Size Of Perforation Research Articles

Evaluation of Cyanoacrylate Tissue Adhesive Glue Application Outcomes in Corneal Thinning and Perforation

Objectives: Corneal thinning and perforation are ocular emergencies necessitating urgent intervention to prevent visual impairment or enucleation. Cyanoacrylate tissue adhesive is frequently used to maintain globe integrity in these cases. However, gaps remain in understanding the outcomes of corneal gluing and the factors influencing its efficacy. This case series evaluates the clinical characteristics and outcomes of glue application in corneal thinning and perforation. Methods: A retrospective chart review was conducted on patients treated for corneal thinning and perforation at the University of Florida between January 2012 and May 2023. Demographic data, clinical history, glue application details, and posttreatment outcomes were collected and analyzed. Results: The study included 128 eyes from 125 subjects. Corneal perforation was found in 71 eyes (55.5%), mostly centrally (49.2%). The leading cause of perforation/thinning was microbial infection (45.3%). The average number of glue applications per eye was 1.66. Within 1 month, 23 patients (18.0%) required only glue reapplication, 37 (28.9%) required surgical intervention (regardless of glue reapplication), and 68 (53.1%) required no further treatment. Factors significantly linked to gluing failure (requiring surgery within 1 month) in univariate analysis included large perforation size, microbial infection, ocular surface disorder, single glue application, and indirect application via sterile drape. Multivariate analysis showed that only large perforation size was significantly associated with gluing failure. Conclusion: Corneal glue application is an effective temporizing measure for corneal thinning and perforation, with multiple applications potentially providing added stability to the globe. However, the need for surgical intervention is high.

Improving heat transfer in an air-cooled engine by redesigning the fins

Heat transfer modelling and simulation were carried out in a single-cylinder, four-stroke, air-cooled engine to evaluate the heat transfer rate of the engine block. The modelling studies of cylinders with different numbers of fins and different geometry were performed using the SolidWorks computer platform. The tested components were made of 6063-T6 aluminium alloy castings. The simulation concerned different numbers of fins as well as changing the geometry of fins with circular and rectangular perforations. The results of the studies showed the possibility of improving the power to mass ratio for cylinder efficiency and heat transfer rate. It was shown that a large number of fins leads to an increased heat transfer rate, but it affects the overall engine efficiency due to the increase in the total engine mass. Circular perforation is a better design solution than rectangular perforated fins with the same cross-section. Circular perforation provides a lower engine cylinder mass and gives more than 4 % better heat transfer rate. The perforation size was tested using circular perforations with a diameter of 7.14 mm, 8.5 mm and 10 mm. With a 7.14 mm diameter perforation the heat transfer rate increases slightly compared to the other tested ones, while a 10 mm diameter perforation provides the best mass reduction.

Influence of Schneiderian membrane perforation during maxillary sinus floor augmentation with lateral approach on dental implant survival rates: a retrospective study in a university setting.

The primary objective of this study was to compare implant survival rates (ISR) in patients undergoing maxillary sinus floor augmentation (MSFA) with lateral approach with and without membrane perforation. Secondary objectives were to establish the percentage of perforations in these procedures and to evaluate the influence of perforation size on ISR. This retrospective study included patients requiring MSFA with lateral approach. Cases were assigned to two groups according to the occurrence or not of perforation. The exact size of each perforation was registered. Descriptive statistics and associations between the groups were calculated. This study analyzed data from 90 MSFA in 72 patients. Membrane perforation occurred in 24.44%. A total of 170 implants were placed; 72.35% were placed under intact membranes and 27.65% on repaired membranes. The overall ISR in MSFA procedures with intact membranes was 98.37%, and 93.62% in perforated membranes. No statistically significant relationship between groups was observed although the odds of implant failure increased by 4.125 times when perforation occurred. In turn, no statistically significant relationship was observed between perforation size and ISR. Implants inserted below repaired membranes had a lower ISR compared with implants inserted below intact membranes although the difference was not statistically significant. Moreover, no significant statistical correlation was observed between perforation size and ISR. Membrane perforation does not have a significant influence on subsequent implant survival rates. Knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Correlation of Air-Bone Gap on Pure Tone Audiometry with the Size of Perforation Assessed on Oto-Endoscopy.

To determine the correlation between the air-bone gap on pure tone audiometry with size of perforation oto-endoscopically. Study Design: A descriptive study. Place and Duration of the Study: Department of ENT - Head and Neck Surgery, Dow University of Health Sciences (DUHS), from February 2020 to August 2021. Methodology: A total of 43 patients with dry central pars tensa tympanic membrane perforation were diagnosed through oto-endoscopy during the study. The mean air-bone gap was calculated by assessing each air-bone gap through pure tone audiometry at different frequencies i.e., 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz. Air-bone gap was found to be the average value of these frequencies. The photograph of the tympanic membrane was taken oto-endoscopically, and the ratio between size of the perforation to the entire area of the tympanic membrane was measured. During the course of the study, a total of 43 patients agreed to provide consent for this study. Out of the 43 patients, 16 (37.2%) were males and 27 (62.8%) were females. The age range was from 18 to 50 years with average age of 38.302 ± 5.74 years. The mean perforation size was 28.255 ± 9.16% while the mean air-bone gap was 28.000 ± 3.89 dB. It was concluded that the Pearson's correlation coefficient is directly correlated to perforation size and air-bone gap (r = 0.898, p <0.001). Further, hearing loss decreases with decreased middle ear volume and mastoid pneumatisation. Moreover, no change was seen in the mean air-bone gap according to the location of perforation. The hearing loss due to perforation of the tympanic membrane was correlated to the size of the perforation. Further, hearing loss decreases with reduced middle ear volume and mastoid pneumatisation. Size of perforation, Hearing loss, Air-bone gap, Oto-endoscopy, Conductive deafness, Mastoid pneumatisation.

Feasibility of Super-thin Anterolateral Thigh Free Flap for Oral and Pharyngeal Reconstruction.

To highlight the feasibility of employing super-thin ALT free flaps for reconstruction of complex oral cavity and oropharyngeal defects. Retrospective chart review. Sixteen super-thin ALT free flaps were performed in 15 patients between 2020 and 2023 for reconstruction of oral cavity defects (seven oral tongue, three floor of mouth, three buccal, two oropharynx, one lower lip). Flap success rate was 100% with only minor complications reported, with no patient requiring return to the operating room within 30 days and no patient requiring radial forearm free flap reconstruction. One patient experienced partial flap failure, one patient experienced superficial necrosis of the distal skin paddle measuring 1 cm, and one patient was converted intraoperatively to a contralateral traditional ALT free flap due to insufficient perforator size. Average operative time was 509 min, average length of hospitalization was nine days, and two patients required gastrostomy placement prior to discharge for dysphagia. Super-thin ALT free flap harvest technique represents a feasible option for oral cavity and oropharyngeal reconstruction in select patients and does not require additional surgical training, invasive testing, or technology. It can be readily adopted by reconstructive surgeons with a simple adaptation in existing ALT harvest technique. Level 4 Laryngoscope, 2024.

Investigation of the Effect of Parametric Patterned Façade and Resulting Daylight Illuminance on Students’ Mood and Task Performance in Architecture Studio-Based Tutoring

Parametric design is one of the thriving contemporary architectural treatments that not only has an influence on the design of building envelopes but is capable of affecting the users physically and psychologically. The efficiency of the daylight resulting from the facade is greatly affected by the envelope’s perforation shapes, sizes, and distribution. This research builds upon a prior study which investigated the effect of Parametric Patterned Façade on daylight performance, quality, and visual comfort concluding with the choice of the highest-performing pattern for daylight metrics. The chosen pattern is the “Triangles Pattern” which was put in situ where the field experiment took place. The current study analyzed the effect of illuminance, and illuminance distribution resulting from the parametric patterned facade on architecture students’ mood and task performance in the setting of an architecture studio-based tutoring. Both quantitative and qualitative research methods were adopted; quantitative through the utilization of a Spatial Ability Test to assess students’ task performance, and qualitative through a self-reporting mood assessment, and subjective daylight perception questionnaire. The analysis was conducted through three types of tests to investigate the research hypothesis; statistical analysis of hypothesis (t-test), PANAS schedule for mood assessment, and comparative analysis of the subjective questionnaire between the base case condition and the parametric patterned façade condition. The results of paired sample study indicated that the students’ performance was enhanced after the exposure to the second condition (PPF condition) over the first (BC condition). Also, for the NA assessment, both PANAS assessment and t-test analysis results showed a difference in means between the two conditions indicating that there was an enhancement of the NA. Finally, a framework is proposed for the utilization of a Parametric Patterned façade in an educational setting. The implications of this experiment inform architects of the importance of daylighting techniques to enrich the educational environment, and how to establish a research methodology for the enhancement of daylight design using both technical and psychological approaches.

Factors affecting fat myringoplasty in elderly patients with chronic otitis media: A case control study

BackgroundWe compared and analyzed the surgical results of fat myringoplasty between elderly and young adult patients with chronic otitis media. We also investigated whether underlying diseases and other factors impact the surgical outcome.MethodsWe retrospectively reviewed the data of 141 patients who underwent fat myringoplasty for chronic otitis media for five years. They were compared by age, sex, underlying disease, perforation size, pre- and postoperative pure tone audiometry, postoperative otorrhea, postoperative re-perforation, and cause of re-perforation.ResultPostoperative re-perforation was more common in the elderly group, albeit with no significant difference (p = 0.072). The factors affecting re-perforation were insufficient fat graft (44.4%), postoperative infection (33.3%), and nasal blowing (22.2%). Our findings revealed no significant association between preoperative perforation size and re-perforation (p = 0.391). Additionally, we found no significant relationship between hypertension and re-perforation (p > 0.99), nor between age group and postoperative infection (p = 0.488). Diabetes was also not significant (p = 0.640). Following surgery, both groups exhibited a significant improvement in hearing.ConclusionAlthough age and underlying conditions play significant roles in the healing process, our results suggest that external factors such as infection, nasal blowing, cough, and insufficient grafted fat tissue have a similarly significant impact on surgical outcomes in elderly patients with COM as they do in adults. In conclusion, the decision to perform surgery in elderly patients with COM should be based on a comprehensive assessment of the patient’s overall health status, hearing, use of hearing aids, and the indications for surgery.

Comparative experiments on the flow morphology of liquid nitrogen and water in perforated structured packing

Cryogenic distillation is the primary method for air separation, with corrugated plate packing as the main packing for heat and mass transfer between nitrogen and oxygen. The perforated structure on the corrugated plate packing can directly change the liquid distribution characteristics, thereby affecting the packing’s flow and mass transfer performance. Currently, the effect of perforated structure is mainly revealed by room temperature fluids such as water and air, while on the practical cryogenic fluids such as liquid nitrogen, it is seldom studied. In this study, the effects of perforation size ranging from 2 to 8 mm on the flow of water and liquid nitrogen on the perforated plates were investigated and compared by a high-speed camera. It was observed that water could hardly flow through the perforations, it completely covers the perforations, forming a continuous liquid film on the surface of the perforations. The expected role of perforations in redistributing water on the back side of the corrugated plate is relatively minor. While for liquid nitrogen, the presence of the perforated structure helps fluid redistribution on the back side of the plate, as it can easily flow through the perforations with diameters between 2 mm and 8 mm. It is found that when the perforation diameter exceeds 6 mm, liquid nitrogen will form suspended liquid droplets within the holes, which could be a risk of premature flooding. Under similar conditions, the wetting rate of liquid nitrogen reaches 86.90 % −99.48 %, higher than that of water which is about 10.26 % −78.82 %. The results show that perforations have quite different effects on the flow characters of water and liquid nitrogen due to their disparate physic properties.

ANALYSIS OF I-BEAM WITH CORRUGATED WEB AND TECHNOLOGICAL PERFORATIONS UNDER STATIC LOAD

The article is aimed at studying the operation of welded I-beams with corrugated web and technological perforations under static loading. The relevance of the study is due to the lack of specific instructions on the pitch, diameter and methods of strengthening technological perforations in the Republic of Kazakhstan and other countries. In this study the method of computer modeling with the help of the program complex LIRA-SAPR-2022 was used. The study was carried out for the beam, taking into account different sizes of perforations in the beam web, distances between the perforations, with and without perforation. The beam deformability and the beam stability with and without perforations under static concentrated load was analyzed. Twenty-nine beam models were analyzed, three circular perforations with diameters of 0,25 , 0,5 , 0,75 were formed in the webs of the beam models, where is the height of the corrugated web. The center of the perforations was located in the middle of the web height. The distance between the centers of the perforations were taken 2d, 3d and 4d, where d is the diameter of the perforation. Analysis of the performance of beam models with perforations under load showed that the bearing capacity of the beam decreases with increasing perforation pitch and perforation diameter. The most optimum perforation diameter for design may be perforation diameter 0,25 and 0,5 with perforation pitch 2d.

Endoscopic Tympanoplasty in Chronic Otitis Media with Inactive Mucosal Disease

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Chronic otitis media (COM) is a condition usually seen in patients attending the ENT department. Chronic inactive mucosal disease (CIMD) is characterized by tympanic membrane (TM) perforation with hearing loss. Endoscopic tympanoplasty (ET) is a surgical method to repair TM perforation with minimal invasion. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; The present analysis was done to find out the outcome of ET surgeries in CIMD. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; Retrospective data analysis was done in 30 patients underwent ET with endoscopic under-lay technique at Al-Ameen medical college, Vijapur, India. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; Average age of patients was 34.17±9.52 years. Majority (40%) patients were from 18-30 years of age group. There were 12 (40%) males and 18 (60%) females. Right-side and left-side CIMD was equally distributed in 30 patients. Sixteen (53.3%) and 14 (46.7%) patients were having right and left TM perforation, respectively. TM perforation size was small, medium and large in 43.3%, 30% and 26.7% of patients, respectively. Twenty-eight (93.3%) patients had temporalis fascia and 2 (6.7%) patients had tragal cartilage as graft material. Two (6.7%) patients had graft rejection without improvement in hearing. No patient had complication or any miscellaneous issues. Eighteen (60.0%), 11 (36.7%) and 1 (3.3%) pre-operative patient with pure-tone average (PTA) had mild, moderate, and severe conductive hearing loss (CHL), respectively. All patients with PTA were improved after surgery. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;ET is an effective, minimally invasive, and less painful surgical technique for repair of central TM perforations in CIMD.

Homogenisation of nonlinear Dirichlet problems in randomly perforated domains under minimal assumptions on the size of perforations

AbstractIn this paper we study the convergence of nonlinear Dirichlet problems for systems of variational elliptic PDEs defined on randomly perforated domains of $$\mathbb {R}^n$$ R n . Under the assumption that the perforations are small balls whose centres and radii are generated by a stationary short-range marked point process, we obtain in the critical-scaling limit an averaged nonlinear analogue of the extra term obtained in the classical work of Cioranescu and Murat (Res Notes Math III, 1982). In analogy to the random setting recently introduced by Giunti, Höfer and Velázquez (Commun Part Differ Equ 43(9):1377–1412, 2018) to study the Poisson equation, we only require that the random radii have finite $$(n-q)$$ ( n - q ) -moment, where $$1&lt;q&lt;n$$ 1 &lt; q &lt; n is the growth-exponent of the associated energy functionals. This assumption on the one hand ensures that the expectation of the nonlinear q-capacity of the spherical holes is finite, and hence that the limit problem is well defined. On the other hand, it does not exclude the presence of balls with large radii, that can cluster up. We show however that the critical rescaling of the perforations is sufficient to ensure that no percolating-like structures appear in the limit.

Local buckling behaviour of web perforated cold-formed steel lipped channel columns

To connect beams and bracings with storage rack uprights, closely spaced perforations are provided along the web, flanges, and rear flanges of uprights. These perforations can significantly lower the ultimate capacity of such compression members with the possible influence of its natural buckling modes. This capacity reduction can depend on various parameters such as (a) geometrical shape, proportioning of cross-section, and stiffeners; (b) perforation shape, size, spacing, and location; (b) slenderness of member, cross-section, and elements of cross-section; and (d) material properties. A thorough understanding of the influence of the above-mentioned factors is necessary for the accurate strength prediction of perforated Cold-formed steel (CFS) compression members. Even though the current design standards are updated for the accurate strength prediction of unperforated CFS compression members, they do not collectively account for the influence of all the aforementioned factors on the load-carrying capacity of the perforated CFS members, particularly for the local buckling capacity. Though the Direct Strength Method (DSM) of design is the most accepted method for accurate strength prediction of CFS members even for complex cross-sectional shapes, recent research on the strength evaluation of perforated CFS members using DSM has emphasized the need for refinement in DSM. The Modified Direct Strength Method (MDSM), which accounts for the simultaneous buckling of flanges and web, includes the cross-section aspect ratio and cross-section slenderness to predict more accurately the local buckling design strength. However, it was developed only for unperforated specimens. Hence, a systematic experimental and numerical investigation was done to understand the influence of the perforation in the local buckling behavior of the lipped channel section. In total, 14 specimens, including 2 unperforated and 12 web perforated CFS lipped channel stub columns were physically tested with fixed support conditions. The Finite Element Analysis using ABAQUS software was used to conduct an extensive parametric numerical study. The results were used to compare the strength curves of DSM and MDSM and the modification in the design curves has been proposed by considering the erosion in strength due to the presence of perforation.

FP2.9 - Colonoscopy perforation: a single centre study

Abstract Aim Colonoscopy is increasing utilized as a diagnostic &amp; therapeutic tool. Colonoscopy perforation is reported to occur in 1/1500 (diagnostic colonoscopy), 1/500 (polypectomy) &amp; 1/50 (EMR) procedures. The aim of the study is to evaluate the management of colonoscopy perforation at a single centre. Methods Colonoscopy is carried out on patients with colorectal cancer trigger symptoms (altered bowel habit, rectal bleeding, weight loss, abdominal pain, anaemia, ano-rectal symptoms, etc), family history screening, colorectal cancer &amp; polyp surveillance. This is cohort study carried out since 2012 to December 2023 on all colonoscopy perforations carried out at a single centre. Results N = 22 Age (yrs) 70.8 ± 3.4 Sex (M:F) 4 : 18 BMI (kg/m2) 25.3 ± 1.8 ASA 2 Sigmoid Perf site (n) 13 LOS (days) 6 ± 6.5 Deaths (n) 30 day 3 60 day 3 90 day 3 IBD (n) 3 DD (n) 11 WCC (x109/L) 11.3 ± 1.4 CRP (mg/L) 100.1 ± 25.7 Lactate (mmol/L) 1.3 ± 0.7 Op time (mins) 119.0 ± 15.3 Bx 6 Polypectomy 5 Colonoscopy 21 (9 incomplete) Flexi siggy 1 Sedation 16 Entonox 5 GA 1 Xray 10 CT scan 22 Conservative 9 Surgery 13 Stoma (n) 6 Lap 2 Lap open 2 Open 9 Conclusion Colonic perforation during colonoscopy is increased in: polypectomy (especially right colonic), therapeutic EMR, diseased bowel (IBD inflammatory bowel disease, diverticular disease), &amp; in challenging colons. The management of colonoscopy perforation should individualized with early clinical &amp; radiological diagnosis. Site and size of colonic perforation determines management. Good bowel preparations, minimizes contamination and therefore allows safe conservative management of small colonoscopy perforation.

Perforated Peptic Ulcer in Lagos. Risk Factors and Management Outcome

Abstract Background: Complications of peptic ulcers, such as bleeding, gastric outlet obstruction, and perforation, can be life-threatening and may require surgical intervention. Perforated peptic ulcer (PPU) presents mostly as a surgical emergency and is one of the leading causes of secondary peritonitis with significant morbidity and mortality. The clinical outcome of surgical treatment of peptic ulcers varies due to the varying patterns of presentations and interventions between countries. There are few documented series on PPU in Nigeria. This paper reviews the management outcome of PPU in our institution. Materials and Methods: A retrospective review of the available medical records of patients managed for PPU between February 2008 and February 2023 was conducted. All patients had a single anterior peptic ulcer perforation managed by a modified Graham’s patch. Data analysis was performed using IBM SPSS for Windows, Version 23 (IBM Corp., Armonk, NY, USA). Results: There were 107 PPU patients comprising 93 males and 14 females. The mean age of all patients was 41 years. The peak prevalence of PPU was found among patients aged 30–39 years. Delayed presentation was recorded in about half of the patients. Ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) was the most common risk factor for PPU. Among the 93 documented cases, perforated gastric ulcers (71 cases) were found in a much higher proportion than duodenal ulcers (22 cases). Large ulcer (10–30 mm) was the main perforation size category found in 47 out of 83 recorded PPU cases. PPU size was not associated with the incidence of complications or mortality. The median duration of hospital stays was 13 (1–19) days. Surgical site infection was the most common complication after surgery. Conclusion: PPU is present in our predominantly male patients in their fourth decade of life. Ingestion of NSAIDs is a major risk factor. Duodenal ulcers were the predominant type seen in our patients. Documented perforated ulcer sizes in our patients are predominantly in the large category. Surgical site infection, systemic sepsis, and superficial wound infection were major complications in our patients.

Study of effects of perforation layouts on wave energy dissipation caused by a submerged perforated breakwater in front of a vertical seawall

Perforated structures are a promising alternative to traditional breakwaters for constructing harbors and protecting coastlines. Perforated structures can effectively remove wave energy from ocean waves by the energy dissipation associated with the turbulence generated by the flow through the perforations in the structure. Understanding the factors that may affect the hydrodynamic characteristics of flow through a perforated plate is important for designing perforated marine structures. The purpose of this research was to determine the wave energy dissipation performance of thin-walled plates with various perforation configurations using OpenFOAM-based CFD simulation. Ten different plate configurations were designed and tested with a constant porosity while varying the distribution, shape, and size of the perforations, to determine the impacts to energy dissipation performance. The energy dissipation was quantified by CFD simulations of wave-interaction with a submerged perforated plate placed vertically in front of a vertical backwall (“seawall”). Physical wave flume experiments were also conducted to verify and validate the numerical models. The results showed that the perforation distribution, shape, and size play a minimal role in the energy dissipation performance when porosity is held constant. The minimal performance deviation between the perforation configurations was consistent across a range of wave periods and amplitudes.

Cyanoacrylate glue: An emerging alternative for sealing of corneal perforation

Maintaining corneal wound integrity is an important goal in corneal perforations resulting from either traumatic or non- traumatic etiology. Tissue adhesives (TA’s) are group of synthetic or naturally occurring compounds, which helps in wound reconstruction and have emerged as alternatives to conventional sutures. Our study aims to evaluate the efficacy N- butyl cyanoacrylate TA in corneal perforations following infectious keratitis by assessment of its morphological and functional outcome. A prospective observational study conducted over a period of 6 months on 42 eyes of 42 patients with perforated corneal ulcer, fulfilling the inclusion criteria, presenting to our outpatient department. A standard technique was used to apply TA to the site of perforation under topical anaesthesia in all patients and they were followed-up for a period of 6 weeks. Data analysis was done using SPSS software (Version 22) and P value calculated by Pearson Chi-square test (Fisher exact test). P- value &amp;#60; 0.05 was considered statistically significant. Morphological outcome in this study showed statistically significant relationship with causative organism and size of the perforations (p&amp;#60;0.05). The functional outcome showed statistically significant relationship with location of perforation, duration of symptoms and duration of stay of glue (p&amp;#60;0.05). TA’s works well when the corneal perforation is &amp;#60;1.5 mm in diameter. The morphological outcome of TA depends upon etiology, size of perforations and complications significantly. Functional outcome of tissue adhesive shows significant association with location of perforation, duration of symptoms and stay of glue.

Audiological results of myringoplasty performed by trainee surgeons (ENT residents) under supervision—analytic study

BackgroundMyringoplasty is one of the most common surgeries performed in otology centers, with many factors influencing the success rate, including the size and site of perforation, function of the Eustachian tube, revision surgery, and expertise of the surgeons. It is well established that the perforation closure rate is lower when performed by trainee surgeons than by senior otologists. Myringoplasty performed by trainees tends to pose more iatrogenic trauma to middle ear mucosa, less gentle manipulation of ossicles, and prolonged operation time compared with operations performed by experienced surgeons, all of which might produce more damage to middle ear structures and consequently negatively affect the closure rate of TM and audiological outcome. This study aimed to assess the audiological outcomes of successfully closed perforation myringoplasty performed by a trainee under supervision.MethodsThe study design was an analytic cross-sectional study of 35 patients aged between 6 and 62 years diagnosed with safe TM perforation. All patients had two audiograms, one before surgery and the other 3 months after surgery. The exclusion criteria included any case with cholesteatoma, tumor, tympanosclerosis, or ossicular erosion/fixation because this study aimed to study the sole effect of closing TM perforation without any other confounding factor.ResultsThe results indicate a mean hearing improvement of 12.25 dB of ABG and 10.6 dB of AC thresholds at the four frequencies of 500, 1000, 2000, and 4000 Hz. The mean of the residual ABGs at the four frequencies is 14.2 dB. There were no correlations between the amount of air conduction threshold improvement and age, gender, side of the affected ear, area of perforation, or duration of disease (p > 0.05 for all tests).ConclusionAlthough the rate of perforation closure in myringoplasties performed by trainees is lower than that of experienced surgeons, the audiological outcomes of myringoplasties performed by trainees under supervision were acceptable; however, further research is recommended.

Plasminogen - safe for treatment of chronic tympanic membrane perforation: a phase 1 randomized, placebo-controlled study

Background There is a need for a simpler and accessible intervention to heal tympanic membrane perforations than myringoplasty that is todaýs golden standard. Experimental studies have identified plasminogen as a promising agent for medical treatment of chronic tympanic membrane perforation. Aims/Objectives This was a phase 1, prospective, randomized, placebo-controlled study with the main objective to evaluate the safety of injecting plasminogen in the vicinity of the tympanic membrane in subjects with chronic tympanic membrane perforation. Material and Methods Adults diagnosed with a dry chronic tympanic membrane perforation were recruited for an injection schedule with Human plasminogen 10. Adverse events, audiometry, VAS fluctuations and size of perforation, were monitored throughout the length of the study. Results It was possible to perform the injections according to schedule in all subjects. None of the subjects experienced any severe adverse events. Most common adverse event was ear pain. No signs of ototoxicity were reported. Conclusions and Significance This pilot study suggests that plasminogen injections close to the tympanic membrane as treatment for chronic tympanic membrane injections are safe and feasible, encouraging further dose-escalating studies.

Risks and Safety of CO2 Pipeline Transport: A Case Study of the Analysis and Modeling of the Risk of Accidental Release of CO2 into the Atmosphere

In the field of CO2 capture and sequestration, ensuring the safety of pipeline infrastructure is paramount to successful climate change mitigation efforts. This study investigates the dynamics of CO2 dispersion from pipeline systems, assessing not only the transport process but also the physical properties and associated hazards. Advanced simulation techniques are used to model how different states of CO2 (gas, liquid, and supercritical) and varying pipeline characteristics—such as perforation sizes, flow rates, and orientations—affect the dispersion patterns in the event of a leak. Simulations cover a range of atmospheric conditions, emphasizing the role of atmospheric stability and wind speed in shaping dispersion and defining potential impact zones. An analysis of historical pipeline accidents is included to inform risk management strategies. The results show that the orientation of the pipeline has a significant effect on dispersion, with downward leaks causing the largest impact zones, particularly under supercritical conditions. The results highlight the need for adaptive safety strategies that take into account real-time CO2 transport conditions and localized environmental data. By integrating these factors, the study recommends refining safety protocols and emergency response strategies to improve pipeline resilience and public safety against potential leaks. Key findings include the quantification of the relationship between leak parameters and dispersion areas, providing a valuable framework for future safety improvements.

Conservative treatment of intraperitoneal bladder perforations: a conscious choice or forced measure

Intraperitoneal traumatic perforations of the bladder of any origin (e.g., external trauma, iatrogenic injuries) and spontaneous ruptures are conditions that, according to the canons of surgery, require emergency surgical intervention by one or another access. However, some studies have indicated the possibility of conservative management of such patients — both adults and children. A review of publications describing the results of conservative treatment of patients with intraperitoneal bladder perforations was performed. Overall, 2,679 publications related to intraperitoneal perforations of the bladder were found in the available scientific databases, of which only 72 focused on issues of conservative treatment. In 13 of them, the possibility of such an approach is denied, but without reference to their own material. Analysis of the literature demonstrated that conservative management of intraperitoneal perforations of the may be feasible in certain circumstances, sometimes being a crucial measure. Indications for conservative treatment techniques include the absence of peritonitis, small perforation size, and short periods from the moment of perforation. However, all these indications are in the nature of opinions and assumptions and are not part of algorithmic tactics. The effectiveness of this approach remains unclear. The frequency of unsatisfactory outcomes ranges from 10% to 50%, which indicates the inappropriateness of conservative treatment. With the small number of studies and conflicting results obtained prohibits us to consider this technique as the method of choice for treating patients with intraperitoneal perforations of the bladder.