Satisfactory Position Research Articles

An application of posterior cervical and transoral approaches to treating primary malignant osseous tumors in craniovertebral junction

To investigate the surgical method for primary malignant osseous tumors in the craniovertebral junction (CVJ) and its effectiveness. The clinical data of 7 patients with primary malignant osseous spinal tumors in CVJ, which collected between September 2010 and April 2019, were retrospectively analyzed. There were 5 males and 2 females, aged 23 to 75 years (median, 56 years). All patients were diagnosed as chordoma in 4 cases, plasmacytoma in 2 cases, and fibrosarcoma in 1 case. The disease duration ranged from 0.7 to 36.0 months, with an average of 12.2 months. Lesion location: 1 case of C 0, 1, 3 cases of C 2, 1 case of C 1, 2, 1 case of C 2, 3, and 1 case of C 0-2. Preoperative visual analogue scale (VAS) score was 6.7±2.1, the Japanese Orthopaedic Association (JOA) score was 15.6±2.4. According to American Society of Spinal Cord Injury (ASIA) grading system, there was 1 case of grade C, 1 case of grade D, and 5 cases of grade E. According to Enneking stage of spinal malignant tumor, there was 1 case of stage ⅠB, 2 cases of stage ⅡB, and 4 cases of stage Ⅲ. According to Weinstein-Boriani-Biagini (WBB) stage, there was 1 case of 5-8/A-D, 1 case of 4-9/A-D, 1 case of 6-7/B-D, 1 case of 6-7/A-D, 2 cases of 1-12/A-D, and 1 case of 3-10/A-D. All these patients were treated with tumor extended resection, bone graft fusion, and internal fixation via posterior cervical approach, as well as tumor (stage Ⅰ or stage Ⅱ) boundary resection via transoral or submandibular approach. Meanwhile, anterior reconstructive fusion was procedured with bone grafting Cage needed to place the internal fixation. The operation time was 307-695 minutes (mean, 489.57 minutes), and the intraoperative blood loss was 400-2 000 mL (mean, 1 107.14 mL). There was no intraoperative injury in vertebral artery and spinal cord or any related postoperative complications, including incision infection, intracranial infection, and pulmonary infection. All the patients were followed up 3-57 months (mean, 21 months). Postoperative X-ray film and CT showed that the internal fixation screw was firm and in a satisfactory position, and the bone graft was fused at 3-6 months after operation. Symptoms such as neck pain, limb numbness, and fatigue relieved to different degrees after operation. At 3 months after operation, the VAS score improved to 1.7±0.8 ( t=7.638, P=0.000); while the JOA score improved to 16.1±1.5, but no significant difference was found when compared with preoperative score ( t=1.549, P=0.172). According to ASIA grading system, 1 patient with grade C had upgraded to grade D after operation, while the remaining patients had no change. There were 4 cases of recurrence after operation, in which those patients were with high malignancy of tumors before the first surgery. Their tumors also affected a wide range of slope or surrounding soft tissues and could not be completely removed. Among the 4 cases, 1 patient underwent transoral tumor removal operation again, while the other 3 cases gave up further treatment. There was no recurrence among the remaining 3 cases. Primary malignant osseous tumors in the CVJ can be completely exercised via means of trabsoral or submandibular approach. Meanwhile the anterior reconstruction can be achieved by placing special Cage specimen. These two methods together with postoperative adjuvant treatments such as radiotherapy and chemotherapy can improve the survival time of patients and reduce tumor recurrence.

Efficacy of height-based formula to predict insertion depth of left-sided double lumen tube: A prospective observational study.

The insertion depth of the left-sided double-lumen tube needs careful positioning and bronchoscopic confirmation. Several formulae based on body height have been used for estimating the optimal insertion depth of a left-sided double-lumen tube. We conducted this prospective study to test the hypothesis that our earlier developed height-based formula (0.25 × body height0.916) could predict the accurate insertion depth of a left-sided double-lumen tube. After obtaining ethical approval, 66 patients who underwent thoracic surgery were included. A left-sided double-lumen tube was advanced blindly to the predicted depth of insertion calculated using our formula. The optimal position of the left-sided double-lumen tube was confirmed using a fibreoptic bronchoscope. The primary outcome was the percentage of tubes placed in the optimal position without the need for further adjustments. The secondary outcomes included the need for bronchoscopic adjustments and the final correct insertion depth of the left-sided double-lumen tube. The formula resulted in an optimum position of the left-sided double-lumen tube without further adjustments in 45 patients (70%) (95% confidence interval 58%-80%). The left-sided double-lumen tube was withdrawn or advanced in 18.2% and 12.1%, respectively, to achieve the optimal insertion depth. We found that our formula provided satisfactory positioning in about 70% of patients and that in the remaining patients, the adjustments required to achieve satisfactory positioning under fibreoptic bronchoscope guidance were minimal. Nevertheless, as it is not possible to predict which patients will have a satisfactory tube position, bronchoscopic confirmation for the final positioning is still required.

Accuracy of C-Arm Guided Insertion of Ommaya Reservoir Tube in Recurrent Cystic Craniopharyngiomas

Abstract Background: Caniopharyngiomas in spite of being benign tumors they have a high rate of recurrence of which cysts constitute major component. Ommaya Reservoir System (ORS) is a simple manoeuvre for percutaneous drainage of cysts. Aim of Study: To evaluate the efficacy of using C-arm as a guiding tool for placement of Ommaya reservoir tube in predominantly cystic recurrent craniopharyngiomas. Patients and Methods: This study included 8 patients with clinically symptomatic and radiologically confirmed recurrent craniopharyngioma with significant cystic part. These patients were treated by C-arm guided insertion of Ommaya reservoir tube. The technique is described in details. CT brain was obtained in the first post-operative night to assess the position of the tube. Post-operative clinical and radiological evaluations were compared to the pre-operative. Results: This study included 6 males and 2 females, ranging in age from 5 years to 38 years with mean age of 18.4 years. Headache was the most common presenting complaint, followed by visual impairment. All surgeries were performed with C-arm guidance and post-operative CT brain documented satisfactory position of the tube in 7 cases and only one case required second look surgery for repositioning of the tube with the same technique. Significant post-operative improve-ment of headache and visual symptoms were encountered in all cases due to decompression of the optic chiasm by cyst drainage. Conclusion: C-arm assisted insertion of Ommaya reservoir tube is a reliable method that can minimize the errors of free hand technique and of special value in low facility centers.

Capacitating relatives of incapacitated patients.

Capacitating relatives of incapacitated patients.

Adaptive PID Controller Using Sliding Mode Control Approaches for Quadrotor UAV Attitude and Position Stabilization

This paper proposes an auto-tuning adaptive proportional-integral-derivative control (APIDC) system for attitude and position stabilization of quadrotor unmanned aerial vehicle (UAV) under parameter uncertainties and external disturbances. By employing sliding mode control as the adaptive mechanism, this technique can overcome the manual controller’s re-tuning gains in a proportional-integral-derivative controller. Furthermore, a fuzzy compensator is used to eliminate the chattering phenomena caused by the sliding mode control. The auto-tuning process is based on the gradient descent technique and the Lyapunov stability theorem. Using simulations, the proposed APIDC scheme is able to achieve a satisfactory attitude and position tracking performance of the quadrotor UAV. The proposed APIDC system also shows high robustness under parameter uncertainties and external disturbances.

Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique.

BackgroundThis study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.MethodsThis case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.ResultsThis new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.ConclusionsThe approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.

Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy

Introduction. Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for ?non-response? to CRT pacemaker could be the failure to achieve optimal left ventricular (LV) lead position due to severe curve or stenosis/occlusion of the target vein. Case report. We presented a 79-old-male patient, New York Heart Association (NYHA) class III, with atrial fibrillation, chronic coronary syndrome (CCS), and prior myocardial infarction. The patient underwent coronary artery bypass surgery and mechanical prosthetic aortic valve implantation. He was indicated for CRT. The patient?s venogram revealed ostial/proximal severe curve and stenosis of the posterolateral vein, the only vein of coronary sinus that led to anatomically optimal LV segment for stimulation. After the balloon angioplasty of the curved and stenotic portion of the target vein with compliant balloon 4.0 ? 30 mm, a satisfactory and stable position of quadripolar LV lead was achieved. Conclusion. Compliant balloon angioplasty could be a safe and efficient way to override severe coronary vein stenosis in some CRT cases.

CUSTOMIZING AIRWAY STENT FOR MULTICENTRIC MALIGNANT AIRWAY OBSTRUCTION

TYPE: Abstract Publication TOPIC: Procedures PURPOSE: A middle-aged man with adenocarcinoma of sigmoid colon and solitary liver metastasis underwent neoadjuvant chemotherapy followed by hemicolectomy and hepatectomy. The cancer progressed and he developed endobronchial metastasis resulting in near-total obstruction of left main bronchus (LMB) and bilateral pulmonary nodules. METHODS: Laser photoresection of LMB tumor was performed followed by covered self-expanding metallic stent (SeMS). He received radiation and anti-angiogenic therapy. Six months later, he complained of worsening dyspnea and stridor. CT Thorax revealed complete occlusion of the distal end of stent with collapse of left lung. Rigid bronchoscopy revealed tumor in-growth through the stent; tumor at the main carina causing 70% obstruction of the right main bronchus (RMB), and a polypoidal mass arising from the right middle lobe bronchus. Tumor debulking was performed within the stent and at the carina with argon plasma coagulation (APC) and rigid forceps, and the polypoidal mass was removed with electrosurgical snare. The left limb of silicone Y stent was cut to accommodate the SeMS while another circular cut was made just beyond the take-off of the right limb. The right limb of Y stent was deployed into bronchus intermedius, the circular cut maintained aeration to the right upper lobe (RUL). Post procedural CXR showed re-expansion of the left lung with satisfactory position of the silicon and SeMS stents. RESULTS: Figure 1. Bronchoscopic images CONCLUSIONS: Complex Airway Obstruction interferes with airflow and insertion of airway stents provide relief and complement ablative techniques. Modification of stents may prove to be beneficial to these patients. CLINICAL IMPLICATIONS: Please refer above DISCLOSURE: No significant relationships. KEYWORDS: central airway obstruction, airway stent

Early Management of Acute Unilateral Vocal Fold Paralysis: Update of the Literature

Unilateral vocal fold paralysis (UVFP) often leads to significant morbidity that may include dysphonia, swallowing problems and aspiration. The best timing for medialization procedures is still controversial. Published data suggest that early intracordal injection positively affects long-term outcomes. To critically review current literature in order to determine if early treatment of acute UVFP influences clinical outcomes of the patients. Nonsystematic literature review. A literature review was performed, using the Pubmed database. All relevant articles published in English addressing the effect of early treatment in acute unilateral focal fold paralysis were analyzed. Twenty-six articles were included due to their scientific interest. Published literature suggests that early intracordal injection in patients with UVFP reduces pulmonary infections, hospital length of stay and improves voice parameters. Also, patients who receive early intracordal injection seem to be less likely to undergo subsequent medialization thyroplasty. Early intracordal injection should be offered to patients with newly diagnosed UVFP since it promotes a satisfactory position of the vocal fold and seems to improve clinical outcomes. More investigation, with long-term follow up data and treatment randomization, is necessary to develop clinical consensus for these patients.

Benign temporomandibular joint tumours with extension to infratemporal fossa and skull base: condyle preserving approach

This article introduces a modified surgical approach combining condylotomy with posterior disc attachment release for the resection of large non-malignant masses located in the infratemporal fossa and involving the skull base. This retrospective study included 14 patients treated at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University between January 2010 and December 2016. Clinical evaluations (visual analogue scale (VAS) for pain, maximum inter-incisal opening (MIO), and complications) and radiological findings (magnetic resonance imaging (MRI) and computed tomography (CT)) were collected pre- and postoperatively. All patients had satisfactory surgical exposure and complete resection of the neoplasms. During an average follow-up of 54.8 months, no clinical or radiographic signs of recurrence were reported. MIO increased from 28mm preoperatively to 35.4mm postoperatively (P<0.001). The pain VAS score changed from 5.4 preoperatively to 0.7 postoperatively (P<0.001). Neural function was normal for all patients. Postoperative MRI and CT scans showed a satisfactory disc position and condyle morphology, with no resorption. Three-dimensional reconstruction of the postoperative CT scan also demonstrated healing of the skull base defects. The modified surgical approach combining condylotomy with posterior disc attachment release is suitable for the removal of large non-malignant masses involving the infratemporal fossa and skull base.

Neonatal Nurse Practitioner Use of Ultrasonography to Verify Umbilical Venous Catheter Placement in the Neonatal Intensive Care Unit.

Literature dating back to 1982 supports the use of ultrasound to confirm UVC position as a more reliable method compared to x-ray. The use of ultrasound to confirm UVC position remains infrequent in the NICU. To determine the feasibility of training an NNP in the acquisition and interpretation of a parasternal short-axis (PSAX) image of the heart to confirm UVC position. A retrospective review of 48 charts evaluated descriptive data using standard technique of an x-ray to confirm UVC placement. An NNP was trained to acquire and interpret a parasternal short-axis (PSAX) cardiac view by a pediatric cardiologist. The NNP independently and prospectively evaluated 21 neonates and determined whether the UVC was in satisfactory or unsatisfactory position. The same image was blindly over-read by the pediatric cardiologist. Agreement between the NNP and pediatric cardiologist interpretations as well as the pediatric cardiologist and radiologist interpretations was evaluated using the κ-test. Initial pediatric cardiology interpretation of UVC position showed the UVC to be malpositioned in 66% of neonates (n = 14). NNP and pediatric cardiology interpretations in UVC position had 86% agreement (κ-0.667). Pediatric cardiology (ultrasound) and radiology interpretations (x-ray) in UVC position had 86% agreement (κ-0.69). It is feasible to train NNPs to perform and accurately interpret a single PSAX ultrasound image to determine satisfactory UVC position. Increasing the use of ultrasound to determine satisfactory position of UVCs in the NICU can reduce unnecessary exposure to ionizing radiation in neonates.

Tibial Intraosseous Insertion in Pediatric Emergency Care: A Review Based upon Postmortem Computed Tomography

Objective: The proximal tibia is a recommended and commonly used site for pediatric emergency intraosseous vascular access (IO). During forensic whole body postmortem computed tomography (PMCT), we evaluated accuracy of emergency placement of tibial IO access.Methods: We conducted a retrospective review of 92 state medical examiner cases to assess presence and placement of tibial IO needles. Insertions were classified as successful (needle tip in the medullary portion of the bone) or unsuccessful (all other non-medullary placements) based upon position of the needle tip. Medical records were reviewed for patient age, equipment, and where an insertion was attempted, as well as if IO placement occurred in a prehospital or hospital environment.Results: Thirty-one cases with 42 tibial devices (aged 3 weeks to 16 years, median 4 months) were identified. In 25 insertions (60%), the needle tip was in satisfactory position. In 17 placements (40%), needle tip was unsatisfactory and included tibia perforation (6), tip embedded in the cortex (6), and needle missed the bone (5). In patients older than 6 months, all six placements of a 15-mm needle were successful. In infants age 6 months or younger, 14 placements (56%) were successful and 11 (44%) unsuccessful. The 25-mm IO needle was successfully placed in five of six children older than 6 months. In infants age 6 months or younger, the 25-mm needle was unsuccessfully placed in five of five attempts.Conclusion: In infants 6 months of age or younger, tibial IO needle insertion had a 53% failure rate (non-medullary placement). Failures occur during both prehospital and emergency department care. In infants age 6 months or younger, use of a 25-mm needle should be avoided. Procedures for IO insertion in infants age 6 months or younger should be reviewed and modification considered.

SWOT Analysis of Bangladeshi Apparel Industries Compared to Global Market and a Comprehensive Scenario

In this project work, from the top readymade garments or apparel exporter countries, three countries like China, Vietnam and India are taken with Bangladesh for comparison. For the work, SWOT analysis method is used to find Strength, Weakness, Opportunities and Threats for the apparel industry of each country. Information and data are collected from reliable sources like the statistics and rankings of the World Bank, WTO, WLO, different journals which are published internationally. The aim of this study is to determine the genuine present scenario of Bangladeshi apparel industry compared to the competitor countries and to study how we are improving compared to them. This work indicates the specific points where we have to improve immediately and the points that we have to take really good care of. Hence as a result after conducting the SWOT analysis the obtained information and all the data, tables and graphs illustrate that the scenario of the Bangladeshi apparel sector is in satisfactory position though the alarming thing is that the competitor countries are putting more effort to improve their condition and they are getting it rapidly. On the other hand, our effort is less and we are not improving significantly except our recent compliance, GDP and green factory initiatives. In this work we find out a solution by analyzing which points are needed to work on for sustaining as a tough competitor in the apparel exporter market share for a longer period and to make maximum export earnings.

Platform position control of floating wind turbines using aerodynamic force

This paper presents platform position control of utility-scale floating offshore wind turbines in surge and sway directions using aerodynamic thrust force. The position control will be useful in mitigating the wake effect, and thus maximizing the total power capture, of an offshore wind farm. A linear-quadratic-integrator (LQI) controller is designed to achieve the control objectives of platform position transfer to a specified position for the wake loss mitigation, as well as of platform position regulation against disturbances in wind and wave. Power regulation during and after the position transfer is accomplished by the standard constant-power strategy. It is demonstrated, through simulations of a 5-MW wind turbine in the FAST software, that the LQI controller can attain satisfactory platform position transfer and regulation.

Application of Logistic Regression for Production Machinery Efficiency Evaluation

Production companies operate in a complex economic, technological, social and political environment. There are a number of factors contributing to a satisfactory market position, the most important one being a properly defined and implemented strategy. It needs, however, to be continuously monitored and, if necessary, modified. One of the elements subject to such evaluation is the efficiency of the production processes, which has become the genesis of this article. In response to the methods presented in the literature, a proposal using the logistic regression method for this purpose is presented. The dichotomous form of the dependent variable makes it possible to make such an evaluation in an unambiguous manner and to determine the significance and influence of selected factors on the result thereof.

Should the supraspinatus tendon be excised in the case of reverse shoulder arthroplasty for fracture?

In the case of reverse shoulder arthroplasty (RSA) for proximal humeral fractures (PHFs) with tuberosity reconstruction, it is unclear whether the supraspinatus tendon continues to play a role. The aim of this study was to evaluate the clinical and radiological outcomes of RSA for PHFs in a large cohort of elderly patients and compare the results in the case of supraspinatus excision or preservation. In this retrospective multicentre study, 150 patients (mean age 77years, 93% female) were reviewed and radiographed with a minimum follow-up of 24months. The same Grammont prosthetic design was used in all cases (inclination angle 155°, non-lateralised glenosphere). Patients were divided into two groups: Group A (n = 117) underwent supraspinatus excision and Group B supraspinatus preservation (n = 33). Complications were recorded, and shoulder function, active mobility and subjective results were assessed. At a mean follow-up of 59months, there was no statistical difference in the complication rate (6% vs. 6.8%, p = 1), mean Constant score (61 points vs. 59 points, p = 0.52), simple shoulder value (74% vs. 73.9%, p = 0.9), active anterior elevation (125° vs. 128°, p = 0.45) and internal rotation (4.9 points vs. 4.1 points, p = 0.2). However, mean active external rotation was better in Group A (22° vs. 13°, p = 0.01). The greater tuberosity healing rate in satisfactory position did not differ statistically between the groups (68% vs. 55%, p = 0.14). In the case of RSA with tuberosity reconstruction for acute PHFs, there is no clear evidence that supraspinatus preservation is advantageous.

2754 A Gaping Hole in the Stomach - A Rare PEG Tube Complication

INTRODUCTION: Up to 200,000 gastrostomy tubes (PEG) are placed in the United States each year, with a success rate over of 95%. Here we present a patient with complaints of abdominal pain and discharge from the PEG site, who was found to have an interesting EGD finding. CASE DESCRIPTION/METHODS: A 52 year old cachectic woman with a history of opioid abuse, roux-en-Y gastric bypass for obesity 14 years prior, and PEG placement due to inadequate oral intake almost 3 months prior to her admission, presents to the ED with worsening abdominal pain, nausea, intermittent vomiting and discharge of fecal like material from PEG site for the last few days. On exam patient appeared cachectic, disheveled, and had diffuse erythema of her abdominal wall. Vital signs were significant for hypothermia to 91.3 F, and bradycardia. Labs were significant for sodium of 152. CT abdomen and pelvis showed the PEG tube in satisfactory position. She was started on IV fluids and antibiotics but soon became hypoxic and tachycardic requiring medical ICU care. Subsequently, bleeding around the PEG tube was noted. Hemoglobin dropped from 9.8 to 7.2 within 9 hours. Lavage of the PEG tube revealed coffee ground material. Due to patient’s tenuous respiratory status, it was decided to perform an upper endoscopy by accessing the stomach via the gastrostomy fistula. The PEG tube balloon was deflated and the endoscope was easily inserted without resistance. The peritoneum was immediately visualized, which contained undigested food (Figure 1). The endoscope was withdrawn and was navigated into the body of the stomach, via a large opening. A significant amount of undigested material was seen in the remnant stomach (Figure 2). There was an opening between the remnant stomach and the gastric pouch (Figure 3), which was traversed with the endoscope. The gastric pouch was severely ulcerated and the gastrojejunal anastomosis could not be identified. The patient was then transferred to the hospital where her previous surgery and PEG tube were placed. There, her hospital course was complicated by ARDS requiring intubation. She eventually underwent replacement of PEG tube and after 50 days of hospitalization, she was discharged home. DISCUSSION: Procedure related complications such as perforation can occur anywhere from &lt;0.5-1.8%. In this case, although the PEG tube may have initially been placed in the stomach, the replacement balloon PEG tube may have been inserted into the peritoneum. Complications such as these should always be a consideration.

1864 Gastric Outlet Obstruction as a Complication of Replaced Gastrostomy Tube

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is a common procedure for the provision of long term enteral nutrition (1). Indications for PEG tube replacement include tube malfunction, dislodgement, or scheduled exchange (2). Complications of replacement include bleeding, infection, and tube misplacement (3). Gastric outlet obstruction (GOO) is a rare complication seen when the tube is inserted distal to the pylorus or the balloon is overfilled (4). CASE DESCRIPTION/METHODS: An 86-year-old woman with a history of previous stroke necessitating prolonged enteral feeding through PEG presented to the hospital due to a clogged PEG tube. The tube was replaced at bedside via the percutaneous route and gastric fluid was aspirated. The tube was noted to be 2 cm deeper than prior to the procedure. A water-soluble contrast study through the PEG tube was obtained to confirm proper position (Figure 1) which showed contrast within the small bowel. The radiologist concluded the gastrostomy tube was in satisfactory position and tube feedings were resumed. Overnight, the patient experienced several episodes dark emesis. An endoscopy the next morning revealed the gastrostomy tube balloon was inflated in the duodenal bulb causing a GOO (Figure 2). The tube was repositioned in the stomach (Figure 3) and the patient was discharged 4 days later. DISCUSSION: This case illustrates the importance of establishing a standardized approach to the confirmation and documentation of PEG tube replacement. The marker on the replacement tube should be close to that of the previous tube. Notably, resistance to traction at a greater depth than expected may represent post-pyloric placement of the balloon. Finally, when imaging is obtained, fluoroscopy should be performed at an oblique angle and contrast should be observed in the stomach to confirm correct placement.

Measurement of Dynamic Responses from Large Structural Tests by Analyzing Non-Synchronized Videos.

Image analysis techniques have been employed to measure displacements, deformation, crack propagation, and structural health monitoring. With the rapid development and wide application of digital imaging technology, consumer digital cameras are commonly used for making such measurements because of their satisfactory imaging resolution, video recording capability, and relatively low cost. However, three-dimensional dynamic response monitoring and measurement on large-scale structures pose challenges of camera calibration and synchronization to image analysis. Without satisfactory camera position and orientation obtained from calibration and well-synchronized imaging, significant errors would occur in the dynamic responses during image analysis and stereo triangulation. This paper introduces two camera calibration approaches that are suitable for large-scale structural experiments, as well as a synchronization method to estimate the time difference between two cameras and further minimize the error of stereo triangulation. Two structural experiments are used to verify the calibration approaches and the synchronization method to acquire dynamic responses. The results demonstrate the performance and accuracy improvement by using the proposed methods.

Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis.

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.