Repair Attempts Research Articles

Is a dilated inguinal ring a good predictor of a hernia?

Diagnosis of a groin hernia based on the size of the external inguinal ring is not always reliable. The external ring can be dilated without a hernia being present, or it can be of normal size when a hernia is present. All techniques of hernia repair attempt to reconstruct the posterior floor of the inguinal canal. The posterior approach allows visualization of the entire groin area, and any form of hernia can be defined and repaired without examining the external inguinal ring. The recurrence rate with this approach is less than 2%.

Difficulties in troubleshooting automated manufacturing systems

Based on the results of an empirical study of the process of troubleshooting in computer-controlled manufacturing systems, we highlight sources of difficulty encountered by expert maintenace personnel in acquiring and using information to diagnose faults. We focus on difficulties in collecting background information, testing hypotheses, making repair attempts, and generating beliefs about causes of failures. Recommendations are provided for how to make people more effective in the troubleshooting task by (i) changing management policies and practices at the plant level, (ii) modifying the process control hardware and software that already exists on the plant floor, and (iii) improving the design of new hardware and software for the next generation of process control systems.

Correction of penile curvatures caused by unsuccessful hypospadias repair using the scrotal septum pedicled skin tube principle combined with corporoplasty and a modified meatoglanuloplasty.

Scrotal septum pedicled skin tube urethroplasty combined with a modified meatoglanuloplasty and corporoplsty were used in 2 adults. They had three previous hypospadias repair attempts in their childhood, leaving them with a meatus near the glans but with severe ventral penile curvature. Scrotal septum pedicled skin flaps used for the repair, by providing natural vascularization and offering more flexibility, allow the surgeon to reconstruct long urethral defects. The cosmetic and functional results of this combined technique are satisfactory. This principle can also be applied in adult hypospadias cases with deficient preputium in which the midanterior scrotum contains a shiny non-hair-bearing skin.

Legislative Responses to the Plight of New Car Purchasers: A Missed Marketing Opportunity

The purpose of this paper is to review the trend in federal and state legislation to solve the warranty-related problems of purchasers of new automobiles with serious mechanical problems which cannot be eliminated by a reasonable number of repair attempts. These cars are commonly called “lemons.” The managerial implications of these trends with respect to the consumer-complaining literature are discussed.

Homologous dura use in problem pocket repair.

Recently the author has noted that the use of dura results in a neo-drum, seemingly more resistant to posterior-superior quadrant retraction than autologous temporalis fascia. This presentation, 25 ears representing 22 patients with follow-up between 26 and 41 months, reflects the particular use now assigned to homologous dura in drum and adjacent area repair; namely, the posterior-superior quadrant and attic. The present use follows disappointment with previous drum repair attempts which in time seemed to be fruitless because progressive retraction with adhesions redeveloped. In a substantial way the use of dura as discussed in this paper is very similar to the use of autologous cartilage as reported by Glasscock with regard to recurrent retraction tendencies.

Radionuclide injury to the lung.

Radionuclide injury to the lung has been studied in rats, hamsters, dogs, mice and baboons. Exposure of the lung to high dose levels of radionuclides produces a spectrum of progressively more severe functional and morphological changes, ranging from radiation pneumonitis and fibrosis to lung tumors. These changes are somewhat similar for different species. Their severity can be related to the absorbed radiation dose (measured in rads) produced by alpha, beta or gamma radiation emanating from various deposited radionuclides. The chemicophysical forms of radionuclides and spatial-temporal factors are also important variables. As with other forms of injury to the lung, repair attempts are highlighted by fibrosis and proliferation of pulmonary epithelium. Lung tumors are the principal late effect observed in experimental animals following pulmonary deposition of radionuclides at dose levels that do not result in early deaths from radiation pneumonitis or fibrosis. The predominant lung tumors described have been of epithelial origin and have been classified, in decreasing frequency of occurrence, as adenocarcinoma, bronchioloalveolar carcinoma, epidermoid carcinomas and combined epidermoid and adenocarcinoma. Mesothelioma and fibrosarcoma have been observed in rats, but less commonly in other species. Hemangiosarcomas were frequency observed in dogs exposed to beta-gamma emitters, and occasionally in rats exposed to alpha emitters. These morphologic changes in the lungs of experimental animals were reviewed and issues relevant to the prediction of human hazards discussed.

Radionuclide Injury to the Lung

Radionuclide injury to the lung has been studied in rats, hamsters, dogs, mice and baboons. Exposure of the lung to high dose levels of radionuclides produces a spectrum of progressively more severe functional and morphological changes, ranging from radiation pneumonitis and fibrosis to lung tumors. These changes are somewhat similar for different species. Their severity can be related to the absorbed radiation dose (measured in rads) produced by alpha, beta or gamma radiation emanating from various deposited radionuclides. The chemicophysical forms of radionuclides and spatial-temporal factors are also important variables. As with other forms of injury to the lung, repair attempts are highlighted by fibrosis and proliferation of pulmonary epithelium. Lung tumors are the principal late effect observed in experimental animals following pulmonary deposition of radionuclides at dose levels that do not result in early deaths from radiation pneumonitis or fibrosis. The predominant lung tumors described have been of epithelial origin and have been classified, in decreasing frequency of occurrence, as adenocarcinoma, bronchioloalveolar carcinoma, epidermoid carcinomas and combined epidermoid and adenocarcinoma. Mesothelioma and fibrosarcoma have been observed in rats, but less commonly in other species. Hemangiosarcomas were frequency observed in dogs exposed to beta-gamma emitters, and occasionally in rats exposed to alpha emitters. These morphologic changes in the lungs of experimental animals were reviewed and issues relevant to the prediction of human hazards discussed.

Morphologic findings in dens evaginatus

10 specimens of dens evaginatus were partly examined by light microscopy, and by scanning electron microscopy. The morphological findings were consistent with the diagnosis of dens evaginatus although they indicated that the morphology of the evagination appears more complex than is seen in decalficied material alone. In two cases SEM revealed the existence of dental hard material within the evagination which in the other cases was filled out by necrotic pulpal material. This probable attempt of repair of the evagination is shortly discussed.

1980 Volvo award in basic science. Proteoglycans in experimental intervertebral disc degeneration.

An animal model of intervertebral disc degeneration induced surgically by ventral nuclear herniation in the rabbit produces morphologic changes of disc degeneration. Histologic characteristics and proteoglycan changes have been studied at various times after herniation. After injury, there was metaplasia into fibrocartilage originating from the cells along the margins of the annular wound, with proliferation of cells changing almost the entire disc space into fibrocartilage. A vertebral osteophyte occurred through an endochondral ossification sequence. Aggregating proteoglycans had two periods of repletion in the early course of degeneration. The water content of the disc was rapidly but only transiently restored in the first two days after herniation, whilst the changes in the total proteoglycan content of the disc paralleled these changes. Hyaluronic acid content decreased rapidly after herniation, but the size of the proteoglycan monomers did not change with degeneration. It is suggested that loss of confined fluid mechanics signals an abortive repair attempt rather than that of biochemical changes in proteoglycans initiate disc degeneration.

Repair of Severed Brachial Plexus-Reply

The article did not contain do's and don't's; however, the failure of peripheral nerve surgery is due to numerous factors, one of which is the inability to find the ends of the nerves; another is the severe necrosis and ischemia after extensive mobilization of the nerve ends, and, at least until very recently, the failure of nerve grafts. The statement that actual nerve length is not lost is unsupported. Kline 1 claims that even in primary repair attempts, he finds immediate retraction of both proximal and distal stumps and suggests that the longstanding separation of stumps would appear to make repair even more difficult. Campbell, from his experience in World War II, even favored anchorage in preference to temporary suture, asserting that the latter aggravated fibrosis and resulted in gaps at the second operation that were greater than those requiring closure after anchorage. It is advantageous to allow

A Study on Different Surgical Methods used for Repair of Vesicovaginal Fistulas in Dhaka Medical College Hospital

This cross sectional study was carried out on hundred patients of vesicovaginal fistula who were admitted and underwent surgical treatment in Dhaka Medical college Hospital (DMCH), Dhaka, during the period of January, 2001 to June, 2003. The aim of this study was to obtain the outcome of the different methods of repair of different types of vesicovaginal fistula. An in-depth interview was taken from patients by using an open ended questionnaire. Necessary information about the procedure applied, together with results of operation were recorded in the data sheet. The result of this study showed that the anatomical success in closure of fistula occurred in 94% cases. In 38% of cases the size of the fistula were small in size, in 49% cases location were at the Junction of bladder neck, 78% of cases experienced no postoperative complications. Route of operation were vaginal in 84% cases. Previous attempt of repair were in 62% cases whereas in 38% women had history of operation. Obstetric vesicovaginal fistula is a curable condition. The success rate has been increased over time. More complicated cases which have been failed in previous attempts of repair are being referred. Most of the unsuccessful repair were bad cases (2%). So more training and experience of surgeons for repair of fistulas, employing modified technique wherever applicable can improve the result. DOI: 10.3329/medtoday.v22i1.5598 Medicine Today Vol.22(1) 2010. 12-14