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PubMed1997

Bioventing pilot test results at the low point drain area, Offutt AFB, Nebraska.

The purpose of this paper was to describe the application of bioventing technology at the LPD site at Offutt AFB, Nebraska and present the results of the 15-month pilot test. The preliminary tests indicated sufficient hydrocarbon contamination was present with the necessary soil characteristics to warrant an extended bioventing pilot test. The six month in situ respiration test indicated that progress was being made in reducing the TVH concentrations and biological activity was still occurring. Laboratory analysis of the final soil samples confirmed the reduction in TRPH and BTEX concentrations indicating that the site is close to complete remediation. However, owing to reduced air flow at greater distances from the VW, more biodegradation is still needed near MPB. The reduced biodegradation at MPB could also be due to the high water tables resulting from heavy rains during the summer and fall of 1993. The local water table was above the VW and MP screens for several months. The operation of the blower will continue until the site is completely remediated. The single VW pilot test at the LPD site at Offutt AFB has proven the effectiveness of bioventing in reducing TRPH and BTEX contamination in the subsurface. The installation, operation and maintenance costs were minimal. The effectiveness of this application has resulted in three additional bioventing applications at Offutt AFB including the first, full-scale system located in the state of Nebraska.

Biodegradation, Environmental↗
PubMed1979

Subclavian arterioplasty for the ipsilateral subclavian-to-pulmonary artery shunt.

A new technique is described to avoid kinking and improve flow in the ipsilateral subclavian-to-pulmonary artery shunt. Experience with this procedure is reviewed in 35 infants and children with a variety of cyanotic congenital heart disease, including 10 with tricuspid atresia. Of these, 17 had had previous shunts: a Waterston shunt in six, a Glenn shunt in six, and a contralateral Blalock-Taussig shunt in five. The mean age was 5.6 years (range, 1 day to 16 years), and the mean follow-up was 24 months (range, 11 months to 4.5 years). There were no early deaths (less than 30 days), but there were two late deaths. There were three shunt failures at 2 weeks, 1 month, and 10 months; two of the failures were in infants aged 1 day and 4 days at operation. There were no late shunt failures. The patency by the life table method was 91.4% at 6 months, 88.5% at 1 year, with no further drop-off. It is concluded that subclavian arterioplasty can be performed safely and offers improved shunt patency in comparing to the ipsilateral Blalock-Taussig shunt.

Adolescent↗
PubMed1979

Total anomalous pulmonary venous drainage.

Twelve patients with total anomalous pulmonary venous drainage (TAPVD) underwent complete surgical correction. Six were of the supracardiac type, 2 were cardiac and 4 of the infracardiac type. Pulmonary hypertension due to pulmonary vein obstruction was present in 6 patients. There were 6 early deaths, which occurred on the table or soon after surgery. One patient died 8 months after the operation because of a marked obstruction of the pulmonary venous inflow. Early diagnosis and operative correction in these severely ill patients should not be delayed. Postoperative intensive care and long-term follow-up are of the greatest importance.

Cardiac Catheterization↗
PubMed2001

[Thymoma-report of 166 patients].

OBJECTIVE: To discuss the characteristics of operation and the prognosis of 166 patients with thymoma. METHODS: 166 thymoma patients were treated from February 1985 to February 2000. By Masaoka staging system, there were 102 (61.4%) stage I, 28 (16.9%) stage II, 24 (14.5%) stage III, 12 (7.2%) stage IV a and 0 stage IV b lesions. The relation between stage and survival rate was analyzed. RESULTS: One (0.6%) patient died of the operation. 137 (82.5%) patients underwent radical operation. Thirty patients were lost to follow-up. With the life table method, the 10-year survival rate was 56.8%, with 79.8% for stage I, 51.6% for stage II, 33.5% for stage III and 0% for stage IV patients. CONCLUSION: Diagnosis of thymoma still depends on both clinical and pathological findings, which are correlated with stage. The principal treatment is to resect the tumor as completely as possible so as to relieve the symptoms and prolong the life of the patient.

Adult↗
PubMed2002

Validation of diving decompression tables.

Research on the validation of decompression tables is one of the common subject areas of the co-operation undertaken between the Defence and Civil Institute of Environmental Medicine, Toronto, Canada, and The Naval Academy of Gdynia, Poland. For several years now, a systematic survey of diving technologies has been conducted among the target projects financed by the Polish State Committee for Scientific Research and the Polish Navy. Among the most important problems discussed have been various aspects of decompression safety. The present paper shows a study to standardise and unify validation procedures for decompression in the Polish Navy.

Algorithms↗
PubMed1978

[Spieghel's hernia and its treatment].

It is reported about 12 patients with hernias through the spigelian fascia, among them one case with a rare bilateral hernia. The cause of these hernias are congenital or acquired gaps in the fascia transversalis medial to the linea semilunaris. Mostly they are discovered below the umbilicus in the height of the linea semicircularis, lateral to the rectussheath and medial to the spigelian line. All clinical details are shown in a table (Tab. 1). There is referred about localisation, sex, age, complications before operation (e.g. incarceration), complaints of the patients and operative findings. The results correspond to those of other authors. Seldom a spigelian hernia is noticed in children. To diagnose a spigelian hernia it is very important to think of it, for the symptoms are often not very characteristically and the clinical findings misleading. At times only operation reveals the real diagnosis. The operation is often simple and remaining complaints are very seldom; we didnt see any. Sometimes the operative finding requires an extensive laparotomia and bowel resection. If one finds the abdominal wall intact, one should open the abdomen in every case.

Abdominal Muscles↗
PubMed1991

National Electronic Telecommunications System for Surveillance--United States, 1990-1991.

The National Electronic Telecommunications System for Surveillance (NETSS) was developed by CDC and the Council of State and Territorial Epidemiologists (CSTE) for collecting, transmitting, analyzing, and publishing weekly reports of notifiable diseases and injuries from the 50 states, New York City, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and Commonwealth of the Northern Mariana Islands. Operation of NETSS is facilitated by CDC/CSTE agreements on reportable conditions, protocols for formatting and transmitting data, standard case definitions, and designated staff members in each participating agency who provide and prepare the data for weekly publication in MMWR. This report describes the development and operation of NETSS and presents tabulations of national surveillance data for 1990 (tables on pages 505-510).

Centers for Disease Control and Prevention, U.S.↗
PubMed1990

[The treatment of proximal femoral fractures using the interlocking nail].

The good result hoped for with interlocking nailing of the proximal part of the femoral shaft is only possible when precise diagnosis is of the fracture form is made with reference to informative X-rays and a meticulous operative technique is observed. Therefore, positioning of the patient on an extension table, the repositioning of the bone, the choice of the insertion point for the nail, and careful drilling are of the utmost important. All follow-up examinations conducted in 42 patients, we found good or very good results in 32 cases, satisfactory results in 7, and poor results in 3.

Adolescent↗
PubMedDate not supplied

[Identification based on medical findings].

1. The indications such as the place of finding, the identification of clothes or other personal items, represent only the first step towards the identification of a corpse. 2. An identification based on medical data, other than dental, is often possible, more often than it is believed. 3. The forensic pathologist plays a double role in the case of such an identification: a) in the phase of the inquiry, he must contact the investigators and the families to explain his wishes and the different possibilities of identification. b) he must use the gathered information in the appropriate way. 4. It would be desirable to compose some statistical tables of the various medical elements useful for the identification (mutilations, surgical operations, etc...). We present six cases of identification in our practice.

Adult↗
PubMed1979

[Position of behavior therapy among the psychiatric therapies].

In the fourth table, we have classified the most important measures of behaviour therapy: desensitivization, operating conditioning, aversive therapy and negative learning. These courses of action can play an important role in psychiatry and can enrich the therapeutic repertory through their rational use, placed in a general plan of treatment. Moreover, these methods are usually excluded from the tought theories and they do not see in the neurotic troubles a consequence of unconscious conflicts; these conflicts must become conscious again, but they must appear, then, as the result of the learning of bad behaviour.

Aversive Therapy↗
PubMed1995

[Myocardial revascularization in left coronary trunk lesion in patients over 65 years old].

PURPOSE: To study the short and long-term follow-up of patients with left main coronary artery disease (LMCAD) and age over 65 years, by comparing the results with patients under 65 years-old. METHODS: Twenty-two patients with LMCAD and mean age of 69 +/- 3.5 years (group I) were underwent isolated coronary artery bypass grafting (CABG) and compared to 31 patients with LMCAD, mean age of 54 +/- 7 years (group II), who also underwent isolated CABG. The life-table Kaplan-Meyer method was used to estimate the post-operative survival. The chi-square and Student "t" test were used when necessary. RESULTS: Despite higher operative mortality in group I (9.1% x 3.2%), the difference was statistically not significant. The operative morbidity was similar in both groups. Actuarial survival at 4 years was 85% in group I and 95% in group II. Actuarial survival free of cardiac events was 69% in group II and 75% in group II. CONCLUSION: The CABG is well tolerated and had low morbidity and acceptable mortality in old patients with LMCAD. The long-term survival in these patients was very similar to the younger patients.

Actuarial Analysis↗
PubMed1977

Technical adjuncts in neurosurgery.

Modifications of several surgical adjuncts are presented: a balanced microscope stand with mouthpiece and hand controls, a piston release operating stool, a support device for resting the surgeon's arms, a table mounted arm with coupling head for attaching self-retaining brain retractors, fish hook retractors, suction tubes, bipolar forceps, aneurysm clips and mobile tip mirrors. Although many of these changes are minor, they considerably facilitate microneurosurgical procedures.

Microsurgery↗
PubMed1998

Radical surgery and reoperation in supratentorial malignant glial tumors.

The treatment modalities for gliomas are still questioning and searching. We reviewed the effect of the extent of surgical resection and reoperation on the length and quality of survival in 152 consecutive patients who underwent operation for supratentorial gliomas at GATA Neurosurgery clinic between 1985 to 1995. Seventy-two patients (50%) had glioblastoma multiforme (GBM), and 48 patients (33%) had anaplastic astrocytoma (AA). Gross total resection was achieved in 70 cases (49%), subtotal resection was performed in 60 cases (42%), and biopsy was carried out in 14 cases (9%). Thirty-two patients were reoperated for recurrency and the median interval between the first operation and reoperation was 9.5 months in glioblastoma multiforme, and 11.7 months in anaplastic astrocytoma. The resection groups were compared for age, sex, preoperative and postoperative Karnofsky rating, tumor location, postoperative radiation therapy, and chemotherapy, and survival according to multivariate analysis. Preoperative Karnofsky rating and surgical resection type were the most important factors related to survival after operation or reoperation. The gross total resection group lived longer than the subtotal resection group by life table analysis. Median survival of GBM was 76 weeks in gross total resection group, and 33 months in AA group with total resection (p < 0.001). Preoperative Karnofsky scores had a statistically significant effect on the quality of life and survival after operation and reoperation in all cases (p = 0.005). Radical surgery and reoperation also improve quality and length of life in selective malignant supratentorial gliomas.

Adolescent↗
PubMed1992

The Rationale and Results of Gastroplasty/Distal Gastric Bypass.

A recent review of the results of gastroplasties done at the University of Alberta Hospital showed that there was a high incidence of late weight loss failure. Therefore a new operation, gastroplasty/distal gastric bypass, has been performed on 263 patients. This operation results In a profound (mean greatest percentage excess weight loss of 87% at approximately 2 years) and lasting weight loss (mean final percentage excess weight loss of 78%) at 4 years, range 2-7.5 years post-operatively. Only 0.9 % of patients failed to maintain at least a 40% excess weight loss. The operation achieves its effect through a moderate restriction that permits patients to eat normal table food from the time of discharge and with a mild metabsorption that is not ordinarily associated with diarrhea or notable deficiencies. Certain patients required debanding of the stoma and others developed staple-line eventration. Neither of these events after long-term follow-up resulted in weight loss failure nor in other serious side-effects. It Is concluded that moderate failure of the gastroplasty stoma and staple line does not necessarily result in weight loss failure, because the malabsorptive portion of the operation remains intact. Low hemoglobin occurred in 16% of cases and deficiency of serum iron In 34%; a much smaller number of patients had chronic or Intermittent deficiencies of these entities. Correction was easily achieved with oral replacement. Deficiencies in albumin, calcium, phosphorus and folate were rarely seen and minimal elevation of serum AST values occurred In just over 1% of patients. Chronic deficiencies or elevations were not seen in these patients. Stomal ulcer occurred in 6% of patients and bleeding associated with stomal ulcer in 1%. Half the patients with ulcer were managed with H&inf2; blockers, the other half with vagotomy. Both forms of treatment when individualized effectively prevent re-ulceration.

Journal Article↗
PubMed1989

The treatment of thoracic outlet syndrome: a comparison of different operations.

Although transaxillary first rib resection is one of the popular treatments for thoracic outlet syndrome today, recurrences and nerve injuries have led to investigation of other operations that might reduce complications and improve results. This article compares the results of transaxillary first rib resection with (1) scalenectomy (anterior and middle) and (2) supraclavicular first rib resection with scalenectomy. Between 1964 and 1987, 668 primary operations were performed for thoracic outlet syndrome on 491 patients. Seventy-one percent were women. Eight-six percent gave histories of neck trauma, often a whiplash injury (traumatic thoracic outlet syndrome); 4.5% had cervical ribs. Common symptoms included paresthesia in the hands (90%); arm pain (80%); neck pain (86%); and occipital headaches (69%). On physical examination, tenderness over the scalene muscles and duplication of symptoms with the arms abducted to 90 degrees in external rotation were present in over 90% of patients. By use of life-table analysis methods, success after surgery was found to be the same for all operations: 91% to 93% at 3 months; 76% to 79% at 1 to 2 years; 70% to 73% at 3 to 5 years; and 69% to 72% at 5 to 10 years. After rib resection plexus injuries occurred in 2.6%, with partial disability in 0.5%. No plexus injuries occurred after scalenectomy, but temporary phrenic nerve palsy occurred in 4.4%. Scalenectomy is as successful an operation as first rib resection for traumatic thoracic outlet syndrome and has fewer serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

[Preoperative diagnosis with stereotactic biopsy is a good predictor of breast cancer in radiologically non-benign breast lesions].

OBJECTIVE: To evaluate histological needle biopsy in breast lesions classified radiologically as 'non-benign'. DESIGN: Prospective, descriptive. SETTING: Hospital Velp, Velp, the Netherlands. METHODS: 232 women with an 'uncertain', 'suspicious' or 'malignant' result of mammography, if necessary supplemented by echography, were subjected to histological biopsy from a breast between 1 January 1994 and 1 January 1997. The earlier biopsies were made with a 16 Gauge (G) needle, those after April 1996 with a 14 G needle, as a rule under stereotactic control. In principle, operation was performed after a positive result. Concerning the women operated after the biopsy, the results of the histological examinations were compared in a 2 x 2 table. RESULTS: 165 of the 232 patients (71%) had breast cancer. Of the 59 patients classified roentgenologically as 'uncertain', 15 (25%) had breast cancer, of the 'suspicious' cases this ratio was 44/67 (66%) and of the 'malignant' results it was 106/106 (100%). Operation was performed in 186 women. The biopsy findings and the surgical preparation were in agreement in 169 patients (91%). The sensitivity of the stereotactic biopsy was 90%, its specificity 93%. One woman was over-treated (axillary lymph node resection) because of a biopsy classified as malignant performed on a rare tumour ultimately diagnosed as 'adenomyo-epithelioma with epithelial atypia'. The proportion of false-negative results was 36%. The predictive value of a positive result was 99%, that of a negative result 63%. CONCLUSION: A diagnostic stereotactic biopsy after roentgenological classification based on mammography and echography had a good predictive value regarding the probability of breast cancer.

Biopsy, Needle↗