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PubMed2003

Note on the S-matrix propagation algorithm.

A set of full-matrix recursion formulas for the W --> S variant of the S-matrix algorithm is derived, which includes the recent results of some other authors as a subset. In addition, a special type of symmetry that is often found in the structure of coefficient matrices (W matrices) that appear in boundary-matching conditions is identified and fully exploited for the purpose of increasing computation efficiency. Two tables of floating-point operation (flop) counts for both the new W --> S variant and the old W --> t --> S variant of the S-matrix algorithm are given. Comparisons of flop counts show that in performing S-matrix recursions in the absence of the symmetry, it is more efficient to go directly from W matrices to S matrices. In the presence of the symmetry, however, using t matrices is equally and sometimes more advantageous, provided that the symmetry is utilized.

Journal Article↗
PubMed1975

[Review on the afterloading technics in gynecological radiotherapy].

A review of clinically used afterloading techniques - remote controlled and manually operated ones - is given by tables. The advantages of afterloading techniques are discussed with regard to radiation protection as well as to the therapy of gynecologic carcinomas.

Cesium Radioisotopes↗
PubMed2001

The importance of anatomical variants of the sapheno-femoral junction in lower-limb varicose vein surgery.

BACKGROUND: In the surgical strategy of lower limb varicose veins, the fundamental objective is to prevent relapses. For this purpose, after having examined the international literature on the most frequent relapse causes, the authors emphasize that erroneous diagnosis, varicose disease natural development and incorrect surgical treatment are very important. METHODS: They report their experience about the sapheno-femoral junction anatomic variants that have been verified at the surgical table on 532 consecutive patients operated on for lower limb varicose veins. Of 532 patients 449 (84.4%) patients were women and 83 (15.6%) were men; all of them were, on average 49+/-26 years old. They were all with derivative from sapheno-femoral junction incontinence varicose veins that can be classified according to CEAP (C2-3-4/Ep/As 2-3/Pr). On these patients, 430 (80.8%) patients have had an operation of internal saphena long stripping; 65 (12.3%) patients have had an operation of saphena short stripping and 37 (6.9%) patients have had an operation of internal simple rossectomy. RESULTS: The authors have inspected all collateral veins of the sapheno-femoral junction and they have noticed 135 variants (25.2%) that are very important for the surgeon and, among these variants, they have discovered some collaterals, that flow under the sapheno-femoral junction (about 4%), are particularly insidious and they are the cause of sure relapse if they are ignored. CONCLUSIONS: The purpose of the work is to emphasize the importance of knowing sapheno-femoral junction changeability that is often the cause of relapse after surgical treatment.

Female↗
PubMed2001

Laparoscopy for colon cancer.

Laparoscopic resection of the colon is certainly feasible. There are conflicting reports regarding decreased postoperative pain, resumption of gastrointestinal function, and earlier return to work. There is no change in either mortality or morbidity when compared with open resection. For benign disease laparoscopic colonic resection is ideal if performed by a surgeon who performs the operation frequently. For malignant disease, [table: see text] at this stage, laparoscopic colonic resection should only be performed in the setting of a randomized controlled trial. The future of laparoscopic surgery for colon cancer will be decided by oncologic parameters. There is good evidence that a laparoscopic resection can be technically equivalent to its open counterpart. The data on recurrence, both local and distant, and long-term survival will become clearer when results of randomized controlled trials currently underway become available. The issue of port-site recurrence is a major concern in laparoscopic colorectal cancer surgery. The reported incidence is low; however, its cause remains unexplained and its presence in patients with early stage tumors cannot be ignored.

Clinical Trials as Topic↗
PubMed1992

Old and new MMPI-derived scales and the short-MAST as screening tools for alcohol disorder.

Ten previously published and two new MMPI-derived scales were compared with the short-form of the Michigan Alcohol Screening Test (SMAST-13) in terms of sensitivity and specificity at detecting alcohol disorder in a study of 100 alcohol out-patients, 100 mental health out-patients, and 100 college students. The SMAST-13 and the new MMPI-derived alcoholism scales performed best at detecting alcohol disorder on multiple criteria including the standard contingency table, relative efficiency, and receiver operator characteristic analyses. These conclusions, were found to be robust in separate analyses for males and females.

Adolescent↗
PubMedDate not supplied

Cardiac surgery at high altitude.

Eleven children between 4 and 17 years of age underwent ligation of a patent ductus arteriosus during two medical camps in September 2003 and August 2004 at the Sonam Norboo Memorial District Hospital at Leh, Ladakh (11,400 feet above mean sea level). These children had a low mean arterial oxygen saturation while breathing room air. They were all acclimatized to high altitude. Surgery was performed under general anaesthesia with endotracheal intubation. Patients were extubated on the table. All children survived the operation and were discharged within 5-6 days following surgery. No surgical or anaesthetic complications were encountered. Simple cardiac surgical procedures such as ligation of a patent ductus arteriosus can be performed safely at high altitudes.

Adolescent↗
PubMedDate not supplied

Diagnosis and management of failing lower extremity arterial reconstructions prior to graft occlusion.

In 191 instances, infrainguinal graft occlusion was presumed because of a rethreatened foot, diminished pulses and/or decreased ankle pressure. Routine urgent arteriography revealed 38 instances where the graft was patent (22 vein, 16 PTFE). Ten of these grafts were to the femoral artery, 18 to the popliteal artery and 10 were to infrapopliteal arteries. The deterioration despite a patent graft was due to development of inflow stenosis (15), vein graft lesions (13) or distal disease progression (10). All were treated successfully by percutaneous transluminal angioplasty (30) or simple local operative revisions (8). Cumulative life table patency rates 2 years after reintervention were 89% for failing reconstructions to the femoral artery, 94% for those to the popliteal artery and 89% for infrapopliteal procedures. Comparable rates for limb salvage were 90%, 100% and 100%, respectively. These findings underscore the importance of urgent angiography in suspected lower extremity graft failure. Defects may be detected before real graft occlusion occurs and appropriate interventional treatment can provide important additional periods of limb salvage.

Angioplasty, Balloon↗
PubMed1978

The definitive technique of selective proximal vagotomy with pyloroplasty appropriate to form and function in surgery of peptic ulcer disease.

The overall efficiency of the ff-PYPL is most apparent when we compare our own large series of long-term observations of SPV, accompanied with these pyloroplasty forms with all types of DU, in contrast to the series of SPV without pyloroplasty of some other authors with a smaller number of patients and a shorter observation period (Table 1). The table shows that the combination operation of complete SPV with ff-PYPL (Fig. 17) assures the clinical permanent healing of DU. In GU the results of the nonresecting method are less satisfying. Twenty-two percent of the GU patients must have selective vagotomy with antrectomy because of antral disorder, destroyed antral innervation, or suspicion of malignancy.

Cranial Nerves↗
PubMedDate not supplied

[Obstetrical activities at the Dakar Principal Hospital (a 4-year retrospective 1978-1981)].

The authors give an account of the obstetrical activity at Dakar Principal Hospital over the last four years. After a short description of the operating conditions, they present two tables: one displays the comprehensive activity and the other lists the indications for the cesarean section which are, most frequently, carried out with an emergency background and the incidence of which rates much lower (2,9 p. 100) than reported in the industrialized countries.

Cesarean Section↗
PubMed1995

[Small intestine transplantation. Experimental microsurgical model in rats].

Small bowel transplantation may eventually become the definitive solution for those patients who suffer from irreversible intestinal failure and that currently depend on parenteral nutrition for survival. Microsurgical transplantation models in rats are widely used for the application of a great variety of immunological and physiological tests. Herein we report our experience after 30 intestinal harvestings and 12 intestinal transplantations in rats. The following criteria were established to assess the surgical procedures: operative time (harvesting and back table, cold ischemic time and warm ischemic time), vascular and intestinal complications and gut histology before and after transplantation. Average time for the donor surgery (harvesting and back table) was 97.19 min. Average warm ischemic time (includes vascular anastomoses) was 115 min. Histological assessment after 3, 4 and 5 hours of cold ischemia (lactated Ringer's solution with 2.4% mannitol at 4 degrees C) showed only mild ischemic changes. Two thrombotic complications were observed: one at the site of the portalcava anastomosis and one at the aortic suture. Hypovolemic shock was the most common cause of death (9/12) and there was no survival beyond 48 hours. Post-transplantation gut histology showed moderate ischemic injury. We conclude that the harvesting technique, as well as the preservation method used are adequate to obtain grafts in a fast and reliable fashion. However, the number of rats transplanted in this experience do not permit statistical analysis of morbidity and mortality at the present time.

Animals↗
PubMed1985

Results of an aggressive surgical approach to gastric carcinoma during a twenty-three-year period.

The early work of Dr. William Longmire with total gastrectomy for gastric carcinoma prompted us to initiate an aggressive surgical approach to gastric carcinoma in 1960: in curative resections radical total gastrectomy with hepaticoceliac-left gastric arterial node dissection was to be performed for tumors involving the entire stomach or upper two thirds and radical 80% to 90% subtotal gastrectomy with similar node dissection for tumors located in the antrum. During a 23-year period 213 patients with confirmed gastric carcinoma were studied. Celiotomy was performed in 192: advanced gastric cancer was found in 185 and seven had early gastric cancer. In only 80 patients could resections for "cure" be done. In 31 patients who underwent total or extended total gastrectomy the operative mortality rate was 9.6%, and life table survival curves show a better survival rate than in 49 patients treated by subtotal gastrectomy, with an operative mortality rate of 16.3%. The study shows the urgent need for diagnosis of early gastric cancer by gastroscopic screening of adults at risk and the meager salvage by radical resection in advanced disease.

Actuarial Analysis↗
PubMed1992

[Sexuality following spinal anesthesia. A retrospective study of young men (less than 55 years old].

A retrospective study was undertaken in order to determine whether the rumor that the use of spinal anesthesia in young men has a possible negative influence on sexual potency is justified or not. METHOD. Under the assumption that men up to the age of 55 years are generally sexually active, 1016 patients who were operated upon under spinal anesthesia (Ga. 22 and 25) during the last 5 years were requested to answer questions about their convalescence with emphasis on their pre- and postoperative sexual life. If they developed difficulties in this particular aspect, their opinion about the possible reasons was asked. RESULTS. Usable responses were obtained from almost 48% of the patients (Table 1). We excluded from the study those operations that could themselves have negatively influenced sexuality (Table 2). The patients belonged--as far as known--to ASA groups I-III (Fig. 2). Four-fifths of the patients had recovered completely 6 months after surgery (Fig. 4); their recovery was independent of the postoperative time interval (Table 1). Seventy-five percent were sexually active within 3 months after their operation (Fig. 6). There was no correlation between risk group and degree of recovery (Fig. 7, Tables 3 and 5). Nine of the preoperatively active patients did not have sex afterward, whereas 50% of the preoperatively inactive ones became active postoperatively (Tables 6 and 7). Four-fifths of the abstinent ones did not want sex or had no partner (Fig. 8). In no case was anesthesia mentioned as the cause of unwanted sexual abstinence (Fig. 9, Tables 3 and 4). Two patients who had resumed sexual activity but seemed dissatisfied with their sexual drive mentioned anesthesia as a possible cofactor in connection with surgery or psychological problems (Table 5). CONCLUSION. This is, as far as we know, the only study that has specifically investigated sexuality in relation to spinal anesthesia. The results show clearly that after uncomplicated, routine spinal anesthesia there is no negative influence on sexual potency. Nevertheless, should occasional difficulties with sexuality arise, spinal anesthesia does not have to be considered a primary causative factor.

Adolescent↗
PubMed1980

Immediate prognosis and five year survival after arterial embolectomy following myocardial infarction.

One hundred and twenty-two patients with 135 arterial emboli, 31 of whom had had a recent myocardial infarction, were seen during a 12 year period. Six patients died after embolectomy, resulting in a 19 per cent in-hospital mortality, and in five patients, amputation was required. The median time from infarction to embolization was 14 days. Length of follow-up period after operation ranged from four to 73 months, with a mean of 36 months. Life table analysis of patients alive 30 days after operation revealed a cumulative five year survival rate of only 26 per cent, recurrent myocardial infarction being responsible for 60 per cent of the deaths. This is in contrast with an approximate 60 to 70 per cent five year survival rate reported in the literature for patients having an infarction only. Although the immediate mortality was greater than that for patients with arterial emboli without infarction, an aggressive approach directed toward limb salvage is urged in these patients, as manifested by the 84 per cent salvage rate in this series.

Actuarial Analysis↗
PubMed1995

A follow up of silastic sling for genuine stress incontinence.

OBJECTIVE: To assess the use of silastic sling for genuine stress incontinence. DESIGN: Retrospective descriptive analysis. SETTING: Tertiary referral centre for urogynaecology. SUBJECTS: Eighty-eight women with urodynamically proven genuine stress incontinence, 10 had coexistent detrusor instability. In 74 women, the sling operation was for recurrent incontinence. INTERVENTION: A low Pfannenstiel incision was used and a suburethral tunnel dissected to insert the sling, which was attached under minimal tension with non-absorbable sutures to each ileopectineal ligament. MAIN OUTCOME MEASURES: Clinical and urodynamic data were assessed between two and three months post-surgery; thereafter clinical assessment and pad testing were performed at yearly intervals for five years. RESULTS: The subjective cure at three months was 81% and the objective cure was 69%. There was a fall in success rate with increasing number of continence operations, and this was statistically significant for women with three or more previous continence operations (P < 0.05). Neither age, parity nor menopausal status made a statistical difference to the cure rate. Twenty-three women had reached their fifth year follow up and the success rate using life table analysis was 71%. Post-operatively, 29 women had detrusor instability: 22 women developed detrusor instability de novo and seven had detrusor instability presurgery. Urodynamic findings postsurgery showed an increase (P < 0.001) in outflow resistance. Four women required removal of sling for voiding difficulties. Ten women developed sling erosions: five vaginal, four bladder erosions and one urethral erosion. After removal of the sling, seven women still remained continent. CONCLUSIONS: A silastic sling operation for the treatment of genuine stress incontinence provides a good long term cure, considering that 45% of women had two or more previous failed continence operations. The high prevalence of detrusor instability and voiding difficulties postsurgery should be noted.

Adult↗
PubMedDate not supplied

Colour displays and look-up tables: real time modification of digital images.

Image processing in biomedical research has become customary, along with use of colour displays to run image processing packages. The performance of softwares is highly dependent on the device they run on: architecture of colour display, depth of frame buffer, existence of look-up table, etc. Knowledge of such basic features is therefore becoming very important, especially because results can differ from device to device. This introductory paper discusses hardware features and software applications. A general architecture of colour displays is exposed, comparing the features of the most commonly used devices. Basic organisation of memory, electron gun and screen are analysed for each type of display, concluding with a more detailed study of raster scan devices. Frame buffer and look-up table organisation are then analysed in relation with overhead expenses such as time and memory. Relation between image data and displayed images is discussed. By means of examples, the manipulation of colour tables is examined in detail, showing how to improve display of images without altering image data. Finally, the basic operations performed by the look-up table editor developed at University of Geneva are presented.

Color↗
PubMed1989

Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice.

In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic cholangiography 50 patients were randomised to the two treatment alternatives. All 25 patients randomised to endoprosthesis were treated by this procedure, whereas only 19 of 25 patients randomised to bypass surgery underwent operative biliary-digestive anastomosis. Life table analysis revealed no difference in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass.

Aged↗
PubMed1984

An analysis of blood usage in elective surgery.

Pre-operative blood requests are often greatly in excess of the number of units of blood actually transfused during elective surgical procedures. Such practices are costly in terms of laboratory manpower and leads to unnecessary wastage of blood due to outdating. Developing guidelines for the number of blood units to cross-match preoperatively for surgical procedures optimises the use of blood. This study reports on blood ordering patterns and offers guidelines on the maximum number of units of blood to order for some of the commoner surgical procedures. The use of a Type and Screen procedure is recommended for those operations where blood is regularly ordered but rarely used. Operative procedures listed under the Surgical Tables 1 and 2 and the Minor Surgical Procedure Table, Ministry of Health, Singapore, fall into this group.

Blood Grouping and Crossmatching↗