosis on the calvarial dural surface. Sutures treated with FGFR2 mutant osteoblasts and rhNoggin remained patent. Conclusion The chimeric nude rate model is a viable model of craniosynostosis. FGFR2 mutations in osteoblasts induce bridging osteosynthesis demonstrating one of the mechanisms for premature suture fusion. Topical application of rhNoggin protein prevents craniosynostosis in the weanling nude rat xenotransplantation model of syndromic craniosynostosis. PMID:19627528

  2. Clinical and pathological assessment of different suture techniques for microvascular anastomosis in rat femoral artery

    PubMed Central

    El-Shazly, Mohamed

    2007-01-01

    This study examined the clinical and pathological features after a microvascular anastomosis of a rat femoral artery using four different suture techniques. Sixty Sprage-Dawely rats were divided randomly into 4 groups. Fifteen bisected arteries (one from each animal) in Group I, II, III and IV were sutured with the simple interrupted suture, continuous suture, sleeve suture and cuff suture, respectively. The anastomosis times in Group I, II, III and IV were 28.67, 14.67, 15.47 and 15.93 min, respectively. Immediate bleeding that stopped without intervention (grade I) was observed in 67%, 73% and 60% of the anastomosed vessels in Groups II, III and IV, respectively, while 60% of the vessels in Group I showed light bleeding that was inhibited by gentile pressure (grade II). All vessels examined appeared to be patent at 5 and 15 min after the anastomosis. On the 7th day postoperatively, the vessels of Group I showed the highest patency rate (93%) compared with Groups II (67%), III (73%) and IV (87%). Moreover, there were more pronounced pathological changes in Group I than in the other groups. These changes included endothelial loss, endothelial proliferation, degeneration and necrosis of the tunica media. Suture materials surrounded by an inflammatory reaction were also observed. In conclusion, the simple interrupted suture is preferable for microvascular anastomosis due to its highest patency rate. The other techniques investigated can be good alternatives because of their short anastomotic time and moderate pathological changes. PMID:17679774

  3. The Importance of Craniofacial Sutures in Biomechanical Finite Element Models of the Domestic Pig

    PubMed Central

    Bright, Jen A.

    2012-01-01

    Craniofacial sutures are a ubiquitous feature of the vertebrate skull. Previous experimental work has shown that bone strain magnitudes and orientations often vary when moving from one bone to another, across a craniofacial suture. This has led to the hypothesis that craniofacial sutures act to modify the strain environment of the skull, possibly as a mode of dissipating high stresses generated during feeding or impact. This study tests the hypothesis that the introduction of craniofacial sutures into finite element (FE) models of a modern domestic pig skull would improve model accuracy compared to a model without sutures. This allowed the mechanical effects of sutures to be assessed in isolation from other confounding variables. These models were also validated against strain gauge data collected from the same specimen ex vivo. The experimental strain data showed notable strain differences between adjacent bones, but this effect was generally not observed in either model. It was found that the inclusion of sutures in finite element models affected strain magnitudes, ratios, orientations and contour patterns, yet contrary to expectations, this did not improve the fit of the model to the experimental data, but resulted in a model that was less accurate. It is demonstrated that the presence or absence of sutures alone is not responsible for the inaccuracies in model strain, and is suggested that variations in local bone material properties, which were not accounted for by the FE models, could instead be responsible for the pattern of results. PMID:22363727

  4. Evaluation of five different suture materials in the skin of the earthworm (Lumbricus terrestris).

    PubMed

    Salgado, Melissa A; Lewbart, Gregory A; Christian, Larry S; Griffith, Emily H; Law, Jerry McHugh

    2014-01-01

    The purpose of this study was to determine which suture material is the most appropriate for dermal closure of terrestrial annelids. This paper describes the tissue reactions of the earthworm, Lumbricus terrestris, to five different types of suture materials in order to determine which suture material is the most appropriate for dermal closure. Silk, monofilament nylon, polydiaxonone, polyglactin 910, and chromic gut were studied. There was mild to moderate tissue reaction to all five suture materials. In all of the biopsies wound-healing reaction consisted of aggregates of blastemal cells which appeared in various stages of dedifferentiation from the body wall. Inflammatory cells infiltrated the wound sites, reminiscent of the typical foreign body reaction in vertebrates. The results indicate polyglactin 910 would be the best suture material with regards to tissue security and reaction scores. Chromic gut occupies the next position but there were problems with suture security over time. This appears to be the first suture material performance study on a terrestrial invertebrate. The earthworm, Lumbricus terrestris, was chosen for its wide availability, size, and the extensive species knowledge base. The earthworm may prove to be a good surgical/suture model for economically important invertebrates such as mollusks, tunicates, and insect larval stages.

  5. Antibacterial-Coated Suture in Reducing Surgical Site Infection in Breast Surgery: A Prospective Study

    PubMed Central

    Laas, Enora; Poilroux, Cécile; Bézu, Corinne; Coutant, Charles; Uzan, Serge; Rouzier, Roman; Chéreau, Elisabeth

    2012-01-01

    Background. To reduce the incidence of microbial colonization of suture material, Triclosan- (TC-)coated suture materials have been developed. The aim of this study was to assess the incidence of suture-related complications (SRC) in breast surgery with and without the use of TC-coated sutures. Methods. We performed a study on two consecutive periods: 92 patients underwent breast surgery with conventional sutures (Group 1) and 98 with TC-coated sutures (Group 2). We performed subgroups analyses and developed a model to predict SRC in Group 1 and tested its clinical efficacy in Group 2 using a nomogram-based approach. Results. The SRC rates were 13% in Group 1 and 8% in Group 2. We found that some subgroups may benefit from TC-coated sutures. The discrimination obtained from a logistic regression model developed in Group 1 and based on multifocality, age and axillary lymphadenectomy was 0.88 (95% CI 0.77–0.95) (P < 10−4). There was a significant difference in Group 2 between predicted probabilities and observed percentages (P < 10−5). The predicted and observed proportions of complications in the high-risk group were 38% and 13%, respectively. Conclusion. This study used individual predictions of SRC and showed that using TC-coated suture may prevent SRC. This was particularly significant in high-risk patients. PMID:23316373

  6. A novel suture retention test for scaffold strength characterization in ophthalmology.

    PubMed

    Küng, Florian; Schubert, Dirk W; Stafiej, Piotr; Kruse, Friedrich E; Fuchsluger, Thomas A

    2016-12-01

    Sutures are a common way to attach scaffolds in patients. For tubular cardiac scaffolds, the 'suture retention strength' is commonly used to evaluate the resistance of a scaffold against the pull-out of a suture. In order to make this quantity accessible for ophthalmological scaffolds the test procedure has been modified in a novel way. Polycaprolactone (PCL) films of different thicknesses and an amniotic membrane (AM) were used for the experiments. Circular samples with a radius of 7mm were taken and a suture was passed through each sample and tied to a loop. The sample was clamped in a tensile tester and a bolt was passed through the loop. The suture was then pulled with a constant deformation rate until pull-out occurred. The suture retention strength, the deformation at the suture retention strength, and the deformation at rupture were determined for each sample. The presented modified suture retention test allows to measure the relevant parameters of samples on the scale of ophthalmological scaffolds in a reproducible way. A comparison between the first data on PCL and AM has been made.

  7. [Assessment of the effectiveness of the suture with triclosan coated in emergency surgery].

    PubMed

    Darvin, V V; Lobanov, D S; Krasnov, E A; Gvozdetsky, A N

    2017-01-01

    The aim of the study was to evaluate the effectiveness of the suture with a coating of triclosan on the dynamics of postoperative course in emergency surgical patients, comparing the postoperative period in the application of the suture with coating and without it.

  8. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nonabsorbable poly(ethylene terephthalate... Devices § 878.5000 Nonabsorbable poly(ethylene terephthalate) surgical suture. (a) Identification. Nonabsorbable poly(ethylene terephthalate) surgical suture is a multifilament, nonabsorbable, sterile,...

  9. Isolated posterior cruciate ligament calcification

    PubMed Central

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism. X-rays demonstrated calcification of the PCL. CT and MRI excluded any other intra-articular and extra-articular pathology. Arthroscopic debridement of the calcium deposits was performed and the symptoms resolved immediately, while the postoperative x-rays were normal. Histological examination confirmed the calcium nature of the lesion. Two years postoperatively the patient remains asymptomatic. PMID:22669889

  10. An innovative method to evaluate the suture compliance in sealing the surgical wound lips

    PubMed Central

    Saleh, Farid; Palmieri, Beniamino; Lodi, Danielle; Al-Sebeih, Khalid

    2008-01-01

    Background and aim: The increasing number of surgical procedures performed with local anesthesia, followed by immediate patient discharge from the hospital, emphasizes the need for a tight waterproof suture that is capable of maintaining its tensile strength in the postoperative phase when the wound tumescence, edema due to the anesthetic drug, and surgical trauma disappear. Moreover, the issue of having an accurate surgical wound closure is very relevant in vivo in order to prevent hemorrhage and exogenous microbial infections. This study aimed at designing a new a lab technique that could be used for evaluating the best surgical material. Using such a technique, we compared the wound-lip-sealing properties of three commonly-used suture threads, namely polyurethane, polypropylene, and polyamide. Materials and methods: The mechanical properties of same-size suture threads made from polyurethane, polypropylene, and polyamide, were compared in order to define the one that possess the best elastic properties by being able to counteract the tension-relaxation process in the first 12 hours following surgery. The tension holding capacity of the suture materials was measured in both in vivo and in vitro experiments. The surface area of the scar associated with the three different suture threads was measured and compared, and the permeability of the three different suture threads was assessed at 0 minute, 2 minute, 4 minute, 6 minute, and 8 minute- interval. Results: Results showed that polyurethane suture threads had significantly (P < 0.05) better tensile strength, elongation endurance before breakage, and better elasticity coefficient as compared to polypropylene and polyamide suture threads. Moreover, polyurethane suture threads were significantly (P < 0.05) more impermeable as compared to the other two suture thread types (polypropylene and polyamide). This impermeability was also associated with a tighter wound-lip-sealing ability, and with significantly (P < 0

  11. Celastrol nanoparticles inhibit corneal neovascularization induced by suturing in rats

    PubMed Central

    Li, Zhanrong; Yao, Lin; Li, Jingguo; Zhang, Wenxin; Wu, Xianghua; Liu, Yi; Lin, Miaoli; Su, Wenru; Li, Yongping; Liang, Dan

    2012-01-01

    Purpose Celastrol, a traditional Chinese medicine, is widely used in anti-inflammation and anti-angiogenesis research. However, the poor water solubility of celastrol restricts its further application. This paper aims to study the effect of celastrol nanoparticles (CNPs) on corneal neovascularization (CNV) and determine the possible mechanism. Methods To improve the hydrophilicity of celastrol, celastrol-loaded poly(ethylene glycol)-block-poly(ɛ-caprolactone) nanopolymeric micelles were developed. The characterization of CNPs was measured by dynamic light scattering and transmission electron microscopy analysis. Celastrol loading content and release were assessed by ultraviolet-visible analysis and high performance liquid chromatography, respectively. In vitro, human umbilical vein endothelial cell proliferation and capillary-like tube formation were assayed. In vivo, suture-induced CNV was chosen to evaluate the effect of CNPs on CNV in rats. Immunohistochemistry for CD68 assessed the macrophage infiltration of the cornea on day 6 after surgery. Real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were used to evaluate the messenger ribonucleic acid and protein levels, respectively, of vascular endothelial growth factor, matrix metalloproteinase 9, and monocyte chemoattractant protein 1 in the cornea. Results The mean diameter of CNPs with spherical shape was 48 nm. The celastrol loading content was 7.36%. The release behavior of CNPs in buffered solution (pH 7.4) showed a typical two-phase release profile. CNPs inhibited the proliferation of human umbilical vein endothelial cells in a dose-independent manner and suppressed the capillary structure formation. After treatment with CNPs, the length and area of CNV reduced from 1.16 ± 0.18 mm to 0.49 ± 0.12 mm and from 7.71 ± 0.94 mm2 to 2.29 ± 0.61 mm2, respectively. Macrophage infiltration decreased significantly in the CNP-treated corneas. CNPs reduced

  12. Tibetan Apples and Oranges: Surficial Sutures and Overlapping Lithospheres

    NASA Astrophysics Data System (ADS)

    Chen, W. P.; Hung, S. H.; Wang, C. Y.; Tseng, T. L.

    2014-12-01

    Multi-scale, finite-frequency tomography across the Himalayas-Tibet shows a clear, subhorizontal anomaly of high VP and VSin the upper mantle that can be traced from under N. India all the way to beneath central Tibet. This configuration of the "Greater India" (GI), or the submerged, northern portion of the Indian shield, is combined with other constraints to reconstruct position of the Indian lithospheric mantle (ILM) relative to Asia back to about 15 Ma ago, or the onset of the latest magmatic activity in Tibet. By then, the leading edge of the ILM (Indian mantle front, IMF) has advanced subhorizontally past the entire Lhasa terrane and also probably have caused the lithospheric mantle beneath the Qiangtang terrane to thicken. The thickening is likely to have led to Rayleigh-Taylor instability, causing widespread but small volume of magmatic activity in northern Tibet. Meanwhile, the detached lithospheric mantle foundered through the upper mantle to rest at the bottom of the mantle transition zone (MTZ), just above the lower mantle. This detached lithospheric mantle manifests itself as a large-scale seismic anomaly of high compressional wave speed (VP) but curiously is undetectable through shear-waves. Based on laboratory data for nominally anhydrous olivine and its high-pressure polymorphs (NAO), the discordant results between P- and S-waves is explained by abundant hydroxyls in the foundered lithospheric mantle, a hypothesis supported by other evidences as well. Since NAO can hold ~1 wt% of water throughout the upper mantle and the MTZ, foundering of thickened lithospheric mantle caused by continental collision is an under-appreciated but effective pathway for water to enter the deep mantle. Currently, the Indus-Yarlung suture between northern India and the Lhasa terrane appears to be an inactive, crustal feature, as the GI continues to pass beneath it. On the other hand, even though the IMF has now advanced northward beyond the Bangong-Nujiang suture (BNS

  13. The high momentum spectrometer drift chambers

    NASA Astrophysics Data System (ADS)

    Abbott, D.; Baker, O. K.; Beaufait, J.; Bennett, C.; Bryant, E.; Carlini, R.; Kross, B.; McCauley, A.; Naing, W.; Shin, T.; Vulcan, W.

    1992-12-01

    The High Momentum Spectrometer in Hall C will use planar drift chambers for charged particle track reconstruction. The chambers are constructed using well understood technology and a conventional gas mixture. Two (plus one spare) drift chambers will be constructed for this spectrometers. Each chamber will contain 6 planes of readout channels. This paper describes the chamber design and gas handling system used.

  14. Effects of myrrh on the strength of suture materials: an in vitro study.

    PubMed

    Alshehri, Mohammed A; Baskaradoss, Jagan Kumar; Geevarghese, Amrita; Ramakrishnaiah, Ravikumar; Tatakis, Dimitris N

    2015-01-01

    The present in vitro study sought to determine the effects of myrrh-containing solutions on common suture materials used in periodontal surgery. Three commonly used suture materials (silk, polyglactin 910, polytetrafluoroethylene) were immersed in four thermostatically controlled experimental media to simulate daily oral rinsing activity, namely -artificial saliva, normal saline solution with 0.2% Commiphora myrrh, full-concentration (100%) Commiphora myrrh oil, and a myrrh-containing commercial mouthwash. Tensile strength was measured at the end of each day using an Instron tensile testing machine. Silk sutures were susceptible to tensile strength loss when exposed to 0.2% myrrh solution once daily for 5 days. Myrrh-containing commercial mouthwash had no effect on tensile strength, but all three suture materials lost tensile strength when exposed to 100% myrrh oil. For patients that routinely use myrrh mouthwashes postoperatively, findings of this study suggested that silk sutures might not be the optimal material choice.

  15. Lateral intercrural suture in the caucasian nose: Decreased domal divergence angle in endonasal rhinoplasty without delivery

    PubMed Central

    Berger, Cezar Augusto Sarraf; Mocelin, Marcos; Soares, Caio Márcio Correia; Pasinato, Rogério; Frota, Andreia Ellery

    2012-01-01

    Summary Introduction: Several techniques can be performed to improve nasal tip definition such as cartilage resection, tip grafts, or sutures. Objctive: To evaluate the outcome of lateral intercrural suture at the lower lateral cartilage by endonasal rhinoplasty with a basic technique without delivery in decreasing the angle of domal divergence and improving the nasal tip definition. Method: This prospective study was performed in 64 patients in which a suture was made on the board head of the lower lateral cartilage in the joint between the dome and lateral crus, using polydioxanone (PDS) with sharp, curved needle. Results: In all of the cases, better definition of the nasal tip was achieved by intercrural suturing for at least 6 months postoperatively. Conclusion: Lateral intercrural suture of the lower lateral cartilage provides improved nasal tip definition and can be performed by endonasal rhinoplasty without delivery in the Caucasian nose. PMID:25991941

  16. Microbiology of Explanted Suture Segments from Infected and Noninfected Surgical Patients

    PubMed Central

    Krepel, Candace J.; Marks, Richard M.; Rossi, Peter J.; Sanger, James; Goldblatt, Matthew; Graham, Mary Beth; Rothenburger, Stephen; Collier, John; Seabrook, Gary R.

    2013-01-01

    Sutures under selective host/environmental factors can potentiate postoperative surgical site infection (SSI). The present investigation characterized microbial recovery and biofilm formation from explanted absorbable (AB) and nonabsorbable (NAB) sutures from infected and noninfected sites. AB and NAB sutures were harvested from noninfected (70.9%) and infected (29.1%) sites in 158 patients. At explantation, devices were sonicated and processed for qualitative/quantitative bacteriology; selective sutures were processed for scanning electron microscopy (SEM). Bacteria were recovered from 85 (53.8%) explanted sites; 39 sites were noninfected, and 46 were infected. Suture recovery ranged from 11.1 to 574.6 days postinsertion. A significant difference in mean microbial recovery between noninfected (1.2 isolates) and infected (2.7 isolates) devices (P < 0.05) was noted. Staphylococcus epidermidis, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Peptostreptococcus spp., Bacteroides fragilis, Escherichia coli, Enterococcus spp., Pseudomonas aeruginosa, and Serratia spp. were recovered from infected devices, while commensal skin flora was recovered from noninfected devices. No significant difference in quantitative microbial recovery between infected monofilament and multifilament sutures was noted. Biofilm was present in 100% and 66.6% of infected and noninfected devices, respectively (P < 0.042). We conclude that both monofilament and braided sutures provide a hospitable surface for microbial adherence: (i) a significant difference in microbial recovery from infected and noninfected sutures was noted, (ii) infected sutures harbored a mixed flora, including multidrug-resistant health care-associated pathogens, and (iii) a significant difference in the presence or absence of a biofilm in infected versus noninfected explanted devices was noted. Further studies to document the benefit of focused risk reduction strategies to minimize suture contamination and

  17. Ultrasonography in the evaluation of the mid-palatal suture in rapid palatal expansion

    PubMed Central

    Gumussoy, I; Bayrakdar, I S; Dagistan, S; Caglayan, F

    2014-01-01

    Objectives: Orthodontists usually evaluate the mid-palatal sutural opening with occlusal radiography. The purpose of this article is to evaluate the sutural opening with ultrasonography (USG) in a series of patients undergoing rapid palatal expansion (RPE). Methods: The study included 87 USG images and 87 occlusal radiographs from 29 healthy patients (mean age, 13.9 years; range, 11–20 years; boys, 12; girls, 17) who required RPE treatment. The sutural opening was assessed with USG, and the amount of sutural expansion as mesiodistal length was measured immediately after appliance practice (T0), 10 turns (T1) and 20 turns (T2) during the expansion period. Sutural expansion evaluated by occlusal radiographs was scored at every stage. Measurements obtained by USG and scores observed in the occlusal radiographs were compared by non-parametric Kendall's tau test. Results: Both USG and radiographic images revealed normal anatomical structure during pre-expansion (stage T0). On USG, sutural expansion was seen in 19 patients at stage T1. There was no expansion at this stage in ten patients. At stage T2, on USG and radiography, an increase in the amount of expansion was observed in 19 patients with sutural expansion at stage T1 and sutural expansion was observed in 5 patients without sutural expansion at stage T1. No expansion was observed at both stages T1 and T2 in five patients. USG measurements and occlusal scores in both T1 and T2 turns showed statistically significant correlation (p < 0.001). Conclusions: The results indicate that USG might be a useful method to assess mid-palatal sutural opening in patients undergoing RPE. PMID:25168810

  18. Huge interparietal posterior fontanel meningohydroencephalocele

    PubMed Central

    Dos Santos, Manuel Filipe Dias; de Santa Barbara, Rita de Cassia

    2015-01-01

    Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion. PMID:26484324

  19. Longevity of Posterior Composite Restorations

    PubMed Central

    Opdam, N.J.M.; van de Sande, F.H.; Bronkhorst, E.; Cenci, M.S.; Bottenberg, P.; Pallesen, U.; Gaengler, P.; Lindberg, A.; Huysmans, M.C.D.N.J.M.; van Dijken, J.W.

    2014-01-01

    The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years’ follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces. PMID:25048250

  20. The functional significance of the squamosal suture in Australopithecus boisei.

    PubMed

    Rak, Y

    1978-07-01

    A juvenile Australopithecus boisei specimen from the Omo basin, southern Ethiopia, is found to exhibit and extraordinarily large overlap of the temporal squama on the parietal, a phenomenon shared with at least two adult specimens of A. boisei. An attempt is made to interpret the overlap as a structural (bony/ligamentous) adaptation necessitated by the unique combination of certain components of the masticatory system of A. boisei. These are: (1) the massiveness and strength of the temporalis muscle, (2) its relatively anterior location, and (3) the lateral position of the masseter muscle due to the flaring of the zygomatic arches. The effect of the temporalis muscle is to create excessive pressure on the portion of the squamosal suture along the parietal, while the lateral placement of the masseter and the resultant increase of pressure on the temporal squama via the zygomatic arch tend to "loosen" the contact between the temporal and parietal bones.

  1. A high rate proportional chamber

    SciTech Connect

    Henderson, R.; Fraszer, W.; Openshaw, R.; Sheffer, G.; Salomon, M.; Dew, S.; Marans, J.; Wilson, P.

    1987-02-01

    Gas mixtures with high specific ionization allow the use of small interelectrode distances while still maintaining full efficiency. With the short electron drift distances the timing resolution is also improved. The authors have built and operated two 25 cm/sup 2/ chambers with small interelectrode distances. Also single wire detector cells have been built to test gas mixture lifetimes. Various admixtures of CF/sub 4/, DME, Isobutane, Ethane and Argon have been tested. Possible applications of such chambers are as beam profile monitors, position tagging of rare events and front end chambers in spectrometers.

  2. Neutron detection via bubble chambers.

    PubMed

    Jordan, D V; Ely, J H; Peurrung, A J; Bond, L J; Collar, J I; Flake, M; Knopf, M A; Pitts, W K; Shaver, M; Sonnenschein, A; Smart, J E; Todd, L C

    2005-01-01

    Research investigating the application of pressure-cycled bubble chambers to fast neutron detection is described. Experiments with a Halon-filled chamber showed clear sensitivity to an AmBe neutron source and insensitivity to a (137)Cs gamma source. Bubble formation was documented using high-speed photography, and a ceramic piezo-electric transducer element registered the acoustic signature of bubble formation. In a second set of experiments, the bubble nucleation response of a Freon-134a chamber to an AmBe neutron source was documented with high-speed photography.

  3. The posterior iris-claw lens outcome study: 6-month follow-up

    PubMed Central

    Jare, Nana Madhukar; Kesari, Ashwini Ganesh; Gadkari, Salil S; Deshpande, Madan D

    2016-01-01

    Purpose: The purpose of this study was to evaluate functional and anatomical outcomes of posterior iris-claw intraocular lens (IOL) implant for correction of aphakia in eyes with inadequate capsular support. Materials and Methods: Prospective case series of 108 aphakic eyes with inadequate capsular support which underwent posterior iris-claw IOL with a 6-month follow-up period was conducted. The cases belonged to two clinical settings: elective secondary implantation and those with intraoperative posterior dislocation of cataractous lens or IOL. Main outcome measures were visual acuity, anterior chamber reaction, stability of IOL, endothelial cell count, intraocular pressure (IOP), and cystoid macular edema (CME). Results: The mean best-corrected visual acuity was LogMAR 0.25. None had chronic anterior chamber inflammation. The mean difference in central endothelial counts before surgery and 1 month after surgery was 104.21 cell/mm2 (4.92%). There was no statistically significant difference in central endothelial cell count at 1 and 6 months (P = 0.91) and also in the central macular thickness at preoperative and after 6 months suggestive of CME (P = 0.078). Three eyes had raised IOP which were managed with neodymium-doped yttrium aluminum garnet laser peripheral iridotomy. There were no IOL dislocations or other adverse events in our series. Conclusion: Posterior chamber iris-claw lenses are a good option in eyes with inadequate posterior capsular support. Chronic inflammation, poor lens stability, or significant central endothelial cell loss was not observed during the 6-month follow-up period. PMID:28112126

  4. IRIS Leaves Thermal Vacuum Chamber

    NASA Video Gallery

    This video shows the transportation of the IRIS observatory from the thermal vacuum chamber back to the clean tent for final testing and preparations for delivery to the launch site at Vandenberg A...

  5. Vaporization chambers and associated methods

    DOEpatents

    Turner, Terry D.; Wilding, Bruce M.; McKellar, Michael G.; Shunn, Lee P.

    2017-02-21

    A vaporization chamber may include at least one conduit and a shell. The at least one conduit may have an inlet at a first end, an outlet at a second end and a flow path therebetween. The shell may surround a portion of each conduit and define a chamber surrounding the portion of each conduit. Additionally, a plurality of discrete apertures may be positioned at longitudinal intervals in a wall of each conduit, each discrete aperture of the plurality of discrete apertures sized and configured to direct a jet of fluid into each conduit from the chamber. A liquid may be vaporized by directing a first fluid comprising a liquid into the inlet at the first end of each conduit, directing jets of a second fluid into each conduit from the chamber through discrete apertures in a wall of each conduit and transferring heat from the second fluid to the first fluid.

  6. The multigap resistive plate chamber

    SciTech Connect

    Zeballos, E. Cerron; Crotty, I.; Hatzifotiadou, D.; Valverde, J. Lamas; Neupane, S.; Williams, M. C. S.; Zichichi, A.

    2015-02-03

    The paper describes the multigap resistive plate chamber (RPC). This is a variant of the wide gap RPC. However it has much improved time resolution, while keeping all the other advantages of the wide gap RPC design.

  7. Cyclically controlled welding purge chamber

    NASA Technical Reports Server (NTRS)

    Gallagher, Robert L. (Inventor)

    1996-01-01

    An arrangement for butt-welding cylindrical sections of large, thin-wall tanks includes a rotatable mandrel with side-by-side sets of radial position adjusters. Each set of adjusters bears on one of the tank sections adjacent the seam, to prevent the sections from sagging out-of-round. The mandrel rotates relative to the welder, so that a continuous seam is formed. A purge chamber is fixed in position behind the seam at the weld head, and is flushed with inert gas. The purge chamber includes a two-sided structure which is contiguous with the cylindrical sections and a circumferential vane to form an open-ended tube-like structure, through which the radial position adjusters pass as the mandrel and cylindrical workpiece sections rotate. The tube-like structure is formed into a chamber by a plurality of movable gates which are controlled to maintain a seal while allowing adjusters to progress through the purge chamber.

  8. Light diffusing fiber optic chamber

    DOEpatents

    Maitland, Duncan J.

    2002-01-01

    A light diffusion system for transmitting light to a target area. The light is transmitted in a direction from a proximal end to a distal end by an optical fiber. A diffusing chamber is operatively connected to the optical fiber for transmitting the light from the proximal end to the distal end and transmitting said light to said target area. A plug is operatively connected to the diffusing chamber for increasing the light that is transmitted to the target area.

  9. Episcleral macular buckling for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole

    PubMed Central

    Tian, Jiao; Tang, Luo-Sheng; Guo, Xiao-Jian; Luo, Yong-Heng

    2013-01-01

    AIM To evaluate anatomical and visual outcomes of episcleral macular buckling (EMB) for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole. METHODS Five cases of EMB for initial failure of retinal reattachment after internal limiting membrane (ILM) peeling and silicone oil tamponade caused by myopic macular hole were retrospectively reviewed. A silicone sponge sutured directly across the macular region was performed on the silicone oil filled eyes. Silicone oil was removed no sooner than 1 month post-EMB. The duration of follow-up time after removal of silicone oil was more than 3 months. RESULTS Retinas of five eyes were all reattached at the last follow-up. The postoperative vision ranged from counting fingers to 0.08. CONCLUSION Anatomical results improved after EBM for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole, which was not evident for visual outcome. PMID:23638417

  10. Imaging of the Posterior Skull Base.

    PubMed

    Job, Joici; Branstetter, Barton F

    2017-01-01

    The posterior skull base can be involved by a variety of pathologic processes. They can be broadly classified as: traumatic, neoplastic, vascular, and inflammatory. Pathology in the posterior skull base usually involves the lower cranial nerves, either as a source of pathology or a secondary source of symptoms. This review will categorize pathology arising in the posterior skull base and describe how it affects the skull base itself and surrounding structures.

  11. Posterior peritoneal recesses: assessment using CT

    SciTech Connect

    Rubenstein, W.A.; Auh, Y.H.; Zirinsky, K.; Kneeland, J.B.; Whalen, J.P.; Kazam, E.

    1985-08-01

    Intraperitoneal compartments may extend posteriorly to the level of known retroperitoneal structures at several locations within the abdomen. These locations include the posterior subhepatic or hepatorenal space, the splenorenal space, the retropancreatic recess, the paracolic gutters, and the pararectal fossae. Because of their posterior location, fluid collections within these compartments may be mistaken radiologically for retroperitoneal masses. The sectional anatomy of these spaces and particularly their appearance on computed tomographic scans, are illustrated in this paper.

  12. Posterior ankle impingement in the dancer.

    PubMed

    Moser, Brad R

    2011-01-01

    Dancers spend a lot of time in the relevé position in demi-pointe and en pointe in their training and their careers. Pain from both osseous and soft tissue causes may start to occur in the posterior aspect of their ankle. This article reviews the potential causes of posterior ankle impingement in dancers. It will discuss the clinical evaluation of a dancer and the appropriate workup and radiographic studies needed to further evaluate a dancer with suspected posterior ankle impingement.

  13. Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion

    PubMed Central

    Angelieri, Fernanda; Cevidanes, Lucia H. S.; Franchi, Lorenzo; Gonçalves, João R.; Benavides, Erika; McNamara, James A.

    2014-01-01

    Introduction In this study, we present a novel classification method for individual assessment of midpalatal suture morphology. Methods Cone-beam computed tomography images from 140 subjects (ages, 5.6-58.4 years) were examined to define the radiographic stages of midpalatal suture maturation. Five stages of maturation of the midpalatal suture were identified and defined: stage A, straight high-density sutural line, with no or little interdigitation; stage B, scalloped appearance of the high-density sutural line; stage C, 2 parallel, scalloped, high-density lines that were close to each other, separated in some areas by small low-density spaces; stage D, fusion completed in the palatine bone, with no evidence of a suture; and stage E, fusion anteriorly in the maxilla. Intraexaminer and interexaminer agreements were evaluated by weighted kappa tests. Results Stages A and B typically were observed up to 13 years of age, whereas stage C was noted primarily from 11 to 17 years but occasionally in younger and older age groups. Fusion of the palatine (stage D) and maxillary (stage E) regions of the midpalatal suture was completed after 11 years only in girls. From 14 to 17 years, 3 of 13 (23%) boys showed fusion only in the palatine bone (stage D). Conclusions This new classification method has the potential to avoid the side effects of rapid maxillary expansion failure or unnecessary surgically assisted rapid maxillary expansion for late adolescents and young adults. PMID:24182592

  14. Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure

    PubMed Central

    Kim, Jin Hwi; Byun, Seung Won; Song, Jae Yeon; Kim, Yeon Hee; Lee, Hee Joong; Park, Tae Chul; Lee, Keun Ho; Hur, Soo Young; Park, Jong Sup; Lee, Sung Jong

    2016-01-01

    Abstract We compared results using unidirectional barbed sutures and conventional sutures for vaginal cuff closure during total laparoscopic hysterectomy (TLH).The electronic medical records and surgical videos of 170 patients who underwent TLH between January 2013 and March 2015 at Uijeong-bu St. Mary's Hospital of Catholic University of Korea were reviewed. Vaginal cuffs were closed using the 2-layer continuous running technique with unidirectional barbed sutures (V-Loc; Covidien, Mansfield, MA) in 64 patients and with polycolic acid Vicryl; Ethicon, Somerville, NJ sutures in 106 patients. Procedure time, clinical characteristics, and postoperative complications were compared between the 2 study groups. There were no differences in clinical characteristics (age, body mass index, and demographic data) between groups. The mean suturing time was significantly reduced in the barbed group (7.2 vs 12.2 minutes; P < 0.001), although the mean number of stitches was greater than in the Vicryl group (14.1 vs 12.3, P < 0.001). Perioperative complications, including episodes of vaginal bleeding, vaginal cuff cellulitis, and postoperative fever, did not differ between groups. There were no instances of vaginal cuff dehiscence in either group. Unidirectional barbed sutures can be used safely to reduce procedure time and surgical difficulty relative to conventional sutures in laparoscopic vaginal cuff closure. PMID:27684850

  15. Development of silver nano-coatings on silk sutures as a novel approach against surgical infections.

    PubMed

    De Simone, S; Gallo, A L; Paladini, F; Sannino, A; Pollini, M

    2014-09-01

    The infections give rise to a range of clinical problems and prolong hospitalization with increased healthcare costs. Moreover, persistent infections exasperate the problem of antibiotic resistance. The aim of this study was the development of effective and low-cost antibacterial silver coatings on surgical sutures by adopting an innovative photochemical deposition process to prevent early contamination of surgical wounds. The silver deposition technology adopted in this work is an innovative process based on the in situ photoreduction of a silver solution. The samples were dipped in the silver solution and then exposed to UV radiation in order to induce the synthesis of silver clusters on the surface of the suture. The homogeneous distribution of silver particles on the surface and on the cross-section of the treated sutures was demonstrated. All the antibacterial studies clearly demonstrated that the use of novel silver treated sutures could represent clinical advantages in terms of the prevention of surgical infections against bacterial colonization. The silver coating deposited on the sutures demonstrated no cytotoxic effect on a selected cell population. The results obtained suggested that the antibacterial silver-coated sutures developed in this work could represent an interesting alternative to conventional sutures, with evident advantages in terms of prevention of the surgical infections and on the health costs. In addiction, very low concentrations of silver significantly inhibited the microbial load, without affecting the cell viability.

  16. BCL11B expression in intramembranous osteogenesis during murine craniofacial suture development.

    PubMed

    Holmes, Greg; van Bakel, Harm; Zhou, Xueyan; Losic, Bojan; Jabs, Ethylin Wang

    2015-01-01

    Sutures, where neighboring craniofacial bones are separated by undifferentiated mesenchyme, are major growth sites during craniofacial development. Pathologic fusion of bones within sutures occurs in a wide variety of craniosynostosis conditions and can result in dysmorphic craniofacial growth and secondary neurologic deficits. Our knowledge of the genes involved in suture formation is poor. Here we describe the novel expression pattern of the BCL11B transcription factor protein during murine embryonic craniofacial bone formation. We examined BCL11B protein expression at E14.5, E16.5, and E18.5 in 14 major craniofacial sutures of C57BL/6J mice. We found BCL11B expression to be associated with all intramembranous craniofacial bones examined. The most striking aspects of BCL11B expression were its high levels in suture mesenchyme and increasingly complementary expression with RUNX2 in differentiating osteoblasts during development. BCL11B was also expressed in mesenchyme at the non-sutural edges of intramembranous bones. No expression was seen in osteoblasts involved in endochondral ossification of the cartilaginous cranial base. BCL11B is expressed to potentially regulate the transition of mesenchymal differentiation and suture formation within craniofacial intramembranous bone.

  17. BCL11B expression in intramembranous osteogenesis during murine craniofacial suture development

    PubMed Central

    Holmes, Greg; van Bakel, Harm; Zhou, Xueyan; Losic, Bojan; Jabs, Ethylin Wang

    2014-01-01

    Sutures, where neighboring craniofacial bones are separated by undifferentiated mesenchyme, are major growth sites during craniofacial development. Pathologic fusion of bones within sutures occurs in a wide variety of craniosynostosis conditions and can result in dysmorphic craniofacial growth and secondary neurologic deficits. Our knowledge of the genes involved in suture formation is poor. Here we describe the novel expression pattern of the BCL11B transcription factor protein during murine embryonic craniofacial bone formation. We examined BCL11B protein expression at E14.5, E16.5, and E18.5 in 14 major craniofacial sutures of C57BL/6J mice. We found BCL11B expression to be associated with all intramembranous craniofacial bones examined. The most striking aspects of BCL11B expression were its high levels in suture mesenchyme and increasingly complementary expression with RUNX2 in differentiating osteoblasts during development. BCL11B was also expressed in mesenchyme at the non-sutural edges of intramembranous bones. No expression was seen in osteoblasts involved in endochondral ossification of the cartilaginous cranial base. BCL11B is expressed to potentially regulate the transition of mesenchymal differentiation and suture formation within craniofacial intramembranous bone. PMID:25511173

  18. Introduction of a New Suture Method in Repair of Peripheral Nerves Injured with a Sharp Mechanism

    PubMed Central

    Saied, Alireza; Shekaari, Majid Asadi; Sadeghifar, Amirreza; Karbalaeikhani, Ali

    2015-01-01

    Background: The standard method for repair of an injured peripheal nerve is epineural repair with separate sutures. Herein we describe a method in which the nerve is sutured with continous sutures. In fact this method has not been utilized for nerve repair previously and our purpose was to compare it to the standard method. If it proved to be successful it would replace the standard method in certain circumstances. Methods: The proposal of the clinical trial was given a reference number form the ethics comitee. 25 dogs in which the scaitic nerve was cut by a sharp blade under genaeral anesthesia were divided randomly into three groups: control (5 dogs), repair of sciatic nerve with simple sutures (10) and repair with continous sutures (10). In the control group the nerve was not repaired at all. After 6 weeks the dogs were killed and the nerve was studied by light and electronic microscopes. The amount of consumed suture material, time of repair, myelin thickness and axon diiameter were examined. Ultrastructural studies were performed to assess degeneration and regeneration findings. Results: Time of repair and the amount of consumed suture material were significantly lower in the continous group (P<0.001). No difference was found with regard to light microscopy findings and regeneration was confirmed by electron microscopy in the continous group. Conclusion: The method described in the present study, provided a result similar to the standard method. Though undobtfully it has some limitations, can replace the standard method in many circumstances. PMID:26550589

  19. The course of nonproliferative diabetic retinopathy following ECCE with posterior chamber IOL implantation.

    PubMed

    Raniel, Y; Teichner, Y; Friedman, Z

    1994-01-01

    A prospective study on the effect of ECCE + IOL implantation on the course of diabetic retinopathy (DR) in 59 eyes showed that in one to three years following surgery, progression of DR, including the development of newly formed one, occurred in 28.8% of the eyes. This was more marked in patient with IDDM (IDDM-46%, NIDDM-24%) as well as in eyes with pre-operative BDR (pre-operative BDR-62.5%, no pre-operative BDR-16.3%). Final visual acuity was better in eyes without pre-operative DR as well as in eyes that did not show progression of the retinopathy.

  20. PFOS affects posterior swim bladder chamber inflation and swimming performance of zebrafish larvae.

    PubMed

    Hagenaars, A; Stinckens, E; Vergauwen, L; Bervoets, L; Knapen, D

    2014-12-01

    Perfluorooctane sulphonate (PFOS) is one of the most commonly detected perfluorinated alkylated substances in the aquatic environment due to its persistence and the degradation of less stable compounds to PFOS. PFOS is known to cause developmental effects in fish. The main effect of PFOS in zebrafish larvae is an uninflated swim bladder. As no previous studies have focused on the effect of PFOS on zebrafish swim bladder inflation, the exact mechanisms leading to this effect are currently unknown. The objective of this study was to determine the exposure windows during early zebrafish development that are sensitive to PFOS exposure and result in impaired swim bladder inflation in order to specify the mechanisms by which this effect might be caused. Seven different time windows of exposure (1-48, 1-72, 1-120, 1-144, 48-144, 72-144, 120-144h post fertilization (hpf)) were tested based on the different developmental stages of the swim bladder. These seven time windows were tested for four concentrations corresponding to the EC-values of 1, 10, 80 and 95% impaired swim bladder inflation (EC1=0.70 mg L(-1), EC10=1.14 mg L(-1), EC80=3.07 mg L(-1) and EC95=4.28 mg L(-1)). At 6 days post fertilization, effects on survival, hatching, swim bladder inflation and size, larval length and swimming performance were assessed. For 0.70 mg L(-1), no significant effects were found for the tested parameters while 1.14 mg L(-1) resulted in a reduction of larval length. For 3.07 and 4.28 mg L(-1), the number of larvae affected and the severity of effects caused by PFOS were dependent on the time window of exposure. Exposure for 3 days or more resulted in significant reductions of swim bladder size, larval length and swimming speed with increasing severity of effects when the duration of exposure was longer, suggesting a possible effect of accumulated dose. Larvae that were only exposed early (1-48 hpf) or late (120-144 hpf) during development showed no effects on the studied endpoints. The results demonstrate that PFOS does not affect the budding phase, and does not cause deflation of already inflated swim bladders. PFOS clearly affects processes that take place during the inflation phase and might also have an effect on the formation of the tissue layers forming the swim bladder.

  1. Anterior chamber angle in the exfoliation syndrome.

    PubMed Central

    Wishart, P K; Spaeth, G L; Poryzees, E M

    1985-01-01

    The gonioscopic findings of 76 patients with the exfoliation syndrome were reviewed. A high frequency of narrowness of the anterior chamber (AC) angle was found (32%). 18% had angles considered occludable, and 14% had obvious angle-closure glaucoma as shown by the presence of peripheral anterior synechias (PAS). Increased pigmentation of the posterior trabecular meshwork (PTM) was noted in all cases. When this pigmentation was markedly asymmetrical, unilateral exfoliation with glaucoma was common in the more pigmented eye. In addition heavy angle pigmentation in the absence of exfoliation was noted in the fellow eye of patients with characteristic exfoliated material in the other eye. Increased pigmentation of the PTM may be the earliest detectable sign of the exfoliation syndrome (ES). The clinical significance of our estimating PTM pigmentation at the 12 o'clock position is discussed. In view of the accelerated optic nerve damage associated with the development of glaucoma secondary to ES, routine estimation of the pigmentation of the PTM at 12 o'clock is recommended in the hope of early detection of cases of otherwise inapparent ES. Images PMID:3966996

  2. A miniature tension sensor to measure surgical suture tension of deformable musculoskeletal tissues during joint motion.

    PubMed

    Kiriyama, Yoshimori; Matsumoto, Hideo; Toyama, Yoshiaki; Nagura, Takeo

    2014-02-01

    The aim of this study was to develop a new suture tension sensor for musculoskeletal soft tissue that shows deformation or movements. The suture tension sensor was 10 mm in size, which was small enough to avoid conflicting with the adjacent sensor. Furthermore, the sensor had good linearity up to a tension of 50 N, which is equivalent to the breaking strength of a size 1 absorbable suture defined by the United States Pharmacopeia. The design and mechanism were analyzed using a finite element model prior to developing the actual sensor. Based on the analysis, adequate material was selected, and the output linearity was confirmed and compared with the simulated result. To evaluate practical application, the incision of the skin and capsule were sutured during simulated total knee arthroplasty. When conventional surgery and minimally invasive surgery were performed, suture tensions were compared. In minimally invasive surgery, the distal portion of the knee was dissected, and the proximal portion of the knee was dissected additionally in conventional surgery. In the skin suturing, the maximum tension was 4.4 N, and this tension was independent of the sensor location. In contrast, the sensor suturing the capsule in the distal portion had a tension of 4.4 N in minimally invasive surgery, while the proximal sensor had a tension of 44 N in conventional surgery. The suture tensions increased nonlinearly and were dependent on the knee flexion angle. Furthermore, the tension changes showed hysteresis. This miniature tension sensor may help establish the optimal suturing method with adequate tension to ensure wound healing and early recovery.

  3. B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly.

    PubMed

    Boyar, Ibrahim Hakan; Boynukalın, Fazilet Kübra; Boyar, Nuray; Vural, Mehmet

    2011-01-01

    Congenital anomalies of the uterus may cause gynecologic, obstetric and fertility problems. Obstetrical complications are reported to occur more commonly with mullerian duct anomalies, such as postpartum hemorrhage (PPH). Uterine compression sutures may be effective in controlling PPH in these conditions as an alternative to hysterectomy, especially if the patient has a desire to conceive. As the shape of the uterus is changed in congenital malformation, the usage of compression sutures such as B-Lynch can be more difficult. In this study we report a case of PPH accompanying a large septae, treated with B-Lynch suture. A 24 year old, multigravid and nulliparous patient (G:3) was admitted to our clinic with vaginal bleeding and abdominal pain at 31 weeks of gestation. Emergency cesarean section was performed for abruptio placenta and PPH occurred subsequently. A deep uterine septum was revealed during operation. Intermittent fundal massage and intravenous uterotonics were used to improve uterine tonicity without any improvement. After the B-Lynch suture was performed, the bleeding diminished dramatically. As the shape of the uterus is changed in congenital malformation, the application of secondary interventions in postpartum hemorrhage can be more difficult. There can be slippage or overlapping of the suture while using a B-Lynch suture. Because the uterine shape is not completely distorted, patients with septate uterus can be candidates for a B-Lynch suture. There is no such reported case from the literature regarding efficacy of B-Lynch suture in mullerian anomalies. his case illustrates the potential benefits of B-Lynch compression suture in an uterus with mullerian anomalies.

  4. Triclosan-coated sutures and sternal wound infections: a prospective randomized clinical trial.

    PubMed

    Steingrimsson, S; Thimour-Bergström, L; Roman-Emanuel, C; Scherstén, H; Friberg, Ö; Gudbjartsson, T; Jeppsson, A

    2015-12-01

    Surgical site infection is a common complication following cardiac surgery. Triclosan-coated sutures have been shown to reduce the rate of infections in various surgical wounds, including wounds after vein harvesting in coronary artery bypass grafting patients. Our purpose was to compare the rate of infections in sternotomy wounds closed with triclosan-coated or conventional sutures. A total of 357 patients that underwent coronary artery bypass grafting were included in a prospective randomized double-blind single-center study. The patients were randomized to closure of the sternal wound with either triclosan-coated sutures (Vicryl Plus and Monocryl Plus, Ethicon, Inc., Somerville, NJ, USA) (n = 179) or identical sutures without triclosan (n = 178). Patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). The primary endpoint was the prevalence of sternal wound infection according to the Centers for Disease Control and Prevention (CDC) criteria. The demographics in both groups were comparable, including age, gender, body mass index, and rate of diabetes and smoking. Sternal wound infection was diagnosed in 43 patients; 23 (12.8%) sutured with triclosan-coated sutures compared to 20 (11.2%) sutured without triclosan (p = 0.640). Most infections were superficial (n = 36, 10.1%), while 7 (2.0%) were deep sternal wound infections. There were 16 positive cultures in the triclosan group and 17 in the non-coated suture group (p = 0.842). The most commonly identified main pathogens were Staphylococcus aureus (45.4%) and coagulase-negative staphylococci (36.4%). Skin closure with triclosan-coated sutures did not reduce the rate of sternal wound infection after coronary artery bypass grafting. (clinicaltrials.gov: NCT01212315).

  5. 63. Interior view, kitchen chamber, north elevation. The kitchen chamber ...

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

    63. Interior view, kitchen chamber, north elevation. The kitchen chamber was completed in the first stages of phase III construction. The paneled wall to the fireplace's right displays a phase III molding profile. The mark between the cabinet doors and on the large lower panel indicates the former position of a partition wall. The chimney-breast paneling bears a phase I profile and might have been moved to the room when the fireplace mass in the hall was reduced. - John Bartram House & Garden, House, 54th Street & Lindbergh Boulevard, Philadelphia, Philadelphia County, PA

  6. Plasma chemistry in wire chambers

    SciTech Connect

    Wise, J.

    1990-05-01

    The phenomenology of wire chamber aging is discussed and fundamentals of proportional counters are presented. Free-radical polymerization and plasma polymerization are discussed. The chemistry of wire aging is reviewed. Similarities between wire chamber plasma (>1 atm dc-discharge) and low-pressure rf-discharge plasmas, which have been more widely studied, are suggested. Construction and use of a system to allow study of the plasma reactions occurring in wire chambers is reported. A proportional tube irradiated by an {sup 55}Fe source is used as a model wire chamber. Condensable species in the proportional tube effluent are concentrated in a cryotrap and analyzed by gas chromatography/mass spectrometry. Several different wire chamber gases (methane, argon/methane, ethane, argon/ethane, propane, argon/isobutane) are tested and their reaction products qualitatively identified. For all gases tested except those containing methane, use of hygroscopic filters to remove trace water and oxygen contaminants from the gas resulted in an increase in the average molecular weight of the products, consistent with results from low-pressure rf-discharge plasmas. It is suggested that because water and oxygen inhibit polymer growth in the gas phase that they may also reduce polymer deposition in proportional tubes and therefore retard wire aging processes. Mechanistic implications of the plasma reactions of hydrocarbons with oxygen are suggested. Unresolved issues in this work and proposals for further study are discussed.

  7. Neutron Detection via Bubble Chambers

    SciTech Connect

    Jordan, David V.; Ely, James H.; Peurrung, Anthony J.; Bond, Leonard J.; Collar, J. I.; Flake, Matthew; Knopf, Michael A.; Pitts, W. K.; Shaver, Mark W.; Sonnenschein, Andrew; Smart, John E.; Todd, Lindsay C.

    2005-10-06

    The results of a Pacific Northwest National Laboratory (PNNL) exploratory research project investigating the feasibility of fast neutron detection using a suitably prepared and operated, pressure-cycled bubble chamber are described. The research was conducted along two parallel paths. Experiments with a slow pressure-release Halon chamber at the Enrico Fermi Institute at the University of Chicago showed clear bubble nucleation sensitivity to an AmBe neutron source and insensitivity to the 662 keV gammas from a 137Cs source. Bubble formation was documented via high-speed (1000 frames/sec) photography, and the acoustic signature of bubble formation was detected using a piezo-electric transducer element mounted on the base of the chamber. The chamber’s neutron sensitivity as a function of working fluid temperature was mapped out. The second research path consisted of the design, fabrication, and testing of a fast pressure-release Freon-134a chamber at PNNL. The project concluded with successful demonstrations of the PNNL chamber’s AmBe neutron source sensitivity and 137Cs gamma insensitivity. The source response tests of the PNNL chamber were documented with high-speed photography.

  8. Emulsion Chamber Technology Experiment (ECT)

    NASA Technical Reports Server (NTRS)

    Gregory, John C.; Takahashi, Yoshiyuki

    1996-01-01

    The experimental objective of Emulsion Chamber Technology (ECT) was to develop space-borne emulsion chamber technology so that cosmic rays and nuclear interactions may subsequently be studied at extremely high energies with long exposures in space. A small emulsion chamber was built and flown on flight STS-62 of the Columbia in March 1994. Analysis of the several hundred layers of radiation-sensitive material has shown excellent post-flight condition and suitability for cosmic ray physics analysis at much longer exposures. Temperature control of the stack was 20 +/-1 C throughout the active control period and no significant deviations of temperature or pressure in the chamber were observed over the entire mission operations period. The unfortunate flight attitude of the orbiter (almost 90% Earth viewing) prevented any significant number of heavy particles (Z greater than or equal to 10) reaching the stack and the inverted flow of shower particles in the calorimeter has not allowed evaluation of absolute primary cosmic ray-detection efficiency nor of the practical time limits of useful exposure of these calorimeters in space to the level of detail originally planned. Nevertheless, analysis of the observed backgrounds and quality of the processed photographic and plastic materials after the flight show that productive exposures of emulsion chambers are feasible in low orbit for periods of up to one year or longer. The engineering approaches taken in the ECT program were proven effective and no major environmental obstacles to prolonged flight are evident.

  9. Plant growth chamber M design

    NASA Technical Reports Server (NTRS)

    Prince, R. P.; Knott, W. M.

    1986-01-01

    Crop production is just one of the many processes involved in establishing long term survival of man in space. The benefits of integrating higher plants into the overall plan was recognized early by NASA through the Closed Ecological Life Support System (CELSS) program. The first step is to design, construct, and operate a sealed (gas, liquid, and solid) plant growth chamber. A 3.6 m diameter by 6.7 m high closed cylinder (previously used as a hypobaric vessel during the Mercury program) is being modified for this purpose. The chamber is mounted on legs with the central axis vertical. Entrance to the chamber is through an airlock. This chamber will be devoted entirely to higher plant experimentation. Any waste treatment, food processing or product storage studies will be carried on outside of this chamber. Its primary purpose is to provide input and output data on solids, liquids, and gases for single crop species and multiple species production using different nutrient delivery systems.

  10. Iridium-Coated Rhenium Combustion Chamber

    NASA Technical Reports Server (NTRS)

    Schneider, Steven J.; Tuffias, Robert H.; Rosenberg, Sanders D.

    1994-01-01

    Iridium-coated rhenium combustion chamber withstands operating temperatures up to 2,200 degrees C. Chamber designed to replace older silicide-coated combustion chamber in small rocket engine. Modified versions of newer chamber could be designed for use on Earth in gas turbines, ramjets, and scramjets.

  11. Posterior repair and sexual function

    PubMed Central

    Komesu, Yuko M.; Rogers, Rebecca G.; Kammerer-Doak, Dorothy N.; Barber, Matthew D.; Olsen, Ambre L.

    2011-01-01

    OBJECTIVE The purpose of this study was to determine the effect of posterior repair (PR) on sexual function in patients who have undergone incontinence and/or pelvic reconstructive surgery. STUDY DESIGN A cohort study of women who underwent incontinence and/or prolapse surgery was performed. Participants completed the pelvic organ prolapse urinary incontinence sexual questionnaire (PISQ) before and after the operation. PISQ scores were compared between women who underwent PR and women who did not. RESULTS Of 73 study participants, 30 women underwent PR; 43 women did not (no PR). Although there was no difference in dyspareunia between groups pre-op, dyspareunia prevalence post-op was significantly lower in the no PR group. Preoperative PISQ scores were similar between groups. After the operation, both groups significantly improved their PISQ scores, without a difference between groups. CONCLUSION Although the incidence of dyspareunia differed between PR and no PR groups, overall improvement in sexual function was reflected in improved total PISQ scores that occurred irrespective of PR performance. PMID:17618777

  12. Shape memory alloy fixator system for suturing tissue in minimal access surgery.

    PubMed

    Xu, W; Frank, T G; Stockham, G; Cuschieri, A

    1999-01-01

    A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators is described in terms of the thermal shape recovery of shape memory alloy and a novel form of finite element analysis, which uses a nonlinear elastic element for the material property. Thermal analysis of the fixators and surrounding tissue is used to predict the temperature distribution during and after the application of electric current heating. This was checked in an in vitro experiment, which confirmed that deployment caused no detectable collateral damage to surrounding tissue. In vivo animal studies on the use of the shape memory alloy fixator for suturing tissue are ongoing to establish safety and healing effects.

  13. Synthesis and characterization of aliphatic polyurethane fiber: a potential suture material.

    PubMed

    Ray, A R; Bhowmick, A

    1991-10-01

    Polyurethane fibers were synthesized and characterized by IR, 1H NMR, DSC, and GPC. Their properties as fiber were compared with commercially available sutures of polypropylene, polyamide, polyester, and silk.

  14. Bilateral squamosal suture synostosis: A rare form of isolated craniosynostosis in Crouzon syndrome

    PubMed Central

    Tandon, Yasmeen K; Rubin, Michael; Kahlifa, Mohamed; Doumit, Gaby; Naffaa, Lena

    2014-01-01

    Craniosynostosis is a pathologic condition which is characterized by the premature fusion of cranial sutures. It may occur alone or in association with other anomalies making up various syndromes. Crouzon syndrome is the most common craniosynostosis syndrome. Bicoronal sutures fusion is most commonly involved in Crouzon syndrome. There have only been a handful of cases of squamosal suture synostosis described in the surgery literature with the few ones described in Crouzon syndrome associated with other types of craniosynostosis. To the best of our knowledge, we are presenting the first case of isolated bilateral squamosal suture synostosis in a patient with Crouzon syndrome in a radiology journal with emphasis on its radiological appearance. PMID:25071892

  15. Stem cells of the suture mesenchyme in craniofacial bone development, repair and regeneration

    PubMed Central

    Maruyama, Takamitsu; Jeong, Jaeim; Sheu, Tzong-Jen; Hsu, Wei

    2016-01-01

    The suture mesenchyme serves as a growth centre for calvarial morphogenesis and has been postulated to act as the niche for skeletal stem cells. Aberrant gene regulation causes suture dysmorphogenesis resulting in craniosynostosis, one of the most common craniofacial deformities. Owing to various limitations, especially the lack of suture stem cell isolation, reconstruction of large craniofacial bone defects remains highly challenging. Here we provide the first evidence for an Axin2-expressing stem cell population with long-term self-renewing, clonal expanding and differentiating abilities during calvarial development and homeostastic maintenance. These cells, which reside in the suture midline, contribute directly to injury repair and skeletal regeneration in a cell autonomous fashion. Our findings demonstrate their true identity as skeletal stem cells with innate capacities to replace the damaged skeleton in cell-based therapy, and permit further elucidation of the stem cell-mediated craniofacial skeletogenesis, leading to revealing the complex nature of congenital disease and regenerative medicine. PMID:26830436

  16. Timing of cranial suture closure in placental mammals: phylogenetic patterns, intraspecific variation, and comparison with marsupials.

    PubMed

    Rager, Lisa; Hautier, Lionel; Forasiepi, Analía; Goswami, Anjali; Sánchez-Villagra, Marcelo R

    2014-02-01

    Used as markers of postnatal growth closure sequences of 22 ectocranial sutures and synchondroses were recorded in a sample of 1161 skulls belonging to 38 species from all major placental clades: Afrotheria, Xenarthra, Laurasiatheria and Euarchontoglires (Boreoeutheria). The maximum closure level, which is not significantly correlated to body mass, is higher in Afrotheria and Xenarthra than in Boreoeutheria. Only the basioccipito-basisphenoid and the basioccipito-exoccipital synchondroses close in all species sampled, the supraoccipito-exoccipital and the inter-parietal sutures do in most species. Parsimov retrieved more heterochronic shifts for Afrotheria and Xenarthra than for Boreoeutheria. The amount of intraspecific variation differs among the species sampled being high among xenarthran species and low among afrotherians. Specimens (162) representing 12 marsupial genera were also analysed. Placentals exhibit a larger number of suture closures than marsupials and in both groups the sutures at the base of the skull are the first to fuse starting with the basioccipito-exoccipital.

  17. Loss of rotator cuff tendon-to-bone interface pressure after reattachment using a suture anchor.

    PubMed

    Brassart, Nicolas; Sanghavi, Sanjay; Hansen, Ulrich N; Emery, Roger J; Amis, Andrew A

    2008-01-01

    The purpose of this study was to examine the tendon-to-bone interface pressure, contact area, and force after reattaching a tendon to bone by use of a suture and suture anchor. Repairs were made in 8 ovine shoulders in vitro, by use of 3 suture types in each: Ethibond, polydioxanone, or Orthocord. A Tekscan pressure sensor was placed between the tendon and bone and monitored for 1 hour after the repair. The principal finding was a significant loss of approximately 60% of the contact parameters immediately after the suture was tied, followed by further significant loss over the next hour to a mean of only 14% of the initial readings. We concluded that pressure measurement systems that only record the initial maximum pressure would yield overly optimistic results for the actual repair pressure after the repair is completed. The Tekscan system, however, allowed us to monitor pressure reductions that occurred both during and after the repair.

  18. Comparison of seven different suture materials in the feline oral cavity.

    PubMed

    DeNardo, G A; Brown, N O; Trenka-Benthin, S; Marretta, S M

    1996-01-01

    Seven different suture materials were implanted into the oral tissues of 12 cats. The sutures and surrounding tissues were retrieved en bloc from each of two cats on days one, three, seven, 14, 21, and 28 postimplantation. Tissue reaction and suture duration were evaluated by gross visual observation and histological examination. Chromic gut disappeared between days three and seven; polyglactin 910 disappeared between days 14 and 21; and polyglycolic acid disappeared as early as seven to 14 days. Polydioxanone still was intact at day 28 and is recommended as an absorbable material for procedures in which longer healing time is anticipated. All the nonabsorbable suture materials (i.e., polypropylene, stainless steel, and nylon) were intact at day 28 postimplantation. Visual inspection showed polypropylene to have the least tissue reaction.

  19. Modified Quilting Sutures: ANew Technique for Hematoma and Abscess of Nasal Septum.

    PubMed

    Ahmed, Shoaib; Ashfaq, Muhammed; Shabbir, Asad

    2016-06-01

    This study aimed to analyze the results of a modified continuous quilting sutures technique in a series of patients presenting with hematoma and/or abscess of nasal septum (HANS). Only patients with a confirmed diagnosis of HANS without co-morbid conditions (which could predispose to a bleeding tendency), were selected. Following incision and drainage, nasal septal flaps were coapted by applying continuous quilting sutures only. The success rate of this technique in terms of recurrence requiring re-exploration and drainage was 100%. Quilting sutures were generally well tolerated with few complaints. Saddle deformity was the most obvious complication of HANS, seen with septal abscess. Quilting sutures can be considered as an alternative treatment option for HANS. The modified technique employed in this study demonstrated impressive results and avoided the morbidity of nasal packing with fewer complications.

  20. Thoracoscopic esophageal repair with barbed suture material in a case of Boerhaave’s syndrome

    PubMed Central

    Sato, Chiaki; Sakurai, Tadashi; Kamiya, Kurodo; Kamei, Takashi; Ohuchi, Noriaki

    2016-01-01

    A 53-year-old man was referred to our hospital with Boerhaave’s syndrome. Thirty hours after onset, a left thoracoscopic operation was performed, with carbon dioxide pneumothorax and the patient in right semi-prone position. The thoracic cavity was copiously irrigated with physiological saline and a 4-cm longitudinal rupture was identified on the left side of the lower esophagus. The esophageal injury was repaired in 2 layers by using barbed absorbable suture material. The patient was allowed oral feeds after contrast esophagography confirmed the absence of contrast leak at the sutured site on postoperative day 7, and discharged by day 28. Suturing of the ruptured esophagus under thoracoscopic guidance is considered to be difficult and requires expertise. This case report demonstrates that the use of a barbed suture material simplifies thoracoscopic esophageal repair and also highlights the importance of pneumothorax and patient position in improving access to the esophagus. PMID:28149585

  1. Hydrostatic Hyperbaric Chamber Ventilation System

    NASA Technical Reports Server (NTRS)

    Sargusingh, Miriam M.

    2011-01-01

    The hydrostatic hyperbaric chamber (HHC) represents the merger of several technologies in development for NASA aerospace applications, harnessed to directly benefit global health. NASA has significant experience developing composite hyperbaric chambers for a variety of applications, including the treatment of medical conditions. NASA also has researched the application of water-filled vessels to increase tolerance of acceleration forces. The combination of these two applications has resulted in the hydrostatic chamber, which has been conceived as a safe, affordable means of making hyperbaric oxygen therapy available in the developing world for the treatment of a variety of medical conditions. Specifically, hyperbaric oxygen therapy is highly-desired as a possibly curative treatment for Buruli Ulcer, an infectious condition that afflicts children in sub-Saharan Africa. Hyperbaric oxygen therapy is simply too expensive and too dangerous to implement in the developing world using standard equipment. The hydrostatic hyperbaric chamber technology changes the paradigm. The HHC differs from standard hyperbaric chambers in that the majority of its volume is filled with water which is pressurized by oxygen being supplied in the portion of the chamber containing the patient s head. This greatly reduces the amount of oxygen required to sustain a hyperbaric atmosphere, thereby making the system more safe and economical to operate. An effort was taken to develop an HHC system to apply HBOT to children that is simple and robust enough to support transport, assembly, maintenance and operation in developing countries. This paper details the concept for an HHC ventilation and pressurization system that will provide controlled pressurization of the system, and provide adequate washout of carbon dioxide while the subject is enclosed in the confined space during the administration of the medical treatment. The concept took into consideration operational complexity, safety to the

  2. Guanylin peptides regulate electrolyte and fluid transport in the Gulf toadfish (Opsanus beta) posterior intestine.

    PubMed

    Ruhr, Ilan M; Bodinier, Charlotte; Mager, Edward M; Esbaugh, Andrew J; Williams, Cameron; Takei, Yoshio; Grosell, Martin

    2014-11-01

    The physiological effects of guanylin (GN) and uroguanylin (UGN) on fluid and electrolyte transport in the teleost fish intestine have yet to be thoroughly investigated. In the present study, the effects of GN, UGN, and renoguanylin (RGN; a GN and UGN homolog) on short-circuit current (Isc) and the transport of Cl-, Na+, bicarbonate (HCO3-), and fluid in the Gulf toadfish (Opsanus beta) intestine were determined using Ussing chambers, pH-stat titration, and intestinal sac experiments. GN, UGN, and RGN reversed the Isc of the posterior intestine (absorptive-to-secretory), but not of the anterior intestine. RGN decreased baseline HCO3- secretion, but increased Cl- and fluid secretion in the posterior intestine. The secretory response of the posterior intestine coincides with the presence of basolateral NKCC1 and apical cystic fibrosis transmembrane conductance regulator (CFTR), the latter of which is lacking in the anterior intestine and is not permeable to HCO3- in the posterior intestine. However, the response to RGN by the posterior intestine is counterintuitive given the known role of the marine teleost intestine as a salt- and water-absorbing organ. These data demonstrate that marine teleosts possess a tissue-specific secretory response, apparently associated with seawater adaptation, the exact role of which remains to be determined.

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

    PubMed

    Gauthier-Benoît, C; Prat, A

    1979-01-01

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

  4. Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis.

    PubMed

    Wu, X; Kubilay, N Z; Ren, J; Allegranzi, B; Bischoff, P; Zayed, B; Pittet, D; Li, J

    2017-01-01

    To investigate the effectiveness of antimicrobial-coated sutures compared with non-coated sutures in reducing surgical site infection (SSI) and develop recommendations for World Health Organization (WHO) SSI prevention guidelines. We searched Medline, Embase, Cinahl, Cochrane Central Register of Controlled Trials, and WHO Global Health from 1990-16/02/2015 with language restricted to English, Spanish, and French. Meta-analysis was performed with a random-effects model. Meta-regression analysis assessed whether the effect of antimicrobial coating changed according to the type of suture and surgery. Subgroup analyses were based on types of sutures. Quality of the retrieved evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. Thirteen randomized controlled trials (RCTs) and five observational studies (OBSs) met the inclusion criteria. Antimicrobial sutures significantly reduced SSI risk (for RCTs: OR 0.72, 95 % CI 0.59-0.88, p = 0.001, I(2) = 14 %; for OBSs: OR 0.58, 95 % CI 0.40-0.83, p = 0.003, I(2) = 22 %). Only Vicryl Plus vs Vicryl revealed consistent results in favor of antimicrobial sutures (for seven RCTs: OR 0.62, 95 % CI 0.44-0.88, p = 0.007, I(2) = 3 %; for four OBSs: OR 0.58, 95 % CI 0.37-0.92, p = 0.02, I(2) = 41 %). The effect of antimicrobial coating was similar between different suture, wound, and procedure types. Quality of RCT evidence was moderate, and OBS evidence was very low quality. Triclosan-coated sutures may reduce SSI risk. However, the available evidence is of moderate/low quality, and many studies had conflicts of interest.

  5. [Application and development of suture-dragging therapy for anal fistula].

    PubMed

    Wang, Chen; Yao, Yibo; Dong, Qingjun; Liang, Hongtao; Guo, Xiutian; Cao, Yongqing; Lu, Jingen

    2015-12-01

    Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.

  6. Introducing a Favourite Tip Definition and Projection with Tripod Suture in Rhinoplasty

    PubMed Central

    Motamed, Sadrollah; Niazi, Feizollah; Moosavizadeh, Seyed Mehdi; Motaghedi, Babak; Tizmaghz, Adnan

    2017-01-01

    Introduction Surgical manipulation of the lower lateral cartilages of nasal tip could cause subtle but significant responses to the manipulation. The suture-techniques almost always offer a reliable and dramatic method of tip reshaping without a need to break or interrupt the alar rim strip or even adding tip graft. Aim The aim of this study was to describe and assess outcomes of a new suture technique in rhinoplasty by using cephalic dome septal rotation suture for better tip definition. Materials and Methods All consecutive women (62 women) who attended our centre with nasal tip drooping and some degree of columellar retraction, underwent this technique from January 2005 to September 2009. Their ages ranged from 17 to 32 years old. Fifty one primary open and 11 secondary open rhinoplasties were performed using the conventional techniques and then the new suture technique was applied before closing the incisions on each patient. Results The patients were followed-up from 22 to 72 months (mean = 52.3). The projection and rotation was satisfactory in all patients and the final results persisted with only minimal changes over time. Conclusion It is important to say that this new suture is different from ‘tip rotation suture’ that was described by Tebbets. Our suture maintains the favorite tip definition with slight dorsal tip inclination. Indeed, it causes a two-point definition as the columellar lobular angle and the supra tip break definition. In addition, long-term follow-up has shown that this new suture (i.e., cephalic dome-septal rotation suture) is able to maintain optimal position of the nasal tip projection and definition. PMID:28273999

  7. Clinical inquiries. How does tissue adhesive compare with suturing for superficial lacerations?

    PubMed

    Aukerman, Douglas F; Sebastianelli, Wayne J; Nashelsky, Joan

    2005-04-01

    Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection and dehiscence, may be lower with tissue adhesives. Wound closure of superficial lacerations by tissue adhesives is quicker and less painful compared with conventional suturing (strength of recommendation: A, systematic reviews of randomized trials).

  8. Annular-Cross-Section CFE Chamber

    NASA Technical Reports Server (NTRS)

    Sharnez, Rizwan; Sammons, David W.

    1994-01-01

    Proposed continuous-flow-electrophoresis (CFE) chamber of annular cross section offers advantages over conventional CFE chamber, and wedge-cross-section chamber described in "Increasing Sensitivity in Continuous-Flow Electrophoresis" (MFS-26176). In comparison with wedge-shaped chamber, chamber of annular cross section virtually eliminates such wall effects as electro-osmosis and transverse gradients of velocity. Sensitivity enhanced by incorporating gradient maker and radial (collateral) flow.

  9. CHAMBERS FERRY ROADLESS AREA, TEXAS.

    USGS Publications Warehouse

    Houser, B.B.; Ryan, George S.

    1984-01-01

    A geologic and geochemical investigation of the Chambers Ferry Roadless Area, Texas was conducted. The area has probable mineral-resource potential for oil and gas and for lignite. No metallic or additional energy resources were identified in the investigation. Detailed analyses of well logs from the vicinity of the Chambers Ferry Roadless Area, in conjunction with seismic data, are necessary to determine if the subsurface stratigraphy and structure are favorable for the accumulation of oil and gas. A shallow drilling program involving coring on a close-space grid is necessary for determination of the rank and continuity of seams of lignitic sediments in the area.

  10. Test chamber for alpha spectrometry

    DOEpatents

    Larsen, Robert P.

    1977-01-01

    Alpha emitters for low-level radiochemical analysis by measurement of alpha spectra are positioned precisely with respect to the location of a surface-barrier detector by means of a chamber having a removable threaded planchet holder. A pedestal on the planchet holder holds a specimen in fixed engagement close to the detector. Insertion of the planchet holder establishes an O-ring seal that permits the chamber to be pumped to a desired vacuum. The detector is protected against accidental contact and resulting damage.

  11. Anatomy and biomechanics of the vertebral aponeurosis part of the posterior layer of the thoracolumbar fascia.

    PubMed

    Loukas, Marios; Shoja, Mohammadali M; Thurston, Todd; Jones, Virginia L; Linganna, Sanjay; Tubbs, R Shane

    2008-03-01

    There is significant paucity in the literature regarding vertebral aponeurosis. We were able to find only a few descriptions of this specific fascia in the extant medical literature. To elucidate further the anatomy of this structure, forty adult human cadavers were dissected. Both quantitation and anatomical observations were made of the vertebral aponeurosis. The vertebral aponeurosis was identified in 100% of specimens. This fascia was identified as a thin fibrous layer consisting of longitudinal and transverse connective tissue fibers blended together deep to the latissimus dorsi muscle. It attached medially to the spinous processes of the of the thoracic vertebrae; laterally to the angles of ribs; inferiorly to the fascia covering the serratus posterior inferior muscle (superficial lamina of the posterior layer of thoracolumbar fascia); superiorly it ran deep to the serratus posterior superior and splenius capitis muscles to blend with the deep fascia of the neck. At the level of the serratus posterior inferior muscle, the vertebral aponeurosis fused to form a continuous layer descending toward the sacrotuberous ligament covering the erector spinae muscle. Morphometrically, the mean length of the vertebral aponeurosis was 38 cm and the mean width was 24 cm. The mean thickness was three mm. There was no significant difference between left and right sides, gender or age with regard to vertebral aponeurosis length, width, or thickness (P > 0.05). During manual tension of the vertebral aponeurosis, the tensile force necessary for failure had a mean of 38.7 N. In all specimens, the vertebral aponeurosis was capable of holding sutures placed through its substance. We hope that these data will be of use for descriptive purposes and may potentially add to our understanding of the biomechanics involved in movements of the back. As back pain is perhaps the most common reason patients visit their physicians, additional knowledge of this anatomical region is important.

  12. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome.

    PubMed

    Jiang, Yiqiu; Li, Yang; Tao, Tianqi; Li, Wang; Zhang, Kaibin; Gui, Jianchao; Ma, Yong

    2016-01-01

    Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique) and Group 2 (treated with double-row suture technique). There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P = 0.029). Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

  13. Virtual reality robotic surgery simulation curriculum to teach robotic suturing: a randomized controlled trial.

    PubMed

    Kiely, Daniel J; Gotlieb, Walter H; Lau, Susie; Zeng, Xing; Samouelian, Vanessa; Ramanakumar, Agnihotram V; Zakrzewski, Helena; Brin, Sonya; Fraser, Shannon A; Korsieporn, Pira; Drudi, Laura; Press, Joshua Z

    2015-09-01

    The objective of this randomized, controlled trial was to assess whether voluntary participation in a proctored, proficiency-based, virtual reality robotic suturing curriculum using the da Vinci(®) Skills Simulator™ improves robotic suturing performance. Residents and attending surgeons were randomized to participation or non-participation during a 5 week training curriculum. Robotic suturing skills were evaluated before and after training using an inanimate vaginal cuff model, which participants sutured for 10 min using the da Vinci(®) Surgical System. Performances were videotaped, anonymized, and subsequently graded independently by three robotic surgeons. 27 participants were randomized. 23 of the 27 completed both the pre- and post-test, 13 in the training group and 10 in the control group. Mean training time in the intervention group was 238 ± 136 min (SD) over the 5 weeks. The primary outcome (improvement in GOALS+ score) and the secondary outcomes (improvement in GEARS, total knots, satisfactory knots, and the virtual reality suture sponge 1 task) were significantly greater in the training group than the control group in unadjusted analysis. After adjusting for lower baseline scores in the training group, improvement in the suture sponge 1 task remained significantly greater in the training group and a trend was demonstrated to greater improvement in the training group for the GOALS+ score, GEARS score, total knots, and satisfactory knots.

  14. Comparison of viscoelastic properties of suture versus porcine mitral valve chordae tendineae.

    PubMed

    Cochran, R P; Kunzelman, K S

    1991-12-01

    Recent reports have advocated the use of polytetrafluoroethylene (PTFE) suture for replacement or reinforcement of ruptured or elongated mitral valve chordae tendineae. The mechanical properties of PTFE (Gore-Tex) and other sutures were determined and compared to those of porcine mitral valve chordae. The results were analyzed to assess how closely chordal mechanical function may be simulated by synthetic suture materials. Chordae tendineae and suture samples were tested in uniaxial tension using an INSTRON Model 1000 at strain rates of 5 and 10 mm/min. The stress (g/mm2) was plotted versus strain, and the elastic modulus determined as the slope of the curve. Chordae tendineae exhibited a nonlinear viscoelastic stress/strain behavior. The elastic modulus of both suture types tested was significantly higher than that of the chordae. However, the PTFE suture did exhibit some viscoelastic characteristics (hysteresis and creep) that begin to approach the chordal behavior. Chordal viscoelastic behavior results from the inherent composite structure (collagen, elastin, endothelium, water, and ground substance). As yet, no synthetic materials are able to imitate this behavior with the appropriate tensile strength and fatigue resistant characteristics. At present, PTFE appears to be the best synthetic alternative for chordal replacement, due to its limited viscoelastic capabilities. Nevertheless, the need to more nearly approximate the mechanical behavior of mitral valve chordae tendineae with synthetic material warrants further investigation.

  15. CXCL12/CXCR4 axis regulates neovascularization and lymphangiogenesis in sutured corneas in mice

    PubMed Central

    DU, LING-LING; LIU, PING

    2016-01-01

    The present study aimed to determine the plausible functional role of chemokine (C-X-C motif) ligand 12 (CXCL12)/chemokine (C-X-C motif) receptor 4 (CXCR4) in inflammatory corneal hemangiogenesis and lymphangiogenesis in vivo. Corneal hemangiogenesis and lymphangiogenesis were induced by placing an 11-0 nylon suture in an intrastromal position. The expression levels of the vascular endothelial growth factor (VEGF) family, CXCL12 and CXCR4 in the corneas were investigated in the corneas using reverse transcription-quantitative polymerase chain reaction and immunohistochemistry. Corneal hemangiogenic and lymphangiogenic responses were assessed by immunofluorescence using specific antibodies against cluster of differentiation 31 and lymphatic vessel endothelial hyaluronan receptor-1. Subconjunctival injection of AMD3100 to the sutured corneas was also performed. CXCL12/CXCR4 mRNA and protein expression levels increased markedly in suture-induced corneal neovascularization (CNV) and decreased with AMD3100 treatment. Hemangiogenesis and lymphangiogenesis were captured in images using immunofluorescence and were shown to be markedly increased with suture placement and reduced with AMD3100 treatment. VEGF-A/VEGFR-1 and VEGF-C/VEGFR-3 mRNA expression levels were upregulated in the suture placement and control groups, whereas the expression levels of all the factors were downregulated in the AMD3100 treatment group. The results from the present study demonstrated that CXCL12/CXCR4 interactions regulate hemangiogenesis and lymphangiogenesis in suture-induced CNV. AMD3100 may be a novel therapeutic target for the prevention of blindness. PMID:27121088

  16. Subsurface geometry of the Siletz-Klamath suture in southwest Oregon from mangnetotelluric imaging

    NASA Astrophysics Data System (ADS)

    Box, S.; Bedrosian, P. A.

    2006-12-01

    Siletzia, a Paleocene to early Eocene basaltic seamount terrane, was sutured onto western North America in Eocene times and comprises the modern forearc basement throughout the Pacific Northwest. The suture zone is mostly obscured by the Cascades Arc. In southwest Oregon, however, it is preserved where previously accreted Mesozoic terranes in the Klamath Moutains overthrust Siletzia. The geometry of this suture at depth, however, is poorly constrained. In summer 2006, long-period (deep-crustal) and broadband (shallow-crustal) magnetotelluric (MT) data were collected along a 200-km profile stretching from the Pacific coast north of Coos Bay, OR to the California border south of Medford, OR, with an average site spacing of 4 km. South of the suture, the profile crosses Franciscan and Great Valley equivalents, arc lavas and sediments of the Western Klamath terrane, ophiolitic mélange of the Rattlesnake Creek terrane, and the Hayfork volcanic arc terrane, ending within the Condry Mountain Window. The data are in general agreement with the NW surface strike of the suture and the Klamath terranes. A smooth regularized two-dimensional inversion of the data resulted in a preliminary model extending to ~ 50 km depth which fits the data and is in accordance with observed surface geology. The imaged subsurface geometry of the Siletzia-Klamath suture is compared to previous potential-field modeling that suggested a thinning wedge of Silitzia has been thrust within the Klamath terranes.

  17. The Development of the Calvarial Bones and Sutures and the Pathophysiology of Craniosynostosis.

    PubMed

    Ishii, Mamoru; Sun, Jingjing; Ting, Man-Chun; Maxson, Robert E

    2015-01-01

    The skull vault is a complex, exquisitely patterned structure that plays a variety of key roles in vertebrate life, ranging from the acquisition of food to the support of the sense organs for hearing, smell, sight, and taste. During its development, it must meet the dual challenges of protecting the brain and accommodating its growth. The bones and sutures of the skull vault are derived from cranial neural crest and head mesoderm. The frontal and parietal bones develop from osteogenic rudiments in the supraorbital ridge. The coronal suture develops from a group of Shh-responsive cells in the head mesoderm that are collocated, with the osteogenic precursors, in the supraorbital ridge. The osteogenic rudiments and the prospective coronal suture expand apically by cell migration. A number of congenital disorders affect the skull vault. Prominent among these is craniosynostosis, the fusion of the bones at the sutures. Analysis of the pathophysiology underling craniosynostosis has identified a variety of cellular mechanisms, mediated by a range of signaling pathways and effector transcription factors. These cellular mechanisms include loss of boundary integrity, altered sutural cell specification in embryos, and loss of a suture stem cell population in adults. Future work making use of genome-wide transcriptomic approaches will address the deep structure of regulatory interactions and cellular processes that unify these seemingly diverse mechanisms.

  18. Cranial Suture Closure in Domestic Dog Breeds and Its Relationships to Skull Morphology.

    PubMed

    Geiger, Madeleine; Haussman, Sinah

    2016-04-01

    Bulldog-type brachycephalic domestic dog breeds are characterized by a relatively short and broad skull with a dorsally rotated rostrum (airorhynchy). Not much is known about the association between a bulldog-type skull conformation and peculiar patterns of suture and synchondrosis closure in domestic dogs. In this study, we aim to explore breed-specific patterns of cranial suture and synchondrosis closure in relation to the prebasial angle (proxy for airorhynchy and thus bulldog-type skull conformation) in domestic dogs. For this purpose, we coded closure of 18 sutures and synchondroses in 26 wolves, that is, the wild ancestor of all domestic dogs, and 134 domestic dogs comprising 11 breeds. Comparisons of the relative amount of closing and closed sutures and synchondroses (closure scores) in adult individuals showed that bulldog-type breeds have significantly higher closure scores than non-bulldog-type breeds and that domestic dogs have significantly higher closure scores than the wolf. We further found that the prebasial angle is significantly positively correlated with the amount of closure of the basispheno-presphenoid synchondrosis and sutures of the nose (premaxillo-nasal and maxillo-nasal) and the palate (premaxillo-maxillary and interpalatine). Our results show that there is a correlation between patterns of suture and synchondrosis closure and skull shape in domestic dogs, although the causal relationships remain elusive.

  19. Identification and dynamics of a cryptic suture zone in tropical rainforest

    PubMed Central

    Moritz, C.; Hoskin, C.J.; MacKenzie, J.B.; Phillips, B.L.; Tonione, M.; Silva, N.; VanDerWal, J.; Williams, S.E.; Graham, C.H.

    2009-01-01

    Suture zones, shared regions of secondary contact between long-isolated lineages, are natural laboratories for studying divergence and speciation. For tropical rainforest, the existence of suture zones and their significance for speciation has been controversial. Using comparative phylogeographic evidence, we locate a morphologically cryptic suture zone in the Australian Wet Tropics rainforest. Fourteen out of 18 contacts involve morphologically cryptic phylogeographic lineages, with mtDNA sequence divergences ranging from 2 to 15 per cent. Contact zones are significantly clustered in a suture zone located between two major Quaternary refugia. Within this area, there is a trend for secondary contacts to occur in regions with low environmental suitability relative to both adjacent refugia and, by inference, the parental lineages. The extent and form of reproductive isolation among interacting lineages varies across species, ranging from random admixture to speciation, in one case via reinforcement. Comparative phylogeographic studies, combined with environmental analysis at a fine-scale and across varying climates, can generate new insights into suture zone formation and to diversification processes in species-rich tropical rainforests. As arenas for evolutionary experimentation, suture zones merit special attention for conservation. PMID:19203915

  20. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome

    PubMed Central

    Li, Wang; Zhang, Kaibin

    2016-01-01

    Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique) and Group 2 (treated with double-row suture technique). There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P = 0.029). Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique. PMID:28078282

  1. Closure of round cutaneous defects progressively with the purse string suture technique

    PubMed Central

    Küçükdurmaz, Fatih; Agir, Ismail; Gümüstas, Seyitali; Kivilcim, Hakan; Tetik, Cihangir

    2015-01-01

    Introduction There are many closure techniques available to cutaneous surgeons. One of them is the purse-string suture which is used to provide complete or partial closure of round skin defects. In our animal study; we closed skin defects with using subcuticular purse string suture technique by progressively cinching wound and we aim to more rapidly healing according to secondary healing. Methods After anaesthetize, we created a 4 cm diameter circular full thickness skin defect on dorsal area of rats. In group 1, subcuticular purse string suture was applied by using a nonabsorbable and monofilament suture and a sliding arthroscopic knot was applied to both ends. Arthroscopic suture was shift 1 cm forward every day. In group 2 skin defect was leaved open and daily dressing was made and in both group defect diameters were measured every day and noted. Results The skin defects were closed totally after 15 days in group 1 but in group 2 defects were reduced but still had a mean 1,5-cm diameter sircular defect. Conclusion Closing large circular wound with purse string suture and gradual tightening decreases the healing time and expand the skin tissue without using any tissue expander. PMID:26600915

  2. Lightweight Chambers for Thrust Assemblies

    NASA Technical Reports Server (NTRS)

    Elam, Sandra K.; Lee, Jonathan; Holmes, Richard; Zimmerman, Frank; Effinger, Mike; Turner, James E. (Technical Monitor)

    2001-01-01

    The Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) has successfully applied new materials and fabrication techniques to create actively cooled thrust chambers that operate 200-400 degrees hotter and weigh 50% lighter than conventional designs. In some vehicles, thrust assemblies account for as much as 20% of the engine weight. So, reducing the weight of these components and increasing their operating range will benefit many engines and vehicle designs, including Reusable Launch Vehicle (RLV) concepts. Obviously, copper and steel alloys have been used successfully for many years in the chamber components of thrust assemblies. Yet, by replacing the steel alloys with Polymer Matrix Composite (PMC) and/or Metal Matrix Composite (MMC) materials, design weights can be drastically reduced. In addition, replacing the traditional copper alloys with a Ceramic Matrix Composite (CMC) or an advanced copper alloy (Cu-8Cr-4Nb, also known as GRCop-84) significantly increases allowable operating temperatures. Several small MMC and PMC demonstration chambers have recently been fabricated with promising results. Each of these designs included GRCop-84 for the cooled chamber liner. These units successfully verified that designs over 50% lighter are feasible. New fabrication processes, including advanced casting technology and a low cost vacuum plasma spray (VPS) process, were also demonstrated with these units. Hot-fire testing at MSFC is currently being conducted on the chambers to verify increased operating temperatures available with the GRCop-84 liner. Unique CMC chamber liners were also successfully fabricated and prepared for hot-fire testing. Yet, early results indicate these CMC liners need significantly more development in order to use them in required chamber designs. Based on the successful efforts with the MMC and PMC concepts, two full size "lightweight" chambers are currently being designed and fabricated for hot

  3. Treatment implications of posterior fossa ependymoma subgroups.

    PubMed

    Ramaswamy, Vijay; Taylor, Michael D

    2016-11-15

    Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.

  4. Congenital basis of posterior fossa anomalies

    PubMed Central

    Cotes, Claudia; Bonfante, Eliana; Lazor, Jillian; Jadhav, Siddharth; Caldas, Maria; Swischuk, Leonard

    2015-01-01

    The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies. PMID:26246090

  5. Recurrent posterior shoulder instability. Diagnosis and treatment.

    PubMed

    Pollock, R G; Bigliani, L U

    1993-06-01

    Recurrent posterior glenohumeral instability is regarded as a difficult problem to diagnose and treat. A careful history and physical examination are the most helpful tools in making this diagnosis. A positive posterior stress test, demonstrable posterior subluxation, and a sulcus sign are frequently present on examination. Special roentgenographic studies, such as the computerized arthrotomography (arthro-CT) scan, may be used in cases in which plain roentgenographs suggest bony glenoid abnormalities. When conservative therapy fails, there is no consensus on the operative treatment. Procedures that address the soft tissues, such as capsulorrhaphy and posterior labral repair, as well as those that alter the bony geometry of the joint, such as posterior bone blocks and glenoid or humeral osteotomies, have been described. Capsular laxity is the most common pathologic finding in the authors' experience, and they favor the use of a posterior-inferior capsular shift procedure to correct this problem. Augmentation of the repair with a posterior bone block is reserved for unusual cases, such as when glenoid hypoplasia is present or in certain revision situations.

  6. Posterior labral injury in contact athletes.

    PubMed

    Mair, S D; Zarzour, R H; Speer, K P

    1998-01-01

    Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

  7. Fusion Patterns in the Skulls of Modern Archosaurs Reveal That Sutures Are Ambiguous Maturity Indicators for the Dinosauria

    PubMed Central

    Bailleul, Alida M.; Scannella, John B.; Horner, John R.; Evans, David C.

    2016-01-01

    The sutures of the skulls of vertebrates are generally open early in life and slowly close as maturity is attained. The assumption that all vertebrates follow this pattern of progressive sutural closure has been used to assess maturity in the fossil remains of non-avian dinosaurs. Here, we test this assumption in two members of the Extant Phylogenetic Bracket of the Dinosauria, the emu, Dromaius novaehollandiae and the American alligator, Alligator mississippiensis, by investigating the sequence and timing of sutural fusion in their skulls. As expected, almost all the sutures in the emu skull progressively close (i.e., they get narrower) and then obliterate during ontogeny. However, in the American alligator, only two sutures out of 36 obliterate completely and they do so during embryonic development. Surprisingly, as maturity progresses, many sutures of alligators become wider in large individuals compared to younger, smaller individuals. Histological and histomorphometric analyses on two sutures and one synchondrosis in an ontogenetic series of American alligator confirmed our morphological observations. This pattern of sutural widening might reflect feeding biomechanics and dietary changes through ontogeny. Our findings show that progressive sutural closure is not always observed in extant archosaurs, and therefore suggest that cranial sutural fusion is an ambiguous proxy for assessing maturity in non-avian dinosaurs. PMID:26862766

  8. Performance Assessment of Suture Type, Water Temperature, and Surgeon Skill in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters

    SciTech Connect

    Deters, Katherine A.; Brown, Richard S.; Carter, Kathleen M.; Boyd, James W.; Eppard, M. B.; Seaburg, Adam

    2010-05-01

    This study assessed performance of seven suture types in subyearling Chinook salmon Oncorhynchus tshawytscha implanted with acoustic microtransmitters. Nonabsorbable (Ethilon) and absorbable (Monocryl) monofilament and nonabsorbable (Nurolon, silk) and absorbable (Vicryl, Vicryl Plus, Vicryl Rapide) braided sutures were used to close incisions in Chinook salmon. Monocryl exhibited greater suture retention than all other suture types 7 d after surgery. Both monofilament suture types were retained better than all braided suture types at 14 d. Incision openness and tag retention did not differ among suture types. Wound inflammation was similar for Ethilon, Monocryl, and Nurolon at 7 d. Wound ulceration was lower for Ethilon, Monocryl, and Nurolon than for all other suture types at 14 d post-surgery. Fish held in 12°C water had more desirable post-surgery healing characteristics (i.e., higher suture and tag retention and lower incision openness, wound inflammation, and ulceration) at 7 and 14 d after surgery than those held in 17°C water. The effect of surgeon was a significant predictor for all response variables at 7 d. This result emphasizes the importance of including surgeon as a variable in telemetry study analyses when multiple surgeons are used. Monocryl performed better with regard to post-surgery healing characteristics in the study fish. The overall results support the conclusion that Monocryl is the best suture material to close incisions created during surgical implantation of acoustic microtransmitters in subyearling Chinook salmon.

  9. 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.

  10. Ultrastructure, Histochemistry, and Mineralization Patterns in the Ecdysial Suture of the Blue Crab, Callinectes sapidus

    NASA Astrophysics Data System (ADS)

    Priester, Carolina; Dillaman, Richard M.; Gay, D. Mark

    2005-12-01

    The ecdysial suture is the region of the arthropod exoskeleton that splits to allow the animal to emerge during ecdysis. We examined the morphology and composition of the intermolt and premolt suture of the blue crab using light microscopy and scanning electron microscopy. The suture could not be identified by routine histological techniques; however 3 of 22 fluorescein isothiocyanate-labeled lectins tested (Lens culinaris agglutinin, Vicia faba agglutinin, and Pisum sativum agglutinin) differentiated the suture, binding more intensely to the suture exocuticle and less intensely to the suture endocuticle. Back-scattered electron (BSE) and secondary electron observations of fracture surfaces of intermolt cuticle showed less mineralized regions in the wedge-shaped suture as did BSE analysis of premolt and intermolt resin-embedded cuticle. The prism regions of the suture exocuticle were not calcified. X-ray microanalysis of both the endocuticle and exocuticle demonstrated that the suture was less calcified than the surrounding cuticle with significantly lower magnesium and phosphorus concentrations, potentially making its mineral more soluble. The presence or absence of a glycoprotein in the organic matrix, the extent and composition of the mineral deposited, and the thickness of the cuticle all likely contribute to the suture being removed by molting fluid, thereby ensuring successful ecdysis.

  11. Simulation of Layered Magma Chambers.

    ERIC Educational Resources Information Center

    Cawthorn, Richard Grant

    1991-01-01

    The principles of magma addition and liquid layering in magma chambers can be demonstrated by dissolving colored crystals. The concepts of density stratification and apparent lack of mixing of miscible liquids is convincingly illustrated with hydrous solutions at room temperature. The behavior of interstitial liquids in "cumulus" piles…

  12. Nondestructive test of regenerative chambers

    NASA Technical Reports Server (NTRS)

    Malone, G. A.; Stauffis, R.; Wood, R.

    1972-01-01

    Flat panels simulating internally cooled regenerative thrust chamber walls were fabricated by electroforming, brazing and diffusion bonding to evaluate the feasibility of nondestructive evaluation techniques to detect bonds of various strength integrities. Ultrasonics, holography, and acoustic emission were investigated and found to yield useful and informative data regarding the presence of bond defects in these structures.

  13. Chamber Clearing First Principles Modeling

    SciTech Connect

    Loosmore, G

    2009-06-09

    LIFE fusion is designed to generate 37.5 MJ of energy per shot, at 13.3 Hz, for a total average fusion power of 500 MW. The energy from each shot is partitioned among neutrons ({approx}78%), x-rays ({approx}12%), and ions ({approx}10%). First wall heating is dominated by x-rays and debris because the neutron mean free path is much longer than the wall thickness. Ion implantation in the first wall also causes damage such as blistering if not prevented. To moderate the peak-pulse heating, the LIFE fusion chamber is filled with a gas (such as xenon) to reduce the peak-pulse heat load. The debris ions and majority of the x-rays stop in the gas, which re-radiates this energy over a longer timescale (allowing time for heat conduction to cool the first wall sufficiently to avoid damage). After a shot, because of the x-ray and ion deposition, the chamber fill gas is hot and turbulent and contains debris ions. The debris needs to be removed. The ions increase the gas density, may cluster or form aerosols, and can interfere with the propagation of the laser beams to the target for the next shot. Moreover, the tritium and high-Z hohlraum debris needs to be recovered for reuse. Additionally, the cryogenic target needs to survive transport through the gas mixture to the chamber center. Hence, it will be necessary to clear the chamber of the hot contaminated gas mixture and refill it with a cool, clean gas between shots. The refilling process may create density gradients that could interfere with beam propagation, so the fluid dynamics must be studied carefully. This paper describes an analytic modeling effort to study the clearing and refilling process for the LIFE fusion chamber. The models used here are derived from first principles and balances of mass and energy, with the intent of providing a first estimate of clearing rates, clearing times, fractional removal of ions, equilibrated chamber temperatures, and equilibrated ion concentrations for the chamber. These can be used

  14. Deep suture zone in the North Barents Basin

    NASA Astrophysics Data System (ADS)

    Butsenko, Viktor; Kireev, Artem; Piskarev, Alexey; Savin, Vasily; Smirnov, Oleg

    2015-04-01

    Study of sedimentary basin evolution is a part of research for the forecast of oil and gas capacity of the North Barents shelf. Maps of potential fields anomalies are compiled on the basis of the latest geophysical databases, structural maps of the seismic horizons are analyzed, the location of sources of potential fields anomalies are calculated, 3D density and magnetic models of Earth's crust are constructed. Six seismic complexes are allocated in sedimentary cover structure: Devonian - Lower Carboniferous, Upper Carboniferous - Lower Permian, Mid Permian - Lower Triassic, Triassic - Lower Jurassic, Upper Jurassic - Lower Cretaceous, Lower Cretaceous - Quaternary. The research of lateral changes of allocated layers thickness gives an idea of sedimentation in the region on various time intervals. The structural and tectonic scheme of the region is made after analysis of new geologic-geophysical materials. Contact zones of heterogeneous blocks of the crystalline basement are marked, disjunctive dislocations in a sedimentary cover and the upper crust, and also zones of increase of sediments thickness in various seismic complexes are designated. The deep suture zone delimiting Mesozoic and Paleozoic sedimentary basins has the most important geological value among disjunctive zones of the region. This zone stretches along the Admiralty Arch in East part of the North Barents shelf and is marked by negative magnetic anomaly 30-50 km wide. In view of special tectonic value of the suture zone marked by this anomaly we have calculated the 3D magnetic crust model. The sedimentary layers of a model section is based on seismic data. As a result of modeling the studied anomaly of a magnetic field can be approximated by the block of basement rocks of the lowered magnetization (1.2 A/m). The surface of this block is located in a zone of anomaly at a depth of 12-14 km. The asymmetry of anomaly is accounted by an inclination to East of the borders of the block with low

  15. Delayed cerebrospinal fluid leak after watertight dural closure with a polyethylene glycol hydrogel dural sealant in posterior fossa surgery: case report.

    PubMed

    Jito, Junya; Nitta, Naoki; Nozaki, Kazuhiko

    2014-01-01

    A polyethylene glycol (PEG) hydrogel sealant recently has been approved as an adjunct to sutured dural closure in Japan. We treated consecutive six patients with PEG hydrogel sealant in posterior fossa operation. Three of six cases suffered delayed cerebrospinal fluid (CSF) leak after watertight dural closure with the PEG hydrogel sealant, although there was no leak case which was treated with fibrin glue, before 2 years until the adoption of the new material. These patients underwent posterior fossa craniotomy and discharged without remarkable CSF leak. The pseudomeningocele under the occipital wound caused the CSF leak occurr from 5th to 7th week postoperatively. All CSF leak cases needed surgical repair. At the repair, the PEG hydrogel was liquefied and almost absorbed. A fistula on the closure line and a dead space after the absorption of the PEG hydrogel was observed. When the absorbable PEG hydrogel sealant plugs in small gaps of sutured dura, its properties to prevent adhesion might suppress healing process of dural closure, so that CSF could leak through the gaps and collect as a pseudomeningocele in the dead space after absorption of the PEG hydrogel. In posterior fossa surgery a PEG hydrogel sealant should be applied when dural edges are closed tightly without any gaps.

  16. Hydrostatic Hyperbaric Chamber Ventilation System

    NASA Technical Reports Server (NTRS)

    Sarguisingh, Miriam J.

    2012-01-01

    The hydrostatic hyperbaric chamber (HHC) represents the merger of several technologies in development for NASA aerospace applications, harnessed to directly benefit global health. NASA has significant experience developing composite hyperbaric chambers for a variety of applications. NASA also has researched the application of water-filled vessels to increase tolerance of acceleration forces. The combination of these two applications has resulted in the hydrostatic chamber, which has been conceived as a safe, affordable means of making hyperbaric oxygen therapy (HBOT) available in the developing world for the treatment of a variety of medical conditions. Specifically, HBOT is highly-desired as a possibly curative treatment for Buruli Ulcer, an infectious condition that afflicts children in sub-Saharan Africa. HBOT is simply too expensive and too dangerous to implement in the developing world using standard equipment. The HHC technology changes the paradigm. The HHC differs from standard hyperbaric chambers in that the majority of its volume is filled with water which is pressurized by oxygen being supplied in the portion of the chamber containing the patient s head. This greatly reduces the amount of oxygen required to sustain a hyperbaric atmosphere, thereby making the system more safe and economical to operate. An effort was taken to develop an HHC system to apply HBOT to children that is simple and robust enough to support transport, assembly, maintenance and operation in developing countries. This paper details the concept for an HHC ventilation and pressurization system to provide controlled pressurization and adequate washout of carbon dioxide while the subject is enclosed in the confined space during the administration of the medical treatment. The concept took into consideration operational complexity, safety to the patient and operating personnel, and physiological considerations. The simple schematic, comprised of easily acquired commercial hardware

  17. Mechanical properties of all-suture anchors for rotator cuff repair

    PubMed Central

    Zargar, N.; Smith, R. D. J.; Carr, A. J.

    2017-01-01

    Objectives All-suture anchors are increasingly used in rotator cuff repair procedures. Potential benefits include decreased bone damage. However, there is limited published evidence for the relative strength of fixation for all-suture anchors compared with traditional anchors. Materials and Methods A total of four commercially available all-suture anchors, the ‘Y-Knot’ (ConMed), Q-FIX (Smith & Nephew), ICONIX (Stryker) and JuggerKnot (Zimmer Biomet) and a traditional anchor control TWINFIX Ultra PK Suture Anchor (Smith & Nephew) were tested in cadaveric human humeral head rotator cuff repair models (n = 24). This construct underwent cyclic loading applied by a mechanical testing rig (Zwick/Roell). Ultimate load to failure, gap formation at 50, 100, 150 and 200 cycles, and failure mechanism were recorded. Significance was set at p < 0.05. Results Overall, mean maximum tensile strength values were significantly higher for the traditional anchor (181.0 N, standard error (se) 17.6) compared with the all-suture anchors (mean 133.1 N se 16.7) (p = 0.04). The JuggerKnot anchor had greatest displacement at 50, 100 and 150 cycles, and at failure, reaching statistical significance over the control at 100 and 150 cycles (22.6 mm se 2.5 versus 12.5 mm se 0.3; and 29.6 mm se 4.8 versus 17.0 mm se 0.7). Every all-suture anchor tested showed substantial (> 5 mm) displacement between 50 and 100 cycles (6.2 to 14.3). All-suture anchors predominantly failed due to anchor pull-out (95% versus 25% of traditional anchors), whereas a higher proportion of traditional anchors failed secondary to suture breakage. Conclusion We demonstrate decreased failure load, increased total displacement, and variable failure mechanisms in all-suture anchors, compared with traditional anchors designed for rotator cuff repair. These findings will aid the surgeon’s choice of implant, in the context of the clinical scenario. Cite this article: N. S. Nagra, N. Zargar, R. D. J. Smith, A. J. Carr

  18. Mesoproterozoic suturing of Archean crustal blocks in western peninsular India: Implications for India-Madagascar correlations

    NASA Astrophysics Data System (ADS)

    Ishwar-Kumar, C.; Santosh, M.; Wilde, S. A.; Tsunogae, T.; Itaya, T.; Windley, B. F.; Sajeev, K.

    2016-10-01

    The Kumta and Mercara suture zones welding together Archean crustal blocks in western peninsular India offer critical insights into Precambrian continental juxtapositions and the crustal evolution of eastern Gondwana. Here we present the results from an integrated study of the structure, geology, petrology, mineral chemistry, metamorphic P-T conditions, zircon U-Pb ages and Lu-Hf isotopes of metasedimentary rocks from the two sutures. The dominant rocks in the Kumta suture are greenschist- to amphibolite-facies quartz-phengite schist, garnet-biotite schist, chlorite schist, fuchsite schist and marble. The textural relations, mineral chemistry and thermodynamic modelling of garnet-biotite schist from the Kumta suture indicate peak metamorphic P-T conditions of ca. 11 kbar at 790 °C, with detrital SHRIMP U-Pb zircon ages ranging from 3420 to 2547 Ma, εHf (t) values from - 9.2 to 5.6, and TDMc model ages from 3747 to 2792 Ma. The K-Ar age of phengite from quartz-phengite schist is ca. 1326 Ma and that of biotite from garnet-biotite schist is ca. 1385 Ma, which are interpreted to broadly constrain the timing of metamorphism related to the suturing event. The Mercara suture contains amphibolite- to granulite-facies mylonitic quartzo-feldspathic gneiss, garnet-kyanite-sillimanite gneiss, garnet-biotite-kyanite-gedrite-cordierite gneiss, garnet-biotite-hornblende gneiss, calc-silicate granulite and metagabbro. The textural relations, mineral chemistry and thermodynamic modelling of garnet-biotite-kyanite-gedrite-cordierite gneiss from the Mercara suture indicate peak metamorphic P-T conditions of ca. 13 kbar at 825 °C, followed by isothermal decompression and cooling. For pelitic gneisses from the Mercara suture, LA-ICP-MS U-Pb zircon ages vary from 3249 to 3045 Ma, εHf (t) values range from - 18.9 to 4.2, and TDMc model ages vary from 4094 to 3314 Ma. The lower intercept age of detrital zircons in the pelitic gneisses from the Mercara suture ranges from 1464 to 1106

  19. Posterior Hip Pain in an Athletic Population

    PubMed Central

    Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

  20. Posterior cruciate ligament (PCL) injury - aftercare

    MedlinePlus

    Adib F, Curtis C, Bienkowski P Micheli LJ. Posterior cruciate ligament sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, ...

  1. Effects of In Utero Thyroxine Exposure on Murine Cranial Suture Growth

    PubMed Central

    Black, Laurel; Bennfors, Grace; Parsons, Trish E.; Elsalanty, Mohammed E.; Yu, Jack C.; Weinberg, Seth M.; Cray, James J.

    2016-01-01

    Large scale surveillance studies, case studies, as well as cohort studies have identified the influence of thyroid hormones on calvarial growth and development. Surveillance data suggests maternal thyroid disorders (hyperthyroidism, hypothyroidism with pharmacological replacement, and Maternal Graves Disease) are linked to as much as a 2.5 fold increased risk for craniosynostosis. Craniosynostosis is the premature fusion of one or more calvarial growth sites (sutures) prior to the completion of brain expansion. Thyroid hormones maintain proper bone mineral densities by interacting with growth hormone and aiding in the regulation of insulin like growth factors (IGFs). Disruption of this hormonal control of bone physiology may lead to altered bone dynamics thereby increasing the risk for craniosynostosis. In order to elucidate the effect of exogenous thyroxine exposure on cranial suture growth and morphology, wild type C57BL6 mouse litters were exposed to thyroxine in utero (control = no treatment; low ~167 ng per day; high ~667 ng per day). Thyroxine exposed mice demonstrated craniofacial dysmorphology (brachycranic). High dose exposed mice showed diminished area of the coronal and widening of the sagittal sutures indicative of premature fusion and compensatory growth. Presence of thyroid receptors was confirmed for the murine cranial suture and markers of proliferation and osteogenesis were increased in sutures from exposed mice. Increased Htra1 and Igf1 gene expression were found in sutures from high dose exposed individuals. Pathways related to the HTRA1/IGF axis, specifically Akt and Wnt, demonstrated evidence of increased activity. Overall our data suggest that maternal exogenous thyroxine exposure can drive calvarial growth alterations and altered suture morphology. PMID:27959899

  2. A Pentagram Suture Technique for Closing Tumor Resection Sites in the Face

    PubMed Central

    Takeuchi, Masaki; Mori, Satoko; Sakurai, Hiroyuki

    2015-01-01

    Background: Resection of facial skin tumors aims to remove the tumors completely and make the surgical scar unnoticeable as much as possible. By improving the purse string suture method, we developed a new pentagram suture technique that enables simple and safe suturing of small to large defects with early satisfactory esthetic outcomes. The surgical outcomes of a case series were examined in this report. Methods: As in drawing a unicursal star, 5 suture sites were marked at specific intervals around the defect area. A needle with 5-0 polydioxanone suture was passed from the subcutaneous tissue to the superficial dermal layer at one site and then from the superficial dermal layer to the subcutaneous layer at the next site, and the process was repeated until the pentagram was complete. When apposition was not tight enough, a couple of external stitches were added using 6-0 nylon suture. Results: In 13 patients (16 benign or malignant tumors; mean age, 51.1 years) with a mean tumor size of 10.1 ± 5.2 mm and postoperative skin defect diameter of 12.1 ± 8.2 mm, closure did not result in high tension on the suture, and there was reduced mechanical stress at the wound margin. Surgical outcomes were good esthetically at 6 months after surgery without keloid formation or scar contracture. None of the patients had postoperative pain, infection, or tumor recurrence. Conclusions: This simple alternative method for the closure of facial skin defects after skin tumor excision could be performed easily and provided satisfactory surgical outcomes. PMID:26495212

  3. Acrylic polymer-grafted polypropylene sutures for covalent immobilization or reversible adsorption of vancomycin.

    PubMed

    García-Vargas, M; González-Chomón, C; Magariños, B; Concheiro, A; Alvarez-Lorenzo, C; Bucio, E

    2014-01-30

    Glycidyl methacrylate (GMA) and acrylic acid (AAc) were separately grafted onto polypropylene (PP) monofilament sutures by means of pre-irradiation using a (60)Co γ-source, with the purpose of loading vancomycin via (i) covalent immobilization through the glycidyl groups of GMA and (ii) ionic interaction with AAc moieties. The effect of absorbed radiation dose, monomer concentration, temperature and reaction time on the grafting degree was evaluated in detail. GMA grafting ranged from 25% to 800% while the grafting yield of AAc onto PP could be tuned between 9% and 454%, at doses from 5 to 50 kGy and a dose rate 13.7 kGy/h. Grafting of GMA or AAc decreased the decomposition temperature and made the sutures swellable to a certain extent. GMA grafting led to a continuous, smooth and thick coating, which was suitable for immobilization of up to 1.9 μg vancomycin per gram. The immobilized vancomycin enabled a reduction in the Staphylococcus aureus CFU adhered to the suture surface. On the other hand, dried AAc-functionalized sutures exhibited a rough and cracked surface which was responsible for a minor increase in the coefficient of friction. PP-g-AAc sutures exhibited pH-dependent swelling and remarkably high capability to host vancomycin (up to 109.9 mg/g), particularly those with an intermediate degree of grafting. Some AAc-functionalized sutures were shown able to inhibit bacterial growth after successive challenges with fresh lawns. Therefore, tuning the yield of grafting of GMA or AAc may enable the preparation of drug-suture combination products that retain or release, respectively, antimicrobial agents.

  4. Nano-Mechanical Studies on Polyglactin Sutures Subjected to In Vitro Hydrolytic and Enzymatic Degradation.

    PubMed

    Sun, Leming; Wanasekara, Nandula; Chalivendra, Vijaya; Calvert, Paul

    2015-01-01

    An experimental investigation on the effects of in vitro hydrolytic and enzymatic degradation on mechanical properties of polyglactin 910 monofilament sutures was performed by conducting nanoindentation studies using an atomic force microscope (AFM). For hydrolytic degradation, the sutures were incubated in phosphate buffered saline (PBS) solution at three different pH conditions, 5, 7.4, and 10. For enzymatic degradation, esterase was employed at pH condition of 7.4. The property of the sutures changed with time at different conditions were investigated by nanoindentation, tensile test experiments, image analysis using both of scanning electron microscopy (SEM) and AFM, and also Fourier transform infrared spectroscopy (FTIR). The effects of degradation on gradation of Young's modulus values across the cross section of the sutures were studied by doing progressive nanoindentation from center to surface. FTIR studies revealed the formation of new hydroxyl bonds due to both hydrolytic and enzymatic degradations. Nanoindentation results indicated that the degradation does not cause a gradient of Young's modulus of the polyglactin 910 monofilament sutures across the cross section from center to surface at different degradation times for both hydrolytic and enzymatic degradations. However, in general, the Young's modulus of all samples was decreased over 4 weeks of degradation. The microscopic evaluation of the samples also showed both qualitative changes in surface morphology and quantitative changes in surface roughness on the surface of degraded sutures. This study provided a deep understanding of the polyglactin sutures subjected to in vitro hydrolytic and enzymatic degradation, and also opened a new avenue to study the biomaterials at nano-scale.

  5. A pilot study evaluating laparoscopic closure of the nephrosplenic space using an endoscopic suturing device in standing horses.

    PubMed

    Bracamonte, José L; Duke-Novakovski, Tanya

    2016-06-01

    This study evaluated the use of an articulating automated suturing device for laparoscopic closure of the nephrosplenic space in standing horses. Closure of the nephrosplenic space was performed in 4 horses using an automated suturing device. Second-look laparoscopy was performed at 5 weeks. A smooth fibrous adhesion formed between the spleen, the perirenal fascia, and the nephrosplenic ligament in 3 of the 4 horses in which the nephrosplenic space was closed using the automated suturing device. In 1 horse, closure of the nephrosplenic space was not possible due to constant breakage of the endoscopic needle. Intra-operative complications encountered with the automated suturing device were tearing of the perirenal fascia, nephrosplenic ligament, and dorsal splenic capsule along with breakage of the needle. The automated suturing device used in this study for laparoscopic closure of the nephrosplenic space resulted in longer surgery times, suffered instrument failures and delivered inadequate suture.

  6. A pilot study evaluating laparoscopic closure of the nephrosplenic space using an endoscopic suturing device in standing horses

    PubMed Central

    Bracamonte, José L.; Duke-Novakovski, Tanya

    2016-01-01

    This study evaluated the use of an articulating automated suturing device for laparoscopic closure of the nephrosplenic space in standing horses. Closure of the nephrosplenic space was performed in 4 horses using an automated suturing device. Second-look laparoscopy was performed at 5 weeks. A smooth fibrous adhesion formed between the spleen, the perirenal fascia, and the nephrosplenic ligament in 3 of the 4 horses in which the nephrosplenic space was closed using the automated suturing device. In 1 horse, closure of the nephrosplenic space was not possible due to constant breakage of the endoscopic needle. Intra-operative complications encountered with the automated suturing device were tearing of the perirenal fascia, nephrosplenic ligament, and dorsal splenic capsule along with breakage of the needle. The automated suturing device used in this study for laparoscopic closure of the nephrosplenic space resulted in longer surgery times, suffered instrument failures and delivered inadequate suture. PMID:27247467

  7. Gibbs Sampling for Marginal Posterior Expectations

    DTIC Science & Technology

    1991-11-19

    Achcar and Smith (1989) shows that performance of the Laplace method is often very sensitive to parametrization. Morris (1988) offers expansions based on...Berkeley Symp. 1, 453-468. Lindley, D.V. (1980). "Approximate Bayesian Methods" in Bayesian Statistics, J.M. Bernardo, M.H. DeGroot , D.V. Lindley...A.F.M. Smith, University Press, Valencia, Spain. Morris , C. "Approximating Posterior Distributions and Posterior Moments" In: Bayesian Statistics 3, J.M

  8. [Posterior cortical atrophy (Benson-syndrome)].

    PubMed

    Rózsa, Anikó; Szilvássy, Ildikó; Kovács, Krisztina; Boór, Krisztina; Gács, Gyula

    2010-01-30

    We present the characteristics of posterior cortical atrophy--a very rare cortical dementia--in a 69 year old woman's case. Our patient's symptoms began with a visual problem which was initially explained by ophthalmological disorder. After neurological exam visual agnosia was diagnosed apart from other cognitive disorder (alexia without agraphia, acalculia, prosopagnosia, constructional disorder, clock-time recognition disorder, dressing apraxia, visuospatial disorientation). The brain MRI showed bilateral asymmetric parieto-occipital atrophy which is characteristic of posterior cortical atrophy.

  9. Posterior Wnts Have Distinct Roles in Specification and Patterning of the Planarian Posterior Region.

    PubMed

    Sureda-Gómez, Miquel; Pascual-Carreras, Eudald; Adell, Teresa

    2015-11-05

    The wnt signaling pathway is an intercellular communication mechanism essential in cell-fate specification, tissue patterning and regional-identity specification. A βcatenin-dependent signal specifies the AP (Anteroposterior) axis of planarians, both during regeneration of new tissues and during normal homeostasis. Accordingly, four wnts (posterior wnts) are expressed in a nested manner in central and posterior regions of planarians. We have analyzed the specific role of each posterior wnt and the possible cooperation between them in specifying and patterning planarian central and posterior regions. We show that each posterior wnt exerts a distinct role during re-specification and maintenance of the central and posterior planarian regions, and that the integration of the different wnt signals (βcatenin dependent and independent) underlies the patterning of the AP axis from the central region to the tip of the tail. Based on these findings and data from the literature, we propose a model for patterning the planarian AP axis.

  10. Vertigo due to posterior circulation stroke.

    PubMed

    Kim, Ji Soo; Lee, Hyung

    2013-07-01

    Stroke in the distribution of the posterior circulation may present as acute onset spontaneous vertigo and imbalance. Although vertigo due to posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts in the cerebellum or brainstem can present with vertigo without other localizing symptoms. Approximately 17% of patients with isolated posterior inferior cerebellar artery territory infarction presented with isolated vertigo, nystagmus, and postural unsteadiness. A head impulse test can differentiate acute isolated vertigo associated with cerebellar stroke from more benign disorders involving the inner ear. Sometimes acute isolated audiovestibular loss can be the initial symptom of impending posterior circulation ischemic stroke (particularly within the territory of the anterior inferior cerebellar artery). In this case, evaluation of isolated audiovestibular loss may prevent the progression of acute vertigo and hearing loss into more widespread areas of infarction in the posterior circulation. In this article, the clinical syndromes and signs of acute vestibular syndrome due to posterior circulation stroke involving the brainstem and cerebellum are summarized.

  11. Antibacterial suture vs silk for the surgical removal of impacted lower third molars. A randomized clinical study

    PubMed Central

    Sala-Pérez, Sergi; López-Ramírez, Marta; Quinteros-Borgarello, Milva; Valmaseda-Castellón, Eduardo

    2016-01-01

    Background The aim of this study was to evaluate the clinical and microbiological impact of an antibacterial suture (Monocryl® Plus) in the surgical removal of I3M. Material and Methods A “split-mouth”, prospective pilot clinical study was designed involving 20 patients programmed for the surgical removal of I3M. Each side was randomly sutured with Monocryl® Plus or silk suture and removed for microbiological study 72 hours and 7 days after surgery. Presence of SSI, wound bleeding and the degree of discomfort associated with each type of suture material (scored by means of a visual analog scale) were evaluated. The level of contamination of each material was observed under the scanning electron microscope. Results Wound bleeding upon suture removing was slightly greater after 72 hours and 7 days with black silk suture, though the differences were not statistically significant (p=0.752 and p=0.113, respectively). Patient discomfort was very similar with both types of suture material (p=0.861). Only one case of SSI was recorded with black silk suture after 72 hours. Microbiologically, the antibacterial suture showed a lesser presence of microorganisms (p<0.001, at 72h and p=0.033 at 7th day, respectively). The most common bacterial species included grampositive cocci (Streptococcus viridans group, Neisseria spp., Coagulasenegative Staphylococcus and Peptostreptococcus), gramnegative cocci (Veillonella), grampositive Bacilli (Lactobacillus), and gramnegative Bacilli (Prevotella). Conclusions The greatest antibacterial effect of Monocryl Plus suture was observed after 72 hours. According to most authors, there is no doubt that this antibacterial suture can provide little safety in the control of SSI. Key words:Antibacterial suture, monocryl® plus, vicryl® plus, third molar surgery, postoperative infection, surgical site infection (SSI). PMID:26615503

  12. Single wire drift chamber design

    SciTech Connect

    Krider, J.

    1987-03-30

    This report summarizes the design and prototype tests of single wire drift chambers to be used in Fermilab test beam lines. The goal is to build simple, reliable detectors which require a minimum of electronics. Spatial resolution should match the 300 ..mu..m rms resolution of the 1 mm proportional chambers that they will replace. The detectors will be used in beams with particle rates up to 20 KHz. Single track efficiency should be at least 99%. The first application will be in the MT beamline, which has been designed for calibration of CDF detectors. A set of four x-y modules will be used to track and measure the momentum of beam particles.

  13. 21 CFR 868.5470 - Hyperbaric chamber.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... than atmospheric pressure. This device does not include topical oxygen chambers for extremities (§ 878... hyperbaric chamber is a device that is intended to increase the environmental oxygen pressure to promote...

  14. Space Chambers for Crop Treatment

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Vacuum chambers, operated by McDonnell Douglas Corporation to test spacecraft, can also be used to dry water-soaked records. The drying temperature is low enough to allow paper to dry without curling or charging. Agricultural crops may also be dried using a spinoff system called MIVAC, which has proven effective in drying rice, wheat, soybeans, corn, etc. The system is energy efficient and can incorporate a sanitation process for destroying insects without contamination.

  15. Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.

    PubMed

    Kesan, Krushnakumar V; Gupta, Rahul Kumar; Kothari, Paras; Gupta, Abhaya; Mudkhedkar, Kedar; Kamble, Ravikiran; Dikshit, K Vishesh

    2014-06-01

    Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp.

  16. Upper Mantle Structure Around the Trans-European Suture Zone

    NASA Astrophysics Data System (ADS)

    Janutyte, Ilma; Majdanski, Mariusz; Voss, Peter H.; Kozlovskaya, Elena

    2014-05-01

    The Trans-European Suture Zone (TESZ) is the transition between old Proterozoic lithosphere in Northern and Eastern Europe and the younger Phanerozoic lithosphere in Central and Western Europe. The presented study is a part of the PASSEQ 2006-2008 project which is linked to the TOR project realized during 1996-1997. The PASSEQ and the TOR projects aimed to study the lithosphere and asthenosphere structure around the TESZ, but the latter was focused on the northwestern part of the TESZ between Sweden and Denmark - Germany, while the PASSEQ project was focused on the TESZ mainly beneath Poland. During the PASSEQ project 139 short-period and 49 broadband temporary seismic stations were deployed along the transect stretching from Germany throughout Czech Republic and Poland to Lithuania. The array recorded continuous seismic data from May, 2006 to June, 2008. In our study we used data of all available PASSEQ seismic stations and seismic stations of the national seismological networks of the participating countries and compiled a data set of teleseismic P-wave arrivals. The full data set consists of 8308 manually picked arrivals. Due to limited computational power we used the data of the highest quality only, i.e. 6008 picks. The non-linear teleseismic tomography algorithm TELINV was used to obtain the model of P-wave velocity perturbations in the upper mantle around the TESZ. We recovered the upper mantle structure from 70 km down to 350 km in the study area. The results show ±6.5 % P-wave velocity variations compared to the IASP91 velocity model. We found higher velocities beneath the old East European Craton (EEC) east of the TESZ and lower ones beneath the younger Western Europe west of the TESZ. The thickest litosphere was found beneath the EEC (Lithuania) where the higher velocities continue to about 300 km or even more. To the west of the TESZ under the Variscides the average depth of the lithosphere-asthenosphere boundary (LAB) is about 100 km. The TESZ appears

  17. Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT

    PubMed Central

    Angelieri, Fernanda; Franchi, Lorenzo; Cevidanes, Lucia H. S.; Bueno-Silva, Bruno; McNamara, James A.

    2016-01-01

    ABSTRACT Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically. PMID:28125147

  18. The LIFE Dynamic Chamber System

    NASA Astrophysics Data System (ADS)

    Rhodes, Mark; Kane, Jave; Latkowski, Jeffery; Cook, Andrew; Divol, Laurent; Loosmore, Gwendolen; Scott, Howard; Scullard, Christian; Tabak, Max; Wilks, Scott; Moses, Gregory; Heltemes, Thad; Sacks, Ryan; Pantano, Carlos; Kramer, Richard

    2011-10-01

    Dry-wall IFE designs such as LIFE utilize Xe fill gas to protect the target chamber first wall from x-ray heating and ionic debris. A key question is how cool, settled and clean the Xe must be to permit beam propagation and target transport, and how to reach this state at a 10+ Hz shot repetition rate. Xe is at low density in the target chamber, and purified Xe is reinjected at higher density and lower temperature into the larger outer chamber. Maintenance of this density difference due to blast waves generated by implosion of the target capsules is being assessed with HYDRA and 3D VTF, and possible validation experiments are being investigated. Detailed gas response near the wall is being studied using 3D Miranda. A laboratory-scale theta pinch experiment will study cooling and beam propagation in Xe. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  19. The crop growth research chamber

    NASA Technical Reports Server (NTRS)

    Wagenbach, Kimberly

    1993-01-01

    The Crop Growth Research Chamber (CGRC) has been defined by CELSS principle investigators and science advisory panels as a necessary ground-based tool in the development of a regenerative life support system. The focus of CGRC research will be on the biomass production component of the CELSS system. The ground-based Crop Growth Research Chamber is for the study of plant growth and development under stringently controlled environments isolated from the external environment. The chamber has importance in three areas of CELSS activities: (1) crop research; (2) system control and integration, and (3) flight hardware design and experimentation. The laboratory size of the CGRC will be small enough to allow duplication of the unit, the conducting of controlled experiments, and replication of experiments, but large enough to provide information representative of larger plant communities. Experiments will focus on plant growth in a wide variety of environments and the effects of those environments on plant production of food, water, oxygen, toxins, and microbes. To study these effects in a closed system, tight control of the environment is necessary.

  20. Rocket Engine Thrust Chamber Assembly

    NASA Technical Reports Server (NTRS)

    Cornelius, Charles S. (Inventor); Counts, Richard H. (Inventor); Myers, W. Neill (Inventor); Lackey, Jeffrey D. (Inventor); Peters, Warren (Inventor); Shadoan, Michael (Inventor); Sparks, David L. (Inventor); Lawrence, Timothy W. (Inventor)

    2001-01-01

    A thrust chamber assembly for liquid fueled rocket engines and the method of making it wherein a two-piece mandrel having the configuration of an assembly having a combustion chamber portion connected to a nozzle portion through a throat portion is wrapped with a silica tape saturated with a phenolic resin, the tape extending along the mandrel and covering the combustion chamber portion of the mandrel to the throat portion. The width of the tape is positioned at an angle of 30 to 50 deg. to the axis of the mandrel such that one edge of the tape contacts the mandrel while the other edge is spaced from the mandrel. The phenolic in the tape is cured and the end of the wrap is machined to provide a frusto-conical surface extending at an angle of 15 to 30 deg. with respect to the axis of the mandrel for starting a second wrap on the mandrel to cover the throat portion. The remainder of the mandrel is wrapped with a third silica tape having its width positioned at a angle of 5 to 20 deg. from the axis of the mandrel. The resin in the third tape is cured and the assembly is machined to provide a smooth outer surface. The entire assembly is then wrapped with a tow of graphite fibers wetted with an epoxy resin and, after the epoxy resin is cured, the graphite is machined to final dimensions.

  1. Numerical Method for the Design of Healing Chamber in Additive-Manufactured Dental Implants.

    PubMed

    Lee, Hsiao-Chien; Tsai, Pei-I; Huang, Chih-Chieh; Chen, San-Yuan; Chao, Chuen-Guang; Tsou, Nien-Ti

    2017-01-01

    The inclusion of a healing chamber in dental implants has been shown to promote biological healing. In this paper, a novel numerical approach to the design of the healing chamber for additive-manufactured dental implants is proposed. This study developed an algorithm for the modeling of bone growth and employed finite element method in ANSYS to facilitate the design of healing chambers with a highly complex configuration. The model was then applied to the design of dental implants for insertion into the posterior maxillary bones. Two types of ITI® solid cylindrical screwed implant with extra rectangular-shaped healing chamber as an initial design are adopted, with which to evaluate the proposed system. This resulted in several configurations for the healing chamber, which were then evaluated based on the corresponding volume fraction of healthy surrounding bone. The best of these implants resulted in a healing chamber surrounded by around 9.2% more healthy bone than that obtained from the original design. The optimal design increased the contact area between the bone and implant by around 52.9%, which is expected to have a significant effect on osseointegration. The proposed approach is highly efficient which typically completes the optimization of each implant within 3-5 days on an ordinary personal computer. It is also sufficiently general to permit extension to various loading conditions.

  2. Numerical Method for the Design of Healing Chamber in Additive-Manufactured Dental Implants

    PubMed Central

    Lee, Hsiao-Chien; Tsai, Pei-I; Huang, Chih-Chieh; Chen, San-Yuan; Chao, Chuen-Guang

    2017-01-01

    The inclusion of a healing chamber in dental implants has been shown to promote biological healing. In this paper, a novel numerical approach to the design of the healing chamber for additive-manufactured dental implants is proposed. This study developed an algorithm for the modeling of bone growth and employed finite element method in ANSYS to facilitate the design of healing chambers with a highly complex configuration. The model was then applied to the design of dental implants for insertion into the posterior maxillary bones. Two types of ITI® solid cylindrical screwed implant with extra rectangular-shaped healing chamber as an initial design are adopted, with which to evaluate the proposed system. This resulted in several configurations for the healing chamber, which were then evaluated based on the corresponding volume fraction of healthy surrounding bone. The best of these implants resulted in a healing chamber surrounded by around 9.2% more healthy bone than that obtained from the original design. The optimal design increased the contact area between the bone and implant by around 52.9%, which is expected to have a significant effect on osseointegration. The proposed approach is highly efficient which typically completes the optimization of each implant within 3–5 days on an ordinary personal computer. It is also sufficiently general to permit extension to various loading conditions. PMID:28293628

  3. A prospective comparison of octyl-2-cyanoacrylate and suture in standardized facial wounds.

    PubMed

    Handschel, J G K; Depprich, R A; Dirksen, D; Runte, C; Zimmermann, A; Kübler, N R

    2006-04-01

    Regarding the cosmetic results of wound closure using tissue adhesives as opposed to sutured wounds, most published studies are performed on children and with non-standardized lacerations, which makes it difficult to transfer the results to facial incisional wounds in adults. There are also conflicting conclusions about the cosmetic results. The purpose of this randomized prospective study was to compare the cosmetic outcomes of wound closure with sutures and octyl-2-cyanoacrylate in standardized facial wounds in adults. To compare very similar facial wounds, the infraorbital cut (lower eyelid incision) was used in 45 patients. The assessment was performed by patients and surgeons blind to the data. Phase-shifting profilometry was used to measure the profile of the scars. No early complications were observed in any group. The wound depth in the tissue adhesive group was significantly greater than in the suture group. There were no differences in the overall cosmetic results among all patients in the two groups. Interestingly, in the younger patients the result of the sutured wounds was superior to that of the adhesive-treated patients. The Dermabond skin adhesive provides a means of closure of facial surgical wounds without early complications, but adjustment of the edges of the wound and the cosmetic result in younger patients are less successful than with thin sutures.

  4. Mitral valve repair: is there still a place for suture annuloplasty?

    PubMed

    Fundarò, Pino; Tartara, Paolo M; Villa, Emmanuel; Fratto, Pasquale; Campisi, Salvatore; Vitali, Ettore O

    2007-08-01

    Prosthetic ring annuloplasty is considered the gold standard technique for mitral valve repair, but it has been associated with some drawbacks. Suture annuloplasty is less expensive and may have some physiopathologic advantages. We reviewed the literature to assess clinical results of mitral suture annuloplasty. Thirteen series, each reporting more than 50 patients and published in the last 10 years, were included in the analysis. They comprised 1,648 patients with cumulative follow-up of 5,607 patient-years. Our review suggests that suture annuloplasty is a safe procedure, but a trend toward recurrence of annular dilatation with time was reported. In selected cases, suture annuloplasty is effective, and its mid-term clinical results are encouraging and compare well with those of prosthetic ring repair series. The quality of the results varies according to the particular annuloplasty technique used and to the mitral valve pathology treated. Recent technical modifications have been found to decrease the incidence of repair failure and promise to improve the reproducibility of the procedure. Further investigations are warranted to better assess the long-term results of suture annuloplasty, and to determine whether its theoretical functional advantages translate into a real clinical benefit.

  5. Long-term active antimicrobial coatings for surgical sutures based on silver nanoparticles and hyperbranched polylysine.

    PubMed

    Ho, Chau Hon; Odermatt, Erich K; Berndt, Ingo; Tiller, Joerg C

    2013-01-01

    The goal of this study was to develop a long-term active antimicrobial coating for surgical sutures. To this end, two water-insoluble polymeric nanocontainers based on hyperbranched polylysine (HPL), hydrophobically modified by either using glycidyl hexadecyl ether, or a mixture of stearoyl/palmitoyl chloride, were synthesized. Highly stabilized silver nanoparticles (AgNPs, 2-5 nm in size) were generated by dissolving silver nitrate in the modified HPL solutions in toluene followed by reduction with L-ascorbic acid. Poly(glycolic acid)-based surgical sutures were dip-coated with the two different polymeric silver nanocomposites. The coated sutures showed high efficacies of more than 99.5% reduction of adhesion of living Staphylococcus aureus cells onto the surface compared to the uncoated specimen. Silver release experiments were performed on the HPL-AgNP modified sutures by washing them in phosphate buffered saline for a period of 30 days. These coatings showed a constant release of silver ions over more than 30 days. After this period of washing, the sutures retained their high efficacies against bacterial adhesion. Cytotoxicity tests using L929 mouse fibroblast cells showed that the materials are basically non-cytotoxic.

  6. Cellular Midpalatal Suture Changes after Rapid Maxillary Expansion in Growing Subjects: A Case Report

    PubMed Central

    Caprioglio, Alberto; Fastuca, Rosamaria; Zecca, Piero Antonio; Beretta, Matteo; Mangano, Carlo; Piattelli, Adriano; Macchi, Aldo; Iezzi, Giovanna

    2017-01-01

    The present case report aimed to investigate immediate histologic changes in midpalatal suture in humans following rapid maxillary expansion compared to control. Three patients (mean age 8.3 ± 0.9 years) were enrolled in the case report and underwent midpalatal suture biopsy. Two patients underwent treatment before biopsy. The third patient did not show transversal maxillary deficiency and was enrolled as a control. Biopsy samples of midpalatal suture at 7 (subject 1) and 30 days (subject 2) after maxillary expansion as well as of one control (subject 3) were collected and processed for histology. In the control (subject 3) inter-digitations at the palatal suture gap were observed. At 7 days (subject 1) mature bone with small marrow spaces and trabecular bone with the peculiar storiform appearance inside the soft tissue and collagen fibers running parallel only in the central part were present. At 30 days (subject 2), a greater number of newly-formed bone trabeculae with a perpendicular orientation to the long axis of the suture could be seen. At 30 days the fibrous component of bone tissue was less represented compared to the sample at 7 days. Data from the preliminary histological results showed that bone formation was observed in the gap after rapid maxillary expansion, although the healing process was still ongoing. PMID:28287481

  7. Creep rupture behavior of polypropylene suture material and its applications as a time-release mechanism

    SciTech Connect

    Kusy, R.P.; Whitley, J.Q.

    1983-05-01

    The controlled failure of polypropylene (PP) sutures is studied via creep rupture tests. From plots of log time (tB) vs. stress (sigma), linear relationships are generated over the failure times of 1-1000 h. Results show that as a function of stress, the time dependence varies with irradiation dose (15, 20, 25, and 50 Mrad), irradiation atmosphere (air and vacuum), suture diameter (7-0, 6-0, 5-0, and 4-0), and test temperature (26 and 37 degrees C). For a given stress, the time to failure is least for the greatest dose in the presence of air and at the highest temperature. When suture loops are wrapped around a small wire sheave, however, failure occurs in the largest suture as much as two decades sooner than the smallest suture studied. Within the limitations stated herein, they are independent of test method, loop diameter, aging, and humidity. Consequently, after irradiation in vacuum and postirradiation heat treatment, the processed material may be stored at room temperature for at least 1 month. Such materials are advocated when the time release of a dental or medical device is required, for example, in the self-activating cleft palate appliance.

  8. Comparison of fibrin glue and suture in the healing of teat incisions in lactating goats.

    PubMed

    Alan, M; Yener, Z; Tasal, I; Bakir, B

    2008-05-01

    The aims of this study were to investigate whether fibrin glue can be used to close experimentally induced incisions of the teat (mammary papillae) in lactating goats and to compare the healing of the glued with the sutured incisions. Four clinically healthy lactating dairy goats, namely 8 mammary papillae were used. After surgical preparation of the papillae, a 3.5 cm long incision of each papilla was made through skin, muscular layer and mucosa into the papillary sinus. The wounds in the right papillae in all goats were closed with U-shaped uninterrupted 00 chromic catgut sutures. The wounds in the left papillae in all goats were closed, using fibrin glue. One incision was seen to be dehisced and fistulous one day after in fibrin glued teats. The animals were slaughtered 8 days after surgical manipulation. The mammary papillae were removed and examined in the viewpoint on gross and microscopic findings. The healing of wounds was slower and feeble in glued mammary papillary incisions, however faster and stronger in sutured incisions on day 8 after operations. But, available outcomes like less tissue thickness and positive cosmetic results could be obtained byfibrin glue used on mammary papillary incisions, which are very important for teats to be milked by hand and milking machine. Results suggest that it is advisable to use only one or two simple interrupted sutures in teat incisions glued with fibrin to prevent the dehiscence but with a more reliable healing than the sutured incisions.

  9. Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method.

    PubMed

    Cukurova, I; Cetinkaya, E A; Mercan, G C; Demirhan, E; Gumussoy, M

    2012-04-01

    The trans-septal suturing method has been developed in septoplasty as an alternative to packing. This study was carried out to compare the postoperative results of trans-septal suturing with the anterior Merocel packing technique. The study involved 697 patients who underwent septoplasty. Following surgery, patients were randomly divided into two groups, one with trans-septal suturing and the other with Merocel packing. Patients were asked to record pain levels using a visual analogue scale. Postoperative symptoms and complications were compared. A total of 697 nasal operations were evaluated in the postoperative period considering pain, bleeding, haematoma, septal perforation synechiae and septal perforation. The results for haemorrhage, haematoma, synechiae and perforation were not statistically different (p > 0.05) between groups. In contrast, the level of postoperative pain in patients undergoing trans-septal suturing was significantly less than in the group who received Merocel packing (p < 0.05). Patients with Merocel packing had significantly more pain and nasal discomfort when assessed 1 week after intervention. Therefore, the trans-septal suturing technique may be the preferred option to provide higher patient satisfaction.

  10. The influence of suturing and sepsis on the development of postoperative peritoneal adhesions.

    PubMed Central

    O'Leary, D. P.; Coakley, J. B.

    1992-01-01

    Postoperative peritoneal adhesions are a major cause of morbidity. The purpose of this study was to investigate the potential contributions of suturing and sepsis to their formation in animals undergoing laparotomy. Suturing the peritoneum with plain catgut was associated with a high incidence of adhesions to the wound at 8 days (11/15), but this was significantly less at 25 days (5/15, P less than 0.04). Use of monofilament nylon, or non-suture, were each associated with a low incidence of adhesions. Wound strength was significantly greater at 25 days than at 8 days (P less than 0.0005), but did not differ between groups. In a separate experiment, bacterial infection, even in the absence of a particulate carrier, proved to be a potent cause of postoperative peritoneal adhesions (8/9, P = 0.02) compared with uninfected controls (3/10). Suturing the peritoneum in the presence of infection caused an especially high incidence of adhesions to the wound (8/9, P = 0.004 vs 2/10 unsutured). It is concluded that the lowest incidence of adhesions to the wound is likely to be obtained, both in uninfected and in infected cases, if the peritoneum is not sutured during closure of abdominal wounds, and that such an approach does not compromise wound strength. PMID:1567133

  11. Vitreous asteroid hyalosis prolapse into the anterior chamber simulating iris metastasis.

    PubMed

    Shields, Carol L; Romanelli-Gobbi, Massi; Lally, Sara E; Shields, Jerry A

    2012-01-01

    Two asymptomatic elderly women who underwent cataract extraction 7 or more years previously and with intraocular lens placement presented with a linear bead-like white multinodular mass in the inferior angle simulating iris metastasis versus large inflammatory precipitates. There was no iris infiltration. In the first case, the posterior lens capsule was intact and there was no evidence of gelatinous vitreous in the anterior chamber, whereas in the second case, the capsule was open and there was gelatinous vitreous prolapse. In both cases, there was asteroid hyalosis in the vitreous. Both patients were diagnosed with prolapsed vitreous asteroid hyalosis into the anterior chamber and managed with observation. Vitreous asteroid hyalosis can prolapse into the anterior chamber of pseudophakic elderly patients with or without capsular opening and can simulate an intraocular tumor.

  12. [Intraocular lenses for the correction of refraction errors. Part 1: phakic anterior chamber lenses].

    PubMed

    Kohnen, T; Baumeister, M; Cichocki, M

    2005-10-01

    In this overview, the current status of intraocular lens surgery to correct refractive error is reviewed. The interventions are divided into additive surgery with intraocular lens implantation without extraction of the crystalline lens (phakic intraocular lens, PIOL) or the removal of the crystalline lens with implantation of an IOL (refractive lens exchange, RLE). Phakic IOLs are constructed as angle-supported or iris-fixated anterior chamber lenses and posterior chamber lenses that are fixated in the ciliary sulcus. The implantation of phakic IOLs has been demonstrated to be an effective, safe, predictable and stable procedure to correct higher refractive errors. Complications are rare and differ for the three types of PIOL; for anterior chamber lenses these are mainly pupil ovalization and endothelial cell loss.

  13. Making a Fish Tank Cloud Chamber

    ERIC Educational Resources Information Center

    Green, Frances

    2012-01-01

    The cloud chambers described here are large, made from readily available parts, simple to set up and always work. With no source in the chamber, background radiation can be observed. A large chamber means that a long rod containing a weakly radioactive material can be introduced, increasing the chance of seeing decays. Details of equipment and…

  14. Simple Cloud Chambers Using Gel Ice Packs

    ERIC Educational Resources Information Center

    Kamata, Masahiro; Kubota, Miki

    2012-01-01

    Although cloud chambers are highly regarded as teaching aids for radiation education, school teachers have difficulty in using cloud chambers because they have to prepare dry ice or liquid nitrogen before the experiment. We developed a very simple and inexpensive cloud chamber that uses the contents of gel ice packs which can substitute for dry…

  15. EPA GAS PHASE CHEMISTRY CHAMBER STUDIES

    EPA Science Inventory

    Gas-phase smog chamber experiments are being performed at EPA in order to evaluate a number of current chemical mechanisms for inclusion in EPA regulatory and research models. The smog chambers are 9000 L in volume and constructed of 2-mil teflon film. One of the chambers is co...

  16. Gas turbine combustion chamber with air scoops

    SciTech Connect

    Mumford, S.E.; Smed, J.P.

    1989-12-19

    This patent describes a gas turbine combustion chamber. It comprises: means for admission of fuel to the upstream end thereof and discharge of hot gases from the downstream end thereof, and a combustion chamber wall, having an outer surface, with apertures therethrough, and air scoops provided through the apertures to direct air into the combustion chamber.

  17. Uniform-Temperature Walls for Cloud Chambers

    NASA Technical Reports Server (NTRS)

    Fleischman, G.

    1985-01-01

    Flat heat pipes rapidly transfer heat to and from experimental volumes. Heat pipe vapor chamber carries heat to and from thermo electric modules. Critical surface acts as evaporator or condenser in cloud physics experiments. Used as walls of spaceborne atmospheric cloud chambers. On Earth, used as isothermal floors for environmental test chambers.

  18. A Sensitive Cloud Chamber without Radioactive Sources

    ERIC Educational Resources Information Center

    Zeze, Syoji; Itoh, Akio; Oyama, Ayu; Takahashi, Haruka

    2012-01-01

    We present a sensitive diffusion cloud chamber which does not require any radioactive sources. A major difference from commonly used chambers is the use of a heat sink as its bottom plate. The result of a performance test of the chamber is given. (Contains 8 figures.)

  19. Chamber B Thermal/Vacuum Chamber: User Test Planning Guide

    NASA Technical Reports Server (NTRS)

    Montz, Mike E.

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of Chamber B. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  20. Osterix/Sp7 limits cranial bone initiation sites and is required for formation of sutures.

    PubMed

    Kague, Erika; Roy, Paula; Asselin, Garrett; Hu, Gui; Simonet, Jacqueline; Stanley, Alexandra; Albertson, Craig; Fisher, Shannon

    2016-05-15

    During growth, individual skull bones overlap at sutures, where osteoblast differentiation and bone deposition occur. Mutations causing skull malformations have revealed some required genes, but many aspects of suture regulation remain poorly understood. We describe a zebrafish mutation in osterix/sp7, which causes a generalized delay in osteoblast maturation. While most of the skeleton is patterned normally, mutants have specific defects in the anterior skull and upper jaw, and the top of the skull comprises a random mosaic of bones derived from individual initiation sites. Osteoblasts at the edges of the bones are highly proliferative and fail to differentiate, consistent with global changes in gene expression. We propose that signals from the bone itself are required for orderly recruitment of precursor cells and growth along the edges. The delay in bone maturation caused by loss of Sp7 leads to unregulated bone formation, revealing a new mechanism for patterning the skull and sutures.

  1. Light-guided localization within tissue using biocompatible surgical suture fiber as an optical waveguide.

    PubMed

    Choi, Woo June; Park, Kwan Seob; Lee, Byeong Ha

    2014-09-01

    In breast-conserving surgery, an optical wire is a useful surgical guiding tool to optically locate small lesions within the breast tissue. However, the use of a long silica glass fiber as the optical wire can be burdensome to patients because of its stiffness and nonbiocompatibility. We investigate the use of a biocompatible fiber for light localization in tissue. A surgical suture with a diameter of 400 μm and a few centimeters long is employed as the biocompatible optical waveguide to transport the visible laser light to the inner tissue site. Optical location is confirmed with glow ball-like red laser illumination at the tip of the suture embedded within a fresh chicken breast tissue. Effective optical power coupling to the suture is made by using a double-cladding fiber coupler. From this preliminary result, we realize practical light localization with biopolymer waveguides.

  2. Suture granuloma mimicking a recurrent sacro-coccygeal pilonidal sinus after Limberg flap.

    PubMed

    Ardelt, Michael; Dittmar, Yves; Schulz, Birte; Rauchfuss, Falk; Scheuerlein, Hubert; Settmacher, Utz

    2014-12-01

    Sacro-coccygeal pilonidal sinus disease is classified as an asymptomatic, acutely abscess-forming or chronic subcutaneous inflammation in the sacro-coccygeal region featuring characteristic pits in the bottom cleft. Due to high rates of recurrence, two flap techniques have been established in the course of the past three decades. One of them is the Karydakis operation, the other option is a rotation flap named Limberg procedure. We report about a case of suture granuloma in the area of a Limberg flap after recurrent pilonidal sinus with extrusion of the suture material, thus mimicking recurrence. In case of recurrent pilonidal sinus following plastic coverage or primary closure, respectively, the differential diagnosis of suture granuloma should be considered.

  3. Prevalence of biofilms on surgical suture segments in wounds of dogs, cats, and horses.

    PubMed

    König, L; Klopfleisch, R; Kershaw, O; Gruber, A D

    2015-03-01

    The formation of biofilms on surgical implants is thought to play a major role in chronic infection and wound-healing disorders and has been rarely described in veterinary medicine. Due to poor and unreliable results from bacterial culturing, histology may be an economic tool for the detection of biofilms. In this study, the prevalence of biofilms on surgical suture materials and swabs with chronic wound-healing complications in dogs, cats, and horses was assessed by histologic examination using hematoxylin and eosin, Gram, and Giemsa stains, as well as periodic acid-Schiff reaction. Of the 91 tissue samples with intralesional suture material or swab residues associated with inflammation, only 2 contained bacterial colonies arranged in an extracellular polymeric matrix consistent with a biofilm. The results of this study suggest that biofilms on suture material may occur in veterinary medicine.

  4. Performance Assessment of Suture Type in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters

    SciTech Connect

    Deters, Katherine A.; Brown, Richard S.; Carter, Kathleen M.; Boyd, James W.

    2009-02-27

    The objective of this study was to determine the best overall suture material to close incisions from the surgical implantation of Juvenile Salmon Acoustic Telemetry System (JSATS) acoustic microtransmitters in subyearling Chinook salmon Oncorhynchus tshawytscha. The effects of seven suture materials, four surgeons, and two water temperatures on suture retention, incision openness, tag retention, tissue inflammation, and tissue ulceration were quantified. The laboratory study, conducted by researchers at the Pacific Northwest National Laboratory, supports a larger effort under way for the U.S. Army Corps of Engineers, Portland District, aimed at determining the suitability of acoustic telemetry for estimating short- and longer-term (30-60 days) juvenile-salmonid survival at Columbia and Snake River dams and through the lower Columbia River.

  5. Limited open repair of ruptured Achilles tendons with Bunnel-type sutures.

    PubMed

    Park, H G; Moon, D H; Yoon, J M

    2001-12-01

    A new method of repairing Achilles tendons, which uses a small medial skin incision with a Bunnel-type suture, was performed on 14 patients, and the clinical results were found satisfying. In order to restore the Achilles tendon to its original length, restore tensile strength in the suture site, and minimize injury to the sural nerve, an operative procedure has been devised which uses a limited open repair with a Bunnel-type suture. We followed 14 patients who had undergone the new procedure for a mean interval of 26 months after the injury. They returned to work in six weeks and to playing sports in 25 weeks. There were no cases of late rerupture nor injuries to the sural nerve. This technique approximated the preinjury length and resting tension of the musculo-tendinous apparatus and minimized sural nerve injury.

  6. Novel High Efficient Coatings for Anti-Microbial Surgical Sutures Using Chlorhexidine in Fatty Acid Slow-Release Carrier Systems

    PubMed Central

    Obermeier, Andreas; Schneider, Jochen; Wehner, Steffen; Matl, Florian Dominik; Schieker, Matthias; von Eisenhart-Rothe, Rüdiger; Stemberger, Axel; Burgkart, Rainer

    2014-01-01

    Sutures can cause challenging surgical site infections, due to capillary effects resulting in bacteria permeating wounds. Anti-microbial sutures may avoid these complications by inhibiting bacterial pathogens. Recently, first triclosan-resistances were reported and therefore alternative substances are becoming clinically relevant. As triclosan alternative chlorhexidine, the “gold standard” in oral antiseptics was used. The aim of the study was to optimize novel slow release chlorhexidine coatings based on fatty acids in surgical sutures, to reach a high anti-microbial efficacy and simultaneously high biocompatibility. Sutures were coated with chlorhexidine laurate and chlorhexidine palmitate solutions leading to 11, 22 or 33 µg/cm drug concentration per length. Drug release profiles were determined in aqueous elutions. Antibacterial efficacy against Staphylococcus aureus was assessed in agar diffusion tests. Biocompatibility was evaluated via established cytotoxicity assay (WST-1). A commercially triclosan-containing suture (Vicryl Plus), was used as anti-microbial reference. All coated sutures fulfilled European Pharmacopoeia required tensile strength and proved continuous slow drug release over 96 hours without complete wash out of the coated drug. High anti-microbial efficacy for up to 5 days was observed. Regarding biocompatibility, sutures using 11 µg/cm drug content displayed acceptable cytotoxic levels according to ISO 10993-5. The highest potential for human application were shown by the 11 µg/cm chlorhexidine coated sutures with palmitic acid. These novel coated sutures might be alternatives to already established anti-microbial sutures such as Vicryl Plus in case of triclosan-resistance. Chlorhexidine is already an established oral antiseptic, safety and efficacy should be proven for clinical applications in anti-microbial sutures. PMID:24983633

  7. Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty.

    PubMed

    Cromie, Melinda J; Siston, Robert A; Giori, Nicholas J; Delp, Scott L

    2008-11-01

    Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20-60 degrees ) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1 +/- 4.3 mm to 10.4 +/- 5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2 +/- 9.6 degrees to 49.3 +/- 7.3 degrees). Implanting the prosthesis increased the amount of anterior translation (to 16.1 +/- 4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0-60 degrees) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis.

  8. Transseptal suturing technique in septoplasty: impact on bacteremia and nosocomial colonization.

    PubMed

    Ismi, Onur; Ozcan, Cengiz; Vayısoğlu, Yusuf; Öztürk, Candan; Tek, Sebahat Aslan; Görür, Kemal

    2017-02-20

    Although effects of Merocel(®) nasal packs and silicone splints on nasal flora alterations and bacteremia formation after septoplasty were assessed before, the effect of transseptal suturing technique has not been studied yet. The objective of this study is to compare nasal flora alterations and bacteremia occurrence rates between Merocel packs, silicone splints, and transseptal suturing technique in septoplasty. Ninety patients were divided into three groups randomly: Merocel packing (Group M), silicone splint (Group S), and transseptal suturing without packing (Group T). Group M and S received prophylactic antibiotics and antibiotic pomade application to packs, whereas neither antibiotic prophylaxis nor topical pomade was applied to Group T. Preoperative, after pack removal and 1 month after pack removal nasal swab cultures and preoperative, immediately after surgery and 24 h after surgery blood cultures were taken from all patients. Group M increased Methicillin-sensitive Staphylococcus aureus (MSSA) colonization (p = 0.003) and decreased normal flora colonization (p = 0.038), whereas Group S and T did not affect MSSA or normal flora colonization (p > 0.05). Antibiotic prophylaxis did not affect MSSA colonization (p = 0.14), whereas decreased normal flora colonization (p = 0.029). Transseptal suturing did not prevent bacteremia formation. Postoperative increasing of MSSA colonization in nasal cavity for septoplasty patients can be prevented by using transseptal suturing technique or silicone splints instead of Merocel packing, rather than applying prophylactic antibiotic treatment. Using transseptal suturing does not prevent bacteremia formation during septal surgery. These findings should be kept in mind to prevent postoperative life-threatening infective complications of septoplasty especially in immunosuppressive patients and patients with cardiovascular diseases.

  9. Absorbable or nonabsorbable suture materials for closure of the dura mater?

    PubMed

    Vällfors, B; Hansson, H A; Svensson, J

    1981-10-01

    This study was undertaken to determine which suture material would give the best results for closure of the dura mater. Because there is no need for the suture to remain longer than until healing has occurred and as remaining foreign material will predispose to foreign body reactions and infection, it was considered important to test new absorbable materials like polyglactin 910 (Vicryl) and polyglycolic acid (Dexon) for closure of the dura mater. The reactions from these materials were compared to those of silk and polyester (Ethibond) in dogs 60 days after the suture of dural incisions. The quality of healing with respect to the smoothness of the subdural surface, the presence of adhesions between sutures and the brain surface, the degree of absorption of the material, and reactions around the sutures were evaluated. Vicryl gave the best results, providing a smooth subdural surface without adhesions. It was almost totally absorbed when healing was completed, in contrast to Dexon and the other materials. The cellular reaction around Vicryl was slight. Silk, Ethibond, and Dexon protruded from the subdural surface and adhesions to the arachnoid were common. When the dura mater was removed, these adhesions tore off the leptomeninges with their vascular supply to the cortex. The results of these experiments seem to justify the recommendation of Vicryl for suturing of the dura mater. Such an absorbable material decreases the risk of foreign body reactions, and infections will be more easily combated because of the absence of foreign material. The lack of subdural adhesions is an advantage if reoperation is necessary.

  10. Self-tapping ability of carbon fibre reinforced polyetheretherketone suture anchors.

    PubMed

    Feerick, Emer M; Wilson, Joanne; Jarman-Smith, Marcus; Ó'Brádaigh, Conchur M; McGarry, J Patrick

    2014-10-01

    An experimental and computational investigation of the self-tapping ability of carbon fibre reinforced polyetheretherketone (CFR-PEEK) has been conducted. Six CFR-PEEK suture anchor designs were investigated using PEEK-OPTIMA® Reinforced, a medical grade of CFR-PEEK. Experimental tests were conducted to investigate the maximum axial force and torque required for self-taping insertion of each anchor design. Additional experimental tests were conducted for some anchor designs using pilot holes. Computational simulations were conducted to determine the maximum stress in each anchor design at various stages of insertion. Simulations also were performed to investigate the effect of wall thickness in the anchor head. The maximum axial force required to insert a self-tapping CFR-PEEK suture anchor did not exceed 150 N for any anchor design. The maximum torque required to insert a self-tapping CFR-PEEK suture anchor did not exceed 0.8 Nm. Computational simulations reveal significant stress concentrations in the region of the anchor tip, demonstrating that a re-design of the tip geometry should be performed to avoid fracture during self-tapping, as observed in the experimental component of this study. This study demonstrates the ability of PEEK-OPTIMA Reinforced suture anchors to self-tap polyurethane foam bone analogue. This provides motivation to further investigate the self-tapping ability of CFR-PEEK suture anchors in animal/cadaveric bone. An optimised design for CFR-PEEK suture anchors offers the advantages of radiolucency, and mechanical properties similar to bone with the ability to self-tap. This may have positive implications for reducing surgery times and the associated costs with the procedure.

  11. Suture zones of the Urals as integral prospective ore-bearing tectonic structures

    NASA Astrophysics Data System (ADS)

    Koroteev, V. A.; Sazonov, V. N.; Ogorodnikov, V. N.; Polenov, Yu. A.

    2009-04-01

    Rift-related (1.2 Ga) and collision (380-240 Ma) suture zones of the Urals are described. The riftrelated suture zones comprise an ultramafic-gabbro complex with titanomagnetite mineralization, an ultramafic complex with chromite mineralization, and a complex of alkali granitoids with rare-metal (including REE) mineralization accompanied by K-feldspathites, albitites, and calcite metasomatic rocks. The collision suture zones are distinguished by early collision granitoids specialized for tungsten (scheelite) and gold, as well as by raremetal granites and such derivatives of them as pegmatite and greisen with rare-metal and colored-stone mineralization. The suture zones are characterized by long-term (up to 80 Ma or more) continuous-discontinuous periods of ore deposition; heterogeneous sources of ore matter and ore-bearing fluids; a polyelemental composition of lithogeochemical halos and an integral mineral composition of altered wall rocks; and the occurrence of mafic, intermediate, and felsic dikes at large gold deposits, as well as wide variations in PT parameters of the ore-forming process: T = 620-150°C and P = 3.2-0.6 kbar. Collision played a dual role in ore formation. On the one hand, collision led to deformation and metamorphism of precollision massive sulfide deposits and, to a lesser degree, Au-bearing Fe and Cu skarn and porphyry copper deposits, and, on the other hand, to the formation of new gold, rare-metal, quartz, colored-stone, talc, muscovite, and noble serpentine deposits. As a rule, this polygenetic mineralization differs in age and is related to collision volcanic and plutonic complexes. This diversity can be a good basis for metallogenic analysis, forecasting, and prospecting of various metallic deposits and industrial minerals. Polygenetic mineralization of various age known in suture zones is accompanied by integral lithogeochemical and metasomatic halos characterized by a continuous-discontinuous history. The complexity of ore

  12. Micropatterned Protective Membranes Inhibit Lens Epithelial Cell Migration in Posterior Capsule Opacification Model

    PubMed Central

    Magin, Chelsea M.; May, Rhea M.; Drinker, Michael C.; Cuevas, Kevin H.; Brennan, Anthony B.; Reddy, Shravanthi T.

    2015-01-01

    Purpose To evaluate the ability of Sharklet (SK) micropatterns to inhibit lens epithelial cell (LEC) migration. Sharklet Technologies, Inc. (STI) and InSight Innovations, LLC have proposed to develop a Sharklet-patterned protective membrane (PM) to be implanted in combination with a posterior chamber intraocular lens (IOL) to inhibit cellular migration across the posterior capsule, and thereby reduce rates of posterior capsular opacification (PCO). Methods A variety of STI micropatterns were evaluated versus smooth (SM) controls in a modified scratch wound assay for the ability to reduce or inhibit LEC migration. The best performing topography was selected, translated to a radial design, and applied to PM prototypes. The PM prototypes were tested in an in vitro PCO model for reduction of cell migration behind an IOL versus unpatterned prototypes and IOLs with no PM. In both assays, cell migration was analyzed with fluorescent microscopy. Results All SK micropatterns significantly reduced LEC migration compared with SM controls. Micropatterns that protruded from the surface reduced migration more than recessed features. The best performing micropattern reduced LEC coverage by 80%, P = 0.0001 (ANOVA, Tukey Test). Micropatterned PMs reduced LEC migration in a PCO model by 50%, P = 0.0005 (ANOVA, Tukey Test) compared with both IOLs with no PM and IOLs with SM PMs. Conclusions Collectively, in vitro results indicate the implantation of micropatterned PMs in combination with posterior chamber IOLs could significantly reduce rates of clinically relevant PCO. This innovative technology is a globally accessible solution to high PCO rates. Translational Relevance A novel IOL incorporating the SK micropattern in a membrane design surrounding the optic may help increase the success of cataract surgery by reducing secondary cataract, or PCO. PMID:25883876

  13. Planned posterior assisted levitation in severe subluxated cataract: surgical technique and clinical results.

    PubMed

    Lifshitz, Tova; Levy, Jaime; Kratz, Assaf; Belfair, Nadav; Tsumi, Erez

    2012-01-01

    We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL) in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up.

  14. Functional Effects of Delivering Human Mesenchymal Stem Cell-Seeded Biological Sutures to an Infarcted Heart

    PubMed Central

    Hansen, Katrina J.; Favreau, John T.; Guyette, Jacques P.; Tao, Ze-Wei; Coffin, Spencer T.; Cunha-Gavidia, Anny; D'Amore, Brian; Perreault, Luke R.; Fitzpatrick, John P.; DeMartino, Angelica; Gaudette, Glenn R.

    2016-01-01

    Abstract Stem cell therapy has the potential to improve cardiac function after myocardial infarction (MI); however, existing methods to deliver cells to the myocardium, including intramyocardial injection, suffer from low engraftment rates. In this study, we used a rat model of acute MI to assess the effects of human mesenchymal stem cell (hMSC)-seeded fibrin biological sutures on cardiac function at 1 week after implant. Biological sutures were seeded with quantum dot (Qdot)-loaded hMSCs for 24 h before implantation. At 1 week postinfarct, the heart was imaged to assess mechanical function in the infarct region. Regional parameters assessed were regional stroke work (RSW) and systolic area of contraction (SAC) and global parameters derived from the pressure waveform. MI (n = 6) significantly decreased RSW (0.026 ± 0.011) and SAC (0.022 ± 0.015) when compared with sham operation (RSW: 0.141 ± 0.009; SAC: 0.166 ± 0.005, n = 6) (p < 0.05). The delivery of unseeded biological sutures to the infarcted hearts did not change regional mechanical function compared with the infarcted hearts (RSW: 0.032 ± 0.004, SAC: 0.037 ± 0.008, n = 6). The delivery of hMSC-seeded sutures exerted a trend toward increase of regional mechanical function compared with the infarcted heart (RSW: 0.057 ± 0.011; SAC: 0.051 ± 0.014, n = 6). Global function showed no significant differences between any group (p > 0.05); however, there was a trend toward improved function with the addition of either unseeded or seeded biological suture. Histology demonstrated that Qdot-loaded hMSCs remained present in the infarcted myocardium after 1 week. Analysis of serial sections of Masson's trichrome staining revealed that the greatest infarct size was in the infarct group (7.0% ± 2.2%), where unseeded (3.8% ± 0.6%) and hMSC-seeded (3.7% ± 0.8%) suture groups maintained similar infarct sizes. Furthermore, the remaining suture area

  15. ASSESSMENT OF MECHANICAL AND MANUAL SUTURE IN THE SURGICAL TREATMENT OF THE PHARYNGOESOPHAGEAL DIVERTICULUM

    PubMed Central

    de AQUINO, José Luis Braga; CHAGAS, José Francisco Salles; SAID, Marcelo Manzano; PASCOAL, Maria Beatriz Nogueira; BRANDI-FILHO, Luis Antonio; PEREIRA, Douglas Alexandre Rizzanti; FRUET, Fernanda

    2015-01-01

    Background: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea is to accomplish this surgical procedure, comparing the manual and mechanical suture, in order to evaluate the real benefit of the mechanical technique. Aim: To evaluate the results of the pharyngoesophageal diverticulectomy with cricomyotomy using manual and mechanical suture with regard to local and systemic complications. Method: Fifty-seven patients with pharyngoesophageal diverticula diagnosed through high digestive endoscopy and pharyngeal esophagogram were studied. The applied surgical technique was diverticulectomy with myotomy of the cricopharyngeal muscle, done in 24 patients (42.2%) the mechanical suture (group A) with the mechanical linear suture device and in 33 (57.8%) a manual closure of the pharynx (group B). Results: In the postoperative period, one patient of group A (4.1%) presented fistula caused by dehiscence of the pharyngeal suture, and three of group B (15.1%) presented the same complication, with a good outcome using a conservative treatment. In the same group, three patients (9.0%) presented stenosis of the suture of the pharynx, with good outcome and with endoscopic dilatations, and no patient from group A presented such complication. Lung infection was present in five patients, being two (8.3%) of group A and three (9.0%) on B, having good outcomes after specific treatment. In the late review, done with 43 patients (94.4%) of group A and 22 (88.0%) on B, the patients declared to be pleased with the surgical procedure, because they were able to regain normal swallowing. Conclusion: The diverticulectomy with myotomy and pharyngeal closure using

  16. Fundus autofluorescence imaging in posterior uveitis.

    PubMed

    Durrani, Khayyam; Foster, C Stephen

    2012-01-01

    Although the phenomenon of fundus autofluorescence has been known for decades, it has only recently been recognized as a measure of retinal pigment epithelial function and health. Characteristic fundus autofluorescence patterns have been described in eyes affected by inflammation of the posterior segment, and these patterns have provided insights into the pathogenesis of posterior uveitis entities. In addition, preliminary data indicate that fundus autofluorescence characteristics may serve as markers of disease activity, allow prediction of visual prognosis, and may help determine the adequacy of therapy. We provide an overview of the current state of fundus autofluorescence imaging technology and review our current knowledge of fundus autoflourescence findings and their clinical use in the posterior uveitis entities.

  17. The DELPHI time projection chamber

    SciTech Connect

    Brand, C.; Cairanti, G.; Charpentier, P.; Clara, M.P.; Delikaris, D.; Foeth, H.; Heck, B.W.; Hilke, H.J.; Sulkowski, K.; Aubret, C.

    1989-02-01

    The central tracking device of the DELPHI Experiment at LEP is a Time Projection Chamber (TPC) with an active volume of 2 x 1.34m in length and 2.22m in diameter. Since spring 1988 the TPC has undergone extensive tests in a cosmic ray set-up. It will be installed in the LEP tunnel by early 1989. This report covers the construction, the read-out electronics and the contribution of the TPC to the DELPHI trigger. Emphasis is given to novelties which are not used in similar detectors.

  18. Reversible cortical blindness: posterior reversible encephalopathy syndrome.

    PubMed

    Bandyopadhyay, Sabyasachi; Mondal, Kanchan Kumar; Das, Somnath; Gupta, Anindya; Biswas, Jaya; Bhattacharyya, Subir Kumar; Biswas, Gautam

    2010-11-01

    Cortical blindness is defined as visual failure with preserved pupillary reflexes in structurally intact eyes due to bilateral lesions affecting occipital cortex. Bilateral oedema and infarction of the posterior and middle cerebral arterial territory, trauma, glioma and meningioma of the occipital cortex are the main causes of cortical blindness. Posterior reversible encephalopathy syndrome (PRES) refers to the reversible subtype of cortical blindness and is usually associated with hypertension, diabetes, immunosuppression, puerperium with or without eclampsia. Here, 3 cases of PRES with complete or partial visual recovery following treatment in 6-month follow-up are reported.

  19. Posterior cortical atrophy: a brief review.

    PubMed

    Kirshner, Howard S; Lavin, Patrick J M

    2006-11-01

    Posterior cortical atrophy is a striking clinical syndrome in which a dementing illness begins with visual symptoms. Initially, the problem may seem to be loss of elementary vision, but over time the patient develops features of visual agnosia, topographical difficulty, optic ataxia, simultanagnosia, ocular apraxia (Balint's syndrome), alexia, acalculia, right-left confusion, and agraphia (Gerstmann's syndrome), and later a more generalized dementia. Occasional patients have visual hallucinations and signs of Parkinson's disease or Lewy body dementia. A number of different neuropathologic disorders are associated with posterior cortical atrophy.

  20. A sensitivity analysis to the role of the fronto-parietal suture in Lacerta bilineata: a preliminary finite element study.

    PubMed

    Moazen, Mehran; Costantini, David; Bruner, Emiliano

    2013-02-01

    Cranial sutures are sites of bone growth and development but micromovements at these sites may distribute the load across the skull more evenly. Computational studies have incorporated sutures into finite element (FE) models to assess various hypotheses related to their function. However, less attention has been paid to the sensitivity of the FE results to the shape, size, and stiffness of the modeled sutures. Here, we assessed the sensitivity of the strain predictions to the aforementioned parameters in several models of fronto-parietal (FP) suture in Lacerta bilineata. For the purpose of this study, simplifications were made in relation to modeling the bone properties and the skull loading. Results highlighted that modeling the FP as either an interdigitated suture or a simplified butt suture, did not reduce the strain distribution in the FP region. Sensitivity tests showed that similar patterns of strain distribution can be obtained regardless of the size of the suture, or assigned stiffness, yet the exact magnitudes of strains are highly sensitive to these parameters. This study raises the question whether the morphogenesis of epidermic scales in the FP region in the Lacertidae is related to high strain fields in this region, because of micromovement in the FP suture.

  1. Thrust chamber material technology program

    NASA Technical Reports Server (NTRS)

    Andrus, J. S.; Bordeau, R. G.

    1989-01-01

    This report covers work performed at Pratt & Whitney on development of copper-based materials for long-life, reusable, regeneratively cooled rocket engine thrust chambers. The program approached the goal of enhanced cyclic life through the application of rapid solidification to alloy development, to introduce fine dispersions to strengthen and stabilize the alloys at elevated temperatures. After screening of alloy systems, copper-based alloys containing Cr, Co, Hf, Ag, Ti, and Zr were processed by rapid-solidification atomization in bulk quantities. Those bulk alloys showing the most promise were characterized by tensile testing, thermal conductivity testing, and elevated-temperature, low-cycle fatigue (LFC) testing. Characterization indicated that Cu- 1.1 percent Hf exhibited the greatest potential as an improved-life thrust chamber material, exhibiting LCF life about four times that of NASA-Z. Other alloys (Cu- 0.6 percent Zr, and Cu- 0.6 percent Zr- 1.0 percent Cr) exhibited promise for use in this application, but needed more development work to balance properties.

  2. Treatment rationale of fractured posterior teeth.

    PubMed

    Silvestri, A R; Singh, I

    1978-11-01

    The four types of fractures most frequently encountered in posterior teeth--obliquely directed complete fractures, vertically directed complete fractures, obliquely directed incomplete fractures, and vertically directed incomplete fractures--have been described. A detailed treatment approach for each type has been presented.

  3. Posterior Predictive Model Checking in Bayesian Networks

    ERIC Educational Resources Information Center

    Crawford, Aaron

    2014-01-01

    This simulation study compared the utility of various discrepancy measures within a posterior predictive model checking (PPMC) framework for detecting different types of data-model misfit in multidimensional Bayesian network (BN) models. The investigated conditions were motivated by an applied research program utilizing an operational complex…

  4. Posterior Probabilities for a Consensus Ordering.

    ERIC Educational Resources Information Center

    Fligner, Michael A.; Verducci, Joseph S.

    1990-01-01

    The concept of consensus ordering is defined, and formulas for exact and approximate posterior probabilities for consensus ordering are developed under the assumption of a generalized Mallows' model with a diffuse conjugate prior. These methods are applied to a data set concerning 98 college students. (SLD)

  5. Complicated posterior capsulorhexis: aetiology, management, and outcome

    PubMed Central

    Van Cauwenberge, F.; Rakic, J.; Galand, A.

    1997-01-01

    BACKGROUND—A 1 year retrospective analysis of 650 patients, who underwent a posterior capsulorhexis on their intact capsules, was performed to examine the incidence of complications, their aetiologies, and the outcome.
METHODS—Data were analysed on 32 patients with complicated capsulorhexis for type of surgery, preoperative and postoperative factors, and relative risk factors for vitreous issue.
RESULTS—There were six patients with vitreous loss. The posterior capsulorhexis was uncontrolled in 14 cases and difficult to perform in 12 cases. Implantation into the capsular bag was possible in all cases. Systemic vascular hazard and old age (over 80 years) were found to be statistically significant risk factors for vitreous loss (p=0.002 and p=0.03 respectively). The mean follow up was 13.5 months (range 4-25 months). One patient developed a retinal detachment and two had a transient clinical cystoid macular oedema. Visual acuity of ≥ 20/40 was obtained in 93% of the patients.
CONCLUSION—Loss of control of the posterior capsulorhexis has a low incidence but can lead to serious problems during surgery. A good knowledge of the technique is necessary to complete the procedure with a posterior capsulorhexis of the optimum size without vitreous loss.

 PMID:9135382

  6. Subspecialization in the human posterior medial cortex

    PubMed Central

    Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R.; Fox, Peter T.; Palomero-Gallagher, Nicola; Vogt, Brent A.; Zilles, Karl; Eickhoff, Simon B.

    2014-01-01

    The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-constrained but not task-unconstrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

  7. Posterior dislocation of the shoulder in athletes.

    PubMed

    Samilson, R L; Prieto, V

    1983-07-01

    Although posterior dislocation of the shoulder is a rare injury in athletes, failure to recognize and properly manage acute dislocation may have serious consequences. The article discusses the incidence, mechanism of injury, classification, pathologic findings, clinical and radiologic diagnosis, and management.

  8. BAER suppression during posterior fossa dural opening

    PubMed Central

    Shields, Christopher B.; Shields, Lisa B. E.; Jiang, Yi Dan; Yao, Tom; Zhang, Yi Ping; Sun, David A.

    2015-01-01

    Background: Intraoperative monitoring with brainstem auditory evoked responses (BAER) provides an early warning signal of potential neurological injury and may avert tissue damage to the auditory pathway or brainstem. Unexplained loss of the BAER signal in the operating room may present a dilemma to the neurosurgeon. Methods: This paper documents two patients who displayed a unique mechanism of suppression of the BAER apparent within minutes following dural opening for resection of a posterior fossa meningioma. Results: In two patients with anterior cerebellopontine angle and clival meningiomas, there was a significant deterioration of the BAER soon after durotomy but prior to cerebellar retraction and tumor removal. Intracranial structures in the posterior fossa lying between the tumor and dural opening were shifted posteriorly after durotomy. Conclusion: We hypothesized that the cochlear nerve and vessels entering the acoustic meatus were compressed or stretched when subjected to tissue shift. This movement caused cochlear nerve dysfunction that resulted in BAER suppression. BAER was partially restored after the tumor was decompressed, dura repaired, and bone replaced. BAER was not suppressed following durotomy for removal of a meningioma lying posterior to the cochlear complex. Insight into the mechanisms of durotomy-induced BAER inhibition would allay the neurosurgeon's anxiety during the operation. PMID:25883849

  9. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nonabsorbable poly(ethylene terephthalate) surgical suture. 878.5000 Section 878.5000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... thread prepared from fibers of high molecular weight, long-chain, linear polyesters having...

  10. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonabsorbable poly(ethylene terephthalate) surgical suture. 878.5000 Section 878.5000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... thread prepared from fibers of high molecular weight, long-chain, linear polyesters having...

  11. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nonabsorbable poly(ethylene terephthalate) surgical suture. 878.5000 Section 878.5000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... thread prepared from fibers of high molecular weight, long-chain, linear polyesters having...

  12. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonabsorbable poly(ethylene terephthalate) surgical suture. 878.5000 Section 878.5000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... thread prepared from fibers of high molecular weight, long-chain, linear polyesters having...

  13. 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.

  14. Percutaneous Retrieval of a Central Venous Catheter Sutured to the Wall of the Right Atrium

    SciTech Connect

    Neuerburg, Joerg-M.; Guenther, Rolf W.; Chalabi, Khaled; Hunter, David

    1999-01-15

    A transjugular central venous catheter was inadvertently sutured to the wall of the right atrium in a 63-year-old female during coronary bypass surgery. Using two nitinol Goose Neck snares via a transfemoral and a transjugular approach the catheter was severed into two pieces and retrieved percutaneously.

  15. A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty.

    PubMed

    Turhan, Murat; Bostancı, Aslı; Akdag, Mehmet; Dinc, Oktay

    2013-03-01

    Our objective is to examine the effects of using nasal packing or transseptal suture in septoplasty in young patients, specifically on the polysomnographic parameters in the post-operative period. A total of 43 patients who had undergone septoplasty surgery after a diagnosis of septum deviation were included in the study. Packing was inserted in 23 patients, and transseptal suture was performed in the other 20 patients. A polysomnography test was performed on the patients on the first day after surgery and during the post-operative period. A post-operative increase was found in the apnea-hypopnea index (AHI) within both the packing and suture groups. The AHI increase in the packing group was statistically significant (p < 0.05). In the post-operative period, the fall in average oxygen desaturation in the packing group was significantly higher compared to suture group (p < 0.001). In addition, the arousal index was significantly higher in the packing group (p < 0.05). The use of nasal packing in young patients after septoplasty surgery reduced the quality of life after surgery and had negative effects on respiration during sleep. The finding that nasal packing caused obstructive sleep apnea syndrome even in young patients leads us to hypothesise that the effect of the packing on comorbid patients' respiratory function during sleep would be even more severe.

  16. IMMEDIATE AND LATE EFFECT OF SUTURES IN EXTRASYNOVIAL TENDONS: BIOMECHANICAL STUDY IN RATS

    PubMed Central

    Sardenberg, Trajano; Muller, Sérgio Swain; Garms, Luciana Zauhy; Miduati, Francini Belluci

    2015-01-01

    Objective: The aim of this study was to evaluate the effects on the mechanical properties of rats’ calcaneus tendons, of repair arrangements using suture material in the absence of any healing process. Method: Twelve male Wistar rats were used. They were subjected to placement of a modified Kessler suture stitch in the calcaneus tendon. The sacrifices were performed immediately after and six weeks after the operation. The mechanical properties studied were maximum load, tension in the maximum load and module of elasticity. The contralateral tendon was used as a control. Results: The statistical analysis showed that for the times studied, the values for mechanical properties did not present any significant differences. In relation to the control, i.e. the contralateral tendon without a suture, the results demonstrated that, six weeks after the operation, the values for the modulus of elasticity were lower, whereas there were no significant variations in maximum load or tension at maximum load. Conclusion: Placement of suture material on an extrasynovial tendon without lesions decreased the modulus of elasticity, but it did not interfere with the maximum load or tension at maximum load, six weeks after the operation. PMID:27047823

  17. Crustal-scale duplexing beneath the Yarlung Zangbo suture in the western Himalaya

    NASA Astrophysics Data System (ADS)

    Gao, Rui; Lu, Zhanwu; Klemperer, Simon L.; Wang, Haiyan; Dong, Shuwen; Li, Wenhui; Li, Hongqiang

    2016-07-01

    The fate of the Indian plate during continental collision with Asian terranes, and the proportion of the Indian crust that is underthrust or subducted beneath Tibet as opposed to transferred to the upper (Himalayan) plate, are much debated. The active geometry of low-angle underthrusting or subduction of the Indian plate beneath the Lesser and Greater Himalayan thrust sheets is well known from seismic imaging. Previously, only lower-resolution images of the Main Himalayan Thrust have been obtained beneath the Yarlung Zangbo suture that separates Indian and Asian rocks at the surface. It remains controversial whether the orogenic wedge between the Main Himalayan Thrust and the Yarlung Zangbo suture, formed of Indian crust transferred to the upper plate, is evolving by thrust-faulting in a critical-taper wedge or by southward extrusion of a ductile channel flow. Here we present a seismic reflection profile across the western Himalaya at 81.5° E, and show that the Main Himalayan Thrust dips ~20° to ~60 km depth beneath the Yarlung Zangbo suture, approaching a continuous Moho reflection at ~70-75 km depth. The Indian crust being transported northwards beyond the Yarlung Zangbo suture is no more than ~15 km thick, reduced from its original ~40 km thickness by transfer of material from the lower plate to the upper plate through crustal-scale duplexing.

  18. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... produced by recombinant DNA technology. 878.4494 Section 878.4494 Food and Drugs FOOD AND DRUG... recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is an... deoxyribonucleic acid (DNA) technology. The device is intended for use in general soft tissue approximation...

  19. Effect of suture materials on bacterial survival in infected wounds. An experimental study.

    PubMed

    Osterberg, B; Blomstedt, B

    1979-01-01

    A non-capilllary and a capillary suture material were compared as regards the course of Staphylococcus areus infection at the site of implantation. The materials were implanted in the muscle of the rat, and bacterial counts were made at intervals over 41 days. The number of bacteria recovered at the implantation site during the test period decreased steadily and was significantly lower for the non-capillary than for the capillary materials. In the latter case the bacterial counts did not fall far below the initial value at inoculation. The number of bacteria isolated from the suture thread in relation to the total number from the thread and the surrounding muscle was significantly greater for the capillary material. The difference in the results for the two types of suture materials might be ascribed to differences in the extent to which the bacteria are exposed to the body's defence mechanism; in the case of the capillary suture material the bacteria would tend to be protected through their enclosure in the interstices of the material.

  20. 21 CFR 878.4493 - Absorbable poly(glycolide/l-lactide) surgical suture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Absorbable poly(glycolide/l-lactide) surgical suture. 878.4493 Section 878.4493 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices §...