Cholesteatoma surgery in children: long-term results of the inside-out technique

OBJECTIVE To present the anatomical and functional results of the inside-out technique applied in pediatric cholestetaoma surgery and to evaluate functionality with good hearing results against radicality with lower recurrence rate. METHODS Retrospective analysis and evaluation of the postoperative outcome in a consecutive series of 126 children or 130 ears operated between 1992 and 2008. With the inside-out technique, cholesteatoma is eradicated from the epitympanum toward the mastoid and, as a single stage procedure, functional reconstruction of the middle ear is achieved by tympanoossiculoplasty. RESULTS In 89.2% of all cases, the ear was dry postoperatively. 80.9% of the ears reached a postoperative air-bone gap of 30 dB or less and the median air conduction hearing threshold was 29 dB; in 60.9% of all cases, hearing was postoperatively improved. The recurrence rate was 16.2% in a mean postoperative follow-up 8.5 years. Altogether, 48 ears (36.9%) underwent revision surgery. The complication rate was 3.1% and involved only minor complications. CONCLUSION The inside-out technique allows a safe removal of cholesteatoma from the epitympanum toward the mastoid with a single-stage reconstruction of the ossicular chain. For this reason we support our individual approach, which allows creation of the smallest possible cavity for the size of the cholesteatoma. Our results confirm that the inside-out technique is effective in the treatment of pediatric cholesteatoma.

Investigation of bacteremia induced by removal of orthodontic mini-implants.

The aim of this study was to investigate potential occurrence of bacteremia in orthodontic patients after removal of miniscrews.The study group comprised 30 healthy subjects (17 males, 13 females) with a mean age of 24.1 years treated with self-ligating fixed appliances and mini-implant anchorage. Two 20 ml venous blood samples were obtained prior to and 30-60 seconds after miniscrew explantation following an aseptic technique. Blood culturing in aerobic and anaerobic conditions was carried out by means of the BACTEC blood culture analyzer. Microbiological analysis showed that none of the pre- and post-operative samples exhibited detectable bacteremia. Future research should be focused on determining the collective bacteremic effect of a sequence of orthodontic procedures including miniscrew placement or removal, typically performed during a single treatment session.

A New Approach for Automatic Removal of Movement Artifacts in Near-Infrared Spectroscopy Time Series by Means of Acceleration Data

Abstract: Near-infrared spectroscopy (NIRS) enables the non-invasive measurement of changes in hemodynamics and oxygenation in tissue. Changes in light-coupling due to movement of the subject can cause movement artifacts (MAs) in the recorded signals. Several methods have been developed so far that facilitate the detection and reduction of MAs in the data. However, due to fixed parameter values (e.g., global threshold) none of these methods are perfectly suitable for long-term (i.e., hours) recordings or were not time-effective when applied to large datasets. We aimed to overcome these limitations by automation, i.e., data adaptive thresholding specifically designed for long-term measurements, and by introducing a stable long-term signal reconstruction. Our new technique (“acceleration-based movement artifact reduction algorithm”, AMARA) is based on combining two methods: the “movement artifact reduction algorithm” (MARA, Scholkmann et al. Phys. Meas. 2010, 31, 649–662), and the “accelerometer-based motion artifact removal” (ABAMAR, Virtanen et al. J. Biomed. Opt. 2011, 16, 087005). We describe AMARA in detail and report about successful validation of the algorithm using empirical NIRS data, measured over the prefrontal cortex in adolescents during sleep. In addition, we compared the performance of AMARA to that of MARA and ABAMAR based on validation data.

Quantifying potential nitrogen removal by denitrification in stream sediments at a regional scale

Potential denitrification rates were measured using the acetylene block method, in sediments collected from streams in the sub-tropical, south-east Queensland region of Australia. Our aim was to estimate how much nitrogen could be removed from lotic systems by denitrification at the regional scale. Denitrification measured at 65 sites in August and September from a catchment of 22700 km(2) was extrapolated to all streams and rivers in the region based on the sediment area available for denitrification. Denitrification rates ranged between 4 and 950 mumol N m(-2) h(-1), with most sites having rates below 150 mumol N m(-2) h(-1). Based on these results, the current study estimates that a total of 305 t of nitrogen could be denitrified per year from all streams and rivers in the region, representing 6% of the total annual nitrogen load from surrounding land use. During baseflow conditions, when nitrogen loads to streams are low, the proportion of nitrogen removed through denitrification would be substantially higher, in some cases removing 100% of the nitrogen load. It is proposed that denitrification is an important process maintaining low concentrations of dissolved inorganic nitrogen under baseflow conditions and is therefore likely to enhance nitrogen limitation of primary production in this region.

Development of an on-demand beam pulsing system for Pixe-analysis of thick targets

This work concerns the developnent of a proton irduced X-ray emission (PIXE) analysis system and a multi-sample scattering chamber facility. The characteristics of the beam pulsing system and its counting rate capabilities were evaluated by observing the ion-induced X-ray emission from pure thick copper targets, with and without beam pulsing operation. The characteristic X-rays were detected with a high resolution Si(Li) detector coupled to a rrulti-channel analyser. The removal of the pile-up continuum by the use of the on-demand beam pulsing is clearly demonstrated in this work. This new on-demand pu1sirg system with its counting rate capability of 25, 18 and 10 kPPS corresponding to 2, 4 am 8 usec main amplifier time constant respectively enables thick targets to be analysed more readily. Reproducibility tests of the on-demard beam pulsing system operation were checked by repeated measurements of the system throughput curves, with and without beam pulsing. The reproducibility of the analysis performed using this system was also checked by repeated measurements of the intensity ratios from a number of standard binary alloys during the experimental work. A computer programme has been developed to evaluate the calculations of the X-ray yields from thick targets bornbarded by protons, taking into account the secondary X-ray yield production due to characteristic X-ray fluorescence from an element energetically higher than the absorption edge energy of the other element present in the target. This effect was studied on metallic binary alloys such as Fe/Ni and Cr/Fe. The quantitative analysis of Fe/Ni and Cr/Fe alloy samples to determine their elemental composition taking into account the enhancement has been demonstrated in this work. Furthermore, the usefulness of the Rutherford backscattering (R.B.S.) technique to obtain the depth profiles of the elements in the upper micron of the sample is discussed.

Characterization of wood biochar and evaluation of its adsorption potential for removal of sulphate from produced water in offshore oil and gas industry

This thesis analyses the potential of wood biochar as an adsorbent in removal of sulphate from produced water. In worldwide offshore oil and gas industry, a large volume of waste water is generated as produced water. Sulphur compounds present in these produced water streams can cause environmental problems, regulatory problems and operational issues. Among the various sulphur removal technologies, the adsorption technique is considered as a suitable method since the design is simple, compact, economical and robust. Biochar has been studied as an adsorbent for removal of contaminants from water in a number of studies due to its low cost, potential availability, and adsorptive characteristics. In this study, biochar produced through fast pyrolysis of bark, hardwood sawdust, and softwood sawdust were characterized through a series of tests and were analysed for adsorbent properties. Treating produced water using biochar sourced from wood waste is a two-fold solution to environmental problems as it reduces the volume of these wastes. Batch adsorption tests were carried out to obtain adsorption capacities of each biochar sample using sodium sulphate solutions. The highest sulphur adsorption capacities obtained for hardwood char, softwood char and bark char were 11.81 mg/g, 9.44 mg/g, and 7.94 mg/g respectively at 10 °C and pH=4. The adsorption process followed the second order kinetic model and the Freundlich isotherm model. Adsorption reaction was thermodynamically favourable and exothermic. The overall analysis concludes that the wood biochar is a feasible, economical, and environmental adsorbent for removal of sulphate from produced water.

Gene scanning of VDJH-amplified segments is a clinically relevant technique to detect contaminating tumor cells in the apheresis products of multiple myeloma patients undergoing autologous peripheral blood stem cell transplantation.

Contaminating tumour cells in apheresis products have proved to influence the outcome of patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (APBSCT). The gene scanning of clonally rearranged VDJ segments of the heavy chain immunoglobulin gene (VDJH) is a reproducible and easy to perform technique that can be optimised for clinical laboratories. We used it to analyse the aphereses of 27 MM patients undergoing APBSCT with clonally detectable VDJH segments, and 14 of them yielded monoclonal peaks in at least one apheresis product. The presence of positive results was not related to any pre-transplant characteristics, except the age at diagnosis (lower in patients with negative products, P = 0.04). Moreover, a better pre-transplant response trended to associate with a negative result (P = 0.069). Patients with clonally free products were more likely to obtain a better response to transplant (complete remission, 54% vs 28%; >90% reduction in the M-component, 93% vs 43% P = 0.028). In addition, patients transplanted with polyclonal products had longer progression-free survival, (39 vs 19 months, P = 0.037) and overall survival (81% vs 28% at 5 years, P = 0.045) than those transplanted with monoclonal apheresis. In summary, the gene scanning of apheresis products is a useful and clinically relevant technique in MM transplanted patients.

Topology Optimization of continuum structures with epsilon-relaxed stress constraints

Topology optimization of linear elastic continuum structures is a challenging problem when considering local stress constraints. The reasons are the singular behavior of the constraint with the density design variables, combined with the large number of constraints even for small finite element meshes. This work presents an alternative formulation for the s-relaxation technique, which provides an workaround for the singularity of the stress constraint. It also presents a new global stress constraint formulation. Derivation of the sensitivities for the constraint by the adjoint method is shown. Results for single and multiple load cases show the potential of the new formulation.

Experimental study on the impact of using a fan coil in the evaluation of contaminant removal effectiveness of common air diffusion strategies

Indoor Air 2016 - The 14th International Conference Indoor Air Quality and Climate

On-demand generation and removal of alginate biocompatible microvalves for flow control in microfluidics

[EN] This paper describes, for the first time, the use of alginate hydrogels as miniaturised microvalves within microfluidic devices. These biocompatible and biodegradable microvalves are generated in situ and on demand, allowing for microfluidic flow control. The microfluidic devices were fabricated using an origami inspired technique of folding several layers of cyclic olefin polymer followed by thermocompression bonding. The hydrogels can be dehydrated at mild temperatures, 37◦C, to slightly open the microvalve and chemically erased using an ethylenediaminetetraacetic acid disodium salt (EDTA) solution, to completely open the channel, ensuring the reusability of the whole device and removal of damaged or defective valves for subsequent regeneration.

Terminal interruption of relux source technique in the treatment of active venous ulcers

Introduction: The treatment for venous ulcers in most cases is unsatisfactory, with recurrences and poor healing. Objective: to evaluate adjuvant therapy in the treatment of active venous ulcers. Methods: We analyzed 20 patients with active venous ulcers attending the general Surgery outpatient clinic at the “Dr. José eleuterio gonzález” University Hospital from October 2012 to January 2013. they were randomly divided into 2 groups: group A (11 patients) underwent compression therapy and group B (9 patients) underwent compression therapy plus removal of the vein that gives terminal relux to the ulcer, guided by ultrasound (microphlebectomy). Patients were evaluated weekly (8 weeks). At each assessment, photographs and lesion measurements were taken and pain was evaluated using the visual analog scale. Results: No significant differences were found between the study groups in terms of age, weight, height, body mass index (BMi), ankle-brachial index, and baseline measurement of the ulcer (p>0.05). Group B showed a greater reduction in ulcer size and a statistically signiicant lower score on the visual analog pain scale (p<0.05) from the second and third week of treatment, respectively. Conclusions: the results obtained in patients with surgical procedure (group B) are consistent with the reported eficacy of chronic venous ulcer treatment with saphenectomy (conventional surgery), the difference is that in this study we used a minimally invasive procedure (microphlebectomy).