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Single Procedure (single + procedure)
Selected AbstractsCorrection of facial lipoatrophy using autologous fat transplants in HIV-infected adolescentsHIV MEDICINE, Issue 5 2009C Dollfus Objectives Antiretroviral therapy has dramatically improved the survival of HIV-infected children. Nevertheless, side effects comparable to those found in adults have been encountered, such as facial lipoatrophy, which can have a negative impact on the self-esteem of otherwise healthy adolescents. Cosmetic surgical procedures in adolescents raise psychological issues which need to be specifically addressed and which have never been previously reported in this population. We evaluated the patient satisfaction, safety and cosmetic results of HIV-infected adolescents who experienced autologous fat transplants for the correction of facial lipoatrophy. Methods We report the results of plastic surgery using autologous fat transplants (Coleman's LipostructureÔ) in six HIV-infected adolescents with facial lipoatrophy: three boys and three girls, aged 14,19 years. Results The quantity of reinjected fat on each side of the face varied from 5 to 12 mL within a single procedure. All the patients reported being satisfied or very satisfied with the cosmetic results and reported a positive impact on their daily life. Conclusions With well-trained surgeons and carefully selected indications, corrective surgery of facial lipoatrophy in HIV-infected adolescents can provide immediate and long-lasting benefits in terms of physical appearance and psychological wellbeing, and should be considered as a component of comprehensive care. [source] Spatially adaptive color filter array interpolation for noiseless and noisy dataINTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY, Issue 3 2007Dmitriy Paliy Abstract Conventional single-chip digital cameras use color filter arrays (CFA) to sample different spectral components. Demosaicing algorithms interpolate these data to complete red, green, and blue values for each image pixel, to produce an RGB image. In this article, we propose a novel demosaicing algorithm for the Bayer CFA. For the algorithm design, we assume that, following the concept proposed in (Zhang and Wu, IEEE Trans Image Process 14 (2005), 2167,2178), the initial interpolation estimates of color channels contain two additive components: the true values of color intensities and the errors that are considered as an additive noise. A specially designed signal-adaptive filter is used to remove this so-called demosaicing noise. This filter is based on the local polynomial approximation (LPA) and the paradigm of the intersection of confidence intervals applied to select varying scales of LPA. This technique is nonlinear and spatially-adaptive with respect to the smoothness and irregularities of the image. The presented CFA interpolation (CFAI) technique takes significant advantage from assuming that the original data is noise-free. Nevertheless, in many applications, the observed data is noisy, where the noise is treated as an important intrinsic degradation of the data. We develop an adaptation of the proposed CFAI for noisy data, integrating the denoising and CFAI into a single procedure. It is assumed that the data is given according to the Bayer pattern and corrupted by signal-dependant noise common for charge-coupled device and complementary-symmetry/metal-oxide semiconductor sensors. The efficiency of the proposed approach is demonstrated by experimental results with simulated and real data. © 2007 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 17, 105,122, 2007 [source] Selecting Predictor Subsets: Considering validity and adverse impactINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 3 2010Wilfried De Corte The paper proposes a procedure for designing Pareto-optimal selection systems considering validity, adverse impact and constraints on the number of predictors from a larger subset that can be included in an operational selection system. The procedure determines Pareto-optimal composites of a given maximum size thereby solving the dual task of identifying the predictors that will be included in the reduced set and determining the weights with which the retained predictors will be combined to the composite predictor. Compared with earlier proposals, the simultaneous consideration of both tasks makes it possible to combine several strategies for reducing adverse impact in a single procedure. In particular, the present approach allows integrating (a) investigating a large number of possible predictors (such as multitest battery of ability tests, or a collection of ability and nonability measures); (b) explicit predictor weighting within feasible test procedures of a given limited size. [source] Laparoscopic pyeloplasty for ureteropelvic junction obstruction: Outcome of initial 12 proceduresINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2004MASATSUGU IWAMURA Abstract Background:, Open pyeloplasty has been the gold standard for surgical treatment of ureteropelvic junction (UPJ) obstruction, enjoying a long-term success rate exceeding 90%. Unfortunately, this procedure requires a muscle incision that entails some degree of morbidity. We have, therefore, investigated the feasibility of laparoscopic pyeloplasty for UPJ obstruction and report here the outcomes of our early cases. The median follow up is 25 months (range, 12,42 months). Methods:, Between March 1999 and September 2001 we performed laparoscopic pyeloplasty on 12 ureters in 11 patients presenting with symptomatic hydronephrosis, secondary to a short stenosis of the UPJ or to ventrally crossing vessels; bilateral pyeloplasty was performed as a single procedure in one patient. We performed dismembered Anderson,Hynes pyeloplasty, Fenger plasty and Y-V plasty in eight, two and two ureters, respectively. All procedures were carried out transperitoneally. Results:, The procedure was completed successfully in all cases. Crossing vessels were noted in six of 12 ureters (50.0%). Mean operative time and blood loss in 11 patients (including one bilateral case) were 272.8 min (range, 175,480 min) and 96.4 mL (range, 20,340 mL), respectively. Postoperative complications were noted in two patients (18.2%): one instance of prolonged urine leakage and one anastomotic re-stricture. Eleven of 12 ureters (91.6%) demonstrated a patent UPJ on excretory urography and/or improvement of renal function on diuretic renography at a minimum follow up of 12 months. Conclusion:, Although the procedure requires advanced laparoscopic skills, it can be safely and successfully completed as frequently as the conventional open procedure. Laparoscopic pyeloplasty seems to be a valuable alternative to open pyeloplasty for UPJ obstruction. [source] Contemporary Results of Total Aortic Arch ReplacementJOURNAL OF CARDIAC SURGERY, Issue 3 2004Thoralf M. Sundt M.D. The results of surgical intervention reported from large centers are improving; however, the degree to which these results are reproducible by other surgeons is less clear. We therefore reviewed our recent experience with total aortic arch replacement. Methods: Between July 1, 1997 and July 1, 2001 19 patients underwent complete aortic arch replacement, with or without concomitant procedures. We retrospectively reviewed perioperative results retrieved from the computerized database and clinical records. Results: The mean age of the study population was 68 ± 8.3 years (range 52 to 82), with women predominating (11 women, 8 men). All patients had hypertension. Patient history indicated active or past tobacco abuse in 16 patients (80%); cerebrovascular disease in 3, and peripheral vascular disease in 7 patients. Associated procedures included an elephant trunk in 12 (63%), replacement of the upper descending thoracic aorta in 5 (26%), concomitant coronary artery bypass in 5 (26%), and aortic root replacement in 3 (16%). One patient underwent replacement of the entire aorta from sinotubular ridge to iliac bifurcation in a single procedure. Brachiocephalic reconstruction with a "Y-graft" permitting early antegrade cerebral perfusion was performed in 12 patients. Retrograde cerebral perfusion was performed in ten patients (53%). Perioperatively, death occurred in two patients (11%) and stroke in two (11%). Conclusions: With cautious application, techniques developed in high-volume centers can also achieve satisfactory results when used at centers with a more modest case volume. (J Card Surg 2004;19:235-239) [source] The Efficacy of Inducibility and Circumferential Ablation with Pulmonary Vein Isolation in Patients with Paroxysmal Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2007SHIH-LIN CHANG M.D. Introduction: Some conflicting results of the efficacy of the inducibility test used in the catheter ablation of atrial fibrillation (AF) have been reported. The aim of this study was to investigate the inducibility and efficacy of circumferential ablation with pulmonary vein isolation (PVI) in patients with paroxysmal AF and its relationship to the atrial substrate. Methods and Results: This study consisted of 88 patients with paroxysmal AF who underwent catheter ablation. Electroanatomic mapping using a NavX system was performed and the biatrial voltage was obtained during sinus rhythm. After successful circumferential ablation with PVI, an inducibility test was performed to determine the requirement for creating left atrial (LA) ablation line. After procedure, patients with inducible AF had a higher recurrence rate than did those with noninducibility of AF (55% vs 18%, P = 0.02). The patients with inducible AF after the PVI had a lower biatrial voltage than did those with negative inducibility. The patients with inducible AF after the final procedure who had a recurrence had a lower LA voltage (1.3 ± 0.4 vs 1.8 ± 0.4 mV, P = 0.02) and longer LA total activation time (99 ± 18 vs 88 ± 13 msec, P = 0.02) than did those with noninducible AF and no recurrence. None of the patients had occurrence of LA flutter during the follow-up. Conclusion: After a single procedure of circumferential ablation with PVI and noninducibility, 82% patients did not have recurrence of AF. The inducibility of AF was related to the recurrence of AF. The atrial substrate affected the outcome of the inducibility. [source] Steerable Sheath Catheter Navigation for Ablation of Atrial Fibrillation: A Case-Control StudyPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 7 2008CHRISTOPHER PIORKOWSKI M.D. Background: Lack of stable access to all desired ablation target sites is one of the limitations for efficacious circumferential left atrial (LA) pulmonary vein (PV) ablation. Targeting that, new catheter navigation technologies have been developed. The aim of this study was to describe atrial fibrillation (AF) mapping and ablation using manually controlled steerable sheath catheter navigation and to compare it against an ablation approach with a nonsteerable sheath. Methods and Results: In this case-control-analysis 245 consecutive patients (controls) treated with circumferential left atrial PV ablation were matched with 105 subsequently consecutive patients (cases) ablated with a similar line concept but mapping and ablation performed with a manually controlled steerable sheath. One hundred sixty-six patients were selected to be included into 83 matched patient pairs. Ablation success was measured with serial 7-day Holter electrocardiograms. Patients ablated with the steerable sheath showed an increase in the success rate (freedom from AF) from 56% to 77% (P = 0.009) after a single procedure and 6 months of follow-up. With respect to procedural data no difference could be found for procedure time, fluoroscopy time, irradiation dose, and radiofrequency (RF) burning time. With the steerable sheath mean procedural RF power (33 ± 9 vs 41 ± 4 W; P < 0.0005) and total RF energy delivery (97,498 vs 111,864 J; P < 0.005) were significantly lower and the rate of complete PV isolation significantly increased from 10% to 52% (P < 0.0005). The complication rate was the same in both groups. Among different arrhythmia, procedure, and patient characteristics, the lack of early postinterventional arrhythmia recurrences was the only but powerful predictor for long-term ablation success. Conclusions: An AF mapping and ablation approach solely using a manually controlled steerable sheath for catheter navigation improved the outcome of circumferential left atrial PV ablation at similar intervention times and similar complication rates. The 6-month success rate after a single LA intervention increased from 56% to 77%. 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