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PubMed2003

Parallel molecular computations of pairwise exclusive-or (XOR) using DNA "string tile" self-assembly.

Self-assembling DNA nanostructures are an efficient means of executing parallel molecular computations. However, previous experimental demonstrations of computations by DNA tile self-assembly only allowed for one set of distinct input to be processed at a time. Here, we report the multibit, parallel computation of pairwise exclusive-or (XOR) using DNA "string tile" self-assembly. A set of DNA tiles encoding the truth table for the XOR logical operation was constructed. Parallel tile self-assembly and ligation led to the formation of reporter DNA strands which encoded both the input and the output of the computations. These reporter strands provided a molecular look-up table containing all possible pairwise XOR calculations up to a certain input size. The computation was readout by sequencing the cloned reporter strands. This is the first experimental demonstration of a parallel computation by DNA tile self-assembly in which a large number of distinct input were simultaneously processed.

DNA↗
PubMed1987

[Wound healing and wound irrigation in cesarean section of cattle].

Calves were delivered by Caesarean section in 128 cases during the early months of 1984. All animals were allocated alternately to a trial group and a group of controls. When the peritoneum and transverse muscle had been sutured, the wounds of the animals in the trial group were irrigated and washed with 300 ml. of Betadine (10 per cent of PVP-iodine in water). This was followed by closure of the wound. The animals of the group of controls were not treated. The procedure was performed in ninety-four primiparae (73 per cent) and thirty-four multiparae (27 per cent). The indication for Caesarean section consisted in fetal oversize in 119 cases (93 per cent). Eight calves (6 per cent) were stillborn or died immediately post partum. The proportion of animals in which the placentae were retained, was 9 per cent. Two animals died from peritonitis and intra-abdominal haemorrhage respectively. Irrigation of the wound did not have any effect on the number of wound infections (Table 3). Wound infection occurred in nineteen animals (15 per cent). The operations were performed by six veterinary surgeons (Table 4). The trial group and group of controls treated by each veterinarian did not differ essentially as regards wound healing.

Animals↗
PubMed1993

Upper extremity bypass grafting. A 15-year experience.

OBJECTIVE: To analyze the perioperative morbidity and mortality, long-term patient survival, and patency characteristics of arterial bypass related to upper extremity ischemia. DESIGN: This is a retrospective review of sequential patients undergoing upper extremity arterial bypass during a 15-year period at a single tertiary-care teaching hospital. Data are expressed in a 5-year life-table format and interpreted using log-rank analysis. PATIENTS: Seventy-four patients with upper extremity ischemia undergoing arterial bypass, which included 95 separate operations. MAIN OUTCOME MEASURES: Operative morbidity and mortality, life-table survival, life-table bypass graft patency, and limb salvage are reported. RESULTS: There was no operative mortality, and there was a single major amputation. Survival rate was 86% at 5 years, and overall patency rate was 61.2% at 5 years, with autogenous conduits superior at all sites compared with prosthesis (70.9% vs 37.7%). Secondary operation was inferior to primary bypass (66% vs 48%) and associated with higher morbidity (22% vs 5%). All far distal forearm prosthetic bypass grafts failed within 1 year. CONCLUSIONS: Primary upper extremity bypass with venous conduit is a safe, durable procedure, after which prolonged patient survival can be expected.

Adolescent↗
PubMedDate not supplied

[Otologic surgical procedures in an Ear, Nose and Throat Department in Subotica from 1987 to 2001].

INTRODUCTION: This paper deals with otologic surgical procedures performed in a an Ear, Nose and Throat Department during a 15-year period. The authors compared the number of otologic surgical procedures with the number of laryngomicroscopies and procedures performed in Waldeyer's ring. RESULTS: From January 1, 1987 to December 31, 2001, 1184 patients underwent the following surgical procedures in total endotracheal anesthesia: 285 paracenteses, 473 ventilation tubes insertions, 175 antrotomies or mastoidectomies, 194 tympanoplasties, 34 radical mastoidectomies, 4 facial nerve decompressions, 5 exostoses or osteoma of the external auditory canal operations and 14 stapedectomies. DISCUSSION: Otologic surgical procedures are presented in table 1. In Yugoslav literature Topolac reports approximately 700 tympanoplasties in a 10-year period (1968-1978). Radonjić and associates report 2272 ear operations in the period 1975-1985. Distribution of operations is presented in table 2, whereas in table 3 we can see that the number of operated ears is much greater than the number of operated patients. CONCLUSION: We think that the number of operations is not bigger, because we operate only in critical cases. Our human and technical resources should provide advanced ear microsurgery, but only with financial and organizational support.

Hospital Departments↗
PubMedDate not supplied

[Tonsillectomies and adenoidectomies over a 60-year period (1939-1998) at the Otorhinolaryngology Department in Subotica].

INTRODUCTION: This paper presents available epidemiological data on number and types of surgeries of Waldeyer's ring over a sixty-year period, as well as their interactions. RESULTS: Out of 80.477 patients operated on in the period from December 1, 1939 to Dec 31, 1998, statistical survey included 56.564 patients (Table 1). 26.808 (46.57%) patients were operated in local anesthesia, 23.833 (41.40%) under ether narcosis, and 6.923 (12.026%) patients were operated on under general endotracheal anesthesia. 38.846 (67.48%) tonsillectomies, 12.864 (22.34%) tonsilloadenoidectomies and 5.854 (10.16%) adenoidectomies were performed. DISCUSSION: The percentage of these surgeries is very high, but in the past ten years it has fallen below 50%. General endotracheal anesthesia is being used at the Department since 1966, and ether anesthesia is not being used since 1991. We believe that the number of tonsillectomies is high, because it also includes surgeries performed under local anesthesia, in patients over ten years of age. However, we can conclude that anesthesiological procedures effectively followed trends of medical science.

Adenoidectomy↗
PubMed1989

[Rectal premedication with midazolam in children. A comparative clinical study].

Anesthetic premedication by injection is usually poorly accepted by children, especially those under 10 years of age. Less disturbing for the child is oral premedication, but this increases the risk of aspiration and must be administered 1.5-2 h before anesthetic induction. This double-blind study was performed in children to investigate the efficacy, acceptance, and general safety of midazolam given rectally. METHOD. Rectal premedication was administered to a total of 80 healthy children between 2 and 10 years of age undergoing elective operations. The children were divided randomly into two groups: group I received 0.4 mg/kg and group II 0.5 mg/kg midazolam with the addition of 0.015-0.02 mg/kg atropine. Premedication was carried out on the pediatric ward. The calculated dose was drawn from the ampule and diluted to 8-10 ml with distilled water. This dose was instilled immediately behind the anal sphincter using a suitable plastic applicator (Stanylan). The following parameters were recorded: immediate reaction to the rectal medication, sedative-hypnotic signs, and acceptance of the anesthetic mask. Heart rate and blood pressure were measured before premedication and before the induction of anesthesia. Observations were made for 5 h post-operatively. Any unusual side effects of the treatment were also noted. The existence of any anterograde amnesia was investigated in 20 children (10 in each group) between 6 and 10 years of age. RESULTS. There was no significant difference between the children allocated to the two groups with regard to age, body weight, sex, type of operation, and duration of anesthesia (Table 2). Of the total of 80 children, 66 (82.5%) accepted the rectal instillation well, 12 (15%) moderately well, and 2 (2.5%) poorly. Signs of respiratory depression or allergic reaction to midazolam were not observed in any case. The observations made before induction of anesthesia are presented in Table 3. The children in group II exhibited significantly greater (P less than 0.05) slurred speech than those in group I. A low incidence of hiccup was seen in both groups. Most of the children (27 in group I, 67.5%; 37 in group II, 92.5%: P less than 0.05) were delivered to the operating room lying down, whereas the others were sitting up in bed but showed no desire to get up. Between 10 and 55 min after the premedication, a total of 5 children (12.5%) in group I and 2 (5%) in group II were restless or crying on arrival in the induction room. Most, however, were quiet to tired/drowsy. The optimal sedative-hypnotic action was observed after 20-30 min (Fig. 1). At this time 21.7% of the children in group I were tired/drowsy, whereas 50% in group II were tired/drowsy and 9.1% were asleep but easy to arouse. This effect was significantly greater in group II (P less than 0.01). Acceptance of the mask was comparable in both groups (Table 4) and was tolerated well to very well by 92-97% of the children. (ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Rectal↗
PubMed2006

Comparison of right and left laparoscopic live donor nephrectomy.

OBJECTIVE: To compare the anatomy and function of right and left kidneys retrieved by laparoscopic live donor nephrectomy (LDN). PATIENTS AND METHODS: In all, 84 transperitoneal LDNs were performed, 66 left and 18 right. Two different right-sided LDN techniques were used: initially, the inferior vena cava (IVC) was controlled with a Satinsky clamp introduced through a 6-8 cm right upper quadrant incision, through which the kidney was also removed (six patients). Subsequently, the IVC was completely mobilized by laparoscopic retrocaval dissection (in 12 patients), allowing the use of a linear stapler-cutter, including the caval ostium with the renal vein. The kidney was then removed through a short Pfannenstiel incision. RESULTS: Left kidneys had longer renal veins (38 vs 27 mm; P < 0.05), but there were no differences in arterial length (32 vs 31 mm). Three right kidneys required back-table renal vein lengthening. The operative duration was shorter for right-sided LDNs (132 vs 182 min; P < 0.05). The serum creatinine level at 3 months was 131 vs 134 mmol/L for right and left kidneys, respectively. CONCLUSIONS: Despite faster surgery suggesting that the right LDN is technically easier, there is a greater need for back-table reconstruction of the renal vein. The functional results of right and left kidneys are equivalent.

Humans↗
PubMed2000

Surgical correction of isolated superficial venous reflux reduces long-term recurrence rate in chronic venous leg ulcers.

OBJECTIVES: surgical correction of isolated superficial venous reflux in ulcerated legs may reduce short term recurrence rates but the longer term benefits are unknown. DESIGN: prospective non-randomised cohort study. METHODS: consecutive patients with chronic leg ulcers were prospectively assessed at a one-stop clinic over a 4-year period from July 1995 to July 1999. All patients with ankle brachial pressure indices (ABPI)50.85 were initially treated with weekly four-layer bandaging. Venous duplex studies in all ulcerated legs assessed venous reflux pattern with surgery being offered to all those with isolated superficial reflux, of whom 56% accepted. Patients were advised to wear class two elastic compression stockings after healing. RESULTS: 766 legs in 669 patients were assessed. Six hundred and thirty-three legs had an ABPI50.85, 236 (39%) demonstrating isolated superficial venous reflux. Surgery was performed on 131 of these legs. Twelve and 24 week healing rates were 50% and 72% for operated legs and 62% and 74% for non-operated legs (p=0.67; Kaplan-Meier life table analysis). Recurrence rates at 1, 2 and 3 years were 14%, 20% and 26% for operated legs and 28%, 30% and 44% for non-operated legs (p=0.03; Kaplan-Meier life table analysis). CONCLUSION: surgical correction of superficial venous reflux in legs with chronic leg ulceration may reduce ulcer recurrence rate at 1, 2 and 3 years.

Adult↗
PubMed1977

Operator-assisted semi-automatic karyotyping of banded metaphases.

Computerized chromosome analyses have resulted in up to 25% erroneous classifications, whereas a cytogenetically trained laboratory technician has an error rate of less than 0.1% in the preparation of a karyotype. In the project reported here, computerized classification is eliminated, and instead, the other steps of the analysis leading to the final karyotype are automated. In the instrument is a projection microscope, modified to project the image on paper before the operator. The slide is scanned on a motor-driven scanning table, in search of a suitable metaphase. The operator stops the scanning motor when a suitable metaphase comes into view. The individual chromosomes of the metaphase are then framed, using a view finder, and are identified, after which the chromosome number is entered on a kayboard. The instrument automatically ensures that, for each data entry, the framed chromosome is photographed in such a manner that the chromosome is placed in the proper location with the correct orientation in the karyotype. When all chromosomes have been identified, and the data have been keyed in, a photograph of the finished karyotype is presented. Marking the metaphase chromosomes on the paper, chromosomes are counted within 20 s. With conventional methods, a total chromosome analysis takes 3-6 h, but the above-described device requires 20-30 min.

Computers↗
PubMed2005

NEUROM: a ROM based RNS digital neuron.

In this work, a fast digital device is defined, which is customized to implement an artificial neuron. Its high computational speed is obtained by mapping data from floating point to integer residue representation, and by computing neuron functions through residue arithmetic operations, with the use of table look-up techniques. Specifically, the logic design of a residue neuron is described and complexity figures of area occupancy and time consumption of the proposed device are derived. The approach was applied to the logic design of a residue neuron with 12 inputs and with a Residue Number System defined in such a way as to attain an accuracy better than or equal to the accuracy of a 20-bit floating point system. The proposed design (NEUROM) exploits the RNS carry independence property to speed up computations, in addition it is very suitable for using look-up tables. The response time of our device is about 8 x T(ACC), where T(ACC) is the ROM access time. With a value of T(ACC) close to the 10 ns allowed by the current ROM technology, the proposed neuron responds within 80 ns, NEUROM is therefore the neuron device proposed in the literature which allows for maximum throughput. Moreover, when a pipeline mode of operation is adopted, the pipeline delay can assume a value as low as about 14 ns. In the case study considered, the total amount of ROM is about 5.55 Mbits. Thus, using current technology, it is possible to integrate several residue neurons into a single VLSI chip, thereby enhancing chip throughput. The paper also discusses how this amount of memory could be reduced, at the expense of the response time.

Algorithms↗
PubMed2001

Bender transducer design and operation.

An empirical study covering a wide range of bender transducer sizes and operating frequencies is reported. A spherical device model is shown to give good account of bender performance, including interaction effects. A set of empirical rules for scaling equivalent circuit parameters according to the device geometry is identified. An effective spherical radius, approximately half the diaphragm radius, is identified for the typical bender. The effects of pressure and drive voltage on performance are described for particular devices. Sensitivity factors for the equivalent circuit parameters to the operating conditions are determined. These are related to sensitivity factors for the coupling coefficient (Kc) and electromechanical transformer turns ratio (N). Both these parameters are shown to have similar sensitivity responses, decreasing with pressure (planar stress), and increasing with voltage (electric field). The results of high drive tests carried out at Seneca Lake are reported. Values of conventional figures of merit (FOM(V) and FOM(M)), close to the highest claimed for any underwater transducer, are tabled. When allowance for the operating efficiency is included in the figure of merit definitions, the bender appears to be superior to other device types.

Acoustics↗
PubMed2005

Dose to population as a metric in the design of optimised exposure control in digital mammography.

This paper describes a method for automatic optimisation of parameters (AOP) in digital mammography systems. Using a model of the image chain, contrast to noise ratio (CNR) and average glandular dose (AGD) are computed for possible X-ray parameters and breast types. The optimisation process consists of the determination of the operating points providing the lowest possible AGD for each CNR level and breast type. The proposed metric for the dose used in the design of an AOP mode is the resulting dose to the population, computed by averaging the AGD values over the distribution of breast types in the population. This method has been applied to the automatic exposure control of new digital mammography equipment. Breast thickness and composition are estimated from a low dose pre-exposure and used to index tables containing sets of optimised operating points. The resulting average dose to the population ranges from a level comparable to state-of-the-art screen/film mammography to a reduction by a factor of two. Using this method, both CNR and dose are kept under control for all breast types, taking into consideration both individual and collective risk.

Breast↗
PubMed1987

Surgical treatment of endomyocardial fibrosis.

Forty-six patients with endomyocardial fibrosis underwent endocardiectomy and replacement of tricuspid, mitral, or both atrioventricular valves between April, 1981, and October, 1984, at the Sree Chitra Tirunal Institute, Kerala State, India, which has a high incidence of the disease. Six patients were in New York Heart Association Functional Class III and 40 patients in Class IV. The operative mortality within 30 days of the procedure and late mortality during the first two years postoperation were 21.7% and 13%, respectively. Age under 15 years was a significant correlate of operative mortality (p = .05). Non-fatal thromboembolic episodes occurred in 6 patients during the two years of postoperative observation. The life table estimate of survival inclusive of operative mortality at two years was 67%. Despite high operative mortality, endocardiectomy with atrioventricular valve replacement is advisable for functionally disabled patients with endomyocardial fibrosis whose prognosis otherwise is dismal.

Adolescent↗
PubMedDate not supplied

[Lumbar spinal stenosis. Symptomatology and methods of treatment].

INTRODUCTION: Lumbar spinal stenosis (LSS) may be defined as any type of the narrowing of the spinal nerve root canal (the lateral recess), intervertebral foramina, or its combination. It may be local, segmental or generalized; it can be caused by bone or soft tissue, and the narrowing can involve the bony canal or the dural sac or both. The normal sagital diameter of the lumbar canal is 15 to 25 mm and measurements below this are regarded as suggestively abnormal; a diameter less than 12 mm confirms the presence of stenosis. On the other hand, the lateral recess height less than 3 mm is suggestive, and less than 2 mm is a diagnostic sign of stenosis. There are two large groups of LSS: congenital-developmental stenosis and acquired stenosis with many subgroups (Scheme 1). The number of surgical operations due to LSS is increased during the ensuing years especially in elderly persons. This is why we would like to emphasize the important role of this phenomenon as there are only a few published papers in domestic literature. MATERIAL AND METHODS: In a consecutive series of 38 patients with LSS diagnosed for the last five years (January 1990-December 1994), aged from 20 to 70 years (average age 48.55) there were 21 males (Table 1); 34 of them had LSS as a result of bony changes, while the rest of 4 were iatrogenic (3 after disc extirpation and one after laminectomy) (Fig. 1). Herniation of the nucleus pulposus in combination with LSS was found in 12 patients (31.57%). Local segmental stenosis was identified in 16 patients (42.10%). (Graph. 1) (Fig. 2); the others had the generalized type of stenosis involving two levels (17 patients-44.7%); three levels (4 patients-10.52%) or 4 levels (one patient-2.63%) (Fig. 3). As far as symptomatology is concerned 31 patients had low-back pain with acute radicular complaints and motor weakness as the result of lesion of one or two spinal roots (20 patients). There were no neurogenic claudication or cauda equina compression syndromes. Electromyoneurographic studies (EMNG) in surgically treated patients revealed preoperative signs of muscle denervation in 15 patients (7.42%) (Table 2); the rest of them had signs of chronic irritative lesions of the corresponding root. RESULTS: Twenty one patients were operated on: 19 with signs and symptoms of generalized type of LSS and only two with lateral recess stenosis (Table 2). Congenital developmental stenosis was identified in 6 young patients (20 to 40 years of age) (Fig. 4). Single-level laminectomy with medial facetectomy and nerve root decompression was performed in 10 patients, and the rest of them had two level or three level decompressive laminectomies with medial facetectomy and roots decompression (Fig. 5). Dissectomy was done in 8 patients (Graph 2). None of our patients had concomitant arthrodesis, or needed reoperation. Postoperative EMNG improvement was confirmed in 13 patients of 15 (86.66%); this is about 61.90% in comparison to all operated patients (Table 3). The main complaints after the operation were: low-back pain (70%), leg numbness (70%), slight walking difficulties (60%); however all were able to walk more than 500 meters. The answer to the question how they felt after the operation, 15 patients responded to feel better or much better (71.42%), 3 felt the same (14.28%), and 3 felt worse than before the operation. Five patients retired before the operation, 7 changed their occupation taking an easier job, 9 returned to the same job, and none retired after the operation (Table 3). DISCUSSION: A certain number of patients had congenital-developmental stenosis with thickening of the laminae and development of short, squat pedicles with a decreased anterior-posterior diameter of the spinal canal. There are numerous variations of this pattern which remain asymptomatic until later developmental changes precipitate the typical radiculopathy and cauda equina changes in LSS. (ABSTRACT TRUNCATED)

Adult↗
PubMed1995

Bilateral simultaneous percutaneous nephrolithotomy. A prospective feasibility study.

A prospective study was undertaken to assess the feasibility and safety of bilateral simultaneous percutaneous nephrolithotomy (BPNL) under single anesthesia. BPNL was attempted in 16 consecutive patients with upper tract urolithiasis suitable for percutaneous treatment bilaterally. Bilateral simultaneous PNL could be accomplished in 14 of 16 cases; the opposite side was abandoned in 2 due to technical reasons. The operating sides could be switched within a short period (15 min) by rotating the patient table by 180 degrees. The average total operating time and irrigation time was 83 and 43 min, respectively. A total of 29 tracts and 18 sessions were required for endourologic treatment of 28 units in 14 patients. There was no significant morbidity. Complete clearance was achieved in 11 of 14 patients; there was insignificant residue in 1, while 2 with major residue required adjunct JJ stenting and extra-corporeal shockwave lithotripsy. The average hospital stay was 5.4 days. After initial proficiency with endourology, preparedness for BPNL is advisable in all such cases.

Adult↗
PubMed1994

[Functional and esthetic results of surgery of leg varices].

An experience of 1240 patients suffering from varicose veins of the lower limbs and operated from December 1987 to October 1992, is reported. In order to obtain an objective valuation of functional and aesthetic results, a table with subjective symptoms and clinical and instrumental signs was filled in, before the surgical operation. The correction of anatomic and functional defects and the results so obtained were evaluated by filling in another table after the operation and comparing the postoperative to the preoperative situation. We gave different scores to each parameter considered according to the results obtained and the overall result was obtained by adding up all the different scores for each parameter. In 73.6% of the patients we registered the maximum score, 15 (excellent result), in 1.9% of the patients the score obtained was 10 (sufficient result) and in the remaining 24.5% of the patients the score was variable from 14 to 11 (good result).

Adult↗
PubMed2006

Closed antegrade interlocked nailing of femoral shaft fractures operated up to 2 weeks postinjury in the absence of a fracture table or C-arm.

BACKGROUND: We present our technique of closed nailing in diaphyseal femoral fractures treated between 1 to 14 days postinjury. The purpose of the study was to demonstrate the fact that such fractures can be treated closed in the absence of a fracture table or C-arm. METHODS: In all, 200 consecutive closed femoral fractures were fixed 1 to 14 days postinjury during a period of 2 years. Skeletal traction was applied immediately at admission and sufficient weight was applied to overcome muscle spasm. In most cases, a closed nailing was successfully performed. Distal locking was achieved with either a medinov nail with wings for distal locking, or a standard nail with a jig for the distal lock. RESULTS: The average age of the patients was 30 years. Follow up ranged from 6 to 12 months. Mean duration of follow up was 10 months. All patients had a functional range of movement at the hip and knee with a normal gait. The average time taken for surgery was 90 minutes with an average blood loss of 50 to 100 mL. Time in hospital after surgery was 2 to 10 days. CONCLUSIONS: Delayed closed nailing of femoral fractures can be achieved without a C-arm or a fracture table provided adequate skeletal traction is applied preoperatively and proper attention is paid to the surgical steps as described.

Adult↗
PubMedDate not supplied

Limb lengthening operations.

Limb lengthening operations were first used at the beginning of this century, they were, however, performed more frequently only in the fifties. The various, continuously elongating devices have made possible a substantially greater lengthening than earlier. Wide-range investigations were begun with the various distraction devices and the results were examined in regard to the site of lengthening, the injury of the periosteal and endosteal vascular supply during the operation and the extent and rate of the lengthening. Detailed results of 224 lengthening operations performed in 191 patients are presented in Tables 1 to 8. Attention is called to the fact that the operation should be performed strictly individually, and the patients should be well prepared to the operation and followed carefully. The number of complications increases in direct ratio with the measure of lengthening, the end result is, however, influenced only by a minor part of the complications.

Adolescent↗