Browlifting as an Alternative Procedure for Apraxia of Eyelid Opening

Essential blepharospasm is an idiopathic disorder that consists of spontaneous, spasmodic, and involuntary eyelid closure in the absence of ocular disease. Some patients develop an inability to open their eyelids in the absence of orbicularis spasms. These patients have essential blepharospasm combined with apraxia of eyelid opening. Botulinum toxin injections are the treatment of choice for blepharospasm but results may be insufficient, especially in cases associated with apraxia. Apraxia can be treated surgically by levator aponeurosis advancement, frontalis suspension, and upper myectomy. The authors report the first browlift using polypropylene suture to manage eyelid apraxia associated with blepharospasm as an alternative and minimally invasive procedure.

Altered endothelial function following the Fontan procedure

Objective: Thrombosis has been widely described after the Fontan procedure. The vascular endothelium plays a central role in the control of coagulation and fibrinolysis. The aim of this study was to investigate if patients undergoing a modified Fontan procedure have impaired endothelial function and fibrinolysis in the late postoperative course. Patients and methods: We compared 23 patients aged from 7 to 26 years with age-matched healthy volunteers, collecting blood samples prior to and following standardized venous occlusion testing. Plasma levels of von Willebrand factor antigen, tissue-type plasminogen activator antigen, plasminogen activator inhibitor-1, and D-dimer were measured with enzyme-linked immunosorbent assay. Results: We found increased plasma levels of von Willebrand factor antigen in patients when compared to controls (p = 0.003). At the basal condition, concentrations of tissue-type plasminogen activator antigen and plasminogen activator inhibitor-1 antigen in the plasma, as well as their activity, were not significantly different between patients and controls. Following venous occlusion, concentrations of tissue-type plasminogen activator antigen in the plasma were significantly increased both in patients and controls, compared to pre-occlusion values. D-dimer was within the reference range. Multivariate discriminant analysis differentiated patients and their controls on the basis of differences for plasminogen activator inhibitor-1 and von Willebrand factor antigen (p = 0.0016). Conclusions: Our data suggest that patients with the Fontan circulation may have endothelial dysfunction, as indicated by raised levels of von Willebrand factor. Fibrinolysis seems to be relatively preserved, as suggested by appropriate response to venous occlusion.

Technical modifications in stabilisers and in bar removal in the Nuss procedure

Pectus excavatum is a congenital deformity that can require surgical treatment. Since Nuss proposed a correction technique, several modifications have been proposed in order to achieve more safety and efficiency in the placement and removal of both bars. Our objective is to describe the technique of placing and removing the bars by proposing three technical modifications: two in bar placement and one in the bar removal. We describe two cases where Nuss bars were placed and one case where the bar was removed as per the technical modification proposed herein. According to the original technique, bar stabilisers. were placed close to the lateral bar edges. We propose a more medial position in order to reduce bar displacement. New stabilisers were designed with central grooves in the posterior surface, which allow better sliding. The technical modification suitable for bar removal was the use of a protective film around the bars to protect the surrounding tissues from the sharp edges, and thereby minimise the risk of injuries. All the proposed modifications were performed without any additional surgical risk or perioperative complication. These three technical modifications can be easily and safety performed, and seem to reduce the risk of bleeding with no additional perioperative complications. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Model based procedure for scale-up of wet overflow ball mills Part 1: Outline of the methodology

Bond's method for ball mill scale-up only gives the mill power draw for a given duty. This method is incompatible with computer modelling and simulation techniques. It might not be applicable for the design of fine grinding ball mills and ball mills preceded by autogenous and semi-autogenous grinding mills. Model-based ball mill scale-up methods have not been validated using a wide range of full-scale circuit data. Their accuracy is therefore questionable. Some of these methods also need expensive pilot testing. A new ball mill scale-up procedure is developed which does not have these limitations. This procedure uses data from two laboratory tests to determine the parameters of a ball mill model. A set of scale-up criteria then scales-up these parameters. The procedure uses the scaled-up parameters to simulate the steady state performance of full-scale mill circuits. At the end of the simulation, the scale-up procedure gives the size distribution, the volumetric flowrate and the mass flowrate of all the streams in the circuit, and the mill power draw.

Model-based procedure for scale-up of wet, overflow ball mills - Part II: Worked example

A new ball mill scale-up procedure is developed which uses laboratory data to predict the performance of MI-scale ball mill circuits. This procedure contains two laboratory tests. These laboratory tests give the data for the determination of the parameters of a ball mill model. A set of scale-up criteria then scales-up these parameters. The procedure uses the scaled-up parameters to simulate the steady state performance of the full-scale mill circuit. At the end of the simulation, the scale-up procedure gives the size distribution, the volumetric flowrate and the mass flowrate of all the streams in the circuit, and the mill power draw. A worked example shows how the new ball mill scale-up procedure is executed. This worked example uses laboratory data to predict the performance of a full-scale re-grind mill circuit. This circuit consists of a ball mill in closed circuit with hydrocyclones. The MI-scale ball mill has a diameter (inside liners) of 1.85m. The scale-up procedure shows that the full-scale circuit produces a product (hydrocyclone overflow) that has an 80% passing size of 80 mum. The circuit has a recirculating load of 173%. The calculated power draw of the full-scale mill is 92kW (C) 2001 Elsevier Science Ltd. All rights reserved.

Model-based procedure for scale-up of wet, overflow ball mills - Part III: Validation and discussion

A new ball mill scale-up procedure is developed. This procedure has been validated using seven sets of Ml-scale ball mil data. The largest ball mills in these data have diameters (inside liners) of 6.58m. The procedure can predict the 80% passing size of the circuit product to within +/-6% of the measured value, with a precision of +/-11% (one standard deviation); the re-circulating load to within +/-33% of the mass-balanced value (this error margin is within the uncertainty associated with the determination of the re-circulating load); and the mill power to within +/-5% of the measured value. This procedure is applicable for the design of ball mills which are preceded by autogenous (AG) mills, semi-autogenous (SAG) mills, crushers and flotation circuits. The new procedure is more precise and more accurate than Bond's method for ball mill scale-up. This procedure contains no efficiency correction which relates to the mill diameter. This suggests that, within the range of mill diameter studied, milling efficiency does not vary with mill diameter. This is in contrast with Bond's equation-Bond claimed that milling efficiency increases with mill diameter. (C) 2001 Elsevier Science Ltd. All rights reserved.

A DNA fingerprinting procedure for ultra high-throughput genetic analysis of insects

Existing procedures for the generation of polymorphic DNA markers are not optimal for insect studies in which the organisms are often tiny and background molecular Information is often non-existent. We have used a new high throughput DNA marker generation protocol called randomly amplified DNA fingerprints (RAF) to analyse the genetic variability In three separate strains of the stored grain pest, Rhyzopertha dominica. This protocol is quick, robust and reliable even though it requires minimal sample preparation, minute amounts of DNA and no prior molecular analysis of the organism. Arbitrarily selected oligonucleotide primers routinely produced similar to 50 scoreable polymorphic DNA markers, between individuals of three Independent field isolates of R. dominica. Multivariate cluster analysis using forty-nine arbitrarily selected polymorphisms generated from a single primer reliably separated individuals into three clades corresponding to their geographical origin. The resulting clades were quite distinct, with an average genetic difference of 37.5 +/- 6.0% between clades and of 21.0 +/- 7.1% between individuals within clades. As a prelude to future gene mapping efforts, we have also assessed the performance of RAF under conditions commonly used in gene mapping. In this analysis, fingerprints from pooled DNA samples accurately and reproducibly reflected RAF profiles obtained from Individual DNA samples that had been combined to create the bulked samples.

Characterisation of pore structure of carbon adsorbents using regularisation procedure

The constrained regularisation procedure was applied to compute the pore size distributions (PSDs, f(x)) for a variety of activated carbons using overall adsorption equation based on the combination of the Kelvin equation and the statistical adsorbed film thickness. The impact of the boundary values of relative nitrogen pressure p/p(0) was analysed on the basis of the corresponding alterations in the PSDs. Changes in microporosity and mesoporosity of activated carbons can be described adequately only when the range of p/p(0) is as wide as possible, as at a high initial p/p(0) value, the f(x) curves can be broadened with shifted maxima especially for micropores and narrow mesopores. Comparative analysis of the PSDs and the adsorption potential, adsorption energy and fractal dimension distributions gives useful information on the complete description of the adsorbent characteristics. (C) 2001 Elsevier Science B.V. All rights reserved.

Emotional cue exposure for alcohol abuse: Development of a new treatment procedure to train moderation drinking in the context of dysphoria

Negative mood states are credited to exacerbate excessive drinking among problem drinkers. We developed an emotional cue exposure treatment procedure and applied it to three problem drinkers who have a history of drinking excessively under stressful emotional states. All three preferred a controlled drinking goal and received an average of seven sessions of treatment. Treatment comprised of providing alcohol (priming doses), followed by negative mood induction and response prevention of further drinking. Reductions were observed in the quantity and frequency of drinking, the Beck Depression Inventory, the Severity of Alcohol Dependence Questionnaire (Form C) and the Impaired Control Questionnaire scores. Increments were observed in self-efficacy to face different difficult situations. These gains were maintained at the 6-month follow-up. Providing alcohol to problem drinkers in treatment, followed by negative mood induction and response prevention, is clinically feasible and may benefit clients who drink under a variety of stressful mood states. Copyright (C) 2001 John Wiley & Sons, Ltd.

Corticosteroid-induced glaucoma in a child after a scleral reinforcement procedure

Corticoteroid-induced glaucoma can result from either topical or systemic corticosteroid use. Compared with adults, the corticosteroid response in children is less well known. The case is reported of a child who developed glaucoma after receiving topical corticosteroids following a scleral re-inforcement procedure. The raised intraocular pressure was controlled after cessation of the corticosteroids and with the use of antiglaucoma therapy. As many forms of cortico-steroids are widely used, children on corticosteroids should have regular intraocular pressure measurements as part of their management.

A sponge allelochemical induces ascidian settlement but inhibits metamorphosis

Secondary metabolites synthesised by sessile invertebrates appear to play a role in creating and maintaining space on hard substrata by repelling competitors. In this study, we investigated the responses of the larvae of the ascidian Herdmania curvata to haliclonacyclamine A (HA), the major component of a suite of cytotoxic alkaloids extracted from the sponge Haliclona sp. 628. Both Haliclona sp. 628 and Herdmania curvata inhabit the crest and slope of Heron Island Reef. High rates of settlement were induced in competent H. curvata larvae by a range of concentrations of HA, all lower than that naturally occurring in the sponge. HA did not induce precompetent larvae to settle. Although early metamorphosis of HA-induced larvae was normal, larvae exposed to all but the lowest concentration of HA were developmentally arrested after completion of tail resorption, at about 4 h after the initiation of metamorphosis. These postlarvae underwent extensive cellular necrosis within 24 h. We also demonstrate that the addition of a transcriptional inhibitor, actinomycin D, to larvae also causes inhibition of metamorphosis after tail resorption is completed. Analyses of incorporation of radiolabelled nucleotides to measure levels of transcription during normal development and after the addition of the transcriptional inhibitor indicate that there is a significant burst of transcriptional activity just after tail resorption is completed. Despite inhibiting metamorphosis at the same stage as actinomycin D, HA increases initial rates of RNA synthesis after induction of metamorphosis in a manner similar to that observed in normal postlarvae until the onset of cellular necrosis. We conclude that HA initially induces H. curvata larvae to settle and progress through early metamorphosis possibly by engaging the same pathway as other artificial and environmental cues but subsequently inhibits completion of metamorphosis, resulting in death of the postlarvae. Since HA does not affect overall transcription rates, it appears to disrupt another important developmental process during early metamorphosis.