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Perforation
Kinds of Perforation Terms modified by Perforation Selected AbstractsCURRENT STATUS IN THE OCCURRENCE OF POSTOPERATIVE BLEEDING, PERFORATION AND RESIDUAL/LOCAL RECURRENCE DURING COLONOSCOPIC TREATMENT IN JAPANDIGESTIVE ENDOSCOPY, Issue 4 2010Shiro Oka Bleeding, perforation, and residual/local recurrence are the main complications associated with colonoscopic treatment of colorectal tumor. However, current status regarding the average incidence of these complications in Japan is not available. We conducted a questionnaire survey, prepared by the Colorectal Endoscopic Resection Standardization Implementation Working Group, Japanese Society for Cancer of the Colon and Rectum (JSCCR), to clarify the incidence of postoperative bleeding, perforation, and residual/local recurrence associated with colonoscopic treatment. The total incidence of postoperative bleeding was 1.2% and the incidence was 0.26% with hot biopsy, 1.3% with polypectomy, 1.4% with endoscopic mucosal resection (EMR), and 1.7% with endoscopic submucosal dissection (ESD). The total incidence of perforation was 0.74% (0.01% with the hot biopsy, 0.17% with polypectomy, 0.91% with EMR, and 3.3% with ESD). The total incidence of residual/local recurrence was 0.73% (0.007% with hot biopsy, 0.34% with polypectomy, 1.4% with EMR, and 2.3% with ESD). Colonoscopic examination was used as a surveillance method for detecting residual/local recurrence in all hospitals. The surveillance period differed among the hospitals; however, most of the hospitals reported a surveillance period of 3,6 months with mainly transabdominal ultrasonography and computed tomography in combination with the colonoscopic examination. [source] THERAPEUTIC FISTULOSCOPY FOR THE MANAGEMENT OF PROLONGED POSTOPERATIVE INTRA-ABDOMINAL ABSCESS CAUSED BY SMALL INTESTINAL PINHOLE PERFORATIONDIGESTIVE ENDOSCOPY, Issue 4 2005Yoshihisa Saida Fistuloscopy is an effective treatment for intractable fistula, a sometimes difficult to manage postoperative intra-abdominal complication. A case of a 69-year-old male with an abdominal abscess after he underwent right hemi-colectomy for cecum cancer with invasions into the ileum and sigmoid colon is reported. A re-operation for lavage and drainage was performed 2 weeks after surgery. However, no obvious origin for the pus was located. Although physiological saline lavage was repeatedly performed, the effusion of pus persisted in the drain at the midline incision about 7 months after surgery. Then, fistuloscopy with an upper gastrointestinal endoscope was performed through the hole of the tube. A pinhole that produced a bubble just below the midline incision was observed. Then, an endoscopic retrograde cholangiopancreatography (ERCP) tube was inserted to obtain images of the small intestine by fluorography and findings suggested a diagnosis of perforation of the small intestine, which appeared to explain why resolution of the abscess was prolonged. After direct drainage to the small intestine with a 40-cm-long 7 Fr percutaneous transhepatic cholangio drainage (PTCD) balloon catheter, pus from the tube notably decreased. After confirming that the abscess cavity had disappeared by abdominal computed tomography scan, the PTCD catheter was extracted about 8 months after primary surgery. Since then, no recurrence of cancer or abscess has been observed. In cases of intractable postoperative intra-abdominal abscess, fistuloscopy using smaller diameter gastrointestinal endoscopy appears to be a valuable diagnostic tool. [source] PREDICTING IATROGENIC GALL BLADDER PERFORATION DURING LAPAROSCOPIC CHOLECYSTECTOMY: A MULTIVARIATE LOGISTIC REGRESSION ANALYSIS OF RISK FACTORSANZ JOURNAL OF SURGERY, Issue 3 2006Kamran Mohiuddin Background: Seventeen independent risk factors were examined using multivariate logistic regression analysis to develop a profile of patients most likely at risk from iatrogenic gall bladder perforation (IGBP) during laparoscopic cholecystectomy. Methods: Since 1989, a prospectively maintained database on 856 (women, 659; men, 197) consecutive laparoscopic cholecystectomies by a single surgeon (R. J. F.) was analysed. The mean age was 48 years (range, 17,94 years). The mean operating time was 88 min (range, 25,375 min) and the mean postoperative stay was 1 day (range, 1,24 days). There were 311 (women, 214; men, 97) IGBP. Seventeen independent variables, which included sex, race, history of biliary colic, dyspepsia, history of acute cholecystitis, acute pancreatitis and jaundice, previous abdominal surgery, previous upper abdominal surgery, medical illness, use of intraoperative laser or electrodiathermy, performance of intraoperative cholangiogram, positive intraoperative cholangiogram, intraoperative common bile duct exploration, presence of a grossly inflamed gall bladder as seen by the surgeon intraoperatively and success of the operation, were analysed using multivariate logistic regression for predicting IGBP. Results: Multivariate logistic regression analysis against all 17 predictors was significant (,2 = 94.5, d.f. = 17, P = 0.0001), and the variables male sex, history of acute cholecystitis, use of laser and presence of a grossly inflamed gall bladder as seen by the surgeon intraoperatively were individually significant (P < 0.05) by the Wald ,2 -test. Conclusion: Laparoscopic cholecystectomy, using laser, in a male patient with a history of acute cholecystitis or during an acute attack of cholecystitis is associated with a significantly higher incidence of IGBP. [source] LAPAROSCOPIC CLOSURE OF DUODENAL ULCER PERFORATIONSANZ JOURNAL OF SURGERY, Issue 9 2007Gnanaraj Jesudian MB BS, MCh(Urology), MS(Gen) No abstract is available for this article. [source] Conservative management of duodenal perforation following endoscopic sphincterotomyDIGESTIVE ENDOSCOPY, Issue 2 2005Chee Fook Choong Overall endoscopic retrograde cholangiopancreatography (ERCP) complication rates of 4,10% and mortality rates of 1.5% have been reported. For those patients who fail conservative therapy, a mortality rate of almost 50% has been reported. This has led some authors to recommended early operation in all duodenal perforations. We report two cases of duodenal perforations following endoscopic sphincterotomy. Perforation was suspected immediately post-ERCP in one case and, in the second case, perforation was evident during ERCP and a biliary stent was inserted. Both of the patients were managed conservatively with bowel rest, nasogastric suction, analgesia and intravenous antibiotics. Although abdominal XR and CT showed extensive intraperitoneal and retroperitoneal gas, both of the patients made an uneventful recovery without surgical management. Based on our experience and literature review, routine surgery is not required in patients with duodenal perforations following endoscopic sphincterotomy. Surgery should be considered in any patients with clinical signs of sepsis, abscess or fluid collection in the retroperitoneum or peritoneum, documented ERCP perforation with cholelithiasis, choledocholithiasis or retained hardware. There are currently no strong data to support the benefits of early routine surgery and management should be tailored individually according to the patient's clinical condition and response to therapy. [source] Colonic perforation after endoscopic biopsy of a submucosal tumor: successful conservative treatmentDIGESTIVE ENDOSCOPY, Issue 4 2002Kuang-I. Colonoscopy is a powerful diagnostic and therapeutic procedure with a recognized risk of complications ranging from perforation to hemorrhage and septicemia. Perhaps the most dangerous complication associated with this procedure is bowel perforation. Although some colonic perforations can be treated medically, prompt surgery is generally preferred to minimize morbidity and mortality. We present a case of colonic perforation resulting from bite biopsy followed by mucosal resection of a submucosal tumor. Perforation occurred in a delayed manner despite prophylactic closure of the mucosal defect by the replacement of endoclips. The patient recovered spontaneously after antibiotic treatment and reduction of oral intake. We carried out successful conservative medical treatment of a minor iatrogenically induced bowel perforation without operation. [source] Current management of esophageal perforation: 20 years experienceDISEASES OF THE ESOPHAGUS, Issue 4 2009A. Eroglu SUMMARY Esophageal perforations are surgical emergencies associated with high morbidity and mortality rates. No single strategy has been sufficient to deal with the majority of situations. We aim to postulate a therapeutic algorithm for this complication based on 20 years of experience and also on data from published literature. We performed a retrospective clinical review of 44 patients treated for esophageal perforation at our hospital between January 1989 and May 2008. We reviewed the characteristics of these patients, including age, gender, accompanying diseases, etiology of perforation, diagnosis, location, time interval between perforation and diagnosis, treatment of the perforation, morbidity, hospital mortality, and duration of hospitalization. Perforation occurred in the cervical esophagus in 14 patients (31.8%), thoracic esophagus in 18 patients (40.9%), and abdominal esophagus in 12 patients (27.3%). Management of the esophageal perforation included primary closure in 23 patients (52.3%), resection in 7 patients (15.9%), and nonsurgical therapy in 14 patients (31.8%). In the surgically treated group, the mortality rate was 3 of 30 patients (10%), and 2 of 14 patients (14.3%) in the conservatively managed group. Four of the 14 nonsurgical patients were inserted with covered self-expandable stents. The specific treatment of an esophageal perforation should be selected according to each individual patient. To date, the most effective treatment would appear to be operative management. With improvements in endoscopic procedures, the morbidity and mortality rates of esophageal perforations are significantly decreased. We suggest that minimally invasive techniques for the repair of esophageal perforations will be very important in the future treatment of this condition. [source] Primary malignant melanoma in the oesophagus of a foalEQUINE VETERINARY EDUCATION, Issue 8 2010S. S. Caston Summary A 2-month-old filly was evaluated for severe colic. Ultrasound, abdominocentesis and physical examination findings prompted an abdominal exploratory surgery. Perforation of the stomach was discovered during the surgery. The filly was humanely subjected to euthanasia under anaesthesia and post mortem examination was performed. In addition to gastric and duodenal ulceration, a thickened, black area of the proximal oesophagus was discovered. Histopathology of the lesion revealed primary malignant melanoma. Although rare, primary melanoma can occur in noncutaneous locations. [source] Effectiveness of HERO 642 versus Hedström files for removing gutta-percha fillings in curved root canals: an ex vivo studyINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2009B. Ayd Abstract Aim, To compare the effectiveness of gutta-percha removal and the maintenance of canal anatomy when using the HERO 642 system or Hedström files (H-files) in mandibular molar teeth. Methodology, The root canals of 40 mandibular molar teeth were instrumented using H-files and filled with gutta-percha and sealer. After 1 year in storage, the roots were sectioned horizontally to provide apical, middle and coronal root thirds. Sections were photographed, and an individual muffle was produced for each tooth. Teeth were randomly divided into four groups (n = 10) and the gutta-percha removed using either the HERO 642 system or H-files, with or without solvent. Digital images of the root canals were then re-taken. Root thirds were inspected for lateral perforations, and the percentage of the residual canal filling was determined on postoperative images. Transportation and centring ratio were calculated using preoperative and postoperative images of the cross-sections of root thirds. Results, H-files groups were associated with less filling material than the HERO 642 system (H-files,HERO 642 P = 0.056, H-files,HERO 642+solvent P = 0.041, H-files + solvent,HERO 642 P = 0.018, H-files + solvent,HERO 642 + solvent P = 0.016). The percentage of residual filling material was similar in the apical thirds, and the contribution of solvent to canal debridement was not statistically significant (P > 0.05). Perforation occurred mesiobuccally in 48% of specimens in the apical sections of mesial roots. There were no significant differences for centring ratio, transportation and perforation rate between groups. Conclusions, H-files left less gutta-percha overall; however, there was no difference in the apical third. The effect of solvent was not remarkable. Both instrument systems created a large number of perforations. [source] Selective Barrier Perforation in Porous Alumina Anodized on Substrates,ADVANCED MATERIALS, Issue 7 2008Jihun Oh A new method for perforating the barrier oxide at the base of pores in alumina, which does not involve etching of the alumina, is reported. Anodization of Al layers on W leads to formation of WO3 "plugs" that can be selectively etched without widening the as-anodized pores. We demonstrate this technique, used with templated pore formation, by creating Ni nanoelectrode arrays with fixed electrode spacings (200,nm) but varied electrode diameters. [source] Right Ventricular Perforation due to Migration of a Ventricular LeadJOURNAL OF CARDIAC SURGERY, Issue 3 2010Fabien Doguet M.D. (J Card Surg 2010;25:303) [source] Left Coronary Artery Compression Caused by a False Aneurysm Expansion after Perforation of Type A Aortic DissectionJOURNAL OF CARDIAC SURGERY, Issue 1 2010Jan Vojacek M.D., Ph.D. (J Card Surg 2010;25:72-73) [source] Old is Gold: Tip Electrograms to Diagnose Pacemaker Lead PerforationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2002KIRAN CHANDAN M.D. [source] Rice Fry Texture as Affected by Gum Application and Mechanical PerforationJOURNAL OF FOOD SCIENCE, Issue 8 2001R.S. Kadan ABSTRACT: This study was designed to evaluate the effects on rice fries with respect to lipid and moisture contents, as well as instrumental texture characteristics as a result of either coating with a water-soluble gum solution or processing with a mechanical pinhole. The rice fries were formulated from 2 different rice flour mixtures. Statistical analyses showed that gum application significantly decreased fat absorption during frying and retained more moisture. The incorporation of a pinhole decreased moisture and increased fat contents. Increasing gum application lowered hardness and fracturability values. Gum application improved the overall appearance, as well as decreased popping and blistering of fries during final frying. [source] Perforation of Aortic Root as Secondary Complication after Implantation of Patent Foramen Ovale Occlusion Device in a 31-Year-Old WomanJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2006STEFAN A. LANGE M.D. Transesophageal echocardiography (TEE) revealed a 3-mm-large patent foramen ovale (PFO). No other reason for these neurological events could be found and the patient underwent percutaneous closure of the PFO with a CARDIA® Star 03/30 device without periprocedural complications. Four weeks later, the patient underwent a routine control of device without any adverse clinical symptoms. Surprisingly, echocardiography revealed a perforation of the aortic root by an umbrella strut with a small shunt from the aortic root to the right atrium. Magnetic resonance imaging (MRI) confirmed the diagnosis of device malposition. Consecutively, the patient underwent minimal invasive surgery. After removal of the single perforating strut, the bleeding lesion was closed. The patient remained free of any additional complications during the postoperative course and up until now has had uneventful follow-ups. [source] Tracheal perforation secondary to suture irritation in a dog following a ventral slot procedureJOURNAL OF SMALL ANIMAL PRACTICE, Issue 7 2003D. N. Clements An eight-year-old springer spaniel was presented with acute-onset subcutaneous emphysema of five days' duration. The dog had undergone ventral slot decompression of the C5-C6 intervertebral disc space eight weeks before presentation. Cervical tracheoscopy demonstrated perforation of the dorsal tracheal membrane of the distal cervical trachea. Perforation of the dorsal tracheal membrane secondary to suture knot irritation was confirmed by exploratory surgery. Repair of the perforation was performed by plication of the dorsal tracheal membrane. The dog was represented nine days after the initial surgery with acute recurrence of subcutaneous emphysema. Air leakage at the plicated dorsal tracheal membrane was observed at exploratory surgery, and a bipedicle sternothyroideus muscle flap was used to support the plicated membrane. Recovery was uneventful and 10 months postoperatively there had been no recurrence of clinical signs. [source] Head structures of Karoophasma sp. (Hexapoda, Mantophasmatodea) with phylogenetic implicationsJOURNAL OF ZOOLOGICAL SYSTEMATICS AND EVOLUTIONARY RESEARCH, Issue 2 2007E. Baum Abstract External and internal head structures of adults of Karoophasma sp. were examined and described. The results are compared with conditions found in other representatives of Mantophasmatodea and members of other lower neopteran groups. The X-shaped apodeme of the frons, the unpigmented oval area enclosed by apical branches of the anterior tentorial arms, the oval sclerotisation at the base of the labrum, the sclerotized rounded apical part of the galea, and the loss of M. labroepipharyngalis are probably autapomorphic for Mantophasmatodea. Plesiomorphic features (groundplan of Neoptera) are the orthognathous condition, the absence of parietal ridges, the absence of a gula, the absence of a ,perforation of the corpotentorium', the multisegmented antennae inserted between the compound eyes, the general arrangement of the mouthparts, the shape and composition of the maxillae and labium, and the nearly complete set of muscles. The presence of a transverse muscle connecting the antennal ampullae is a potential synapomorphy of Orthoptera, Phasmatodea and Dictyoptera. Character states suggesting affinities with Grylloblattodea are the absence of ocelli, the elongation of the corpotentorium, and the very similar mandibles with widely separated bases and completely reduced molae. Whether predacious habits are a synapomorphic feature of Mantophasmatodea and Grylloblattodea is uncertain. The retained orthognathous condition in Mantophasmatodea and Mantodea is likely related with different specialized preying techniques in both groups, i.e. rapid forward pushes of the head,prothorax complex, and the use of raptorial legs, respectively. Zusammenfassung Äußere und innere Kopfstrukturen von Imagines von Karoophasma sp. wurden untersucht und beschrieben. Die Ergebnisse wurden mit Befunden bei anderen Vetretern der Mantophasmatodea und bei potentiell nah verwandten Gruppen verglichen. Das x-förmige Frontalapodem, die unpigmentierten, von apikalen Ausläufern der vorderen Tentorialarme abgegrenzten ovalen Felder, die ovale Sklerotisation an der Basis des Labrum, der sklerotisierte, abgerundete Apikalteil der Galea und der Verlust von M. labroepipharyngalis sind wahrscheinlich Autapomorphien der Mantophasmatodea. Plesiomorphe Merkmale (Grundplan der Neoptera) sind die Orthognathie, das Fehlen von Parietalleisten, einer Gula und einer ,Perforation des Corpotentorium', die zwischen den Komplexaugen inserierenden vielgliedrigen Antennen, die Anordnung der Mundwerkzeuge, die Form und Zusammensetzung der Maxillen und des Labiums, und der nahezu vollständige Satz von Kopfmuskeln. Das Vorhandensein eines transversalen Muskels, der die Antennenampullen verbindet, ist eine potentielle Synapomorphie der Orthoptera, Phasmatodea und Dictyoptera. Er fehlt bei den Mantophasmatodea. Apomorphe Merkmale, die ein Schwestergruppenverhältnis mit den Grylloblattodea nahelegen, sind das Fehlen von Ocellen, die Verlängerung des Corpotentorium und die sehr ähnlichen, an der Basis weit voneinander getrennten Mandibeln ohne Mola. Ob die räuberische Lebensweise der Mantophasmatodea und Grylloblattodea eine Synapomorphie darstellt, ist unklar. Die bei den Mantophasmatodea und Mantodea beibehaltene Orthognathie ist wahrscheinlich bei beiden Gruppen mit unterschiedlichen, spezialisierten Jagdtechniken korreliert, mit schnellen Vorstößen des Kopf,Prothorax,Komplexes einerseits, und mit dem Einsatz von spezialisierten Fangbeinen andererseits. [source] Use of Radiofrequency Perforation for Lead Placement in Biventricular or Conventional Endocardial Pacing after Mustard or Senning Operations for D-Transposition of the Great ArteriesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2009SANTABHANU CHAKRABARTI M.D. Background: Endocardial pacemaker lead placement can be challenging after Mustard and Senning operations for transposition of the great arteries (D-TGA), if there is atresia of the systemic venous pathways and because the coronary sinus cannot be used for cardiac resynchronization therapy. Radiofrequency (RF)-assisted perforation techniques have been used in congenital heart disease but have not been reported for use in pacemaker implantation. Methods and Results: We describe RF perforation of an atretic superior systemic venous pathway and systemic venous baffles in three patients after Senning and Mustard operations to implant endocardial pacing systems to achieve conventional or biventricular pacing. Conclusions: RF-energy-assisted perforation is feasible and effective tool to facilitate endocardial lead placement during dual-chamber and biventricular pacemaker implantation in patients with Mustard or Senning operations for D-TGA. [source] Delayed Cardiac Perforation by Defibrillator Lead Placed in the Right Ventricular Outflow Tract Resulting in Massive Pericardial EffusionPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2008ERNEST W. LAU M.D. A 76-year-old man received a dual-chamber implantable cardioverter defibrillator (ICD), with the defibrillator lead positioned within the right ventricular outflow tract. The lead parameters at the time of implantation were satisfactory and the postprocedure chest X-ray showed the leads were in place. The patient was cardioverted from atrial fibrillation during defibrillation threshold testing and commenced on anticoagulation immediately. One month post implantation, he experienced multiple ventricular tachycardia episodes all successfully treated with antitachycardia pacing and shocks by his ICD, but he fell and hit his chest against a hard surface during one of these attacks. He developed a massive pericardial effusion and computed tomography confirmed cardiac perforation by the defibrillator lead. Pericardiocentesis was performed and the defibrillator lead replaced with a different model positioned at the right ventricular apex. The patient made an uneventful recovery. The management and avoidance of delayed cardiac perforation by transvenous leads were discussed. [source] Inadequate ICD Discharges Due to Diaphragmatic Electromyopotential Oversensing as the First Sign of Right Ventricular Lead PerforationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2006UWE K. H. WIEGAND M.D. Right ventricular lead perforation, when acute, is a rare but potentially life-threatening complication of implantable cardioverter defibrillator (ICD) therapy. We report about a patient with early lead perforation presenting with repetitive ICD discharges due to oversensing of diaphragmatic electromyopotentials and describe the management of this complication. [source] Pleural effusion due to intra-abdominal extravasation of parenteral nutrition,PEDIATRIC PULMONOLOGY, Issue 10 2008Jasper V. Been MD Abstract An 8-week-old preterm boy experienced respiratory deterioration due to unilateral pleural effusion. Intra-abdominal extravasation of parenteral fluid with leakage into the pleural cavity was suspected based on biochemical analysis of the effluent. Perforation of the central venous catheter in the peritoneal cavity was subsequently confirmed by contrast roentgenography. As in peritoneal dialysis and hepatic hydrothorax, pleuroperitoneal communication needs to be considered in patients exhibiting pleural effusion with a central venous line below the diaphragm. Pediatr Pulmonol. 2008; 43:1033,1035. © 2008 Wiley-Liss, Inc. [source] Conservative Therapy of Esophageal Perforation With Neck Abscess in a Child,THE LARYNGOSCOPE, Issue 11 2007Matthew C. Miller MD Abstract Conservative management of complicated esophageal perforations has gained favor in recent years. However, there are limited data concerning the applicability of this approach in the pediatric population. We describe the care and outcome of a 14-year-old girl who sustained an esophageal perforation after accidental ingestion of a shard of glass. The patient was treated using ultrasound-guided drainage catheter placement with simultaneous esophagoscopy and postoperative antibiotics. She was discharged within 1 week of presentation and enjoyed an uncomplicated recovery. We believe that selected cases of pediatric esophageal perforation may be safely and effectively treated using a conservative approach. [source] Clinical Symptomatology and Paranasal Sinus Involvement With Nasal Septal PerforationTHE LARYNGOSCOPE, Issue 4 2007FACS, Neil Bhattacharyya MD Abstract Objective: Determine the symptom manifestations, clinical impact, and incidence of chronic rhinosinusitis (CRS) in patients with newly diagnosed nasal septal perforation. Methods: A consecutive series of adult patients with nasal septal perforation were prospectively studied at the time of endoscopic diagnosis with the rhinosinusitis symptom inventory (RSI) and sinus computed tomography (CT). Patients' symptoms in the RSI symptom domains were computed. From the CT scan, septal perforation size and Lund scores were obtained. A separate (control) cohort of patients with CRS without septal perforation was matched to these patients for age, sex, and Lund score. RSI symptom domain comparisons were conducted between groups to determine the additional symptom burden conferred by septal perforation. Results: Thirty-three patients with septal perforation were enrolled (mean age, 48.2 yr; 69.7% female). Mean perforation size was 1.9 (SD, 2.1) cm2. The mean Lund score was 5.8 (SD, 5.3); 16 (57.1%) patients met radiographic criteria for a concurrent diagnoses of CRS. Patients with septal perforation reported significant nasal and facial symptom domain scores (56.8 and 47.0, respectively [range, 0,100]). Oropharyngeal and systemic symptoms were less severe (29.7 and 34.7, respectively). However, after comparison with the matched control patients, no statistically significant differences were identified in sinonasal symptoms between patients with and without septal perforation (all P > .131). Conclusions: Concurrent CRS may frequently accompany nasal septal perforation and may require appropriate treatment along with the perforation itself. The presence of septal perforation does not appear to significantly augment symptom severity in CRS. [source] Vascularized Mucoperiosteal Pull Through Flap for Closure of Large Septal Perforation: A New Technique,THE LARYNGOSCOPE, Issue 4 2007Mark J. Shikowitz MD First page of article [source] Lateral Tympanoplasty for Total or Near-Total Perforation: Prognostic Factors,THE LARYNGOSCOPE, Issue 9 2006Dr. Simon I. Angeli MD Abstract Objective: To identify prognostic factors affecting outcome in lateral tympanoplasty for total or near-total tympanic membrane perforation. Study Design: Retrospective case series. Methods: Patients were those presenting with total or near-total tympanic membrane perforation undergoing lateral tympanoplasty from 1999 to 2004. We systematically collected demographic, clinical, audiologic, and outcome information. Student t test was used to determine group differences. Logistic regression analysis was used to examine the relationship between success of grafting (dependent variable) and the independent variables. Multiple regression analysis was used to examine the relationship between postoperative air-bone gap (ABG) and independent variables. Results: There were seventy-seven cases (58 primary and 19 revision cases) with average follow-up of 17 months. Successful tympanic membrane grafting occurred in 91% of cases. None of the independent variables studied was predictive of the success of graft incorporation (P > .05). The mean preoperative ABG was 29.8 ± 10 dB and improved to a postoperative ABG of 16.5 ± 11 dB (P < .001). Smaller preoperative ABG and normal malleus handle were associated with smaller postoperative ABG. In revision cases, mastoidectomy was associated with better functional results. Conclusions: Successful grafting of near-total and total tympanic membrane perforations occurred in 91% of the cases and was independent of demographic, disease, and technical variables. Disease variables (preoperative ABG and status of malleus handle) had a greater prognostic value on postoperative ABG than other variables. In revision tympanoplasty, mastoidectomy is associated with a better functional outcome. [source] Herstellung von Graphennanobändern durch Abschälen von Schichten mehrwandiger Kohlenstoffnanoröhren: die Reißverschluss-Methode,ANGEWANDTE CHEMIE, Issue 36 2009Andreas Hirsch Unsichtbare Perforation: Mit einem eleganten Reißverschlussverfahren lassen sich mehrwandige Kohlenstoffnanoröhren glatt zu Graphennanobändern öffnen (siehe Schema). Weil Graphen über einzigartige elektronische Eigenschaften verfügt, ist damit ein effizienter Weg zur Entwicklung einer modernen Nanoelektronik geebnet. [source] Perforation of Meckel's Diverticulum by a fishboneANZ JOURNAL OF SURGERY, Issue 11 2008Umit Sekmen MD No abstract is available for this article. [source] Perforation of the aortic sinus after closure of atrial septal defects with the Atriasept occluder,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2009Stephen Brown Abstract Percutaneous atrial septal defect closure is routinely performed nowadays because of the ease of implantation as well as the low complication rate. The Atriasept ASD occluder is a low profile, double disc device; over the years several modifications have been made. We report two cases of aortic sinus perforation by the Atriasept ASD occluder (model 2007). Two asymptomatic patients, in whom the device was implanted, were noticed to have metal projecting into the aorta. Real-time fluoroscopy showed fractures of the outer metal ring with abnormal movement of one of the struts of the device. One patient is being conservatively managed and in the other the device was surgically removed due to the presence of a second ASD, which needed closure. Transesophageal echocardiography and fluoroscopy may be necessary to identify this potentially life-threatening complication of this device. © 2009 Wiley-Liss, Inc. [source] Perforation complicating carotid artery stenting: The use of a covered stentCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2006Robert S. Dieter MD Abstract Carotid artery angioplasty and stenting has emerged as an effective strategy for the treatment of significant carotid artery stenosis. Perforation during carotid artery stenting is a very rare potential complication of the procedure. We describe a case of carotid artery perforation that occurred during postdilation of the carotid artery stent. In our case this potentially serious complication was successfully treated with a covered stent-graft. © 2006 Wiley-Liss, Inc. [source] Spontaneous localized intestinal perforation and intestinal dilatation in very-low-birthweight infantsACTA PAEDIATRICA, Issue 11 2006Tsugumichi Koshinaga Abstract Aim: To elucidate how spontaneous localized intestinal perforation (SLIP) is related to intestinal morphological features such as dilatation in very-low-birthweight (VLBW) infants. Methods: The medical records of 13 VLBW infants (<1500 g) undergoing laparotomy between 1983 and 2003 for presumed SLIP were retrospectively reviewed. Clinical findings including maternal, prenatal and perinatal factors were analysed, and the clinical and surgical findings upon laparotomy were compared. Results: Postnatal pathological conditions included patent ductus arteriosus (n= 7), sepsis (n= 2), respiratory distress syndrome (n= 7), intraventricular haemorrhage (n= 2), an indwelling catheter via the umbilical vein (n= 1) and pneumonia (n= 1). Indomethacin was used in seven neonates with patent ductus arteriosus, and dexamethasone preventive therapy was employed in one neonate for bronchopulmonary dysplasia. Operative findings revealed a localized small punched-out perforation in the ileum. Five patients had intestinal dilatation: two with a perforation in the middle of the dilated intestine, and three with a perforation proximal to the region of dilatation. The muscularis propria was absent in the dilated intestine of four patients. Conclusion: This study found no significant relationship between perforation and dilatation of the intestine. Perforation may occur in any portion of the ischaemic intestine when circulatory failure becomes severe, and is not necessarily restricted to the dilated intestine. We believe that SLIP and intestinal dilatation may occur on the same basis in low-birthweight infants; however, the disease process may be aetiologically different. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||