Hasil untuk "Surgery"

R. Bucholz

98 A.A.O.S. INSTRUCTIONAL COURSE LECTURE reduction is mandatory if the tuberosity fragment remains retracted under the acromion. 4. A fracture of the lesser tuberosity may be one of the diagnostic signs in posterior dislocation of the shoulder. 5. Fracture-dislocations of the shoulder are severe injuries which are difficult to treat. If closed reduction fails, open operation should be done. 6. The abduct-ion method of treating fractures about the shoulder has limited use. The relaxed muscle position with the arm at the side is preferred as it gives much better functional results.

S. Trokel, R. Srinivasan, B. Braren

Kazuhiro Ichihara, In Dae Jong, Yasuyoshi Tsutsumi

Using the rational surgery formula for the Casson--Walker--Lescop invariant of links in the $3$-sphere, we show that any null-homologous knot in a rational homology sphere admits at most two pairs of integral purely cosmetic surgeries. We also present constraints for null-homologous knots in certain $3$-manifolds with the first Betti number one or two to admit purely cosmetic surgeries. As another application, we show that, for a null-homologous knot in some $3$-manifolds, including $S^2 \times S^1$, there are at most two knots which are inequivalent to the given one, but whose exteriors are orientation-preservingly homeomorphic to that of the given one.

Ian Hambleton, Ozgun Unlu

We complete the description of surgery obstructions up to homotopy equivalence for closed oriented manifolds with finite fundamental group. New examples are presented of non-trivial obstructions for Arf invariant product formulas in codimensions $\geq 4$, which give counterexamples to the well-known ''Oozing Conjecture'' from the 1980's.

Puja Jagasia, BA, Shivani A. Shah, MD, MBA, Kazimir Bagdady, BS et al.

Summary:. Arteriovenous (AV) loops formed from the greater saphenous vein and femoral artery can facilitate free tissue transfer to the abdomen or pelvis when adequate recipient vessels are not available. Here, we present the application of this technique in 3 cases where patients had significant abdominal or pelvic defects due to oncological resection or trauma. AV loops were successfully created using a saphenous vein turned up into the femoral artery at the level of the groin. These loops were then tunneled through the groin and cut back to form recipient vessels for anterolateral thigh (ALT) flaps in a single-stage procedure. In all 3 cases, AV loops constructed with this technique served as reliable conduits for free ALT flaps. Only 1 complication occurred. Following a drop in tissue oximetry, 1 patient was taken back to the operating room. A stitch was found to be compressing the pedicle. Following release, no further complications were observed and all patients achieved complete wound healing. In this article, we highlight key surgical techniques to maintain the orientation of the vein during AV loop anastomosis, which prevents kinking. We provide technical insights regarding tunneling the AV loop through the groin without compression, anchoring the pedicle appropriately, and positioning the ALT flap anastomosis. Our success with this technique underscores its potential in facilitating complex pelvic and abdominal reconstruction.

Kyle Hayden, Lisa Piccirillo, Laura Wakelin

We prove that, for each fixed rational number $p/q \in \mathbb{Q}$, there exists a pair of distinct knots whose $p/q$-surgeries are orientation-preservingly homeomorphic. This confirms a 1978 conjecture of Gordon.

Ilya Besedin, Michael Kerschbaum, Jonathan Knoll et al.

Quantum error correction is needed for quantum computers to be capable of fault-tolerantly executing algorithms using hundreds of logical qubits. Recent experiments have demonstrated subthreshold error rates for state preservation of a single logical qubit. In addition, the realization of universal quantum computation requires the implementation of logical entangling gates. Lattice surgery offers a practical approach for implementing such gates, particularly in planar quantum processor layouts. In this work, we demonstrate lattice surgery between two distance-three repetition-code qubits by splitting a single distance-three surface-code qubit. Using a quantum circuit fault-tolerant to bit-flip errors, we achieve an improvement in the value of the decoded $ZZ$ logical two-qubit observable compared to a similar non-encoded circuit. By preparing the surface-code qubit in initial states parametrized by a varying polar angle, we evaluate the performance of the lattice surgery operation for non-cardinal states on the logical Bloch sphere and employ logical two-qubit tomography to reconstruct the Pauli transfer matrix of the operation. In this way, we demonstrate the functional building blocks needed for lattice surgery operations on larger-distance codes based on superconducting circuits.

Naoki Ikezawa, Takayuki Okamoto, Yoichi Yoshida et al.

Abstract A stroke is a medical emergency and thus requires immediate treatment. Paramedics should accurately assess suspected stroke patients and promptly transport them to a hospital with stroke care facilities; however, current assessment procedures rely on subjective visual assessment. We aim to develop an automatic evaluation system for central facial palsy (CFP) that uses RGB cameras installed in an ambulance. This paper presents two evaluation indices, namely the symmetry of mouth movement and the difference in mouth shape, respectively, extracted from video frames. These evaluation indices allow us to quantitatively evaluate the degree of facial palsy. A classification model based on these indices can discriminate patients with CFP. The results of experiments using our dataset show that the values of the two evaluation indices are significantly different between healthy subjects and CFP patients. Furthermore, our classification model achieved an area under the curve of 0.847. This study demonstrates that the proposed automatic evaluation system has great potential for quantitatively assessing CFP patients based on two evaluation indices.

Takashi Nagase, MD, Shinichiro Oda, MD, PhD, Yoshinobu Maeda, MD et al.

The conventional Damus-Kaye-Stansel procedure may cause coronary artery compression when the coronary arteries are situated between the great arteries. We have performed a modified Damus-Kaye-Stansel procedure utilizing a “flap-bridging technique,” in which an inverted U-shaped flap incised from the aorta is bridged to the main pulmonary trunk, creating sufficient space between the great arteries, in an 8-month-old boy who was a Fontan candidate with congenitally corrected transposition of the great arteries. This modified approach yielded favorable outcomes without coronary events and can effectively prevent coronary obstruction in cases where the coronary arteries run between the great arteries.

Gabriela Rus, Nadim Al Hajjar, Paul Tucan et al.

Control systems used in Minimally Invasive Surgery (MIS) play a crucial role in ensuring preci-sion and safety throughout procedures. This paper presents a control architecture developed for a robotic system designed for MIS operations. The modular structure of the control system allows for compatibility with a range of procedures in abdominal and thoracic regions. The proposed control system, employing the master-slave concept, is presented alongside the experimental model. Functional validation is obtained by performing a Siemens NX simulation and comparing the results with several experimental runs using the experimental model of the robot. With its compact size and stiffness, the system holds promise for integration with other robotic systems. Future efforts will be dedicated to exploring and optimizing this potential collaboration to enhance the overall capabilities of robotic-assisted surgery.

E. Lin, S. Calvano, S. Lowry

R. Khouri, B. Cooley, A. Kunselman et al.

Lei Xiaofeng, Huang Xuezhu

Anesthesia management of fetal pulmonary valvuloplasty (FPV) is difficult, requiring careful consideration of both the mother and the fetus. Few reports have been published on specific anesthesia implementation and intraoperative management. We report the case of a pregnant woman who was treated with FPV under combined spinal epidural anesthesia (CSEA) with dexmedetomidine in the second trimester of pregnancy. Meanwhile, the application of fetal anesthesia through the umbilical vein was optimal. During the operation, the vital signs of the pregnant woman were stable with no complications and the fetal bradycardia was corrected by intracardiac injection of epinephrine. Four months postoperatively, a boy was born alive by full-term transvaginal delivery. CSEA may be a suitable anesthesia method for FPV surgery. Nevertheless, maternal hemodynamic stability maintenance, effective fetal anesthesia, and timely fetal resuscitation were necessary.

M. Offidani, S. Morè, M. Cavo et al.

L. Cohn, David H. Adams, G. Couper et al.

M. Braga, A. Vignali, L. Gianotti et al.

F. Pattou, F. Combemale, S. Fabre et al.

Michael J. Mack

Tomoaki Doi, Takamitsu Hori, Takashi Onuma et al.

Aim In acute medicine, we occasionally treat life‐threatening conditions such as sepsis and trauma, which cause severe thrombocytopenia. Serum thrombopoietin levels have been reported to increase under the condition of thrombocytopenia related to severity. Collagen is a crucial activator of platelets, and Rho family members, such as Rho/Rho‐kinase and Rac, play roles as active molecules involved in the intracellular signaling pathways in platelet activation. The present study aimed to elucidate the effects of thrombopoietin (TPO) on subthreshold low‐dose collagen‐stimulated human platelets in terms of Rho/Rho‐kinase and Rac. Methods Platelet‐rich plasma donated from healthy volunteers was stimulated by the subthreshold low‐dose of collagen after pretreatment with TPO and/or NSC23766, an inhibitor of the Rac‐guanine nucleotide exchange factor interaction, or Y27632, an inhibitor of Rho‐kinase. Platelet aggregation was measured using an aggregometer based on laser‐scattering methods. Proteins involved in intracellular signaling were analyzed using western blotting, and the secretion of platelet‐derived growth factor‐AB from activated platelets was determined using an enzyme‐linked immunosorbent assay. Results Under the existence of TPO, the low dose of collagen remarkably elicited the aggregation and platelet‐derived growth factor‐AB secretion of platelets, which were suppressed by NSC23766 and Y27632. The combination of TPO and collagen considerably induced a transient increase of guanosine triphosphate (GTP)‐binding Rac and GTP‐binding Rho followed by an increase of phosphorylated cofilin, a Rho‐kinase substrate. Conclusion These results strongly suggest that TPO and collagen in low doses cooperatively potentiate human platelet activation through both Rac and Rho/Rho‐kinase mediated pathways.

Akiko Tomita-Kobayashi, Tomoko Fujimoto, Shoko Takada et al.

Abstract Background Symptomatic sick sinus syndrome is one of the indications for pacemaker implantation, and we have to consider to program the pacemaker to an asynchronous pacing mode during an operation. Case presentation We reported two cases with a pacemaker implanted for sick sinus syndrome undergoing cardiac operation. We changed programming of the pacemaker to an asynchronous pacing mode (DOO) and modulated the programmed atrioventricular delay to avoid ventricular pacing, resulting in better hemodynamic condition. Although we observed premature ventricular contraction, no lethal arrhythmias induced by the R-on-T phenomenon were noted. Conclusion Programming of the pacemaker to an asynchronous pacing mode and modulation of the programmed atrioventricular delay to avoid ventricular pacing may be an option for pacemaker management during an operation.