Radiolarians from ODP Leg 119, Kerguelen Plateau

Radiolarians are abundant and well preserved in the Neogene of the Kerguelen Plateau. They are common and moderately to well preserved in the Oligocene sequences of Site 738, where the Eocene/Oligocene boundary was observed for the first time in subantarctic sediments, and Site 744. Radiolarians are absent from all glacial sediments from Prydz Bay. Classical Neogene stratigraphic markers were tabulated at all sites. Correlations with paleomagnetic ages were made at Sites 745 and 746 for 26 Pliocene-Pleistocene radiolarian events. Many Miocene to Holocene species are missing from Sites 736 and 737, which were drilled in shallow water (less than 800 m). The missing species are considered to be deepliving forms. Occurrences and relative abundances of morphotypes at six sites are reported. Two new genera (Eurystomoskevos and Cymaetron) and 17 new species (Actinomma kerguelenensis, A. campilacantha, Prunopyle trypopyrena, Stylodictya tainemplekta, Lithomelissa cheni, L. dupliphysa, Lophophaena(?) thaumasia, Pseudodictyophimus galeatus, Lamprocyclas inexpectata, L. prionotocodon, Botryostrobus kerguelensis, B. rednosus, Dictyoprora physothorax, Eucyrtidium antiquum, E.(?) mariae, Eurystomoskevos petrushevskaae, and Cymaetron sinolampas) are described from the middle Eocene to Oligocene sediments at Sites 738 and 744. Twenty-seven stratigraphic events are recorded in the middle to late Eocene of Site 738, and 27 additional stratigraphic datums are recorded, and correlated to paleomagnetic stratigraphy, in the early Oligocene at Sites 738 and 744. Eight radiolarian events are recorded in the late Oligocene at Site 744. New evolutionary lineages are proposed for Calocyclas semipolita and Prunopyle trypopyrena.

Radiolarian assemblages of ODP Leg 117 sites

Significant numbers of radiolarians ranging in age from late middle Miocene to Recent were recovered from six sites drilled on the Oman margin and Owen Ridge. Sparse faunas were recovered from five additional sites on the Oman margin and one site on the Indus Fan. Detailed range charts and biozonations are presented for most sites. The radiolarian assemblages are peculiar in that numerous common tropical forms, some of which are biomarkers, are absent or very rare. In addition, some species not usually found in tropical assemblages are present. These forms, indicative of up welling conditions, fall into three categories: (1) endemic upwelling: species endemic to upwelling and not previously described from the Indian Ocean; (2) displaced temperate: temperate forms not usually found in tropical waters; and (3) enhanced tropical: tropical forms which are more abundant and/or robust in areas of upwelling. Comparison of the Oman margin/Owen Ridge fauna with that recovered from the Peru margin upwelling area (ODP Leg 112) suggests that the assemblage may be globally diagnostic of upwelling conditions. The onset of upwelling is marked by the appearance of siliceous biota at about 11.9 Ma, and there is some indication of a decrease in the strength of the upwelling signal at about 9.6 Ma. A strong pulse in, or strengthening of, the upwelling mechanism is indicated by a marked fauna change at 4.7 Ma. There is a weaker signal, implying a change in upwelling conditions, at about 1.5 Ma.

Traité de la fistule de l'anus ou du fondement, dans lequel on expose ses causes, ses signes, les remedes pour le guerir, & les moyens de s'en preserver /

Mode of access: Internet.

The chirurgical works of Percivall Pott, with his last corrections. : to which are added, a short account of the life of the author, a method of curing the hydrocele by injection, and occasional notes and observations /

Published in London in 1771 and 1808.

A study of large-bowel volvulus in urban Australia

Background: Large-bowel volvulus is a rare cause of bowel obstruction in the industrialized world. We analyzed the presentation and outcome of 49 patients at the Princess Alexandra Hospital, Brisbane, Australia, who received a diagnosis of colonic volvulus from 1991 to 2001. Methods: A retrospective chart study was carried out. Results: Twenty-nine patients had sigmoid volvulus (59%), 19 patients had cecal volvulus (39%) and 1 patient had a transverse colon volvulus (2%). The diagnosis of sigmoid volvulus was made accurately on plain abdominal radiography or contrast enema in 90% of cases (n = 26), compared with only 42% of cases (n = 8) of cecal volvulus. Twenty-two patients with sigmoid volvulus were treated initially with endoscopic decompression. The success rate was 64% (n = 14). There was a high early recurrence rate of sigmoid volvulus for those treated by endoscopic decompression alone (43%) during a mean period of 32 days. Of the 14 patients with cecal volvulus who were treated with right hemicolectomy, 12 had primary anastomosis and 2 had end ileostomy with mucous fistula formation. There was no anastomotic leak following right hemicolectomy with primary anastomosis, even though 6 of these patients had an ischemic cecum. Conclusions: Endoscopic decompression of the sigmoid volvulus was safe and effective as an initial treatment but has a high early recurrence rate. Any patient who is fit enough to undergo operation should have a definitive procedure during the same admission to avoid recurrence. Cecal volvulus is associated with a higher incidence of gangrene and is treated effectively by right hemicolectomy with or without anastomosis. The need for swift operative intervention is emphasized.

OSTEOTOMIA SEGMENTAR DE MAXILA CASO CLÍNICO

A Osteotomia Segmentar de Maxila ou Osteotomia Le Fort I Segmentada é um procedimento que tem se tornado, cada vez mais comum, nas cirugias para as correções das deformidades dentofaciais, conhecidas como Cirurgias Ortognáticas. Este procedimento é muito bem indicado para a correção das discrepâncias maxilares, nos diferentes planos e num único tempo cirúrgico, otimizando assim, o tempo de tratamento a que o paciente é submetido. A estabilidade esquelética transversal e a oclusal dos pacientes, que são submetidos a este tipo de osteotomia, tem sido objeto de estudo na literatura , assim como também, os potenciais riscos e complicações inerentes a este procedimento como, a desvitalização dentária, fístula oro-nasal, perda dentária, necrose de algum segmento da maxila ou até mesmo, de toda a maxila. O objetivo deste trabalho é apresentar o caso clínico de um paciente submetido à osteotomia segmentar de maxila, e fazer uma revisão da literatura abrangendo os últimos 10 anos, com artigos que abordam a estabilidade deste tipo de procedimento, assim como também os potenciais riscos e complicações aos pacientes submetidos a este procedimento. Utilizando algumas palavras chave na base de dados eletrônica PUBMED, 12 artigos foram selecionados para este trabalho, no período de 2002 a 2012. A Osteotomia Segmentar de Maxila é um procedimento estável e seguro, com baixo índice de complicação, quando indicado corretamente e com os devidos cuidados no pré, trans e pós operatórios.

Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience

Background During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes. Methods 831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed. Results At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications. Conclusions The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.

(Appendix A) Radiolarian abundance in ODP Hole 202-1241A

A quantitative radiolarian study at Ocean Drilling Program Site 1241 in the eastern tropical Pacific enables us to reconstruct paleoceanographic changes that occurred since the latest middle Miocene. Today, this site is located just under the Eastern Pacific Warm Pool (EPWP). Based on the abundance variations of radiolarian characteristic species which are indicators of upwelling and thermocline changes, it is suggested that three notable changes occurred at 10.6, 9.8, and 4.2 Ma in the region. Four distinct periods of oceanographic conditions bounded by these notable changes were characterized on the basis of the following: (1) stratified seawater (12.0 to 10.6 Ma); (2) a shallowing of the thermocline and an increasing of upwelling (10.6 to 9.8 Ma); (3) significant inflow of warm water to the eastern tropical Pacific caused by an intensified Northern Equatorial Countercurrent (NECC), resulting in the formation of EPWP (9.8 to 4.2 Ma); and (4) the reduction of the EPWP and the NECC, and an increase in upwelling (4.2 to 0 Ma). The timing of these paleoceanographic events indicated the strong relations with the opening and closing of the Indonesian and Central American (Panama) Seaways. The reduction of the EPWP (this study) and the deepening of the thermocline in western Pacific at about 4.2 Ma (Cannariato and Ravelo, 1997; Chaisson and Ravelo, 2000) indicated a change from a state resembling El Niño in the late Miocene and the early Pliocene time to a state resembling La Niña by the late Pliocene

Bilateral lung and liver hydatid cysts. Case report

Introduction. Synchronous occurrence of pulmonary and hepatic hydatid cysts is an uncommon manifestation of hydatid disease that is observed in less than 10% of cases. We report a rare case of bilateral lung (with bronchial fistula) and liver cyst, surgically treated after medical therapy. Case report. A 44-year-old housewife reporting fever, anorexia and fatigue that had been present for the previous 20 days received diagnosis of bilateral lung and liver hydatid cyst. Because of the dimensions of right lung cyst and the successive bronchial fistolization, we proceeded to three-stage operation of two thoracotomies and a laparotomy to control the risk of further rupture. After surgery, all post-operatives were uneventful. Complete resolution of the therapy with no evidence of recurrence at 2 years follow-up. Conclusion. We emphasize the need to search for additional hydatids in patients who present with either pulmonary or liver hydatids. The simultaneous treatment of liver and lung should be reserved to patients in good conditions; in all other cases, especially when one cyst is more symptomatic than the others or has more risk of rupture, we prefer to treat single cyst.

Cholecystectomy by single incision laparoscopic surgery (SILS): early experience and technique standardization

Single Incision Laparoscopic Surgery (SILS) is a recent surgical technique, first described in the 1990s. Its aim is to optimize the esthetic result offered by laparoscopy by minimizing the number of abdominal incisions. Various preliminary studies have been carried out on the application of SILS, especially in cholecystectomy and appendectomy. This study evaluates the preliminary results of cholecystectomy by SILS (SILS™ Port) conducted between October 2009 and February 2011 on 21 patients (4 men and 17 women) with a mean age of 49.9 years and a mean Body Mass Index (BMI) of 22.8. All patients were treated by the same team, which had previously undergone six months’ simulator training. There were two main selection criteria, both evaluated intraoperatively: absence of adhesions and of significant inflammatory sequelae from previous cholecystitis; and suitable distance between gallbladder and SILS access port. Conversion to traditional laparoscopy was necessary in just two cases, while an accessory trocar was introduced in another two cases. Conversion to open surgery was not necessary in any case. One case of SILS cholecystectomy was complicated by postoperative bile leakage, which was treated conservatively, as the fistula had a low output. The mean duration of hospitalization was 3.6 days. This preliminary experience led us to conclude that SILS is safe and highly satisfactory in the postoperative phase, thanks to the reduced need for painkillers and the improved esthetic result.

Cirurgia endoscópica em tumores nasosinusais: experiência do IPOLFG

Introdução: Os tumores nasais são, classicamente, abordados pela via externa mas recentemente tem-se optado, também, pela via endoscópica. No entanto, em tumores localmente avançados, poderá não ser possível a remoção completa. Material e métodos: Foram analisados os processos clínicos dos 14 doentes com tumor das fossas nasais removido por via endoscópica no IPOLFG entre 2005 e 2012. Resultados: Dos 14 doentes, 8 apresentavam tumor maligno e 5 tumor benigno. Não houve preponderância de nenhum tipo histológico. 7 doentes realizaram RT adjuvante e 1 foi submetido a esvaziamento ganglionar cervical ipsilateral. Foram registadas 2 complicações cirúrgicas: 1 fístula de LCR e 1 complicação minor. Apenas 2 doentes recidivaram, recorrendo-se à via externa em 1. Conclusões: A abordagem de tumores nasais por via endoscópica é uma opção eficaz mas é necessária uma correta avaliação da extensão tumoral para decisão da via cirúrgica a utilizar, para remoção completa e obtenção de margens livres.