Congenital tracheal anomalies.

Congenital tracheal lesions are rare, but important, causes of morbidity in infants and children. Consequently, experience in their management is limited and dispersed. Given its small diameter, the juvenile trachea is obstructed easily by various natural causes, or following a surgical intervention. The diagnosis of a congenital, tracheal, obstructive anomaly is based on a high degree of suspicion in infants and children with respiratory distress accompanied by retraction. In this article, the authors discuss the various causes of these conditions, their diagnostic features, and the treatment possibilities.

Paperikoneen uuden lyhytkiertoprosessin sovellutuskehitys

Työssä tutkittiin uuden ShortFlowÔ-konseptin eri osa-alueiden toimivuutta paperikoneen lyhytkierrossa. Prosessin sekoituspumppuna perinteinen keskipakopumppu korvataan potkuri-pumpulla, joten työssä selvitettiin uudentyyppisen pumpun kavitointirajat, säädettävyys ja sen soveltuminen suunniteltuun tehtävään ja toiminta-alueeseen. Prosessiin kuuluu myös uudentyyppinen viirakaivo, josta selvitettiin sen kyky poistaa ilmaa ja virtauskäyttäytyminen kaivossa. Hienopaperikoneen osalta kartoitettiin prosessiin liittyviä riskejä ja ShortFlowÔ-lyhytkiertoprosessin kannattavuutta investointina. Työn kirjallisessa osassa on käsitelty lyhytkiertoa eri osa-alueittain. Aluksi on lyhytkierron yleisempi tarkastelu, jossa on selvitetty lajittelua, ilmanpoistoa ja pumppauksia. Erityisempää huomiota on kiinnitetty ShortFlowÔ-lyhytkiertoprosessiin liittyviin erityispiirteisiin joita ovat sakeamassalajittelu, täyteaineet paperitehtaalla, hylky ja virtausten sekoittuminen. Sekoituspumpun osalta on käsitelty myös kavitointia hieman tarkemmin. Työn kokeellisessa osassa suunniteltiin prosessin koelaitteisto, joka myös koeajettiin. Potkuripumpun koeajossa määritettiin potkuripumpun toiminta-alue ja säädettävyys. Pumpun todettiin sekoittavan ja ilman vaikutus potkuripumpun ominaisuuksiin todettiin merkityksettömäksi pumpun toiminta-alueella. Viirakaivon koeajossa selvisi, että viirakaivo poistaa ilmaa suunnittelualueella ja kaivolle löytyi muoto, jossa virtauskäyttäytyminen viirakaivossa eri laskeutumisnopeuksilla on mahdollisimman häiriötöntä. Hienopaperikoneen osalta riskien kartoituksessa selvisi, ettei täyteaine aiheuta ongelmia ja että päällystelaattaa sisältävä hylky on lajiteltava ennen lyhytkiertoa. ShortFlowÔ-lyhytkiertoprosessi oli edullisin sekä käyttö- että investointikustannuksiltaan.

Repeatability, correlation and path analysis of physical and chemical characteristics of peach fruits

This study aimed to determine the number of measurements necessary to evaluate physical and chemical characteristics of peach fruits, study the relationships between them and their direct and indirect effects on the content of ascorbic acid and total carotenoids. The characteristics skin and pulp color, fruit weight, suture, equatorial and polar diameters, firmness, soluble solids (SS), titratable acidity (TA), SS/TA ratio, ascorbic acid and total carotenoids were evaluated in 39 cultivars of peach and 3 cultivars of nectarine from the orchard of the Universidade Federal de Viçosa. The repeatability coefficient was estimated by ANOVA and CPCOR. Phenotypic correlation coefficients (rf) were estimated and, after the multicollinearity diagnostics, they were unfolded to direct and indirect effects of the explanatory variables on the response variable using path analysis. There was agreement on the magnitude of repeatability coefficients obtained by the two methods; however, they varied among the 14 characteristics. The highest correlations were found between FW, SD, ED and PD. Seven fruits are sufficient to evaluate the physical and chemical characteristics of peach with a correlation coefficient of 90%. The characteristics considered in the path diagrams (b* skin, hº skin, b* pulp, hº pulp, ED, PD, FIR, SS, SS/AT and TC) are not the main determinants of the ascorbic acid. The yellow hue of the pulp (hº pulp) has the potential to be used in indirect selection for total carotenoids.

Microscopic-macroscopic approach for binding energies with the Wigner-Kirkwood method

The semiclassical Wigner-Kirkwood ̄h expansion method is used to calculate shell corrections for spherical and deformed nuclei. The expansion is carried out up to fourth order in ̄h. A systematic study of Wigner-Kirkwood averaged energies is presented as a function of the deformation degrees of freedom. The shell corrections, along with the pairing energies obtained by using the Lipkin-Nogami scheme, are used in the microscopic-macroscopic approach to calculate binding energies. The macroscopic part is obtained from a liquid drop formula with six adjustable parameters. Considering a set of 367 spherical nuclei, the liquid drop parameters are adjusted to reproduce the experimental binding energies, which yields a root mean square (rms) deviation of 630 keV. It is shown that the proposed approach is indeed promising for the prediction of nuclear masses.

Collagen (NeuraGen®) nerve conduits and stem cells for peripheral nerve gap repair

Le système nerveux périphérique est responsable de la transmission des impulses motrices, ainsi que de la réception des afférences sensorielles. Les lésions traumatiques des nerfs périphériques conduisent à une impotence fonctionnelle qui peut être dévastant, notamment chez les travailleurs manuels,. La récupération fonctionnelle est donc le but principal dans chirurgie des nerfs périphériques. Malheureusement, une suture directe des moignons nerveux est souvent impossible dans le contexte des traumatismes complexes qui surviennent lors des accidents. La suture nerveuse par interposition d'autogreffe reste le gold standard dans la pratique chirurgicale mais nécessite le sacrifice d'un nerf donneur, avec dysesthésie et possibles douleurs neuropathiques conséquentes. Alternativement, des guides tubulaires pour les nerfs peuvent être utilisées si le gap nerveux est inférieur à 3 cm. Plusieurs guides résorbables en collagène sont approuve en Europe et aux Etas Unis (FDA). Dans cette étude, des conduits de collagène ont été associe a des cellules régénératives (cellules souches adultes) comme stratégie supplémentaire de régénération. Une fois testé le rapport des cellules avec le biomatériau (NeuraGen® nerve guides) in vitro, une étude in vivo dans le rat a été effectuée. Les différents groupes de conduits ont été supplémentés respectivement avec Schwann cells (SC); avec cellules souches adultes dérivées de la moelle épinière, différentiées en cellules "Schwann-like" (dMSC); avec cellules souches adultes dérivées de la graisse, différentiées en cellules "Schwann-like" (dASC). Un groupe de conduits avec du milieu de culture sans cellules a été utilisé comme group control. Les conduits ont été utilisés pour combler un gap de 1cm dans un model de section totale du nerf sciatique chez le rat. Deux semaines post implantation, une analyse immuno-histochimique a été effectuée pour évaluer la régénération axonales et l'infiltration de cellules de Schwann au niveau du conduit. Les cellules ont montré une adhérence efficace aux parois de collagène. En particulier, les cellules de Schwann ont montré une amélioration significative au niveau du sprouting distale. Par contre, aucune différence significative n'a été remarquée entre les groupes pour le sprouting axonale proximal. De plus, si les cellules souches ont montré un pattern de sprouting diffus, les cellules de Schwann ont par contre garanti un cône de croissance typique, associé a une affinité remarquable pour les parois de collagène. NeuraGen® guides pourraient donc être un moyen adapté a l'association avec la thérapie cellulaire en raison de la bonne adhérence des cellules au biomatériau. Des modifications de surface dans le but d'améliorer la performance neurotrophique cellulaire in vivo (e.g. peptides de matrice extracellulaire) pourront être utilisées dans des applications futures.

The Combined Pedicled Anterolateral Thigh and Vastus Lateralis Flap as Filler for Complex Perineal Defects.

Extensive defects of the pelvis and genitoperineal region are a reconstructive challenge. We discuss a consecutive series of 25 reconstructions with the pedicled anterolateral thigh (ALT) flap including muscle part of the vastus lateralis (VL) in 23 patients from October 1999 to September 2012.Only surface defects larger than 100 cm and reconstructions by composite ALT + VL were included in this retrospective analysis. Of the 23 patients, 19 underwent oncologic resection, whereas 4 cases presented Fournier gangrene. Three patients did not reach 6 months of follow-up and were excluded from further data analysis. Among the remaining 20 patients (22 reconstructions), average follow-up period was 14 months (range, 10-18 months). Patient's average age was 60 years. Average size of the defect was 182 cm.Postoperative complications included 1 (4.5%) flap necrosis out of 22 raised flaps, 1 partial flap necrosis after venous congestion, and 2 cases where a complementary reconstructive procedure was performed due to remaining defect or partial flap failure. In 6 cases, peripheral wound dehiscence (27%) was treated by debridement followed by split-thickness skin graft or advancement local flaps. Defect size was significantly related to postoperative complications and increased hospital stay, especially in those patients who underwent preoperative radiotherapy. At the end of the follow-up period, a long-term and satisfactory coverage was obtained in all patients without functional deficits.This consecutive series of composite ALT + VL flap shows that, in case of extended defects, the flap provides an excellent and adjustable muscle mass, is reliable with minimal donor-site morbidity, and can even be designed as a sensate flap.

Laparoscopic technique to perform a true Stamm gastrostomy in children.

PURPOSE: A surgical gastrostomy is mandatory in cases where a PEG is not feasible. Various minimally invasive techniques have been described, but many involve unusable materials in small children and/or have risk of disunion. We describe a technique for true Stamm gastrostomy performed by laparoscopy (LSG) with a purse string suture and four points of attachment onto the wall. METHOD: We reviewed 20 children who underwent an LSG from 2010 to 2013. After incision of the skin at the location planned for the gastrostomy, using three 3-5mm ports the stomach is fixed to the wall by three suspension stitches, which are entered and then emerged subcutaneously. A fourth stitch of attachment is used to make an award on the stomach and tie around the gastrostomy tube. RESULTS: Mean age was 4.2years, with 70% aged <2years. All children were malnourished, most often severely. All but two underwent a concomitant fundoplication. Feeding through the gastrostomy started on D0 or D1. Total feeding by gastrostomy was achieved in a mean duration of 2.9day. Mean hospital stay was 4.5days. There was no perioperative complication. Mean follow-up was 14months. Once, the balloon was accidently deflated and reinflated in the wall leading to its necrosis. Five peristomial granulomas were noticed. It was always possible to replace the tube by a gastrostomy device at least 6weeks after surgery. CONCLUSION: This new technique for true Stamm gastrostomy by laparoscopy reproduces exactly the one done by laparotomy, without special equipment. It can be made since the neonatal period, in all the circumstances when a laparoscopy is possible.

Estimations of topographically correct regeneration to nerve branches and skin after peripheral nerve injury and repair.

Peripheral nerve injury is typically associated with long-term disturbances in sensory localization, despite nerve repair and regeneration. Here, we investigate the extent of correct reinnervation by back-labeling neuronal soma with fluorescent tracers applied in the target area before and after sciatic nerve injury and repair in the rat. The subpopulations of sensory or motor neurons that had regenerated their axons to either the tibial branch or the skin of the third hindlimb digit were calculated from the number of cell bodies labeled by the first and/or second tracer. Compared to the normal control side, 81% of the sensory and 66% of the motor tibial nerve cells regenerated their axons back to this nerve, while 22% of the afferent cells from the third digit reinnervated this digit. Corresponding percentages based on quantification of the surviving population on the experimental side showed 91%, 87%, and 56%, respectively. The results show that nerve injury followed by nerve repair by epineurial suture results in a high but variable amount of topographically correct regeneration, and that proportionally more neurons regenerate into the correct proximal nerve branch than into the correct innervation territory in the skin

Right ventricular rupture due to recurrent mediastinal infection with a closed chest.

Right ventricular (RV) rupture in cases of mediastinitis following cardiac surgery is a rare and dangerous complication. Bleeding from the right ventricle occurs mainly after sternal reopening, due to either iatrogenic manipulation (wire removal, lesions due to wiring maneuvers) or mechanical shearing forces, producing direct injury. We present a case of RV wall perforation due to infection in a recurrent postoperative mediastinitis with a closed chest. The current literature on treatment of postoperative mediastinitis is also reviewed.

Single Heartstring aortotomy for multiple off-pump venous bypass grafts.

Off-pump coronary bypass grafting may decrease the rate of stroke, due to minimal aortic manipulation. For venous grafts, clampless hemostasis when performing the proximal anastomosis can be achieved using the Heartstring device. We describe a technique using a single device to suture two veins to one aortotomy. This technique requires less space and could be advantageous in very short, small, and calcified aortas. In to our experience, this technique is rapid, simple, easy to reproduce, and cost-saving.

Nanoparticle Labels in Bioaffinity Assays

Nanoparticles offer adjustable and expandable reactive surface area compared to the more traditional solid phase forms utilized in bioaffinity assays due to the high surface to-volume ratio. The versatility of nanoparticles is further improved by the ability to incorporate various molecular complexes such as luminophores into the core. Nanoparticle labels composed of polystyrene, silica, inorganic crystals doped with high number of luminophores, preferably lanthanide(III) complexes, are employed in bioaffinity assays. Other label species such as semiconductor crystals (quantum dots) or colloidal gold clusters are also utilized. The surface derivatization of such particles with biomolecules is crucial for the applicability to bioaffinity assays. The effectiveness of a coating is reliant on the biomolecule and particle surface characteristics and the selected coupling technique. The most critical aspects of the particle labels in bioaffinity assays are their size-dependent features. For polystyrene, silica and inorganic phosphor particles, these include the kinetics, specific activity and colloidal stability. For quantum dots and gold colloids, the spectral properties are also dependent on particle size. This study reports the utilization of europium(III)-chelate-embedded nanoparticle labels in the development of bioaffinity assays. The experimental covers both the heterogeneous and homogeneous assay formats elucidating the wide applicability of the nanoparticles. It was revealed that the employment of europium(III) nanoparticles in heterogeneous assays for viral antigens, adenovirus hexon and hepatitis B surface antigen (HBsAg), resulted in sensitivity improvement of 10-1000 fold compared to the reference methods. This improvement was attributed to the extreme specific activity and enhanced monovalent affinity of the nanoparticles conjugates. The applicability of europium(III)-chelate-doped nanoparticles to homogeneous assay formats were proved in two completely different experimental settings; assays based on immunological recognition or proteolytic activity. It was shown that in addition to small molecule acceptors, particulate acceptors may also be employed due to the high specific activity of the particles promoting proximity-induced reabsorptive energy transfer in addition to non-radiative energy transfer. The principle of proteolytic activity assay relied on a novel dual-step FRET concept, wherein the streptavidin-derivatized europium(III)-chelate-doped nanoparticles were used as donors for peptide substrates modified with biotin and terminal europium emission compliant primary acceptor and a secondary quencher acceptor. The recorded sensitized emission was proportional to the enzyme activity, and the assay response to various inhibitor doses was in agreement with those found in literature showing the feasibility of the technique. Experiments regarding the impact of donor particle size on the extent of direct donor fluorescence and reabsorptive excitation interference in a FRET-based application was conducted with differently sized europium(III)-chelate-doped nanoparticles. It was shown that the size effect was minimal

Improving the efficiency of PV low-power processing circuits by selecting an optimal inductor current of the DC/DC converter

In the context of autonomous sensors powered by small-size photovoltaic (PV) panels, this work analyses how the efficiency of DC/DC-converter-based power processing circuits can be improved by an appropriate selection of the inductor current that transfers the energy from the PV panel to a storage unit. Each component of power losses (fixed, conduction and switching losses) involved in the DC/DC converter specifically depends on the average inductor current so that there is an optimal value of this current that causes minimal losses and, hence, maximum efficiency. Such an idea has been tested experimentally using two commercial DC/DC converters whose average inductor current is adjustable. Experimental results show that the efficiency can be improved up to 12% by selecting an optimal value of that current, which is around 300-350 mA for such DC/DC converters.

On the Rule of Mixtures for Predicting Stress-Softening and Residual Strain Effects in Biological Tissues and Biocompatible Materials

In this work, we use the rule of mixtures to develop an equivalent material model in which the total strain energy density is split into the isotropic part related to the matrix component and the anisotropic energy contribution related to the fiber effects. For the isotropic energy part, we select the amended non-Gaussian strain energy density model, while the energy fiber effects are added by considering the equivalent anisotropic volumetric fraction contribution, as well as the isotropized representation form of the eight-chain energy model that accounts for the material anisotropic effects. Furthermore, our proposed material model uses a phenomenological non-monotonous softening function that predicts stress softening effects and has an energy term, derived from the pseudo-elasticity theory, that accounts for residual strain deformations. The model’s theoretical predictions are compared with experimental data collected from human vaginal tissues, mice skin, poly(glycolide-co-caprolactone) (PGC25 3-0) and polypropylene suture materials and tracheal and brain human tissues. In all cases examined here, our equivalent material model closely follows stress-softening and residual strain effects exhibited by experimental data

Pienitaajuinen radiosekoitin

Normaalisti radiovastaanottimet on luokiteltavissa suoriin vastaanottimiin ja superheterodynevastaanottimiin. Jälkimmäistä nimitetään tavallisesti supervastaanottimeksi. Molemman vastaanottimen oleellisiin osiin kuuluu antennin virityspiiri, supervastaanottimelle lisäksi paikallisoskillaattorin virityspiiri, mikä pitää virittää antennipiirin kanssa samanaikaisesti. Pienillä taajuuksilla, taajuudet luokassa kilo-Hertzejä tai pienemmillä, on antennipiirin viritys resonanssipiirin ominaisuuksista johtuen sitä kapeammalla kaistalla ja sitä hitaampaa mitä pienemmällä taajuudella vastaanotto tapahtuu. Lisäksi virityspiiri hyvyysluku Q on vaikea saada sopivaksi, mikäli viritys on muuten käytännöllinen, säädettävä resonanssipiiri. Vaadittaessa kiinteätaajuista viritystä on käytännöllistä hyödyntää sähkömekaanisia osia, siis keraamisia tai kvartsikiteitä. Koska kiteitten ja korkean hyvyysluvun piirin värähtely jatkuu useita värähtelyjaksoja ennen saapuneitten värähtelyjen sammumista, kestää myös kauan aikaa, ennen kuin värähtely piirissä on loppu. Pienitaajuinen resonanssipiiri saavuttaa maksimivirtansa hitaasti, jos hyvyysluku on iso, kun piiri alkaa johtaa resonanssitaajuista virtaa. Tässä työssä pyritään vastaanotinjärjestelyyn ongelmallisen, pientaajuisen virityspiirin käytön välttämiseksi. Toisena tavoitteena on saada aikaan vastaanotto siten, että tietty pienitaajuinen radiotaajuusalue voidaan kokonaisuudessaan vastaanottaa jatkuva-aikaisesti, ilman antennipiirin jatkuvaa virittämistä erillisille taajuuksille. Laaditaan kytkentä, joka mitoitetaan, simuloidaan ja mitataan.

The Role of the Delay Time in the Modeling of Biological Range Expansions

The time interval between successive migrations of biological species causes a delay time in the reaction-diffusion equations describing their space-time dynamics. This lowers the predicted speed of the waves of advance, as compared to classical models. It has been shown that this delay-time effect improves the modeling of human range expansions. Here, we demonstrate that it can also be important for other species. We present two new examples where the predictions of the time-delayed and the classical (Fisher) approaches are compared to experimental data. No free or adjustable parameters are used. We show that the importance of the delay effect depends on the dimensionless product of the initial growth rate and the delay time. We argue that the delay effect should be taken into account in the modeling of range expansions for biological species