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1
Osipovsky, V. M. "Closure of the fecal fistula by bowel evagination." Kazan medical journal 32, no. 7 (September 20, 2021): 615. http://dx.doi.org/10.17816/kazmj80653.
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B-naya Cher va Maria, 57 years old, Russian, peasant woman, s. Svinogorsk, Yelabuga region, was admitted to the surgical department of Kosteneevskaya hospital on 20 / X 30 for a persistent non-healing fecal fistula in the left groin area.
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Moldenhauer, Julie S., Shelly Soni, Jillian Jatres, Juliana Gebb, Nahla Khalek, Christina Paidas Teefey, Mark P. Johnson, et al. "Open Fetal Surgical Outcomes for Myelomeningocele Closure Stratified by Maternal Body Mass Index in a Large Single-Center Cohort." Fetal Diagnosis and Therapy 47, no. 12 (2020): 889–93. http://dx.doi.org/10.1159/000511781.
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<b><i>Background:</i></b> Open maternal-fetal surgery for in utero closure of myelomeningocele (MMC) has become an accepted treatment option for prenatally diagnosed open neural tube defects. Historically, this option has been limited to women with BMI < 35 due to concern for increasing complications in patients with obesity. <b><i>Objective:</i></b> The aim of this study was to evaluate maternal, obstetric, and fetal/neonatal outcomes stratified by maternal BMI classification in women who undergo open maternal-fetal surgery for fetal myelomeningocele (fMMC) closure. <b><i>Methods:</i></b> A single-center fMMC closure registry was queried for maternal demographics, preoperative factors, fetal surgery outcomes, delivery outcomes, and neonatal outcomes. Data were stratified based on maternal BMI: <30, 30–34.99, and ≥35–40, corresponding to normal weight/overweight, obesity class I, and obesity class II. Statistical analysis was performed using statistical software SAS v.9.4 (SAS Institute Inc., Cary, NC, USA). <b><i>Results:</i></b> A total of 264 patients were analyzed, including 196 (74.2%) with BMI <30, 54 (20.5%) with BMI 30–34.99, and 14 (5.3%) with BMI ≥ 35–40. Maternal demographics and preoperative characteristics were similar among the groups. Operative time increased with increasing BMI; otherwise, perioperative outcomes were similar among the groups. Obstetric and neonatal outcomes were similar among the groups. <b><i>Conclusion:</i></b> Increasing maternal BMI did not result in a negative impact on maternal, obstetric, and fetal/neonatal outcomes in a large cohort of patients undergoing open maternal-fetal surgery for fMMC closure. Further study is warranted to determine the generalizability of these results.
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Dr. Niaz Ali, Miss. Rafia Naz Ali, and Miss. Johar Wajahat. "Education in Pakistan: Are the Articles 25A and 37(b) Closing the Gender Gap in KP Province?" Research Journal of Social Sciences and Economics Review (RJSSER) 2, no. 1 (March 7, 2021): 30–35. http://dx.doi.org/10.36902/rjsser-vol2-iss1-2021(30-35).
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This study aims to analyze the effectiveness of articles 25A and 37(b) in closing the gender gap in Pakistan's KP province. This stated Article explains the right to free and compulsory education up to the secondary level. The literature review has shown that two types of factors can affect achieving the goals defined by articles 25A and 37(b). Article 25A provides constitutional efforts to provide free and compulsory education in the chapter of fundamental rights. Article 37(b) enjoined the respective institutions' obligation to remove illiteracy and provide free and compulsory education to the secondary level within the minimum possible period. Clause (f) of the same Article declares how the State will enable Pakistani citizens to participate in national life through education. These claims were named as "efforts." The efforts are under human control. Some factors act against these stated efforts, known as "circumstances," which are natural and out of human control, such as gender gaps, poverty, Pashtunwali culture, etc. In Pakistan, the "efforts" are made to achieve the stated Articles' targets. Still, no policy was developed to answer the "circumstances." This attitude extends hurdles in educating KP girls. Suggestions were made to eradicate these "circumstances" entirely or partially to the extent possible. If these "circumstances" were removed, the girls' ratio of gross enrolment rate would be at least at a high level as boys, and thus the vision explained by the stated Articles can be achieved.
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Mittal, Sushil, Harnam Singh, Gurpreet Singh, Anand Munghate, Anjna Garg, and Manish Yadav. "A comparative study between single layer versus double layer closure in ileostomy reversal." Asian Journal of Medical Sciences 6, no. 2 (September 15, 2014): 43–46. http://dx.doi.org/10.3126/ajms.v6i2.10080.
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Background: Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel. The technique for stoma reversal has remained controversial is the use of either one or two layers of sutures for anastomosis.Methods: Sixty patients with ileostomy were taken for study .These patients divided in two groups A and B, 30 each. These patients were taken up for ileostomy closure in single layer (group A) (n-30) &double layer (group B) (n-30). Results: 60 Patients of ileostomy were studied, divided equally in 2 groups, A decreased intra operative time was seen in Group A when compared with Group B with no any significant comparative complication in these groups. Conclusion: Two-layer anastomosis for ileostomy closure offers no definite advantage over single layer anastomosis in terms of postoperative leak and other complications. Single layer ileostomy closure technique is safe, easy to perform and simply to taught. Considering duration of the anastomosis procedure and medical expenses single-layer intestinal anastomosis may prove the choice of procedure for most of the surgeons. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10080Asian Journal of Medical Sciences Vol.6(2) 2015 44-47
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D., Euvalingam, and Sendhil Nathan. "Comparative study of wound sequlae in layer closure and retention closure of midline laparotomy." International Surgery Journal 6, no. 9 (August 28, 2019): 3316. http://dx.doi.org/10.18203/2349-2902.isj20194072.
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Background: Layered closure of the abdomen has been considered to be ideal until recently however single layer mass (retention) closure technique, in which all the layers of the abdominal wall are closed in single layer is being increasingly used by surgeons. We conducted this study to analyze outcome measures in patients in whom wound closure was done by retention closure and layered closure.Methods: This was a prospective comparative study in which 60 patients undergoing elective or emergency laparotomy were included on the basis of a predefined inclusion and exclusion criteria. In 30 cases (50%) layer closure was done whereas in remaining 30 (50%) patients retention closure technique was used. Major outcome measures studied were time required for wound closure and post-operative complications.Results: Out of 60 studied cases there were 42 (70%) males and 18 (30%) females with M: F ratio of 1: 0.42.The time required for closure in layered suture group (group A) was 26.76±3.36 whereas in case of retention closure suturing it was 19.36±4.35. The difference was found to be statistically highly significant (p<0.0001). The complications rates were found to be statistically significantly higher in layer suturing (Group A) as compared to retention suture group (Group B).Conclusions: We conclude that retention suturing is preferable as compared to layered suturing in patients undergoing midline laparotomy in terms of time required for closure of wound and post-operative complication rates.
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Høg, E. "Tycho Astrometry from 30 Months of Satellite Mission." Symposium - International Astronomical Union 166 (1995): 61–68. http://dx.doi.org/10.1017/s007418090022785x.
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The Hipparcos satellite's star mapper gives photon counts in two spectral channels simultaneously, close to Johnson B and V. The transit times and the signal amplitudes for each star across two groups of four slits are derived and used for astrometry and photometry, respectively, and this constitutes the Tycho project. The present paper describes results of Tycho astrometric data processing, leading from the transit times to the astrometric parameters of the Tycho stars.Some 30 months of Tycho observations, i.e. about 80 percent of the Hipparcos-Tycho mission, have been used to produce a working catalogue of Tycho positions, proper motions and parallaxes of a million stars. The external errors of this preliminary catalogue have been determined by comparison of 98 000 stars common with a preliminary, but much more accurate Hipparcos catalogue. External systematic errors of positions and annual proper motions are less than 0.5 milliarcsecond (mas) and the accidental errors per star are about 30 mas rms at V = 10.5 mag, the median magnitude of the catalogue. It is concluded that a satisfactory accuracy has been achieved.
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Bordé, P., R. F. Díaz, O. Creevey, C. Damiani, H. Deeg, P. Klagyivik, G. Wuchterl, et al. "Transiting exoplanets from the CoRoT space mission." Astronomy & Astrophysics 635 (March 2020): A122. http://dx.doi.org/10.1051/0004-6361/201732393.
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Aims. We report the discovery as well as the orbital and physical characterizations of two new transiting giant exoplanets, CoRoT-30 b and CoRoT-31 b, with the CoRoT space telescope. Methods. We analyzed two complementary data sets: photometric transit light curves measured by CoRoT, and radial velocity curves measured by the HARPS spectrometer. To derive the absolute masses and radii of the planets, we modeled the stars from available magnitudes and spectra. Results. We find that CoRoT-30 b is a warm Jupiter on a close-to-circular 9.06-day orbit around a G3V star with a semi-major axis of about 0.08 AU. It has a radius of 1.01 ± 0.08 RJ, a mass of 2.90 ± 0.22 MJ, and therefore a mean density of 3.45 ± 0.65 g cm−3. The hot Jupiter CoRoT-31 b is on a close-to-circular 4.63-day orbit around a G2 IV star with a semi-major axis of about 0.05 AU. It has a radius of 1.46 ± 0.30 RJ, a mass of 0.84 ± 0.34 MJ, and therefore a mean density of 0.33 ± 0.18 g cm−3. Conclusions. Neither system seems to support the claim that stars hosting planets are more depleted in lithium. The radii of both planets are close to that of Jupiter, but they differ in mass; CoRoT-30 b is ten times denser than CoRoT-31 b. The core of CoRoT-30 b would weigh between 15 and 75 Earth masses, whereas relatively weak constraints favor no core for CoRoT-31 b. In terms of evolution, the characteristics of CoRoT-31 b appear to be compatible with the high-eccentricity migration scenario, which is not the case for CoRoT-30 b. The angular momentum of CoRoT-31 b is currently too low for the planet to evolve toward synchronization of its orbital revolution with stellar rotation, and the planet will slowly spiral-in while its host star becomes a red giant. CoRoT-30 b is not synchronized either: it looses angular momentum owing to stellar winds and is expected reach steady state in about 2 Gyr. CoRoT-30 and 31, as a pair, are a truly remarkable example of diversity in systems with hot Jupiters.
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M., Devaprashanth, Srinivas N. M., and Akhihlandeshwari N. "Limberg flap versus primary closure in the treatment of pilonidal sinus: a randomised clinical study." International Surgery Journal 8, no. 8 (July 28, 2021): 2388. http://dx.doi.org/10.18203/2349-2902.isj20213134.
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Background: Pilonidal sinus is a chronic disease usually involving the sacrococcygeal area. Various treatment modalities exist, yet few comparison studies exist to compare the efficacy of one modality over the other. Hence this randomized clinical study was undertaken as an attempt to compare the outcomes of pilonidal sinus following Limberg flap procedure and primary closure.Methods: 60 patients undergoing surgery for pilonidal sinus disease were considered for the study. 30 patients underwent excision and primary closure and 30 patients underwent Limberg flap repair. They were followed up for 1 year. Duration of hospital stay, duration of inability to work, postoperative infection, wound dehiscence, and postoperative recurrence in a follow up period were recorded. Descriptive statistics, chi- square tests and independent t-test are the statistical tools employed.Results: Mean age was 29.83±4.99 years. Male:female ratio was 5.66:1. The mean duration of hospitalization in group A was significantly less (p<0.05) than group B. The patients in group B returned early to routine work (21.56±3.92 days) as compared to 30.5±5.92 days in group A (p<0.05). 5 of 30 patients in group A and 2 of 30 in group B developed surgical site infection. (p>0.05. 4 patients developed wound dehiscence in group A only which was found to be statistically significant.Conclusions: Limberg flap in treatment of pilonidal sinus is associated with shorter hospitalization, early return to routine work and less wound dehiscence as compared with excision and primary closure. Wound infections are comparable with both the modalities.
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Ghaffar, Naeem, Muhammad Aslam Javed, Farooq Ahmad, Hina Khan, Muhammad Arshad, and Kamran Khalid Khawaja. "Limberg Flap Versus Primary Midline Wound Closure in Treatment of Chronic Pilonidal Sinus Disease." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 18, 2022): 219–20. http://dx.doi.org/10.53350/pjmhs22161219.
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Objective: Current study aims to compare the Limberg flap technique with primary midline wound closure to treat the chronic pilonidal sinus disease. Study design: A comparative study was done in Surgery Department Sir Ganga Ram Hospital Lahore from January 2020 to September 2021 Method: The sample size for the study is 60 patients who were regularly visiting the hospital due to PS disease. All the patients were divided into two groups A and B. Group A had 30 patients treated with the Limberg flap method and group B had 30 patients treated with primary midline wound closure. Before starting the treatment a brief description of the treatment was given to all patients and consent was signed from all participants. The final decision for treatment was decided by the team of senior surgeons as well as with help of the patient's own choice. Limberg flap and primary midline wound closure (PMC) were applied to patients who regularly followed the instruction for chronic pilonidal sinus treatment. Primary midline closure was applied on patients who had a cosmetic concern and did not have a recurrence problem. Results: Total 60 patients were divided into two groups, Group A (Limberg flap) had 30 patients in which 25 (83%) were males and 5 (16.6%) females. The mean age for this group was 25 ± 5.00 years. The patients without a previous history of pilonidal sinus disease (primary case) was 17 (56.6%) and the recurrence case was 13 (14.3%). Group B (primary midline wound closure) had 30 patients in which 18 (60%) were males and 12 (40%) females. The mean age for this group was 28 ± 3.00 years. The patient without a previous history of pilonidal sinus disease (primary case) was 28 (93.3%) and the recurrence case was 2 (6.6%). The comparison of 3rd-week outcomes shows that in group A 25 (83,3%) patients had painless walking, 23 (76.6%) patients start their routine work and 26 (86.6%) patients had treatment satisfaction. In group B 21 (70%) patients reported painless walking, 18 (60%) patients started their routine activity and 22 (73.3%) patients shows satisfaction with treatment. Conclusion: Hence we concluded that a better improvement percentage was measured high in group A (Limberg flap) than group B (PMC). Therefore limberg flap is better technique to treat the chronic pilonidal sinus disease. Keywords: chronic Pilonidal Sinus, primary midline wound closure (PMC), Limberg flap
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H. D., Hareesh, Thrishuli P. B., and Girish Kumar N. M. "Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome." International Surgery Journal 7, no. 2 (January 27, 2020): 471. http://dx.doi.org/10.18203/2349-2902.isj20200300.
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Background: Fasciotomy is a standard treatment for acute compartment syndrome. Historically, fasciotomy incisions were usually left open till oedema settles down. In literature, there is a wide range of wound closure techniques published, but none of them is deemed to be the best. In this study, focus is laid on whether delayed primary closure (DPC) by shoelace technique, is as effective as conventional secondary suturing, in closure of fasciotomy wounds, done for spreading cellulitis.Methods: All those patients who met below mentioned inclusion criteria and underwent fasciotomy, were allocated into 2 groups (A and B) where Group A consists of 30 patients undergoing conventional secondary suturing, whereas Group B consists of 30 patients undergoing DPC by shoelace technique for closure of fasciotomy wounds. Parameters such as duration of hospital stay, time taken for complete wound closure, local wound complications, hospital expenses, anaesthesia related complications between the two groups were compared.Results: Patients who underwent DPC for fasciotomy wound closure achieved wound closure ~7 days earlier with 5 days lesser hospital stay than that of those who underwent conventional secondary suturing. Average health care cost of Group B was significantly lower compared to Group A, but there was no statistically significant difference in incidence of wound infections between the two groups.Conclusions: DPC by shoelace technique, takes less time for wound closure and hence the need for nursing care and hospital stay is significantly reduced in comparison to the conventional secondary suturing method.
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Kuswiyanto, Rahmat Budi, Putria Apandi, Dany Hilmanto, Muhammad Hasan Bashari, and Sri Endah Rahayuningsih. "NT pro- B-type Natriuretic Peptide in the Small Ventricular Septal Defect in Children." Open Access Macedonian Journal of Medical Sciences 9, B (December 6, 2021): 1677–80. http://dx.doi.org/10.3889/oamjms.2021.7592.
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Background: Brain natriuretic peptide is a cardiac hormone secreted from the left ventricular myocardium due to ventricular expansion and volume overload. A recent study shows that small VSD will have risk of ventricular dysfunction in adulthood. Another complications such as endocarditis, congestive heart failure, aortic regurgitation, arrhythmia also we should be aware. Evaluations of the plasma B-type natriuretic peptide level (NT pro BNP) are currently being considered as methods to identify the possible presence of ventricular dilation in small VSD.
Objective: To evaluate the change in plasma B-type natriuretic peptide after transcatheter closure of VSD.
Methods: A pretest-posttest design was conducted on VSD patients before and after transcatheter closure. Plasma B-type natriuretic peptide level were measured before and 30 days after the transcatheter closure of VSD.
Result: A total of 32 peri membranous VSD patients were included in this study with 62.5 % female patients (n=20) and 37.5 % male patients (n=12). A significant decrease was observed in the median NT pro BNP level when the level before closure of 1.08 (0.74 – 3.47) ng/ml was compared to the level after closure of 0.91 (0.68 – 2.07) ng/ml (p<0.05).
Conclusion: Significant decreases in NT pro BNP level are seen in small VSD patients 30 days after transcatheter closure. Patients with small peri membranous VSD are generally considered to need occlusion for their childhood defect.
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Gifford, Mark. "Aristotle on Platonic Recollection and the Paradox of Knowing Universals: Prior Analytics B.21 67a8-30." Phronesis 44, no. 1 (1999): 1–29. http://dx.doi.org/10.1163/156852899762447610.
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AbstractThe paper provides close commentary on an important but generally neglected passage in Prior Analytics B.21 where, in the course of solving a logical puzzle concerning our knowledge of universal statements, Aristotle offers his only explicit treatment of the Platonic doctrine of Recollection. I show how Aristotle defends his solution to the "Paradox of Knowing Universals", as we might call it, and why he introduces Recollection into his discussion of the puzzle. The reading I develop undermines the traditional view of the passage and lends fresh insight into Aristotle's conception of Plato's particular version of innatism; more specifically, when understood as I recommend, the passage strongly suggests that, on Aristotle's view, Plato's theory of Recollection is specifically designed to explain our apprehension of universal truths. The reading I propose also enables us to see how the allegedly non-standard use of the technical term επαγωγη in B.21 can be understood in a perfectly straightforward fashion to refer to an inductive inference from singular statements to the universal truth they exemplify. Owing to this last point in particular, the paper carries serious consequences for our understanding of the purported doublet in the problematic opening chapter to the Posterior Analytics where Aristotle offers his only explicit attempt to solve Meno's Paradox.
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Chang, Qin, Xiao-Lin Wang, Jie Zhu, and Xiao-Nan Li. "Study of b⟶c Induced B¯∗⟶Vℓν¯ℓ Decays." Advances in High Energy Physics 2020 (April 29, 2020): 1–12. http://dx.doi.org/10.1155/2020/3079670.
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In this paper, we investigate the tree-dominated B¯u,d,s,c∗⟶Vℓ−ν¯ℓ (V=Du,d∗,Ds∗,J/ψ and ℓ=e,μ,τ) decays in the Standard Model with the relevant form factors obtained in the light-front quark model. These decays involve much more helicity states relative to the corresponding B¯∗⟶Pℓ−ν¯ℓ and B¯⟶Vℓ−ν¯ℓ decays, and moreover, the contribution of longitudinal polarization mode (V meson) is relatively small, ~30%, compared with the corresponding B meson decays. We have also computed the branching fraction, lepton spin asymmetry, forward-backward asymmetry, and ratio RV∗L≡BB¯∗⟶Vτ−ν¯τ/BB¯∗⟶Vℓ′−ν¯ℓ′ℓ′=e,μ. Numerically, the branching fractions of B¯∗⟶Vℓ′−ν¯ℓ′ decays are at the level of O10−7 and are hopeful to be observed by LHC and Belle-II experiments. The ratios RD∗,Ds∗,J/ψ∗L have relatively small theoretical uncertainties and are close to each other, RD∗∗L≃RDs∗∗L≃RJ/ψ∗L≃0.26,0.270.27,0.29, which are a bit different from the predictions in some previous works. The future measurements are expected to make tests on these predictions.
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Rahman, Md Magfur, Md Rezaul Alam, and A. K. Al-Miraj. "“Cardiac Remodeling after Surgical Patch Closure of Adult Congenital Atrial Septal Defects: Perspective of Bangladesh”." Global Academic Journal of Medical Sciences 4, no. 1 (January 16, 2022): 6–12. http://dx.doi.org/10.36348/gajms.2022.v04i01.002.
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Introduction: Atrial septal defect is one of the congenital heart diseases. An atrial septal defect (ASD) represents a communication between the left and right atrium leading to left to right shunt. It makes up about 10% of all congenital heart diseases after delivery and up to 30—40% of heart defects diagnosed in patients aged over 40 years. Objectives: To identify the status of cardiac remodeling after surgical patch closure of adult congenital atrial septal defects. Methodology: The descriptive and observation study was carried out atDepartment of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to April 2015. The patients both male and female undergoing surgical closure of atrial septal defect, Department of Cardiac Surgery, BSMMU, Dhaka, Bangladesh. Total sixty (60) patients were studied, thirty (30) in each group. Group A: Thirty (30) patients of surgical closure of ASD at or before age of 25 years. Group B: Thirty (30) patients of surgical closure of ASD at or after age of 25 years. A purposive sampling technique was used for sample selection. The sample size was determined by using the standard formula for comparison between two proportions. To make it more convenient and reduce the error sample size of this study was fixed at 60 (30 in each group). Careful history regarding the complaints of Exerttional dyspnoea, Palpitation, Fatigability, General weakness, Electrocardiography (ECG), Chest X ray, Echocardiography (Echo), Left atrial diameter (LA), -Left ventricular internal diameter at the end of diaslole (LVIDd), -Left ventricular internal diameter at the end of systole (LVIDs), Interventricular septal thickness (IVST), Posterior wall thickness (PWT), Fractional shortening (FS), Ejection fraction (EF) were measured. Results: From the result it was found that exertional dyspnoea in 60.0%, palpitation in 70.0%, fatigue in 66.6% and general weakness in 53.33% in group A and in group B exertional dyspnoea in 80.0%, palpitation in 73.33%, fatigability in 63.33% and general weakness in 80.0%. There was no significant difference in presenting complaints distribution in between two groups. From the ECG findings between two study groups it was found that arrhythmia in 13.33%, left axis deviation in 10.0%, right axis deviation 23.330% and in group B arrhythmia in 16.67%, left axis deviation in 13.33%, right axis deviation 36.67%. There were differences between two groups regarding ECG findings. In early age group there was few complains but complains are more in late age group. From the types of ASD between two study groups it was revealed that septum secundum defect is 66.67%, Septum primum 20 % and sinous venosus defect in 13.33 % in group A. In group B septum secundum defect is 76.67%, Septum primum 13.33 % and sinous venosus defect in 10 %. There was no significant difference in type of ASD in between two groups. Conclusion: This study concluded that cardiac remodeling occurs after surgical closure of atrial septal defect in all age group and degree of cardiac remodeling was better in early age group (up to 25 years) compared with late age group (>25 years).
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Yuan, Ming Wei, Yu Yue Qin, Ming Long Yuan, and Hong Li Li. "Modified Octyl-2-Cyanoacrylate Tissue Adhesive for the Closure of Long Surgical Incisions." Advanced Materials Research 750-752 (August 2013): 1597–600. http://dx.doi.org/10.4028/www.scientific.net/amr.750-752.1597.
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Long surgical incisions required application of more flexible cyanoacrylate adhesive to relieve skin tension. A new formulation of octyl-2-cyanoacrylate (OCA) was modified by 0%, 3%, 6% and 9% (w/v) polytrimethylene carbonate (PTMC). The OCA/PTMC adhesives showed higher viscosity and bond strength than OCA monomer. The OCA/6% PTMC adhesive plus subcutaneous suture was used as group A (Treatment group), and the OCA/6% PTMC tissue adhesive alone was used as group B (Control group). 30 days later, there was no apparent scar formation in group A. A linear scar formation still could be seen in group B. The results supported the use of OCA/6% PTMC adhesive alone or adhesive plus subcutaneous suture in long surgical incisions, and the latter maintained better scar formation.
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Moon, Jerald B., David P. Kuehn, and Jessica J. Huisman. "Measurement of Velopharyngeal Closure Force during Vowel Production." Cleft Palate-Craniofacial Journal 31, no. 5 (September 1994): 356–63. http://dx.doi.org/10.1597/1545-1569_1994_031_0356_movcfd_2.3.co_2.
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The purposes of this study were to (a) design and test a new velopharyngeal closure force sensing bulb, and (b) use the closure force bulb to gather additional information on the variations in closure force associated with different vowels. The closure force sensing bulb possessed a flat frequency response to 30 Hz. Its output was highly linear relative to applied gram force. Reliable placement of the bulb in human subjects was achieved following prescribed placement criteria. The bulb was sensitive to small variations in velopharyngeal closure force. In agreement with some previous reports, high vowels were associated with greater velopharyngeal closure forces than low vowels. The results of this Investigation support the notion that articulatory goals are specified for vowels. This vowel specificity was observed during production in both isolation and in context.
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Wolfenstine, J., G. González-Doncel, and O. D. Sherby. "Elevated temperature properties of Mg–14Li–B particulate composites." Journal of Materials Research 5, no. 7 (July 1990): 1359–62. http://dx.doi.org/10.1557/jmr.1990.1359.
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The creep behavior of Mg–14Li particulate composites containing 0,10,20, and 30 vol. % boron particles was evaluated from 230 to 280°C. The results reveal that the creep strength of the particulate composite is increased by a factor of eight over the Mg–14Li matrix with the addition of 30 vol. % boron. The body-centered cubic (bcc) Mg–14Li alloy is shown, however, to be much weaker than hexagonal close-packed (hep) pure magnesium. This difference is attributed to the high rate of atom mobility in the open structure of the Mg–14Li bcc alloy. It is predicted that a Mg–6Li–30B particulate composite, containing an hep matrix structure, will have a higher specific strength at 250°C than the new experimental aluminum base–high iron alloys prepared by rapid solidification processing.
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Abdelraheem, Omar, and Magdy Khalil. "Comparative study between excision with primary closure versus Limberg flap for treatment of primary sacrococcygeal pilonidal sinus." International Surgery Journal 4, no. 11 (October 27, 2017): 3581. http://dx.doi.org/10.18203/2349-2902.isj20174873.
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Background: Surgical treatment of sacrococcygeal pilonidal sinus is associated with significant recurrence rate. However; recent study suggested the use of rhomboid excision and Limberg flap repair as feasible procedure for treatment of pilonidal sinus disease. Our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with Limberg flap by comparing this procedure with the traditional excision and primary closure.Methods: This prospective study included 60 patients with sacrococcygeal pilonidal sinus. The patients were randomly divided into 2 equal groups. Rhomboid excision of the sinus with limberg flap was performed in 30 patients (group A), and excision of the sinus with primary closure was done to the other 30 cases (group B). Demographic data and surgical outcome were compared between both groups.Results: Group A showed significant early retained to work and significant less postoperative pain than group B (P=0.04 and P=0.02 respectively). Incidence of wound dehiscence, postoperative hematoma and seroma was less among group A but without significant difference. The incidence of postoperative infection and recurrence rate was significantly less in group A than group B (P=0.04 and P= 0.035 respectively).Conclusions: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple excision with primary closure in treatment of sacrococcygeal disease. In addition, it is safe and easily procedure; it may be an ideal treatment option in management of pilonidal sinus.
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C., Balaji, Sushanto Neogi, Sadasivam Ramasamy, and Manu Vats. "Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study." International Surgery Journal 6, no. 9 (August 28, 2019): 3233. http://dx.doi.org/10.18203/2349-2902.isj20194057.
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Background: A major surgical complication after emergency midline laparotomy is abdominal fascial dehiscence. Dehiscence is associated with increased morbidity and mortality rates up to 30%, prolonged hospital stay, and a long-term risk of developing incisional hernia. The risk factors of Wound dehiscence can surgeon factors or patient factors. This study was aimed at comparing effectiveness of interrupted-X technique versus conventional continuous closure of rectus sheath in midline laparotomy in emergency setting.Methods: This study was conducted in a total of 100 patients underwent midline laparotomy for perforation peritonitis in emergency setting. Out of which 50 patients underwent rectus sheath closure by interrupted-X technique (group A) and 50 patients by conventional continuous closure (group B) using non-absorbable, monofilament, no.1 polypropylene suture. Necessary preoperative patient data, wound length, the time taken for rectus closure, length of the suture material used, post-operative complications like wound dehiscence, surgical site infection, period of hospital stay were recorded for analysis.Results: Preoperative patient data among both the groups were comparable. Group A was found to have less wound dehiscence (p=0.001 for partial and p=0.008 for complete) and less period of hospital stay (p=0.054), which were statistically significant. Surgical site infections were similar in both groups. Group B was found to have less time taken for closure (p=0.003) and less length of suture material used (p=0.003), which were statistically significant.Conclusions: Interrupted-X technique of rectus sheath closure reduces the rate of wound dehiscence and period of hospital stay, although it consumes more length of suture material and more time for suturing as compared to conventional continuous closure.
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Bongale, Kiran Ravindranath, Vikram Kemmannu Bhat, and Mona Yadav. "The Effect of Epidermal Growth Factor on the Outcomes of Myringoplasty." Annals of Otology and Neurotology 3, no. 01 (March 2020): 23–26. http://dx.doi.org/10.1055/s-0040-1715290.
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Abstract Introduction Chronic otitis media is a widespread disease of developing countries. The burden of the disease continues to be high and so is the demand for surgical myringoplasty. This pilot study aimed to compare in adults the outcomes of myringoplasty with and without the application of epidermal growth factor gel (EGF) with respect to the time taken for graft uptake, improvement of hearing, and complications. Materials and Methods This randomized controlled study was undertaken in a tertiary referral public hospital in a span of 2 years with a sample size of 60 patients. All of them underwent diagnostic nasal endoscopy, otoendoscopy, and pure tone audiometry and treated with conventional underlay myringoplasty using temporalis fascia (Group A—30 cases with EGF, Group B—30 controls without EGF). Patients were followed-up at 15, 30, 90 days postoperatively. Results The average time taken for closure of tympanic perforation and graft uptake by group A was lesser than group B. This difference was found to be statistically significant. Residual perforation at 1 month was commoner in group B as compared with group A. The final improvement of the hearing was the same in both the groups in the healed cases. Conclusion The EGF can be used to improve the outcomes of myringoplasty. It can hasten the closure of tympanic membrane perforation and increase the success rates of the surgery.
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V., Shashikala, Abhilash S. B., Abhishek G., and Prajwal S. Fernandes. "A comparative study between continuous and x-interrupted sutures in emergency midline laparotomies." International Surgery Journal 5, no. 5 (April 21, 2018): 1753. http://dx.doi.org/10.18203/2349-2902.isj20181437.
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Background: Midline laparotomy is the most common technique of abdominal incisions in both emergency and elective settings. Wound dehiscence is related to several factors pertaining to patient besides suture material and method of closure. This study tries to compare continuous sutures with x-interrupted sutures in mass closure of midline laparotomy wound in patients undergoing emergency midline laparotomy for acute peritonitis.Methods: A total of 60 patients undergoing emergency midline laparotomy for secondary peritonitis were considered for the study, 30 of whom underwent closure of abdominal wall with continuous sutures (Group A) and the other 30 with x-interrupted sutures (Group B) using non-absorbable, monofilament, polypropylene suture. Necessary preoperative data, the time required for rectus closure, length of the suture material required, post-operative complications like surgical site infection, wound dehiscence were analyzed.Results: The groups were comparable in means of age and sex distribution. Group A was found to have lesser time for closure of rectus, lesser suture length and lesser suture to wound length ratio when compared with Group B. Surgical site infections were similar in both groups. Patients with rectus sheath sutured in x-interrupted sutures (n=2) had significantly less wound dehiscence as compared with continuous sutures (n=8) (p<0.05).Conclusions: Interrupted -X suture method of suturing reduces post-operative wound dehiscence, although requires more suture and consumes more time than the continuous method of suturing.
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Shezad, Arsalan, Tanzeel Gazder, Syed Rabiullah, Mazahir Zulfiqar, Usman Qamar, Haris Jameel, Saeed Abidi, and Manzoor Hussain. "Comparison of Closure versus Non-closure of Buccal Mucosal Graft Harvesting Site in Urethroplasty." International Journal of Endorsing Health Science Research (IJEHSR) 11, no. 2 (June 1, 2023): 97–103. http://dx.doi.org/10.29052/ijehsr.v11.i2.2023.97-103.
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Background: Buccal mucosal graft is commonly used in substitution urethroplasty for the treatment of anterior urethral strictures. However, the optimal management of the donor site remains a topic of debate. This prospective study aimed to compare the outcomes and morbidity associated with closure versus non-closure of the buccal mucosal graft harvesting site in urethroplasty.
Methodology: A total of 60 patients with anterior urethral strictures underwent buccal mucosal urethroplasty. The patients were divided into two groups: group A (non-closure, n=30) and group B (closure, n=30). Post-operative pain, perioral numbness, early return to diet, and swelling of the cheek were assessed and compared between the two groups. Pain was measured using the Visual Analog Scale (VAS), and statistical analysis was performed using appropriate tests.
Results: The mean age of the patients was 35.73 ± 13.42 years, and the mean length of the stricture was 58.45 ± 26.87 mm. Post-operative pain scores measured through VAS were comparable between the closure and non-closure groups at different time points. Perioral numbness was observed in 43.33% of the non-closure group and 30.0% of the closure group (p=0.284). Early return to diet was reported in 40.0% of the non-closure group and 70.0% of the closure group (p=0.019). Swelling of the cheek was noted in 53.33% of the non-closure group and 33.33% of the closure group (p=0.118).
Conclusion: This study suggests that non-closure of the buccal mucosal graft harvesting site in urethroplasty results in less post-operative pain, early return to diet, and lower perioral numbness. However, it is associated with increased swelling of the cheek. These findings support the use of non-closure as a viable alternative to closure of the buccal mucosal graft harvesting site. Further research with larger sample sizes and longer-term follow-up is warranted to validate these findings and assess additional outcomes such as stricture recurrence and cosmetic outcomes.
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Das, Anupam, and Ajay Kumar Singh. "Primary abdomen closure (using sheath relaxation) versus staged closure (using modified Bogota) following laparotomy in secondary peritonitis: a comparative study." International Surgery Journal 8, no. 1 (December 28, 2020): 278. http://dx.doi.org/10.18203/2349-2902.isj20205893.
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Background: Primary closure or open laparostomy after laparotomy for peritonitis have their own morbidities. In this study, rectus sheath relaxation was used as an alternative to conventional primary closure and compared to the modified Bogota technique in patients of peritonitis.Methods: We included 60 patients of peritonitis with two of the following criteria: APACHE II score 10-20, Mannheim peritonitis index (MPI) 20-30 or post-resuscitation intraabdominal pressure (IAP) >15 mmHg and randomized them to group A (Sheath relaxation technique) and group B (modified Bogota). Outcome criteria studied included procedure failure, complications, pain, mortality and duration of ICU and hospital stay.Results: Both groups were comparable in terms of age, gender, inclusion criteria, ICU stay and mortality. The success rate in group A was 63.33% while in group B, was 53.33% with complication rates of 37% and 46.67% respectively. The pain and duration of hospital stay were significantly less in group A.Conclusions: We concluded that primary abdomen closure using rectus sheath relaxation in select patients was an easy, feasible and better alternative than the staged closure using modified Bogota technique following laparotomy in patients of severe secondary peritonitis. Patients with higher APACHE II and MPI scores may be better managed primarily by modified Bogota technique, while those with lower APACHE II and MPI do well with primary closure with sheath relaxation. The pre- operative APACHE II, MPI and post resuscitation IAP either individually or in combination, could, therefore, predict the wound failure rates, choice of closure techniques.
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Ataide, Wander Luiz Silva, Francisco Assis Oliveira, and Carlos Alberto Dias Pinto. "Balanço de radiação, energia e fechamento do balanço em uma floresta prístina na Amazônia oriental." Revista Brasileira de Geografia Física 13, no. 6 (November 20, 2020): 2603. http://dx.doi.org/10.26848/rbgf.v13.6.p2603-2627.
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A Floresta Nacional de Caxiuanã, localizada no Estado do Pará, ocupa uma área de 324.060 ha, próxima da baía de Caxiuanã, entre os rios Xingu e Amazonas e compreende aproximadamente 70% do município de Portel e 30% do município de Melgaço. O fluxo de energia foi obtido pelo sistema “Eddy Covariance” localizado a 54 metros de altura. Nota-se uma redução de 10,93% comparando os anos de 2015 (2108,1 mm) e 2016 (2367,8 mm), tendo em vista que a redução da precipitação em determinados sítios é uma consequência das mudanças no balanço de energia e água. O albedo médio do dossel na Flona Caxiuanã foi de 8,5% para ambos os anos avaliados. O fechamento do balanço de energia durante o ano de 2015 e 2016 foi da ordem de 74,83% e 69%, valor este abaixo do que é considerado satisfatório (entre 80 e 90%) como encontrado na literatura. A inclusão do termo (S) na equação melhora substancialmente o fechamento do balanço, principalmente para áreas de florestas primárias devido a quantidade de biomassa. Visando a melhora do fechamento, o fluxo de calor latente foi descartado e então estimado como o resíduo da equação Rn – H – G – S, obtendo um fechamento da ordem de 92,05 e 97,26% para 2015 e 2016.Palavras chave: Eddy covariância, balanço de energia, Caxiuanã, fluxo. Balance of radiation, energy and balance closure in a pristine forest in the eastern Amazon A B S T R A C TThe Caxiuanã National Forest, located in the State of Pará, occupies an area of 324,060 ha, close to Caxiuanã Bay, between the Xingu and Amazonas rivers and comprises approximately 70% of the municipality of Portel and 30% of the municipality of Melgaço. The energy flow was obtained by the “Eddy Covariance” system located 54 meters high. A reduction of 10.93% can be seen comparing the years 2015 (2108.1 mm) and 2016 (2367.8 mm), considering that the reduction of precipitation in certain sites is a consequence of changes in the energy balance and water. The average canopy albedo in Flona Caxiuanã was 8.5% for both years evaluated. The closing of the energy balance during the years 2015 and 2016 was of the order of 74.83% and 69%, a value below what is considered satisfactory (between 80 and 90%) as found in the literature. The inclusion of the term (S) in the equation substantially improves the balance sheet closing, mainly for primary forest areas due to the amount of biomass. In order to improve the closure, the latent heat flow was discarded and then estimated as the residue of the Rn - H - G - S equation, obtaining a closure of the order of 92.05 and 97.26% for 2015 and 2016.Key words: Eddy covariance, energy balance, Caxiuanã, flow.
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Manoharan, G. V., T. Sivakumar, and M. Ashok Kumar. "Evaluation of the use of subcutaneous drains to prevent wound complications in abdominal surgeries." International Surgery Journal 5, no. 4 (March 23, 2018): 1368. http://dx.doi.org/10.18203/2349-2902.isj20181112.
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Background: Wound complications like surgical site infections (SSI) and wound dehiscence are common following abdominal surgery for peritonitis. Drains have been used to remove collections from the early days of surgery. The use of drains to remove subcutaneous collections to prevent wound complications needs to be studied.Methods: Sixty patients who underwent surgery for peritonitis were selected for the study. 30 patients underwent conventional abdominal wall closure while the other 30 had suction drains inserted in the subcutaneous tissue. Wounds were observed for complications and time for healing.Results: The incidence of SSI was significantly less in Group A (23%) than in Group B (60%). Similarly, wound dehiscence occurred in 43% of SSI cases in Group A as against 89% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (9 days).Conclusions: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay.
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Koustov, A. V., K. Hosokawa, N. Nishitani, K. Shiokawa, and H. Liu. "Signatures of moving polar cap arcs in the F-region PolarDARN echoes." Annales Geophysicae 30, no. 3 (March 1, 2012): 441–55. http://dx.doi.org/10.5194/angeo-30-441-2012.
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Abstract. Joint observations of the all-sky camera at Resolute Bay (Nunavut, Canada) and the Polar Dual Auroral Radar Network (PolarDARN) HF radars at Rankin Inlet and Inuvik (Canada) are considered to establish radar signatures of poleward moving polar cap arcs "detaching" from the auroral oval. Common features of the events considered are enhanced power or echo occurrence in the wake of the arcs and enhanced spectral width of these echoes. When the arcs were oriented along some of the radar beams, velocity reversals at the arc location were observed with the directions of the arc-associated flows corresponding to a converging electric field. For the event of 9 December 2007, two arcs were poleward progressing almost along the central beams of the Inuvik radar at the speed close to the E × B drift of the bulk of the F-region plasma as inferred from HF Doppler velocities and from independent measurements by the Resolute Bay ionosonde. In global-scale convection maps inferred from all Super Dual Auroral Radar Network (SuperDARN) radar measurements, the polar cap arcs were often seen close to the reversal line of additional mesoscale convection cells located poleward of the normal cells related to the auroral oval.
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Dua, Atul, Nawaz Shariff A., and K. Krishna Prasad. "Comparison of tissue adhesive (N-butyl-2-cyanoacrylate) versus conventional suturing in umbilical hernia surgeries." International Surgery Journal 8, no. 4 (March 26, 2021): 1165. http://dx.doi.org/10.18203/2349-2902.isj20211291.
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Background: Umbilical hernia is a common problem encountered mostly in women. Conventional suturing is used as a traditional method for closure of skin in umbilical hernia surgeries. N-butyl-2-cyanoacrylate glue can be used as an alternative where tissue loss is minimal, minimal scarring, no significant bacterial infection and less postoperative pain. The aim of this study was to determine the effectiveness of tissue adhesive in the closure of umbilical skin incisions compared to conventional sutures.Methods: A prospective study was conducted including 30 patients with umbilical hernia. Patients were allocated into two groups using odd and even method: group A and B. Patients of group A underwent skin closure with topical tissue adhesive and that of group B underwent skin closure with conventional sutures. Skin closure time, postoperative pain, scar assessment using Vancouver scar scale and surgical site infection were recorded. IBS-statistical package for the social sciences (SPSS) 22 version was used to analyse the data.Results: 57% females and 43% males were included in the study. The age of the patients ranged between 18 and 60 years in both the groups. All patients had chief complaint of swelling in the umbilical area. Group A (tissue adhesive) patients had lesser skin closure time and cosmetically better scar than group B (conventional suturing) patients. Surgical site infection was seen in 2 patients in group B and 1 patient in group A.Conclusions: Tissue adhesive is superior as compared to conventional suture in terms of skin closure time, cosmesis, postoperative pain and postoperative surgical complications.
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Sengar, Hari Om Singh, Kailash Charokar, and Prashant Nema. "Closure Methods for Midline Laparotomy Incisions Following Abdominal Surgery - A Comparative Study from Central India." Journal of Evidence Based Medicine and Healthcare 8, no. 24 (June 14, 2021): 2089–93. http://dx.doi.org/10.18410/jebmh/2021/391.
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BACKGROUND The method adopted for incision closure has an influence on the outcomes of wound healing. The study was conducted to compare the ‘mass closure’ method with the conventional layer closure, and to find out the suitable surgical closure method for midline laparotomy incision. METHODS A prospective comparative study was conducted at a tertiary care teaching institute over a period of 2 years. Patients > 14 years of age, who were operated on by midline laparotomy incision, were included in the study group (N = 60). Either a ‘mass closure’ or the conventional layer closure method was adopted as per the operating surgeon’s choice. Based on the method used the cases were allocated into two groups, each with 30 patients. In the ‘mass closure’ group (Group A), continuous suturing was used in 22 patients and interrupted closure in 8 patients. In the ‘layered closure’ group (Group B), the abdomen was closed in layers using absorbable suture for the peritoneum (together with transversalis fascia) and non-absorbable for the linea alba. The patients were followed up postoperatively, and for 6 months after discharge from the hospital in follow-up for the detection of the wound complications. RESULTS The mean age of patients in Group A was 40.9 ± 15.48 years, and 41.03 ± 14.73 in Group B. There were 25 males and 5 females in Group A and 23 males and 7 females in Group B. Closure time of incision was significantly lower in the mass closure group (P < 0.05). The postoperative complications in Group A was 20 % (Seroma-1 patient, infection-3, partial wound dehiscence-1, and hernia-1). In Group B, the overall complication rate was 36 % (Seroma-3 patients, infection-5, burst abdomen- 1, hernia- 2). CONCLUSIONS Mass closure method is better than the conventional layer closure for the midline laparotomy incision. KEYWORDS Laparotomy, Layered Closure, Midline Incision, Mass Closure, Suture Technique
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McWilliam Leitch, E. C., M. Cabrerizo, J. Cardosa, H. Harvala, O. E. Ivanova, A. C. M. Kroes, A. Lukashev, et al. "Evolutionary Dynamics and Temporal/Geographical Correlates of Recombination in the Human Enterovirus Echovirus Types 9, 11, and 30." Journal of Virology 84, no. 18 (July 7, 2010): 9292–300. http://dx.doi.org/10.1128/jvi.00783-10.
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ABSTRACT The relationship between virus evolution and recombination in species B human enteroviruses was investigated through large-scale genetic analysis of echovirus type 9 (E9) and E11 isolates (n = 85 and 116) from 16 European, African, and Asian countries between 1995 and 2008. Cluster 1 E9 isolates and genotype D5 and A E11 isolates showed evidence of frequent recombination between the VP1 and 3Dpol regions, the latter falling into 23 (E9) and 43 (E11) clades interspersed phylogenetically with 46 3Dpol clades of E30 and with those of other species B serotypes. Remarkably, only 2 of the 112 3Dpol clades were shared by more than one serotype (E11 and E30), demonstrating an extremely large and genetically heterogeneous recombination pool of species B nonstructural-region variants. The likelihood of recombination increased with geographical separation and time, and both were correlated with VP1 divergence, whose substitution rates allowed recombination half-lives of 1.3, 9.8, and 3.1 years, respectively, for E9, E11, and E30 to be calculated. These marked differences in recombination dynamics matched epidemiological patterns of periodic epidemic cycles of 2 to 3 (E9) and 5 to 6 (E30) years and the longer-term endemic pattern of E11 infections. Phylotemporal analysis using a Bayesian Markov chain Monte Carlo method, which placed recombination events within the evolutionary reconstruction of VP1, showed a close relationship with VP1 lineage expansion, with defined recombination events that correlated with their epidemiological periodicity. Whether recombination events contribute directly to changes in transmissibility that drive epidemic behavior or occur stochastically during periodic population bottlenecks is an unresolved issue vital to future understanding of enterovirus molecular epidemiology and pathogenesis.
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Mitchell, J. J., S. J. Schwartz, and U. Auster. "Electron cross talk and asymmetric electron distributions near the Earth's bowshock." Annales Geophysicae 30, no. 3 (March 6, 2012): 503–13. http://dx.doi.org/10.5194/angeo-30-503-2012.
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Abstract. Electron distributions in the magnetosheath display a number of far from equilibrium features. It has been suggested that one factor influencing these distributions may be the large distances separating locations at which electrons with different energies and pitch angles must cross the bowshock in order to reach a given point in the magnetosheath. The overall heating requirements at these distant locations depends strongly on the shock geometry. In the absence of collisions or other isotropization processes this suggests that the convolution of electrons arriving from different locations should give rise to asymmetries in the distribution functions. Moreover, such cross-talk could influence the relative electron to ion heating, rendering the shock heating problem intrinsically non-local in contrast to classic shock physics. Here, we study electron distributions measured simultaneously by the Plasma Electron and Current Experiment (PEACE) on board the Cluster spacecraft and the Electrostatic Analyser (ESA) on board THEMIS b during a time interval in which both the Cluster spacecraft and THEMIS b are in the magnetosheath, close to the bowshock, and during which the local magnetic field orientation makes it likely that electron trajectories may connect both spacecraft. We find that the relevant portions of the velocity distributions of such electrons measured by each spacecraft display remarkable similarities. We map trajectories of electrons arriving at each spacecraft back to the locations at which they crossed the bowshock, as a function of pitch angle and energy. We then use the Rankine-Hugoniot relations to estimate the heating of electrons and compare this with temperature asymmetries actually observed. We conclude that the electron distributions and temperatures in the magnetosheath depend heavily on non-local shock properties.
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van Willigen, G., and J. W. N. Akkerman. "Protein kinase C and cyclic AMP regulate reversible exposure of binding sites for fibrinogen on the glycoprotein IIB-IIIA complex of human platelets." Biochemical Journal 273, no. 1 (January 1, 1991): 115–20. http://dx.doi.org/10.1042/bj2730115.
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Platelet aggregation is mediated via binding of fibrinogen to sites on the membrane glycoprotein IIB-IIIA complex which become exposed when the cells are stimulated. We report here evidence of a dynamic and reversible exposure of binding sites for fibrinogen. In the absence of fibrinogen, exposed sites (B*) gradually lose their capacity to bind fibrinogen and close (Bo). On stimulation with platelet-activating factor (PAF, 500 nM) at 22 degrees C, closing of B* is enhanced by agents that raise cyclic AMP levels (10 ng of prostaglandin I2/ml; 5 mM-theophylline), inhibit protein kinase C (PKC; 25 microM-sphingosine; 1 microM-staurosporine), or disrupt the energy supply (30 mM-2-deoxy-D-glucose + 1 mM-CN-), or by raising the temperature to 37 degrees C. Conversely, activation of PKC 1 microM-1,2-dioctanoyl-sn-glycerol; 55 nM-phorbol 12-myristate 13-acetate) and an increase in intracellular [Ca2+] (100 nM-ionomycin + extracellular Ca2+) oppose the disappearance of B*. Phosphorylation of the 47 kDa protein illustrates the tight coupling between PKC and B* under all conditions tested, except when the cyclic AMP level is raised, and B* is converted to Bo without affecting PKC activity. Although the increase in PKC activity is much smaller with ADP or even absent upon stimulation with adrenaline, the control of B* is equally sensitive to modulation of cyclic AMP and PKC activity. We conclude that PAF, ADP and adrenaline regulate exposure of fibrinogen binding sites through a common mechanism consisting of two independent pathways, one dominated by PKC and the other by an as yet unidentified cyclic AMP-sensitive step.
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Weaver, Kristin J., Michael M. McDowell, Michael D. White, Zachary J. Tempel, Nathan T. Zwagerman, Christopher P. Deibert, Christopher M. Bonfield, Stephen Johnson, and Stephanie Greene. "Comparison of Follow-Up Length-Matched Single-Center Myelomeningocele Postnatal Closure Cohort to the Management of Myelomeningocele Study (MOMS) Trial Results." Pediatric Neurosurgery 56, no. 3 (2021): 229–38. http://dx.doi.org/10.1159/000515038.
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<b><i>Objective:</i></b> We sought to compare our large single-institution cohort of postnatal myelomeningocele closure to the 2 arms of the Management of Myelomeningocele Study (MOMS) trial at the designated trial time points, as well as assess outcomes at long-term follow-up among our postnatal cohort. <b><i>Methods:</i></b> A single-institutional retrospective review of myelomeningocele cases presenting from 1995 to 2015 at Children’s Hospital of Pittsburgh was performed. We compared outcomes at 12 and 30 months to both arms of the MOMS trial and compared our cohort’s outcomes at those designated time points to our long-term outcomes. Univariate statistical analysis was performed as appropriate. <b><i>Results:</i></b> One-hundred sixty-three patients were included in this study. All patients had at least 2-year follow-up, with a mean follow-up of 10 years (range 2–20 years). There was no difference in the overall distribution of anatomic level of defect. Compared to our cohort, the prenatal cohort had a higher rate of tethering at 12 months of age, 8 versus 1.8%. Conversely, the Chiari II decompression rate was higher in our cohort (10.4 vs. 1.0%). At 30 months, the prenatal cohort had a higher rate of independent ambulation, but our cohort demonstrated the highest rate of ambulation with or without assistive devices among the 3 groups. When comparing our cohort at these early time points to our long-term follow-up data, our cohort’s ambulatory function decreased from 84 to 66%, and the rate of detethering surgery increased almost 10-fold. <b><i>Conclusions:</i></b> This study demonstrated that overall ambulation and anatomic-functional level were significantly better among our large postnatal cohort, as well as having significantly fewer complications to both fetus and mother, when compared to the postnatal cohort of the MOMS trial. Our finding that ambulatory ability declined significantly with age in this patient population is worrisome for the long-term outcomes of the MOMS cohorts, especially given the high rates of cord tethering at early ages within the prenatal cohort. These findings suggest that the perceived benefits of prenatal closure over postnatal closure may not be as substantial as presented in the original trial, with the durability of results still remaining a concern.
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Masuya, Hayato, Natsumi Kanzaki, and Noritoshi Maehara. "Bursaphelenchus clavicauda n. sp. (Nematoda: Parasitaphelenchidae) isolated from Cryphalus sp. emerged from a dead Castanopsis cuspidata (Thunb.) Schottky var. sieboldii (Makino) Nakai in Ishigaki Island, Okinawa, Japan." Nematology 9, no. 6 (2007): 759–69. http://dx.doi.org/10.1163/156854107782331216.
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AbstractBursaphelenchus clavicauda n. sp. is described and figured. The new species was isolated from Cryphalus sp., a species of bark beetle emerging from a dead log of Castanopsis cuspidata, and reared on Botrytis cinerea. Type specimens were collected from a 2- and 4-week-old culture on Botrytis cinerea. The new species has a body length of ca 665 μm (male) and 770 μm (female), medium (ca 30-50 for males and ca 30-45 for females) a values, b values of ca 9-13 (male) and 10-13 (female), c values of ca 20-28 (male) and 20-27 (female), c′ values of ca 2 (male) and ca 3-5 (female), ca 9-13 μm long stylet, three lines in the lateral field, relatively small (ca 14 μm) and strongly arcuate spicule with recurved and pointed condylus, seven (1 + 2 + 2 + 2) male caudal papillae and club-like female tail with rounded terminus and with or without various shapes of mucro. The new species is close to B. eremus, B. uncispicularis, B. yongensis and several other species possessing a large, recurved and pointed spicular condylus and is distinguished from these species mainly by male spicule, male caudal papillae and female tail morphologies, number of lateral lines and several morphometric values of females and males. Cultured nematodes were used for sequencing the partial (ca 1.6 kbps) small subunit, ITS regions and large subunit of ribosomal DNA for comparisons with those deposited at GenBank. The DNA sequences of the B. clavicauda n. sp. were close to those of B. eggersi, B. eremus, B. tusciae and B. yongensis.
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Pattanshetti, Swapnil Annasaheb, Abhijit S. Gogate, Vidya M. Mahalmani, and Kannikanti Nageswara Rao. "Octyl 2-cyanoacrylate versus conventional suturing of port site skin closure in laparoscopic appendicectomy: a prospective study." International Surgery Journal 8, no. 4 (March 26, 2021): 1094. http://dx.doi.org/10.18203/2349-2902.isj20210972.
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Background: With rapidly developing minimally invasive surgery, the laparoscopic appendectomy has become a preferred method for appendicectomy. Tissue adhesives have become an ideal alternative to conventional sutures and could possibly become the preferred standard of care in many procedures. However, this concept remains unexplored due to scanty data comparing the use of adhesive glues and sutures. The present prospective study was done to compare octyl-2-cyanoacrylate with conventional suturing of port site wound closure in laparoscopic appendicectomy in terms of wound complications, time taken for wound closure and cosmetic outcome.Methods: 60 patients diagnosed to have appendicitis (acute, chronic and recurrent) undergoing laparoscopic appendicectomy were divided into two groups (group A-octyl-2-cyanoacrylate) and (group B- conventional sutures) with 30 in each group. Time taken for wound closure, Wound complications and cosmetic outcome were compared in both groups.Results: Patient demographics were comparable in both the groups. The complications were significantly lower in group A compared to group B. Mean surgical time for wound closure in group A was less compared to group B (p<0.001). Wound closure using octyl-2-cyanoacrylate had lower rate of complications compared to conventional suturing but results obtained were not statistically significant. No significant difference in cosmetic outcome was noted in both groups.Conclusions: Wound closure using octyl-2-cyanoacrylate required significantly less time for skin closure compared to conventional suturing in patients undergoing laparoscopic appendicectomy. However, wound complications and cosmetic outcome using octyl-2-cyanoacrylate did not show statistically significant results compared to conventional suture.
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Harries, Rhiannon L., Julie Cornish, David Bosanquet, Buddug Rees, James Horwood, Saiful Islam, Nadim Bashir, Alan Watkins, Ian T. Russell, and Jared Torkington. "Hughes Abdominal Repair Trial (HART)—abdominal wall closure techniques to reduce the incidence of incisional hernias: feasibility trial for a multicentre, pragmatic, randomised controlled trial." BMJ Open 7, no. 12 (December 2017): e017235. http://dx.doi.org/10.1136/bmjopen-2017-017235.
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ObjectivesIncisional hernias are common complications of midline abdominal closure. The ‘Hughes Repair’ combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. There is evidence to suggest this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared Hughes repair with standard mass closure for the prevention of incisional hernia formation. This paper aims to test the feasibility of running a randomised controlled trial of a comparison of abdominal wall closure methods following midline incisional surgery for colorectal cancer, in preparation to a definitive randomised controlled trial.Design and settingA feasibility trial (with 1:1 randomisation) conducted perioperatively during colorectal cancer surgery.ParticipantsPatients undergoing midline incisional surgery for resection of colorectal cancer.InterventionsComparison of two suture techniques (Hughes repair or standard mass closure) for the closure of the midline abdominal wound following surgery for colorectal cancer.Primary and secondary outcomesA 30-patient feasibility trial assessed recruitment, randomisation, deliverability and early safety of the surgical techniques used.ResultsA total of 30 patients were randomised from 43 patients recruited and consented, over a 5-month period. 14 and 16 patients were randomised to arms A and B, respectively. There was one superficial surgical site infection (SSI) and two organ space SSIs reported in arm A, and two superficial SSIs and one complete wound dehiscence in arm B. There were no suspected unexpected serious adverse reactions reported in either arm. Independent data monitoring committee found no early safety concerns.ConclusionsThe feasibility trial found no early safety concerns and demonstrated that the trial was acceptable to patients. Progression to the pilot and main phases of the trial has now commenced following approval by the independent data monitoring committee.Trial registration numberISRCTN 25616490.
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Fiorillo, A., H. G. Del Vecchio, C. De Rosa, C. Malangone, V. Del Vecchio, D. Giacco, M. Luciano, and M. Maj. "Family burden in major depression: a multicentric survey in 30 italian mental health centres." European Psychiatry 26, S2 (March 2011): 625. http://dx.doi.org/10.1016/s0924-9338(11)72331-8.
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IntroductionFamily burden, defined as the consequences for those in close contact with a severely disturbed psychiatric patient, is now well-documented in schizophrenia research, whereas very few data are available in affective disorders.AimsTo explore:1)the levels of family burden in a sample of key-relatives of patients with major depression;2)the professional and social support for relatives of patients with major depression disorder.Methods324 patients with major depression and their key-relatives were randomly recruited in 30 Italian mental health centres, randomly selected and stratified by geographical area and population density. Family burden was explored in relation to:a)patient's clinical status and disability;b)relatives’ social and professional support.ResultsReduction of leisure (53% of the sample) and social activities (44%) were the most frequently reported sources of practical burden, whereas psychological burden was mainly due to sense of loss (75%) and worries for the future (61%). Family burden is higher in key-relatives with a lower education level (p < .05), and when patients’ symptomatology and social functioning are more severe. Key-relatives who can rely on a stronger support from social network and from mental health professionals have lower levels of family burden (p < .05).ConclusionThese results highlight the need to provide supportive interventions for patients with major depression and their key-relatives.
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Elsaify, Mohammad M., Hatem M. Soltan, Rafik F. Soliman, and Mohamed Gamal Hagag. "Prakash versus figure of eight technique in sternal closure in CABG patients." International Surgery Journal 6, no. 3 (February 25, 2019): 828. http://dx.doi.org/10.18203/2349-2902.isj20190476.
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Background: Median sternotomy was recommended in 1957 by Julian for complete exposure of the heart. Despite the high importance of correct sternotomy, proper sternal closure is vital to ensure fewer post-operative complications. The sternum can be closed by wires and other methods. Sternal closure using the most suitable technique can dramatically reduce the risk of development of such complications.Methods: It is a prospective randomized comparative study of two patient groups, each included 30 patients, diagnosed of ischemic heart disease and underwent CABG. Group A with the patients’ sterna closed by figure of eight method and group B with multi-twist (Prakash) technique. Both groups were compared regarding postoperative pain and complications as superficial and deep sternal wound infections (SSWI, DSWI), wire removal and rewiring within six months of follow up.Results: The mean of minimum post sternotomy pain in group A patients was 24.50±11.7, whereas in patients of group B, it was 27±10.1. Only two patients (group A) suffered sternal dehiscence within six months follow up. The incidence of SSWI and DSWI among both groups was almost similar with only two patient of group A needed wire removal and one of them required rewiring.Conclusions: The multi-twist sternal closure provides better sternal stability after CABG especially in patients who are vulnerable to sternal dehiscence.
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Bansiwal, Rajesh Kumar, Tarun Mittal, Rajeev Sharma, Sanjay Gupta, Simrandeep Singh, Kumar Abhishek, and Ashok Kumar Attri. "Comparative study of abdominal wound dehiscence in continuous versus interrupted fascial closure after emergency midline laparotomy." International Surgery Journal 6, no. 3 (February 25, 2019): 886. http://dx.doi.org/10.18203/2349-2902.isj20190819.
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Background: Laparotomy wound dehiscence is still a puzzle for most of the surgeons. Mortality associated with dehiscence has been estimated at 10-30%. Patients undergoing emergency laparotomy suffer from one of these comorbid conditions which are detrimental to healing. In this scenario interrupted suturing has been found to give good strength and have less incidence of wound dehiscence. The objective of the study was to compare the incidence of abdominal wound dehiscence in emergency midline laparotomy.Methods: This study was conducted on 300 consecutive patients undergoing emergency midline laparotomy in the Department of Surgery, Government Medical College and Hospital. Methods group-A: closed by suturing the rectus sheath using polydioxanone suture 1-0 (PDS) in continuous layer suturing method. group-B: closed by suturing the rectus sheath using polydioxanone suture 1-0 in interrupted layer suturing method.Results: The mean age in group A was 40.47 years and 37.47 in group B. In Group A 20.1% patients had burst abdomen and 5.4% in group B.Conclusions: Interrupted closure of abdominal wall fascia is better in emergency laparotomy as compared to continuous closure.
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Ghirardello, Stefano, Genny Raffaeli, Beatrice Letizia Crippa, Silvia Gulden, Ilaria Amodeo, Dario Consonni, Giacomo Cavallaro, Federico Schena, and Fabio Mosca. "The Thromboelastographic Profile at Birth in Very Preterm Newborns with Patent Ductus Arteriosus." Neonatology 117, no. 3 (2020): 316–23. http://dx.doi.org/10.1159/000507553.
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<b><i>Background:</i></b> The role of hemostasis in the closure of patent ductus arteriosus (PDA) in preterm infants is controversial. <b><i>Objective:</i></b> To assess thromboelastography (TEG) at birth in very-low-birth-weight (VLBW) infants affected by PDA. <b><i>Methods:</i></b> This was an ancillary study of a prospective observational study aimed at defining the TEG profile in healthy VLBW infants in the first month of life. In this analysis, we included neonates of <33 weeks’ gestational age (GA) with PDA and compared TEG traces based on (1) spontaneous closure versus the need for pharmacological treatment and (2) treatment response. We collected blood samples in the 1st day of life to perform recalcified native-blood TEG (reaction time, maximum amplitude, and lysis at 30 min [Ly30)]), standard coagulation tests, and a full blood count. <b><i>Results:</i></b> We enrolled 151 infants with a PDA at the first echocardiogram; 111 experienced spontaneous PDA closure while 40 required treatment. Mean GA was 29.7 ± 1.7 and 27.6 ± 2.1 weeks, and birth weight was 1,158 ± 256 and 933 ± 263 g in the 2 groups, respectively (<i>p</i> < 0.001). The hemostatic profile was similar between groups. Median hematocrit (44.6 and 48.7%; <i>p</i> = 0.01) and platelet count (187 and 216 × 10<sup>3</sup>/μL; <i>p</i> = 0.04) were lower in the treated group, although differences lost significance after controlling for GA and illness severity in the multivariate analysis. Responders to PDA treatment (<i>n</i> = 20) had a significantly lower median Ly30 than nonresponders (0 and 0.7%; <i>p</i> = 0.02). <b><i>Conclusion:</i></b> TEG at birth does not predict spontaneous PDA closure in preterm newborns. Fibrinolysis is enhanced in nonresponders to PDA treatment; this observation warrants further investigation.
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Kaur, Amitpal, Mohit Sharma, Karaninder Singh, and Darpan Bansal. "Triclosan coated vicryl versus uncoated vicryl in preventing surgical site infection: a randomized controlled trial." International Surgery Journal 8, no. 1 (December 28, 2020): 103. http://dx.doi.org/10.18203/2349-2902.isj20205820.
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Background: Surgical site infection (SSI) are one of the most frequently reported health care associated infections. They are commonly associated with greater morbidity, readmissions, ICU admissions, long-term surgical site complications and mortality. Multiple global studies have shown level 1A clinical evidence that the use of triclosan coated suture reduces the incidence of SSI by 30%.Methods: In the proposed prospective study, 100 cases undergoing elective surgery were randomly allocated into Group A and B. Group A were the patients in which wound closure was done using triclosan coated vicryl (vicryl plus) and group B were the patients in which wound closure was done using uncoated vicryl. Then, the patients were followed up for 30 days to observe any signs and symptoms of surgical site infection.Results: Duration as well as severity of pain was decreased in vicryl plus group as compared to uncoated vicryl. Other signs of inflammation such as erythema, swelling, induration and fever were also less in patients who had wound closure using vicryl plus. Wound dehiscence was not observed in either of the groups. Discharge was seen in 1 patient in vicryl plus group but it was seen in 5 patients in uncoated vicryl group. Surgical site infection was seen only in 1 patient in the vicryl plus group, but it was seen in 10 patients uncoated vicryl group.Conclusions: It can be concluded that triclosan coated vicryl (vicryl plus) is better than uncoated vicryl for the prevention of surgical site infection.
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Kumar, Basudev, and Abhinav Jauhari. "Comparison of continuous versus interrupted method of abdominal fascia closure using non - absorbable suture in the patients of acute peritonitis: our experience of 60 cases." International Journal of Research in Medical Sciences 5, no. 8 (July 26, 2017): 3299. http://dx.doi.org/10.18203/2320-6012.ijrms20173100.
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Background: The best method of wound closure would be one that provides adequate tensile strength to the incision until the wound heals and approximates the tissue in a way that normal healing mechanism can occur under optimal circumstance. The suture should remain secure even in the presence of local or systemic infection. The continuous suture has the advantage of an evenly distributed tension across the suture line and being more expedient. It also has the advantage of having a single suture line holding the fascia together. The interrupted suturing technique has the disadvantage of being time consuming.Methods: All the patients of peritonitis were taken up for emergency laparotomy fulfilling the inclusion criteria will be included in the study. They were divided into two groups A and B by randomization technique. Each group contained 30 patients each. Patients included in group A underwent continuous method of abdominal fascia closure post laparotomy. Patients included in group B underwent interrupted method of abdominal fascia closure post laparotomy.Results: In the present study, 60 cases of peritonitis were taken up, out of these mean age in the two groups were 34.03 years and 35.03 years respectively, majority of the patients were male 50 (83.3%); Most common diagnosis was of duodenal perforation peritonitis with 22 patient (36.7%), with Ileal perforation peritonitis 15 patients (25.0%), Kochs perforation peritonitis 13 patient (21.7%); Mean time taken for closure in continuous group was 13.10 minutes as compared to 16.00 minutes in interrupted group, This difference was statistically significant. Wound infection rate in two group were 26.7% and 33.3% respectively, wound infection was present in 30%of total patient. Burst abdomen was present in 20% in both the group.Conclusions: Continuous suturing with polypropylene is comparable to interrupted suturing in terms of wound infection, frequency of burst abdomen. Although continuous suturing is better than interrupted suturing as it is faster, take less time in closure than interrupted closure. Continuous polypropylene thus becomes the preferred material and method of closure for abdominal fascia for acute peritonitis.
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Sander, Anna, Miriam Posselt, Karin Oberle, and Wolfgang Bredt. "Seroprevalence of Antibodies to Bartonella henselae in Patients with Cat Scratch Disease and in Healthy Controls: Evaluation and Comparison of Two Commercial Serological Tests." Clinical Diagnostic Laboratory Immunology 5, no. 4 (July 1, 1998): 486–90. http://dx.doi.org/10.1128/cdli.5.4.486-490.1998.
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ABSTRACT Serologic testing for the presence of antibodies toBartonella henselae is a widely accepted diagnostic procedure for laboratory confirmation of the diagnosis of cat scratch disease (CSD). In this study a commercially available indirect immunofluorescence assay (IFA) based on B. henselae-infected human larynx carcinoma cells (test A) was evaluated. Sera from 42 patients with CSD (20 confirmed by PCR) and 270 sera from healthy controls (consisting of 63 cat owners, 65 individuals whose last close contact with cats was >6 months previously, and 142 persons who had never been exposed to cats) were investigated for antibodies to B. henselae. All patients with CSD had titers of immunoglobulin G (IgG) to B. henselae of 128 or higher (test A; sensitivity, 100%). Of the 270 controls 189 (70%) were seronegative (titer, <64), 38 (14.1%) had titers of 64, 30 (11.1%) had titers of 128, 9 (3.3%) had titers of 256, and 4 (1.5%) had high titers, 512 (test A; specificity, 70%). Of the cat owners and individuals who had never had close contact with cats, 71.4 and 71.12%, respectively, were seronegative, and titers of 64, 128, 256, and 512 were found in 14.3 and 16.2%, 1.6 and 10.5%, 9.5 and 0.7%, and 3.2 and 1.4%, respectively. The sera from the patients and from the first 100 healthy adults without a history of close contact with cats were additionally tested with a second commercially available IFA, based on Vero cells infected withB. henselae and Bartonella quintana (test B). The sensitivity and specificity of test B were 93 and 73%, respectively. For patients with CSD the cross-reactivity betweenB. henselae and B. quintana in this test was 95%. Both systems are highly sensitive but less specific for detection of IgG antibodies to B. henselae in samples from patients with clinically apparent CSD. For detection of IgM antibodies, test A seems to be more sensitive (88%) and more specific (95%) than test B (sensitivity and specificity of 64 and 86%, respectively). The data show that the seroprevalence of antibodies toB. henselae in German individuals is high (30%). Low antibody levels are not sufficient evidence of active or prior infection.
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Yousafzai, Sajjad Mohammad, Murat Ugurlucan, Abid Awan, and Charles C. Canver. "Cost and clinical effectiveness of aggressive surgical debridement and delayed primary closure of infected cardiac surgical wounds." Journal of Wound Care 31, no. 2 (February 2, 2022): 148–53. http://dx.doi.org/10.12968/jowc.2022.31.2.148.
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Objective: Postoperative wound infection in cardiac surgery remains a subject of significant concern due to associated morbidity, prolonged hospital stay and rise in treatment cost. A conservative management approach to postoperative wound infection with topical dressings and healing by secondary intention is not cost-effective and cosmetic results are less acceptable. We developed our institutional protocol for the treatment of infected postoperative cardiac surgical wounds to reduce hospital stay and improve cosmetic outcome. This study aims to compare our institutional protocol with the conservative management approach. Methods: Adult patients with postoperative superficial or deep sternal and/or leg wound infection were divided into two equal-sized groups and data collected from medical records. Group A was treated according to our institutional protocol of aggressive surgical debridement and delayed primary closure. Group B was treated according to conservative management with topical antiseptic wound dressings and healing by secondary intention. Data were analysed in retrospect with comparative statistics. Results: A total of 30 patients took part in the study. Group A (n=15, seven male, eight female) had a mean age of 55.34±12.84 years. Group B (n=15, eight male, seven female) had a mean age of 56.46±10.21 years. Mean length of hospital stay in Group A and Group B was 5.13±2.06 and 36.67±22.28 days, respectively (p<0.0001). Calculated mean hospital costs were 16,271.61±6815.50 Saudi Riyals (approximately equivalent to $4330±700 USD) in Group A and 116,212.2±26,311 Saudi Riyals (approximately equivalent to $30,932±1813 USD) in Group B (p<0.05). Patients in Group A had linear scars comparable with primary postoperative wound scars, whereas patients in Group B had excessive non-linear scarring. Conclusion: In this study, cost and clinical effectiveness of aggressive surgical debridement and delayed primary closure was superior to conservative management with topical antiseptic wound dressings and healing by secondary intention in terms of a shorter hospital stay and better cosmetic outcome.
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Pöyhönen, Pauli, Jouni Kuusisto, Jani Pirinen, Heli Räty, Lauri Lehmonen, Riitta Paakkanen, Nicolas Martinez-Majander, et al. "Orientation of the Atrial Septum to the Inferior Vena Cava May Contribute to the Persistent Patency of the Foramen Ovale." Cardiology 147, no. 2 (2022): 169–78. http://dx.doi.org/10.1159/000522017.
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<b><i>Purpose:</i></b> There is growing evidence that paradoxical embolism through patent foramen ovale (PFO) is a cause for cryptogenic stroke. However, it is still unclear why the foramen ovale fails to close after birth. We studied whether the 3D relations between the atrial septum (AS) and the inferior vena cava (IVC) are associated with PFO. <b><i>Methods:</i></b> We recruited 30 patients (18–49 years) with a first-ever cryptogenic stroke and 30 age- and sex-matched stroke-free controls. Using cardiac magnetic resonance, an approach to evaluate the 3D relations between the AS and the IVC was developed. The presence of interatrial right-to-left shunt was evaluated with transesophageal echocardiography (TEE) in patients and transcranial Doppler in controls. <b><i>Results:</i></b> Of 30 patients, 29 underwent successful TEE, of which 12 (41%) had a shunt. Patients with a shunt had a greater mean 3D angle (γ) between the atrial septal plane and the vector from the orifice of the IVC to the middle of the AS compared with patients without a shunt (45 ± 9° vs. 36 ± 8°, <i>p</i> = 0.017). Of 30 controls, 12 (40%) had a shunt and a greater mean γ compared with controls without a shunt (47 ± 8° vs. 37 ± 10°, <i>p</i> = 0.007). In a pooled analysis, 24 (41%) of 59 subjects with a shunt had a mean γ of 46 ± 9° compared with subjects without a shunt of 37 ± 9° (<i>p</i> < 0.001). <b><i>Conclusions:</i></b> More perpendicular orientation of the atrial septal plane to the orifice of the IVC is associated with PFO, possibly by directing the IVC flow to PFO.
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P. B., Thrishuli, and Pavan Kumar E. "Abdominal wall closure in the presence of sepsis (acute abdomen): role of negative suction." International Surgery Journal 5, no. 2 (January 25, 2018): 407. http://dx.doi.org/10.18203/2349-2902.isj20180040.
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Background: To compare and find out the best method of abdominal wall closure in cases peritonitis between subcutaneous negative suction drainage tube and conventional primary skin and subcutaneous closure.Methods: From September 2015 to September 2017, 100 patients who presented at the emergency department with acute abdominal pain and operated for the same, with features s/o peritonitis were enrolled into the study. 50 of them were managed with subcutaneous negative suction drainage tube during abdominal wall closure (Group A). 50 other patients underwent conventional method of abdominal wall closure (Group B). On table pus c/s was sent for all 100 cases. The surgical wound was observed for signs of infection. Any seropurulent collection from the drain or any discharge from the wound was sent for c/s and the results of which were compared with the results of on table pus c/s. If wound dehiscence was noted, secondary suturing was done after the wound healed. The duration of suction drain placement and stay in the hospital were noted in all cases. The results were analyzed with Chi-square test and Student t test (unpaired) and p values were calculated. A p value of less than 0.05 was considered significant.Results: The incidence of SSI was significantly less in Group A (20%) than in Group B (64%). Similarly, wound dehiscence occurred in 30% of SSI cases in Group A as against 87.1% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (8 days).Conclusions: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay.
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Shimizu, Toshinori, Taichi Uyama, Yasunori Hori, Motohide Tamura, and Nicole Wallack. "High-contrast Imaging around a 2 Myr-old CI Tau with a Close-in Gas Giant." Astronomical Journal 165, no. 1 (December 19, 2022): 20. http://dx.doi.org/10.3847/1538-3881/ac9fd1.
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Abstract Giant planets around young stars serve as a clue to unveiling their formation history and orbital evolution. CI Tau is a 2 Myr-old classical T Tauri star hosting an eccentric hot Jupiter, CI Tau b. The standard formation scenario of a hot Jupiter predicts that planets formed further out and migrated inward. A high eccentricity of CI Tau b may be suggestive of high-e migration due to secular gravitational perturbations by an outer companion. Also, the Atacama Large Millimeter/submillimeter Array 1.3 mm-continuum observations show that CI Tau has at least three annular gaps in which unseen planets may exist. We present high-contrast imaging around CI Tau taken from the Keck/NIRC2 L ′ -band filter and vortex coronagraph that allows us to search for an outer companion. We did not detect any outer companion around CI Tau from angular differential imaging (ADI) using two deep imaging data sets. The detection limits from ADI-reduced images rule out the existence of an outer companion beyond ∼30 au that can cause the Kozai–Lidov migration of CI Tau b. Our results suggest that CI Tau b may have experienced type II migration from ≲2 au in megayears. We also confirm that no planets with ≥2–4 M Jup are hidden in two outer gaps.
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Alshurem, Mohammed, Mubarak M. Aldosari, Danah Aljaafari, Ali Alhashim, Erum Shariff, Ahmad Almatar, Ibrahim Alhashyan, Mohammed Almuaigel, Noor Almohish, and Hassan Altaweel. "Prevalence of Medically Resistant Epilepsy in Saudi Arabia." Neuroepidemiology 55, no. 3 (2021): 232–38. http://dx.doi.org/10.1159/000515743.
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<b><i>Objectives:</i></b> The objective of this study was to evaluate the prevalence of medically resistant epilepsy (MRE) in our hospital and to compare the prevalence with that in other populations. <b><i>Methods:</i></b> We retrospectively analyzed the data of patients who visited the epilepsy clinics at King Fahd University Hospital, Al-Khobar, Saudi Arabia between January 2017 and December 2018. This study included patients aged ≥14 years who had at least 2 unprovoked seizures 24 h apart. Patients who had provoked seizure(s), paroxysmal events, or syncope or had incomplete medical records were excluded. The definition and classification of the International League Against Epilepsy were used. Moreover, we searched the English literature using PubMed and Google Scholar to compare the prevalence of MRE between our population and other populations. <b><i>Results:</i></b> In total, 1,151 patients were screened, and 751 patients were included in the final analysis. Of the 751 patients, 229 (male: 56.3%, female: 43.7%; mean age: 32.07 years, and standard deviation, 12.2 years) had MRE, with a cumulative prevalence of 30%. The etiology was as follows: unknown, 63.3% (<i>n</i> = 145); structural, 31.9% (<i>n</i> = 73); genetic, 3.1% (<i>n</i> = 7); and infectious, 1.7% (<i>n</i> = 4). None of the patients had metabolic or immune-related etiologies. <b><i>Conclusion:</i></b> The prevalence of MRE in our population (30%) is close to that in other populations (30–36.5%). Early identification of such patients is crucial to improve their management.
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Reine Wallenberg, L., Mehri Sanati, and Arne Andersson. "Controlling microvoid formation in TiO2(B) catalyst support." Proceedings, annual meeting, Electron Microscopy Society of America 48, no. 4 (August 1990): 234. http://dx.doi.org/10.1017/s0424820100174308.
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It is known that the support may sometimes influence the performance of close-to-monolayer catalysts by formation of specific surface species of the active phase. For a 1.5 monolayer vanadium oxide catalyst, supported on TiO2B) which is a recently discovered form of titanium dioxide, an increase in conversion rate of more than 2 times was found compared to pure V2O5 in the case of ammoxidation of toluene. On investigation by High Resolution Electron Microscopy (HREM), it was found that a large number of sharply facetted voids, so called “negative crystals”, were present in the TiO2(B) support (Fig. 5). HREM stereo micrographs showed that the voids, 3-30 nm in size, were distributed throughout the bulk of the crystals.In an attempt to open these voids to channels, which would give substantially larger specific surface area of the catalyst, the chemical composition of the starting material was varied.The support was formed by calcining a mixture of KNO3 with TiO2 (anatase) at 950°C, which produces an intermediate support precursor.
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Ellapakurthi, Padminii, and Gotike Siva Prasad Reddy. "The effectiveness of mineralized plasmatic matrix in the closure of alveolar clefts with volumetric assessment." Regenerative Medicine Research 9 (2021): 1. http://dx.doi.org/10.1051/rmr/210004.
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Objectives: The purpose of this study is to assess the effectiveness of mineralized plasmatic matrix in the soft tissue closure of naso-alveolar fistula, to estimate the postoperative bone fill and volume of the graft placed in the alveolar cleft defect using cone-beam computed tomography (CBCT) at 3rd- month and 6th- month. Material and methods: 10 patients, in the age group of 15‑30 years were included in this study. They were diagnosed with unilateral cleft lip and alveolus defects with or without a cleft palate requiring late secondary alveolar bone grafting. Alveolar cleft defects were closed with mineralized plasmatic matrix (MPM), a combination of autogenous iliac bone graft and platelet rich plasma (PRP) and platelet rich fibrin (PRF). Results: The mean defect volume pre-operatively is 0.75 cm3 and at the end of 3rd-month postoperatively is 0.51 cm3 and at 6th-month postoperatively is 0.27 cm3. The average percentage of bone fill between preoperative (A) & 3th- month postoperatively (B) is 33.4% and between 3rd-month (B) and 6th-month post operatively (C) is 49.5%. Conclusions: Utilization of this new matrix (MPM), has shown to be effective in the closure of the cleft defect, oro-nasal fistula and also reduction in the volume of the residual cleft defect seen with sequential cone-beam computed tomography (CBCT) radiographs.
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Cho, Jungyeon. "Obtaining the Strength of the Magnetic Field from E- and B-Modes of Dust Polarization." Astrophysical Journal 953, no. 1 (August 1, 2023): 114. http://dx.doi.org/10.3847/1538-4357/ace10a.
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Abstract We perform numerical simulations of supersonic magnetohydrodynamic (MHD) turbulence and calculate Fourier power spectra of E- and B-modes arising from dust polarization. We pay close attention to the ratio of E-mode to B-mode spectra (a.k.a. E/B power asymmetry) on small spatial scales. We find that the ratio depends on the strength of the mean magnetic field: the stronger the mean magnetic field, the smaller the ratio. More precisely speaking, the ratio scales with the Alfvén Mach number M A , the rms velocity divided by the Alfvén speed of the mean magnetic field, when it lies in the range 1 ≲ M A ≲ 30. This result implies that we can use the E/B power asymmetry to constrain the strength of the mean magnetic field in supersonic and super-Alfvénic MHD turbulence.