Die Inguinal-Hernienplastik nach Lichtenstein: Eine einfache und komplikationsarme Technik, besonders geeignet für die Tageschirurgie [The Lichtenstein inguinal hernia-plasty: a simple and complication-free technique, especially suited for ambulatory surgery].

A consecutive series of 353 patients who underwent Lichtenstein mesh repair for inguinal hernia from the 1st of July 1994 to the 30th of July 1995 were studied. We analysed our indication, technique, complications, follow-up and outcome. Special consideration was given to the advantages and acceptance of day-case surgery. Our results suggest that the Lichtenstein repair should be considered as a new standard procedure, especially outside of hernia centres.

Surgery for incarcerated hernia: short-term outcome with or without mesh.

BACKGROUND: Incarcerated hernias represent about 5-15 % of all operated hernias. Tension-free mesh is the preferred technique for elective surgery due to low recurrence rates. There is however currently no consensus on the use of mesh for the treatment of incarcerated hernias, especially in case of bowel resection. AIM: The aims of this study were (i) to report our current practice for the treatment of incarcerated hernias, (ii) to identify risk factors for postoperative complications, and (iii) to assess the safety of mesh placement in potentially infected surgical fields. METHODS: This retrospective study included 166 consecutive patients who underwent emergency surgery for incarcerated hernia between January 2007 and January 2012 in two university hospitals. Demographics, surgical details, and short-term outcome were collected. Univariate analysis was employed to identify risk factors for overall, infectious, and major complications. RESULTS: Eighty-four patients (50.6 %) presented inguinal hernias, 43 femoral (25.9 %), 37 umbilical hernias (22.3 %), and 2 mixed hernias (1.2 %), respectively. Mesh was placed in 64 patients (38.5 %), including 5 patients with concomitant bowel resection. Overall morbidity occurred in 56 patients (32.7 %), and 8 patients (4.8 %) developed surgical site infections (SSI). Univariate risk factors for overall complications were ASA grade 3/4 (P = 0.03), diabetes (P = 0.05), cardiopathy (P = 0.001), aspirin use (P = 0.023), and bowel resection (P = 0.001) which was also the only identified risk factor for SSI (P = 0.03). In multivariate analysis, only bowel incarceration was associated with a higher rate of major morbidity (OR = 14.04; P = 0.01). CONCLUSION: Morbidity after surgery for incarcerated hernia remains high and depends on comorbidities and surgical presentation. The use of mesh could become current practice even in case of bowel resection.

Implantación de un modelo de red abierta tipo mesh para propagar el acceso libre al servicio de biblioteca y contenidos abiertos

Implantación de un modelo de red abierta tipo mesh para propagar el acceso libre al servicio de biblioteca y contenidos abiertos.

Numerical conformal mapping and mesh generation for polygonal and multiply-connected regions

Details are given of a boundary-fitted mesh generation method for use in modelling free surface flow and water quality. A numerical method has been developed for generating conformal meshes for curvilinear polygonal and multiply-connected regions. The method is based on the Cauchy-Riemann conditions for the analytic function and is able to map a curvilinear polygonal region directly onto a regular polygonal region, with horizontal and vertical sides. A set of equations have been derived for determining the lengths of these sides and the least-squares method has been used in solving the equations. Several numerical examples are presented to illustrate the method.

Numerical solution of the eXtended Pom-Pom model for viscoelastic free surface flows

In this paper we present a finite difference method for solving two-dimensional viscoelastic unsteady free surface flows governed by the single equation version of the eXtended Pom-Pom (XPP) model. The momentum equations are solved by a projection method which uncouples the velocity and pressure fields. We are interested in low Reynolds number flows and, to enhance the stability of the numerical method, an implicit technique for computing the pressure condition on the free surface is employed. This strategy is invoked to solve the governing equations within a Marker-and-Cell type approach while simultaneously calculating the correct normal stress condition on the free surface. The numerical code is validated by performing mesh refinement on a two-dimensional channel flow. Numerical results include an investigation of the influence of the parameters of the XPP equation on the extrudate swelling ratio and the simulation of the Barus effect for XPP fluids. (C) 2010 Elsevier B.V. All rights reserved.

Numerical solution of the PTT constitutive equation for unsteady three-dimensional free surface flows

This work deals with the development of a numerical technique for simulating three-dimensional viscoelastic free surface flows using the PTT (Phan-Thien-Tanner) nonlinear constitutive equation. In particular, we are interested in flows possessing moving free surfaces. The equations describing the numerical technique are solved by the finite difference method on a staggered grid. The fluid is modelled by a Marker-and-Cell type method and an accurate representation of the fluid surface is employed. The full free surface stress conditions are considered. The PTT equation is solved by a high order method, which requires the calculation of the extra-stress tensor on the mesh contours. To validate the numerical technique developed in this work flow predictions for fully developed pipe flow are compared with an analytic solution from the literature. Then, results of complex free surface flows using the FIT equation such as the transient extrudate swell problem and a jet flowing onto a rigid plate are presented. An investigation of the effects of the parameters epsilon and xi on the extrudate swell and jet buckling problems is reported. (C) 2010 Elsevier B.V. All rights reserved.

Numerical solution of the eXtended Pom-Pom model for viscoelastic free surface flows

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A marker-and-cell approach to free surface 2-D multiphase flows

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Three-dimensional transient complex free surface flows: Numerical simulation of XPP fluid

In this paper we present a finite difference MAC-type approach for solving three-dimensional viscoelastic incompressible free surface flows governed by the eXtended Pom-Pom (XPP) model, considering a wide range of parameters. The numerical formulation presented in this work is an extension to three-dimensions of our implicit technique [Journal of Non-Newtonian Fluid Mechanics 166 (2011) 165-179] for solving two-dimensional viscoelastic free surface flows. To enhance the stability of the numerical method, we employ a combination of the projection method with an implicit technique for treating the pressure on the free surfaces. The differential constitutive equation of the fluid is solved using a second-order Runge-Kutta scheme. The numerical technique is validated by performing a mesh refinement study on a pipe flow, and the numerical results presented include the simulation of two complex viscoelastic free surface flows: extrudate-swell problem and jet buckling phenomenon. © 2013 Elsevier B.V.

Free tools and strategies for the generation of 3D finite element meshes: Modeling of the cardiac structures

The Finite Element Method is a well-known technique, being extensively applied in different areas. Studies using the Finite Element Method (FEM) are targeted to improve cardiac ablation procedures. For such simulations, the finite element meshes should consider the size and histological features of the target structures. However, it is possible to verify that some methods or tools used to generate meshes of human body structures are still limited, due to nondetailed models, nontrivial preprocessing, or mainly limitation in the use condition. In this paper, alternatives are demonstrated to solid modeling and automatic generation of highly refined tetrahedral meshes, with quality compatible with other studies focused on mesh generation. The innovations presented here are strategies to integrate Open Source Software (OSS). The chosen techniques and strategies are presented and discussed, considering cardiac structures as a first application context. © 2013 E. Pavarino et al.

A marker-and-cell approach to free surface 2-D multiphase flows

This work describes a methodology to simulate free surface incompressible multiphase flows. This novel methodology allows the simulation of multiphase flows with an arbitrary number of phases, each of them having different densities and viscosities. Surface and interfacial tension effects are also included. The numerical technique is based on the GENSMAC front-tracking method. The velocity field is computed using a finite-difference discretization of a modification of the NavierStokes equations. These equations together with the continuity equation are solved for the two-dimensional multiphase flows, with different densities and viscosities in the different phases. The governing equations are solved on a regular Eulerian grid, and a Lagrangian mesh is employed to track free surfaces and interfaces. The method is validated by comparing numerical with analytic results for a number of simple problems; it was also employed to simulate complex problems for which no analytic solutions are available. The method presented in this paper has been shown to be robust and computationally efficient. Copyright (c) 2012 John Wiley & Sons, Ltd.

A safe and simple solution for intravesical tension-free vaginal tape erosion: removal by standard transurethral resection

OBJECTIVE: To report our experience with the successful removal of visible tension-free vaginal tape (TVT) by standard transurethral electroresection, as intravesical tape erosion after TVT is a rare complication, and removal can be challenging, with few cases reported. PATIENTS AND METHODS: Five patients presenting with TVT erosion into the bladder were treated at our institutions from December 2004 to July 2007; all had standard transurethral electroresection. Their records were reviewed retrospectively to retrieve data on presenting symptoms, diagnostic tests, surgical procedures and outcomes. RESULTS: The median (range) interval between the TVT procedure and the onset of symptoms was 17 (1-32) months. The predominant symptoms were painful micturition, recurrent urinary tract infection (UTI), urgency and urge incontinence. There were no complications during surgery. The storage symptoms and UTI resolved completely after removing the eroded mesh in all but one patient. Cystoscopy at 1 month after surgery showed complete healing of the bladder mucosa. CONCLUSION: Although TVT erosion into the bladder is rare, persistent symptoms, particularly recurrent UTIs, must raise some suspicion for this condition. Standard transurethral electroresection seems to be a safe, simple, minimally invasive and successful treatment option for TVT removal.

Hydrodynamic forces on heave plates for offshore systems oscillating close to the seabed or the free surface

La energía eólica marina es uno de los recursos energéticos con mayor proyección pudiendo contribuir a reducir el consumo de combustibles fósiles y a cubrir la demanda de energía en todo el mundo. El concepto de aerogenerador marino está basado en estructuras fijas como jackets o en plataformas flotantes, ya sea una semisumergible o una TLP. Se espera que la energía eólica offshore juegue un papel importante en el perfil de producción energética de los próximos años; por tanto, las turbinas eólicas deben hacerse más fables y rentables para ser competitivas frente a otras fuentes de energía. Las estructuras flotantes pueden experimentar movimientos resonantes en estados de la mar con largos períodos de oleaje. Estos movimientos disminuyen su operatividad y pueden causar daños en los componentes eléctricos de las turbinas y en las palas, también en los risers y moorings. La respuesta de la componente vertical del movimiento puede reducirse mediante diferentes actuaciones: (1) aumentando la amortiguación del sistema, (2) manteniendo el período del movimiento vertical fuera del rango de la energía de la ola, y (3) reduciendo las fuerzas de excitación verticales. Un ejemplo típico para llevar a cabo esta reducción son las "Heave Plates". Las heave plates son placas que se utilizan en la industria offshore debido a sus características hidrodinámicas, ya que aumentan la masa añadida y la amortiguación del sistema. En un análisis hidrodinámico convencional, se considera una estructura sometida a un oleaje con determinadas características y se evalúan las cargas lineales usando la teoría potencial. El amortiguamiento viscoso, que juega un papel crucial en la respuesta en resonancia del sistema, es un dato de entrada para el análisis. La tesis se centra principalmente en la predicción del amortiguamiento viscoso y de la masa añadida de las heave plates usadas en las turbinas eólicas flotantes. En los cálculos, las fuerzas hidrodinámicas se han obtenido con el f n de estudiar cómo los coeficientes hidrodinámicos de masa añadida5 y amortiguamiento varían con el número de KC, que caracteriza la amplitud del movimiento respecto al diámetro del disco. Por otra parte, se ha investigado la influencia de la distancia media de la ‘heave plate’ a la superficie libre o al fondo del mar, sobre los coeficientes hidrodinámicos. En este proceso, un nuevo modelo que describe el trabajo realizado por la amortiguación en función de la enstrofía, es descrito en el presente documento. Este nuevo enfoque es capaz de proporcionar una correlación directa entre el desprendimiento local de vorticidad y la fuerza de amortiguación global. El análisis también incluye el estudio de los efectos de la geometría de la heave plate, y examina la sensibilidad de los coeficientes hidrodinámicos al incluir porosidad en ésta. Un diseño novedoso de una heave plate, basado en la teoría fractal, también fue analizado experimentalmente y comparado con datos experimentales obtenidos por otros autores. Para la resolución de las ecuaciones de Navier Stokes se ha usado un solver basado en el método de volúmenes finitos. El solver usa las librerías de OpenFOAM (Open source Field Operation And Manipulation), para resolver un problema multifásico e incompresible, usando la técnica VOF (volume of fluid) que permite capturar el movimiento de la superficie libre. Los resultados numéricos han sido comparados con resultados experimentales llevados a cabo en el Canal del Ensayos Hidrodinámicos (CEHINAV) de la Universidad Politécnica de Madrid y en el Canal de Experiencias Hidrodinámicas (CEHIPAR) en Madrid, al igual que con otros experimentos realizados en la Escuela de Ingeniería Mecánica de la Universidad de Western Australia. Los principales resultados se presentan a continuación: 1. Para pequeños valores de KC, los coeficientes hidrodinámicos de masa añadida y amortiguamiento incrementan su valor a medida que el disco se aproxima al fondo marino. Para los casos cuando el disco oscila cerca de la superficie libre, la dependencia de los coeficientes hidrodinámicos es más fuerte por la influencia del movimiento de la superficie libre. 2. Los casos analizados muestran la existencia de un valor crítico de KC, donde la tendencia de los coeficientes hidrodinámicos se ve alterada. Dicho valor crítico depende de la distancia al fondo marino o a la superficie libre. 3. El comportamiento físico del flujo, para valores de KC cercanos a su valor crítico ha sido estudiado mediante el análisis del campo de vorticidad. 4. Introducir porosidad al disco, reduce la masa añadida para los valores de KC estudiados, pero se ha encontrado que la porosidad incrementa el valor del coeficiente de amortiguamiento cuando se incrementa la amplitud del movimiento, logrando un máximo de damping para un disco con 10% de porosidad. 5. Los resultados numéricos y experimentales para los discos con faldón, muestran que usar este tipo de geometrías incrementa la masa añadida cuando se compara con el disco sólido, pero reduce considerablemente el coeficiente de amortiguamiento. 6. Un diseño novedoso de heave plate basado en la teoría fractal ha sido experimentalmente estudiado a diferentes calados y comparado con datos experimentales obtenidos por otro autores. Los resultados muestran un comportamiento incierto de los coeficientes y por tanto este diseño debería ser estudiado más a fondo. ABSTRACT Offshore wind energy is one of the promising resources which can reduce the fossil fuel energy consumption and cover worldwide energy demands. Offshore wind turbine concepts are based on either a fixed structure as a jacket or a floating offshore platform like a semisubmersible, spar or tension leg platform. Floating offshore wind turbines have the potential to be an important part of the energy production profile in the coming years. In order to accomplish this wind integration, these wind turbines need to be made more reliable and cost efficient to be competitive with other sources of energy. Floating offshore artifacts, such oil rings and wind turbines, may experience resonant heave motions in sea states with long peak periods. These heave resonances may increase the system downtime and cause damage on the system components and as well as on risers and mooring systems. The heave resonant response may be reduced by different means: (1) increasing the damping of the system, (2) keeping the natural heave period outside the range of the wave energy, and (3) reducing the heave excitation forces. A typical example to accomplish this reduction are “Heave Plates”. Heave plates are used in the offshore industry due to their hydrodynamic characteristics, i.e., increased added mass and damping. Conventional offshore hydrodynamic analysis considers a structure in waves, and evaluates the linear and nonlinear loads using potential theory. Viscous damping, which is expected to play a crucial role in the resonant response, is an empirical input to the analysis, and is not explicitly calculated. The present research has been mainly focused on the prediction of viscous damping and added mass of floating offshore wind turbine heave plates. In the calculations, the hydrodynamic forces have been measured in order to compute how the hydrodynamic coefficients of added mass1 and damping vary with the KC number, which characterises the amplitude of heave motion relative to the diameter of the disc. In addition, the influence on the hydrodynamic coefficients when the heave plate is oscillating close to the free surface or the seabed has been investigated. In this process, a new model describing the work done by damping in terms of the flow enstrophy, is described herein. This new approach is able to provide a direct correlation between the local vortex shedding processes and the global damping force. The analysis also includes the study of different edges geometry, and examines the sensitivity of the damping and added mass coefficients to the porosity of the plate. A novel porous heave plate based on fractal theory has also been proposed, tested experimentally and compared with experimental data obtained by other authors for plates with similar porosity. A numerical solver of Navier Stokes equations, based on the finite volume technique has been applied. It uses the open-source libraries of OpenFOAM (Open source Field Operation And Manipulation), to solve 2 incompressible, isothermal immiscible fluids using a VOF (volume of fluid) phase-fraction based interface capturing approach, with optional mesh motion and mesh topology changes including adaptive re-meshing. Numerical results have been compared with experiments conducted at Technical University of Madrid (CEHINAV) and CEHIPAR model basins in Madrid and with others performed at School of Mechanical Engineering in The University of Western Australia. A brief summary of main results are presented below: 1. At low KC numbers, a systematic increase in added mass and damping, corresponding to an increase in the seabed proximity, is observed. Specifically, for the cases when the heave plate is oscillating closer to the free surface, the dependence of the hydrodynamic coefficients is strongly influenced by the free surface. 2. As seen in experiments, a critical KC, where the linear trend of the hydrodynamic coefficients with KC is disrupted and that depends on the seabed or free surface distance, has been found. 3. The physical behavior of the flow around the critical KC has been explained through an analysis of the flow vorticity field. 4. The porosity of the heave plates reduces the added mass for the studied porosity at all KC numbers, but the porous heave plates are found to increase the damping coefficient with increasing amplitude of oscillation, achieving a maximum damping coefficient for the heave plate with 10% porosity in the entire KC range. 5. Another concept taken into account in this work has been the heave plates with flaps. Numerical and experimental results show that using discs with flaps will increase added mass when compared to the plain plate but may also significantly reduce damping. 6. A novel heave plate design based on fractal theory has tested experimentally for different submergences and compared with experimental data obtained by other authors for porous plates. Results show an unclear behavior in the coefficients and should be studied further. Future work is necessary in order to address a series of open questions focusing on 3D effects, optimization of the heave plates shapes, etc.

Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost

Objective: To compare tension-free open mesh hernioplasty under local anaesthetic with transabdominal preperitoneal laparoscopic hernia repair under general anaesthetic.

Scaffold-free, Human Mesenchymal Stem Cell-Based Tissue Engineered Blood Vessels.

Tissue-engineered blood vessels (TEBV) can serve as vascular grafts and may also play an important role in the development of organs-on-a-chip. Most TEBV construction involves scaffolding with biomaterials such as collagen gel or electrospun fibrous mesh. Hypothesizing that a scaffold-free TEBV may be advantageous, we constructed a tubular structure (1 mm i.d.) from aligned human mesenchymal cell sheets (hMSC) as the wall and human endothelial progenitor cell (hEPC) coating as the lumen. The burst pressure of the scaffold-free TEBV was above 200 mmHg after three weeks of sequential culture in a rotating wall bioreactor and perfusion at 6.8 dynes/cm(2). The interwoven organization of the cell layers and extensive extracellular matrix (ECM) formation of the hMSC-based TEBV resembled that of native blood vessels. The TEBV exhibited flow-mediated vasodilation, vasoconstriction after exposure to 1 μM phenylephrine and released nitric oxide in a manner similar to that of porcine femoral vein. HL-60 cells attached to the TEBV lumen after TNF-α activation to suggest a functional endothelium. This study demonstrates the potential of a hEPC endothelialized hMSC-based TEBV for drug screening.