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"Kir, M."
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A friendly town that's almost always by the ocean!
\"Ms. Grimalkin's fifth grade class uncovers the secrets of their peculiar town in a series of linked tales\"-- Provided by publisher.
Book
How valuable is P-wave dispersion in the determination of carboxyhemoglobin levels?
Objective:
To determine whether or not wave/interval dispersions in electrocardiography (ECG) are increased, and to define whether wave and interval dispersions are correlated with carboxyhemoglobin (COHb) levels.
Methods:
ECG, complete blood count, and biochemical parameters were taken from 87 patients with carbon monoxide (CO) poisoning as well as 90 control patients with similar age, gender, and body mass index distribution. COHb levels were recorded in CO-poisoning patients. The COHb levels and the relationships with ECG parameters were studied.
Results:
Pmax, Pmin, Pd, PRmax, PRmin, PRd, QTmax, QTmin, QTd, cQTmax, cQTmin, cQTd, Tmax, Tmin, and Td in ECG were higher in intoxicated patients than the control group (p < 0.05 for all). Pearson’s correlation analyses showed moderately significant positive correlations between COHb level and Pmax (r = 0.224; p = 0.037) and Pd (r = 0.222; p = 0.039). The receiver–operator characteristic (ROC) curve showed that a Pd value of 38 ms determined by ECG separates patients with a COHb ≥ 20% with area under the ROC curve of 0.78 (95%CI = 0.71–0.83), a sensitivity of 67.9% (95%CI = 59.4–75.6), a specificity of 95% (95%CI = 83.0–99.2], a positive predictive value of 97.9% (95%CI = 92.5–99.7), and a negative predictive value of 46.3% (95%CI = 35.3–57.7.)
Conclusion:
A significant increase in wave/interval dispersions in the ECG of CO-poisoning patients compared with controls may show that not only a part is affected but both atrium and the ventricles as a whole are affected by hypoxic ischemia. When COHb levels of the patients are unavailable, P dispersion on ECG may show CO poisoning level of the patient.
Journal Article
The extremely high tide!
\"When Talise discovers a mysterious message in a bottle, she is convinced the message is meant for her--and it's telling her to build a boat\"-- Provided by publisher.
Book
Enhancement of superconducting properties of Bi-2212 ceramics by vanadium–sodium co-doping
Bi
2
Sr
2−x
V
x
Ca
1
Cu
1.75
Na
0.25
O
y
superconductors with x = 0, 0.05, 0.1 and 0.25 were prepared by the classic solid-state reaction method. The effects of vanadium substitution have been investigated by means of X-ray powder diffraction, scanning electron microscopy, dc electrical resistivity, and magnetic hysteresis loop measurements. Results show that the superconducting properties of Bi-2212 phase can be significantly improved with x = 0.05 vanadium substitution. SEM micrographs show the presence of plate-like crystals in all samples, implying the composition of 2212 phases. In addition, J
c
values of the samples were calculated from the hysteresis loop measurement by using the Bean’s model showing that J
c
significantly increases with x = 0.05 vanadium substitution.
Journal Article
PP-228 Pulmonary Embolism due to Ruptured Giant Right Atrial Cyst Hydatid in a Child
Discussion Cardiac hydatid cysts are extremely rare particularly in the pediatric age. Because of its potential risk for rupture resulting in systemic or pulmonary dissemination, embolism or anaphylactic shock, prompt diagnosis and early surgery is crucial.
Journal Article
Collapse period of degrading SDOF systems
Seismic demand estimation for a structure is a critical issue for seismic performance assessment so that the potential damage can be estimated realistically. Many researchers proposed simplified methods to estimate the demand of a structure under strong ground motions. However, most of them did not consider degradation and collapse potential of the structures. Even some of theme considered the degradation effect, stiffness and strength degradation effects were considered separately without collapse potential caused by dynamic instability. In this study, collapse potential of SDOF systems caused by dynamic instability with stiffness and strength degradation has been investigated. Nonlinear time history analyses were performed, using an energy-based, strength and stiffness degraded hysteretic model that considers the collapse potential, with 160 earthquake acceleration time histories. An equation was proposed for the estimation of collapse period of SDOF systems as a function of certain strength reduction factor, ductility level and post-capping stiffness ratio. Finally, effects of parameters of the considered hysteretic model and local site conditions on the collapse period were investigated.
Journal Article
Ankle Nerve Block Adjuvant to General Anesthesia Reduces Postsurgical Pain and Improves Functional Outcomes in Hallux Valgus Surgery
Objective: Postoperative pain is a frequent problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia. Subjects and Methods: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into 2 groups: general anesthesia only (group A) and ankle block added to general anesthesia (group B). Age, body-mass index, tourniquet time, duration of surgery, first analgesic need time, perioperative analgesic regimen, visual analog scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and length of hospital stay were recorded. Independent variables were analyzed by t test. Nonparametric data were analyzed by the Mann-Whitney U test. Results: Patient age, demographics, and body mass indices were similar between the 2 groups. The average length of hospital stay was significantly longer in group A (p < 0.01). Group B had a longer time to first analgesic need than group A (p < 0.01). Patients in group B required less analgesic during the postoperative period. Preoperative VAS and AOFAS scores were not statistically dif ferent between the 2 groups. The postoperative day 1 VAS score was significantly lower in group B than in group A. Follow-up visits at 3, 6, and 12 months showed significantly lower VAS and higher AOFAS scores in group B than group A. Conclusion: Ankle block added to general anesthesia may improve early and mid-term postoperative functional outcomes and postoperative pain management in patients who undergo hallux valgus surgery.
Journal Article
Mini-plate fixation via sinus tarsi approach is superior to cannulated screw in intra-articular calcaneal fractures: A prospective randomized study
Objective:
Intra-articular displaced calcaneal fractures are common fractures and are often treated with surgical interventions. Sinüs tarsi approach provides secure access to lateral wall and joint facets. The aim of the study is to compare cannulated screw (CS) fixation and mini-plate (MP) fixation via sinus tarsi approach with Sanders types 2 and 3 fracture of calcaneus.
Methods:
Sixty patients with Sanders types 2 and 3 calcaneal fracture underwent surgical intervention were randomly allocated into two groups as group MP fixation and group CS fixation regarding osteosynthesis method for 5-year period. Open reduction via sinüs tarsi approach was performed in both groups. Demographic variables, time to surgery (TS), operation duration (OD), length of hospital stay (LOS), surgical complications, and reoperations were recorded. Pre- and postoperative Gissane and Böhler angles; calcaneal length, height, and width; ankle anterior-posterior (AP) and lateral X-rays; and computed tomography were also recorded for radiological evaluation and fracture characteristics. Maryland Foot Score (MFS) was used to evaluate functional outcomes.
Results:
Preoperative age, type of fracture, calcaneal length, height, and Gissane and Böhler angles, TS, LOS, and OD were not different between the groups. The postoperative calcaneal widening was significantly better restored in group MP compared with that of group CS. The incidence of reoperation and algoneurodystrophy was statistically higher in group CS than group MP. MFS in group MP was also higher than group CS at final visit.
Conclusion:
MP fixation via sinus tarsi approach is superior to CS fixation in Sanders types 2 and 3 calcaneal fractures.
Journal Article
PP-251 Pulmonary Artery to Left Atrial Fistula Diagnosed Prenataly and Treated Percutaneously Following Birth
Case The patient was initially diagnosed with an enlarged left atrium and ventricle and a fetal echocardiography was performed at 21st gestational week revealing a large fistula originating from the right pulmonary artery and draining into the left atrium.
Journal Article
Sentinel Lymph Node Dissection in Early Stage Vulvar Cancer: A Preliminary Study
The purpose of this study is to determine the diagnostic accuracy of the sentinel lymph node dissection in patients with squamous cell carcinoma of the vulva by using a gamma probe.
Between April 2000 and April 2002, 10 patients with early stage primary vulvar cancer were eligible for the study. One hour before the operation, we injected technetium99 m-labeled microcolloid intradermally at four locations around the tumor. At the operation sentinel using a handheld gamma detection probe identified lymph nodes. After resection of suspected sentinel lymph nodes, standard procedures (uni/bilateral groin dissection and local wide excision or radical vulvectomy) were performed. Sentinel lymph nodes and lypmhadenectomy specimens were sent for histopathologic examination separately. Negative sentinel lymph nodes were reexamined with step sectioning and immunohistochemistry.
In 10 patients, 18 inguinofemoral lymphadenectomies were performed (three unilateral, seven bilateral). We could detect all sentinel lymph nodes by handheld gamma probe, intraoperatively. In three patients two or more sentinel nodes were identified. Histologically positive sentinel lymph nodes were found in six patients. But we detected positive non-sentinel lymph nodes in two patients while the sentinel lymph nodes were negative (NPV = 0.83).
Sentinel lymph node procedure could be implemented in future therapy concepts in early stage vulvar cancer. We could not detect positive sentinel lymph nodes in patients with positive non-sentinel lymph nodes. May be we are in a learning curve to perform the sentinel lymph node procedure. These preliminary results suggest that further study is warranted.
Journal Article