Operation For Transposition Research Articles

Sliding Shape Extraocular Muscle Transposition with Plication: A Novel Method.

Objectives:This study aims to present a novel operation method of delivering both vascular protection and strengthening of the muscles, as well as the transposition of the muscles.Methods:The patients’ files were scanned retrospectively. All patients underwent a complete eye examination in addition to motility examination, both preoperatively and postoperatively. Patients were followed up at least six months. Pre- and post-operative deviation measurement values were compared statistically. Operation technique: After being exposed and the rectus muscle was freed from the facial structure as far as planned resection amount. 6-0 coated vicryl sutures were then placed through the two sides of the muscle while protecting the blood vessels. Then, each suture was placed close to the muscle insertion and was aimed at transposition side. For example, if the target was to transpose the superior rectus at the temporal side, nasal side suture was placed at temporal edge of muscle insertion, and temporal side suture is placed approximately a tendon width laterally to the insertion.Results:In patients who were planned resection 7 mm and over, the procedure for complete muscle widening transposition was successful. Only 2/3 transpositions could be achieved in four patients who underwent less than 7 mm of strengthening. There was no anterior segment ischemia in three patients who underwent three rectus muscle surgery in the same eye.Conclusion:‘Sliding shape’ design extraocular muscle plication found a simple, safe and effective procedure for patients who needed resection and transposition operation. More patients and longer follow-up are needed to understand the real effectiveness.

Comparative analysis of results of revascularization of the first segment of vertebral arteries

Analysed herein is efficacy of various operations on the first segment of the vertebral artery (VA) during treatment of patients with vertebrobasilar insufficiency (VBI). The study enrolled a total of 194 patients with the clinical pattern of VBI induced by an atherosclerotic lesion of the first segment of the VA (stenosis >70%). All patients prior to admission had been receiving a course of medicamentous therapy under neurologist's supervision for more than 6 months with no significant effect. The patients were divided into two groups: Group A included 129 (66.5%) patients with VA tortuosity, subjected to 'open' operations, Group B was composed of 65 (33.5%) patients without VA tortuosity, subjected to stenting of the first segment of the VA. The main criteria of assessing the results were patency of the reconstructed zone and clinical improvement after surgery. In 189 (97.4%) patients we managed to attain stable clinical improvement which persisted after 1 year in 177 (91.2%) patients and after 3 years in 156 (80.2%). In the group of stenting, excellent immediate results were obtained - 100% technical and clinical success. However, in the remote period, the outcomes of 'open' operations turned out to be better as compared with those of stenting. Thus, 3-year clinical efficacy of 'open' and stenting operations amounted to 79.8% and 73.8%, respectively (p>0.05). After 'open' operations there was a significantly lower rate of restenosis of the reconstruction zone (1.6%) than after stenting - 15.4% (p<0.05). However, after 'open' operations the frequency of thrombosis of the reconstructed zone was higher than after stenting - 5.5 vs 1.5% (p>0.05). The incidence of stroke after open operations and after stenting amounted to 2.3 and 3.1%, respectively (p>0.05). Comparative assessment of relapse-free survival after all analysed methods of operations and interventions showed that the best techniques in the long-term perspective turned out to be 'open' operations, and amongst them the operation of transposition of the VA to the common carotid artery (median - 13 years) and the operation of reimplantation of the VA into its ostium (median not achieved in follow up observations for more than 18 years).

The increasing of energy efficiency of international freight truck trains under the concept of energy innovative technologies development motor transport

At the motor transport (MT) the concept of technological and innovative energy saving is actual. However, the existing method of increasing the cost-effective efficiency of motor transport does not correspond to this concept because the basis of the theory of the motor transport process consists of the axioms, which neglected: a) the fragmenting effect of existing technological paradoxes on the integrity of knowledge about motor transport as a sphere of material production; b) the resource, production and technological essence of this process; c) innovative variability of parameters of new cars and transport technologies. In addition, the basis of the fundamental designed scheme of the transport operation is based on simplified mathematical description of the virtual transposition operations. These methodological shortcomings do not allow to analyze and substantiate innovative technical and technological projects of motor transport. For the possibility of realization of the actual concept of technological and innovative energy saving on MT, in NTU the theory and methods of a comprehensive increase of energy efficiency of a car (EREC) of a general type, as well as methods of simulation and test formation of energy saving of motor transport technologies were designed.

Diffuse myocardial fibrosis in adolescents operated with arterial switch for transposition of the great arteries - A CMR study

Diffuse myocardial fibrosis in adolescents operated with arterial switch for transposition of the great arteries - A CMR study

OC64 RESULTS OF PRIMARY ARTERIAL SWITCH OPERATION AFTER 21 DAYS OF AGE FOR TRANSPOSITION OF GREAT ARTERIES WITH INTACT VENTRICULAR SEPTUM

Background and aim: Late arterial switch operation (ASO) for transposition of great arteries (TGA) with intact ventricular septum comes at higher post-operative risk if performed after 3 weeks of age due to left ventricle (LV) deconditioning. We aim to evaluate results of ASO performed after 21 days of life (late) in relation to repair performed in the first 21 days of life (early). Methods: Retrospective single center study in all patients with TGA and intact ventricular septum who underwent ASO (May 2004-February 2016). Patients were divided in early repair (age ≤ 21 days) and late repair (age &gt; 21 days). Differences were assessed with Chi-squared, Man-Whitney test, and student t-Test accordingly to sample size and variable type. Results: Patients included were 137 (male = 93 pts); 55 patients (40%) were in the late repair group and 35 pts (63.7%) had “banana shaped” LV. In the early group (n = 82 pts) 3 pts (3.6%) had “banana shaped” LV. Overall hospital mortality was 8% (n = 11) with no statistical differences between the two groups (late = 5% vs. early = 10%, p = 0.364). In the late repair 13% required postoperative ECMO compared to 7.5% in the early repair although not statistically different (p = 0.295). Post-operative left ventricular dysfunction at discharge occurred in 6 patients with no differences among groups (p = 0.536). Conclusions: Arterial switch operation after 21 days of age can be achieved with good hospital survival although need of postoperative ECMO support is higher due to transitory LV dysfunction without impacting in patients survival.

Sorting permutations with transpositions in O(n3) amortized time

The problem of sorting a permutation π over alphabet ∑={1,2,3…n} with the minimum number of transpositions is known to be intractable. That is, the computation of transposition distance i.e. dt(π), is hard. Such sorting is equivalent to determining the distance between any α, β of the symmetric group Sn over ∑ under the transposition operation. It has applications in computer interconnection networks where a node is denoted by a permutation, and genetics where a genome is modeled by a permutation. The maximum distance between any pair of permutations in Sn is the diameter i.e. diam(Γ(Sn)), of the corresponding Cayley graph Γ(Sn). It corresponds to the maximum latency in the computer interconnection network modeled by Γ(Sn) and the maximum genetic dissimilarity between any pair α, β in Sn. We call transpositions, prefix transpositions, suffix transpositions and prefix/suffix transpositions as block-moves. We design an algorithm to compute dt(π) ∀π in Sn and compute diam(Γ(Sn)) with transpositions in O(n!n3) time and O(n!n2) space; at an amortized time of O(n3). The same can be computed for the remaining block moves in O(n2log⁡n) amortized time and O(n!n) space.

Evaluation of Left Ventricular Function Long Term After Arterial Switch Operation for Transposition of the Great Arteries

Long-term after arterial switch operation for transposition of the great arteries, abnormal coronary anatomy and altered loading conditions could compromise ventricular function. The current study investigates whether left ventricular function, measured with echocardiographic bi-plane ejection fraction and deformation imaging, in patients long term after arterial switch operation for transposition of the great arteries differs from healthy peers. A cross-sectional cohort study of patients at least 12 years after arterial switch operation was analyzed with bi-plane Simpson’s left ventricular ejection fraction (LVEF) and deformation (speckle tracking) echocardiography. 81 patients, median age 20.6 (interquartile range 13.5–28.4) years, were included. LVEF was normal on average at 55.5 ± 6.1%. Global longitudinal strain (GLS) was lower in patients compared to healthy peers throughout all age groups and on pooled average (− 15.4 ± 1.1% vs. − 23.2 ± 0.9%). Although LVEF is normal on average in patients after arterial switch operation for transposition of the great arteries, GLS is impaired compared to healthy peers. The reduced GLS could indicate sub-clinical myocardial dysfunction.

Janelas sem horizonte: uma análise iconográfica da Anunciação no cinema

Em L’Annonciation Italienne – Une histoire de perspective, Daniel Arasse investiga a incidência da perspectiva na iconografia da Anunciação renascentista. Eis o paradoxo identificado: como que a técnica da perspectiva, “forma simbólica” de um mundo comensurável, poderia figurar o Incomensurável? Para responder a esse problema, Arasse busca no brilho interior de cada pintura uma “desordem da perspectiva” para a figuração da divindade. O presente artigo tem por objetivo identificar as formas pelas quais o cinema enfrentou esse desafio. Como migrar para o meio fílmico os motivos pictóricos já estabelecidos pela iconografia da Anunciação? Para contribuir com a discussão, analisaremos dois filmes: As sombras (Jean-Claude Brisseau, 1982) e O estranho caso de Angélica (Manoel de Oliveira, 2010).

Cylindric algebras and finite polyadic algebras

In this survey paper the short history of cylindric and finitary polyadic algebras (term-definitionally equivalent to quasi-polyadic algebras) is sketched, and the two concepts are compared. Roughly speaking, finitary polyadic algebras constitute a subclass of cylindric algebras that include a transposition operator being strong enough. We discuss the following question: should the definition of cylindric algebras include a transposition operator? Results confirm that the existence of a transposition operator ensures representability (by relativised set algebras). The different variants of cylindric algebras including a transposition operator play an important role in the theory of cylindric-like algebras.

Late Results of Half-Turned Truncal Switch Operation for Transposition of the Great Arteries

Conventional Rastelli, Lecompte, and Nikaidoh operations are accepted as standard techniques for complete transposition of the great arteries (TGA) with left ventricular outflow tract (LVOT) obstruction. These operations show serious drawbacks, however, including postoperative obstruction of both ventricular outflow tracts. We developed the half-turned truncal switch operation (HTTSO) to address these problems. Between 2002 and 2017, 14 patients underwent HTTSO. Median age was 1.2 years and median body weight was 8.3 kg. Diagnosis was TGA with pulmonary stenosis in 9 cases, TGA-type double-outlet right ventricle in 4, and TGA with degenerative pulmonary valve after pulmonary arterial banding in 1. The coronary artery was Yacoub type A in 13 and type D in 1. Four patients had a small right ventricle. Pulmonary-aortic annular diameter ratio ranged from 0.43 to 1.00. The right ventricular outflow tract was augmented using a monocuspid polytetrafluoroethylene valved patch in 8 cases. Autologous pulmonary annulus was preserved in 6 cases. Median follow-up was 5.2 years. No early mortality was encountered. Only 1 patient was lost due to arrhythmia, 11 months after HTTSO. No patients showed coronary insufficiency and no outflow tract obstruction was identified. Aortic regurgitation was within mild degree in 12 cases. Additional mitral valvular annuloplasty was required in 3 cases late after HTTSO for moderate-to-severe mitral regurgitation. Risk factors for late death and reoperation were low age and body weight at HTTSO. HTTSO is useful for TGA with LVOT obstruction, ensuring wide, straight ventricular outflow tracts and growth potential.

Preoperative Coronary Anatomy Assessment with Echocardiography and Morbidity After Arterial Switch Operation of Transposition of the Great Arteries

In transposition of the great arteries (TGA), certain coronary patterns have been associated with major adverse events early after the arterial switch operation (ASO). We sought to determine the impact of preoperative echocardiographic (ECHO) diagnosis on the intra­ and postoperative morbidity. All patients with TGA born between June 2001 and June 2017 and who underwent ASO were reviewed. Data on presumed coronary anatomy (CA) preoperatively were obtained from the preoperative ECHO report. Intraoperative CA was categorized according to Yacoub classification. Major postoperative morbidity included at least one of the following: delayed sternal closure (DSC), prolonged (> 72 h) mechanical ventilation, reintubation, peritoneal dialysis (PD), ECMO, reoperation, and readmission within 30 days after surgery. 240 patients with median age of 5 days (range 1–614) and mean weight at surgery was 3.6 kg (1.8–8.4) were included. Preoperative ECHO assessment of CA was available in 228 patients. Intraoperatively, 181 patients (75%) were found to have type A, 25 patients had type B or C or intramural (B–C–IM; 10%), and 34 patients had type D or E (D–E; 14%). Patients with types B, C, and intramural coronary (B–C–IM) had increased risk for delayed sternum closure (9/25 vs. 20/181 in type A and 8/34 in type D–E; p = 0.04), peritoneal dialysis (4/25 vs. 8/181 and 1/34; p = 0.04), and ECMO (2/25 vs. 1/131 and 1/34; p = 0.02). Within the B–C–IM group, preoperative ECHO raised suspicion of type A in 13 patients (i.e., incorrect diagnosis, ID; 52%), whereas non-A CA was suspected in 12 patients (i.e., correct diagnosis, CD; 48%). With the exception of reoperation, which was seen only in the ID subgroup (4/12 vs. 0/10 in the CD subgroup; p = 0.04), the intraoperative (cardiopulmonary bypass time and cross-clamp time) and postoperative morbidity indices were comparable in both ID and CD subgroups (p > 0.1). Although there is a significant risk for early postoperative morbidity in TGA patients with single, interarterial, and intramural CA, there seems to be relatively limited influence of preoperative ECHO assessment of coronary anatomy on this morbidity burden.

О ПЕРВОЙ КРАЕВОЙ ЗАДАЧЕ ДЛЯ СИЛЬНО ВЫРОЖДАЮЩЕГОСЯ ОБЫКНОВЕННОГО ДИФФЕРЕНЦИАЛЬНОГО УРАВНЕНИЯ

Рассмотрен частный случай ранее изученного автором вырождающегося дифференциального оператора второго порядка с сохранением введенных предположений и обозначений. Основное внимание в работе уделяется изучению эффектов, связанных с «сильным» вырождением. Настоящая задача решается для использования в дальнейших исследованиях формально сопряженного (связанного операцией транспонирования) уравнения, а также для получения некоторой теоремы существования и единственности обобщенного решения формально сопряженного уравнения из доказанной теоремы. Использование приведенных ниже результатов, относящихся к данному уравнению, сводится в простейшем случае к операторным уравнениям. Исследованы существование и единственность обобщенного решения первой краевой задачи для данного уравнения с применением теории операторов, также приводится обобщенное решение данного уравнения в случае, связанном с «сильным» вырождением. Результаты, полученные для данного уравнения, содержащего вырождение, будут использованы в дальнейшем для исследования таких уравнений, которые содержат модельные операторы. Уравнения такого вида возникают при математическом моделировании различных физических процессов. We consider a particular case of the earlier studied by the author second order degenerate differential operator with the same assumptions and designations. We focus on the study of the effects associated with the “strong” degeneration. The problem is solved to be used in further researches of formally conjugated (coupled transposition operation) equation and also for obtaining some theorems of existence and uniqueness for generalized solutions of formally conjugated equations from the proved theorem. The use of the following results is reduced to the operator equations in the simplest case. We study existence and uniqueness of the generalized solution of the first boundary value problem for the given equation using the operator theory and obtain the generalized solution to the equation in the case connected with “strong” degeneration. The results will be used in the future for research of equations with model operators which arise in mathematical modeling of various physical processes.

Attenuation of Pulse Pressure Amplification inPatients with Complete Transposition of the Great Arteries After an Arterial Switch Operation in Children.

Although the arterial switch operation has become the standard procedure for infants with complete transposition of the great arteries, possible late adverse events after surgery have not been fully elucidated. One such problem may be the postoperative function of the aorta that is radically manipulated. The current study enrolled 12 patients aged 4-9years who had undergone an arterial switch operation. The ascending and descending aortic pressure waveforms were recorded by a catheter-mounted pressure sensor. The pressure values were compared with those of 28 age-matched controls. The mean patient age was 6.5 ± 1.0years, and the mean age at the time of surgery was 15.2 ± 8.7days. The pulse pressure in the ascending aorta was greater in the patients than in the controls (37.7 ± 5.7 vs. 33.5 ± 5.3mmHg, p = 0.042), while no difference was observed at the descending aorta between the two groups (39.5 ± 5.1 vs. 37.4 ± 5.4mmHg, respectively, p = 0.27). The pulse pressure amplification, defined as the pulse pressure in the descending aorta minus that in the ascending aorta, was significantly lower in patients who had undergone the arterial switch operation than in control patients (1.8 ± 1.6 vs. 4.0 ± 2.3mmHg, p = 0.0052). The augmented pulse pressurein theascending aorta and attenuated pulse pressure amplification observed in children treated with arterial switch surgery for complete transposition of the great arteries may implicate the procedure as a cause of future cardiovascular disease.

Left ventricular function and exercise capacity after arterial switch operation for transposition of the great arteries: a systematic review and meta-analysis.

The arterial switch operation for transposition of the great arteries was initially believed to be an anatomical correction. Recent evidence shows reduced exercise capacity and left ventricular function in varying degrees in the long term after an arterial switch operation. To perform a meta-analysis on long-term exercise capacity and left ventricular ejection fraction after an arterial switch operation. A literature search was performed to cover all studies on patients who had undergone a minimum of 6 years of follow-up that reported either left ventricular ejection fraction, peak oxygen uptake, peak workload, and/or peak heart rate. A meta-analysis was performed if more than three studies reported the outcome of interest. A total of 21 studies reported on the outcomes of interest. Oxygen uptake was consistently lower in patients who had undergone an arterial switch operation compared with healthy controls, with a pooled average peak oxygen uptake of 87.5±2.9% of predicted. The peak heart rate was also lower compared with that of controls, at 92±2% of predicted. Peak workload was significantly reduced in two studies. Pooled left ventricular ejection fraction was normal at 60.7±7.2%. Exercise capacity is reduced and left ventricular ejection fraction is preserved in the long term after an arterial switch operation for transposition of the great arteries.

Left ventricular remodelling in long-term survivors after the arterial switch operation for transposition of the great arteries.

The objective of this study was to quantify imaging markers of myocardial fibrosis and assess myocardial function in long-term transposition of the great arteries survivors after the arterial switch operation (ASO). Paediatric ASO patients were prospectively studied by cardiac magnetic resonance imaging, including first-pass myocardial perfusion, late gadolinium enhancement, and T1 relaxometry, as well as echocardiography for left ventricular (LV) systolic and diastolic function including strain analysis, with comparison to healthy controls. Thirty ASO patients (mean age 15.4 ± 2.9 years vs. 14.1 ± 2.6 years in 28 controls, P = 0.04) were included. Patients had normal LV ejection fraction (EF) (57 ± 5% vs. 59 ± 5%, P = 0.07), but end-diastolic and end-systolic volumes were increased (104 ± 20 mL/m2 vs. 89 ± 10 mL/m2, P < 0.01 and 46 ± 13 mL/m2 vs. 36 ± 7 mL/m2, P < 0.01, respectively). Longitudinal strain at two-, three-, and four-chamber levels of the LV were lower in ASO patients (-19.0 ± 2.6% vs. -20.9 ± 2.3%, P = 0.006, -17.7 ± 2.0% vs. -19.1 ± 2.4%, P = 0.02, and -18.9 ± 1.9% vs. -20.1 ± 1.7%, P = 0.01, respectively), while circumferential strain was higher at all short-axis levels (-24.6 ± 2.3% vs. -19.3 ± 1.6%, P < 0.001 at the mid-ventricular level). LV native T1 times were higher in ASO patients (1042 ± 27 ms vs. 1011 ± 27 ms, P < 0.01) and correlated with LV mass/volume ratio (R = 0.60, P < 0.001). Myocardial scarring or myocardial perfusion defects were not observed in our cohort. Children and adolescents after ASO have normal LV systolic function, in line with their overall good clinical health. At a myocardial level however, imaging markers of diffuse myocardial fibrosis are elevated, along with an altered LV contraction pattern. Whether these abnormalities will progress into future clinically significant dysfunction and whether they are harbingers of adverse outcomes remains to be studied.

Heart failure in grown-up congenital heart disease

The increasing survival to adulthood of patients with congenital heart disease (CHD) has changed the epidemiology of adult CHD (ACHD) patients and has led to an increment in hospitalization rates due to heart failure (HF). ACHD patients hospitalized for HF have a five-fold higher risk of death than those compensated. HF occurs predominantly in patients with tetralogy of Fallot, single ventricles, and after the Mustard operation for transposition of the great arteries. Diagnostic strategies applied in acquired HF patients are usually used to evaluate ACHD patients, but sometimes this can postpone the identification of HF that can become manifest with unusual and peculiar signs or symptoms. In the same way, therapeutic management resembles the acquired HF one, even if no large randomized clinical trials have been conducted in ACHD patients. Therefore, a close monitoring in dedicated units is mandatory in order to identify in time HF manifestations and manage them adequately.

A Principal Component Analysis Algorithm Based on Dimension Reduction Window

Dimensionality reduction is an essential preprocessing step for data mining. Principal component analysis (PCA) is the most classical method of reducing dimension and a variety of methods based on it are extended. However, all these methods require at least one transposition and quadrature operation of the original high-dimensional matrix and the dimension reduction results loss the meaning of the original data, it will inevitably bring difficulties for people to the further analysis of classification or clustering results. We develop a novel algorithm named DRWPCA in this paper, it does not need to map the original data to the space of other dimensions for processing, but realizes the dimension reduction by analyzing the correlation between the dimensions, and therefore the physical meaning of the original data set is retained. It utilizes mathematical statistics to obtain the correlation coefficient or the degree of correlation between attributes. By statistical analysis of the degree of correlation between attributes, the feature with high correlation is removed so as to achieve the goal of reducing the dimension. DRWPCA is inspired by the content of the correlation coefficient part of the digital feature of a random variable, and the sliding window model for traffic control in network engineering. Experimental result demonstrates that the DRWPCA provides promising accuracy, higher ability to reduce dimension and preserves the original information of the data.

Long-Term Anatomical Outcomes of the Arterial Switch Operation for Transposition of the Great Arteries Characterised with Cardiac Magnetic Resonance Imaging

Long-Term Anatomical Outcomes of the Arterial Switch Operation for Transposition of the Great Arteries Characterised with Cardiac Magnetic Resonance Imaging

High-Performance Tensor Contraction without Transposition

Tensor computations---in particular tensor contraction (TC)---are important kernels in many scientific computing applications. Due to the fundamental similarity of TC to matrix multiplication and to the availability of optimized implementations such as the BLAS, tensor operations have traditionally been implemented in terms of BLAS operations, incurring both a performance and a storage overhead. Instead, we implement TC using the flexible BLAS-like Instantiation Software (BLIS) framework, which allows for transposition (reshaping) of the tensor to be fused with internal partitioning and packing operations, requiring no explicit transposition operations or additional workspace. This implementation, TBLIS, achieves performance approaching that of matrix multiplication, and in some cases considerably higher than that of traditional TC. Our implementation supports multithreading using an approach identical to that used for matrix multiplication in BLIS, with similar performance characteristics. The complexity...

Anterior subcutaneous transposition versus anterior subfascial transposition of the ulnar nerve in the treatment of cubital tunnel syndrome

Objective To compare the clinical effects of anterior subcutaneous transposition and anterior subfascial transposition of the ulnar nerve in the treatment of cubital tunnel syndrome. Methods A total of 37 patients with cubital tunnel syndrome were retrospectively analyzed. 18 cases were treated with subcutaneous transposition of ulnar nerve, and 19 cases with anterior transposition of ulnar nerve. The scores of sensory deficits in the ulnar nerve innervation area, the intrinsic muscle strength, claw deformity and ulnar nerve conduction velocity were compared between the two groups. Results Postoperative follow-up period ranged from 6 to 18 months. There was no significant difference between anterior subcutaneous and anterior subfascial transposition of the ulnar nerve. The clinical effects of patients with moderate cubital tunnel syndrome treated by the two anterior transposition operations were much better than that of patients with severe cubital tunnel syndrome. Conclusion There was no difference between the two methods of anterior subcutaneous transposition and anterior subfascial transposition. However, the anterior subfascial transposition combines the advantages of anterior subcutaneous transposition and anterior submuscular transposition. Cubital tunnel syndrome should be actively intervened after being definitely diagnosed. Key words: Cubital tunnel syndrome; Treatment outcome; Anterior subcutaneous transposition; Anterior subfascial transposition