A new approach for the salvage of unsuccessful esophageal atresia repair: A spiral myotomy and delayed definitive operation

Abstract Background Esophageal atresia (EA) is usually accompanied by some form of tracheomalacia. During the early phases in life, excessive dynamic collapse of the trachea can cause a wide spectrum of symptoms ranging from mild complaints to apparent life-threatening events (ALTE’s). Therapeutic strategies for severe tracheomalacia include aortopexy to lift the anterior weakened cartilaginous rings or posterior tracheopexy of the floppy membranous tracheal intrusion. Earlier we have introduced a new approach in which the posterior tracheopexy is performed directly during primary thoracoscopic correction of EA. Methods In the period 2017–2018, all consecutive EA patients (27) underwent a rigid tracheobronchoscopic evaluation during induction of anesthesia prior to the thoracoscopic EA repair. Tracheomalacia was diagnosed in 11 patients. During the subsequent thoracoscopic procedure, the posterior tracheal membrane was fixed to the anterior longitudinal spinal ligament with nonabsorbable sutures. The esophageal ends were then mobilized toward the right hemithorax and anastomosed. Results On preoperative RTB, six patients had a severe (66–99%) mid tracheal collapse and five patients had a moderate (33–66%) collapse. Thoracoscopic posterior tracheopexy with on to three sutures was possible in all 11 patients, prior to the formation of the esophageal anastomosis. Median time per suture was 6 minutes (range: 4–12 minutes). All operative procedures were uneventful. A median follow-up of 10 months (range: 2–22 months) revealed that eight patients recovered without any respiratory symptoms, one patient had respiratory symptoms caused by a suture granuloma that was removed by bronchoscopy, one patient had a respiratory syncytial virus bronchiolitis and one patient had a rhinovirus infection. None of the patients experienced any ALTE’s. Conclusion Eleven patients have been treated by thoracoscopic posterior tracheopexy during primary EA repair. This technique could prevent potentially deleterious sequelae of moderate to severe tracheomalacia that may complicate the lives of EA patients. Also, a second, sometimes complex surgical procedure can be prevented as the posterior tracheopexy is performed during the primary thoracoscopic EA correction.

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A new approach on treatment of esophageal atresia

Annals of Pediatric Surgery ◽

10.1097/01.xps.0000525975.71558 ◽

2018 ◽

Vol 14 (2) ◽

pp. 95-97 ◽

Cited By ~ 1

Author(s):

Lorena M. Fortes ◽

Miriam G. González ◽

Noelia C. Mata ◽

María R. Ruiz ◽

Manuel G. Tellado

Keyword(s):

Esophageal Atresia ◽

New Approach

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A new approach for the management of esophageal atresia without tracheo-esophageal fistula

Journal of Indian Association of Pediatric Surgeons ◽

10.4103/0971-9261.182590 ◽

2016 ◽

Vol 21 (3) ◽

pp. 144 ◽

Cited By ~ 1

Author(s):

NandiniK Bedi ◽

AlkaG Grewal ◽

Shubhra Rathore ◽

Uttam George

Keyword(s):

Esophageal Atresia ◽

Esophageal Fistula ◽

New Approach

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The O–C diagrams of minor planets − a new approach to modelling the rotation

International Astronomical Union Colloquium ◽

10.1017/s0252921100031407 ◽

1999 ◽

Vol 173 ◽

pp. 185-188

Author(s):

Gy. Szabó ◽

K. Sárneczky ◽

L.L. Kiss

Keyword(s):

Error Analysis ◽

Time Dependence ◽

Theoretical Work ◽

Minor Planet ◽

Minor Planets ◽

New Approach ◽

Preliminary Results ◽

Ccd Observations

AbstractA widely used tool in studying quasi-monoperiodic processes is the O–C diagram. This paper deals with the application of this diagram in minor planet studies. The main difference between our approach and the classical O–C diagram is that we transform the epoch (=time) dependence into the geocentric longitude domain. We outline a rotation modelling using this modified O–C and illustrate the abilities with detailed error analysis. The primary assumption, that the monotonity and the shape of this diagram is (almost) independent of the geometry of the asteroids is discussed and tested. The monotonity enables an unambiguous distinction between the prograde and retrograde rotation, thus the four-fold (or in some cases the two-fold) ambiguities can be avoided. This turned out to be the main advantage of the O–C examination. As an extension to the theoretical work, we present some preliminary results on 1727 Mette based on new CCD observations.

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A New Approach to the Demonstration of Oxidase-Localization Using Tannic Acid Or Catechin

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100073933 ◽

1973 ◽

Vol 31 ◽

pp. 698-699

Author(s):

V. Mizuhira ◽

Y. Futaesaku

Keyword(s):

Cross Section ◽

Tannic Acid ◽

Elastic Fiber ◽

The Other ◽

New Approach ◽

Tissue Block ◽

Active Reaction ◽

The Cross

Previously we reported that tannic acid is a very effective fixative for proteins including polypeptides. Especially, in the cross section of microtubules, thirteen submits in A-tubule and eleven in B-tubule could be observed very clearly. An elastic fiber could be demonstrated very clearly, as an electron opaque, homogeneous fiber. However, tannic acid did not penetrate into the deep portion of the tissue-block. So we tried Catechin. This shows almost the same chemical natures as that of proteins, as tannic acid. Moreover, we thought that catechin should have two active-reaction sites, one is phenol,and the other is catechole. Catechole site should react with osmium, to make Os- black. Phenol-site should react with peroxidase existing perhydroxide.

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Processing Immunoperoxidase Labeled Cell Monolayers and Cryostat Sesctions For Electron Microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100120266 ◽

1985 ◽

Vol 43 ◽

pp. 714-715

Author(s):

K. Chien ◽

R. Van de Velde ◽

I.P. Shintaku ◽

A.F. Sassoon

Keyword(s):

Cell Monolayer ◽

Cell Types ◽

Surface Antigens ◽

Immunoperoxidase Method ◽

Reaction Step ◽

Hot Plate ◽

Air Drying ◽

New Approach ◽

Cell Monolayers ◽

Glass Slides

Immunoelectron microscopy of neoplastic lymphoma cells is valuable for precise localization of surface antigens and identification of cell types. We have developed a new approach in which the immunohistochemical staining can be evaluated prior to embedding for EM and desired area subsequently selected for ultrathin sectioning.A freshly prepared lymphoma cell suspension is spun onto polylysine hydrobromide- coated glass slides by cytocentrifugation and immediately fixed without air drying in polylysine paraformaldehyde (PLP) fixative. After rinsing in PBS, slides are stained by a 3-step immunoperoxidase method. Cell monolayer is then fixed in buffered 3% glutaraldehyde prior to DAB reaction. After the DAB reaction step, wet monolayers can be examined under LM for presence of brown reaction product and selected monolayers then processed by routine methods for EM and embedded with the Chien Re-embedding Mold. After the polymerization, the epoxy blocks are easily separated from the glass slides by heatingon a 100°C hot plate for 20 seconds.

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TEM study of a biofilm on copper corrosion

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100163563 ◽

1996 ◽

Vol 54 ◽

pp. 220-221

Author(s):

W. A. Chiou ◽

N. Kohyama ◽

B. Little ◽

P. Wagner ◽

M. Meshii

Keyword(s):

Marine Bacterium ◽

Culture Medium ◽

Copper Alloys ◽

Pure Copper ◽

Localized Corrosion ◽

Natural Seawater ◽

Copper Corrosion ◽

New Approach ◽

The Past ◽

Copper Tolerant

The corrosion of copper and copper alloys in a marine environment is of great concern because of their widespread use in heat exchangers and steam condensers in which natural seawater is the coolant. It has become increasingly evident that microorganisms play an important role in the corrosion of a number of metals and alloys under a variety of environments. For the past 15 years the use of SEM has proven to be useful in studying biofilms and spatial relationships between bacteria and localized corrosion of metals. Little information, however, has been obtained using TEM capitalizing on its higher spacial resolution and the transmission observation of interfaces. The research presented herein is the first step of this new approach in studying the corrosion with biological influence in pure copper.Commercially produced copper (Cu, 99%) foils of approximately 120 μm thick exposed to a copper-tolerant marine bacterium, Oceanospirillum, and an abiotic culture medium were subsampled (1 cm × 1 cm) for this study along with unexposed control samples.

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High resolution at low voltage: A new approach

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100152355 ◽

1989 ◽

Vol 47 ◽

pp. 76-77

Author(s):

Arthur V. Jones

Keyword(s):

Low Voltage ◽

Emission Sources ◽

New Approach ◽

Design Concepts ◽

Probe Diameter ◽

Low Voltage Operation ◽

Sufficient Intensity ◽

Electron Microscopes ◽

Scanning Electron Microscopes ◽

Immersion Type

With the introduction of field-emission sources and “immersion-type” objective lenses, the resolution obtainable with modern scanning electron microscopes is approaching that obtainable in STEM and TEM-but only with specific types of specimens. Bulk specimens still suffer from the restrictions imposed by internal scattering and the need to be conducting. Advances in coating techniques have largely overcome these problems but for a sizeable body of specimens, the restrictions imposed by coating are unacceptable.For such specimens, low voltage operation, with its low beam penetration and freedom from charging artifacts, is the method of choice.Unfortunately the technical dificulties in producing an electron beam sufficiently small and of sufficient intensity are considerably greater at low beam energies — so much so that a radical reevaluation of convential design concepts is needed.The probe diameter is usually given by

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