scholarly journals A prospective observational analytical study on Rouviere’s sulcus: a single institutional study

2020 ◽  
Vol 7 (6) ◽  
pp. 1821
Author(s):  
Bana Bihari Mishra ◽  
Archana Kumari Acharya ◽  
Jyoti Ranjan Dash ◽  
Debabrata Sahu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Paradigm Shift ◽  
Visual Inspection ◽  
Analytical Study ◽  
Common Type ◽  
Common Bile Duct Injury ◽  
Open Type ◽  
Closed Type ◽  
Different Types

Background: Laparoscopic cholecystectomy is the most commonly performed laparoscopic surgery worldwide. Safe cholecystectomy is the priority to reduce the morbidity and mortality. There is a paradigm shift from extensive Calot’s dissection to identification of Rouviere’s sulcus and lesser dissection. Identification and analysis of Rouviere’s sulcus will help us doing a safe cholecystectomy and avoiding further injuries to bile ducts.Methods: The study included 160 cases of laparoscopic cholecystectomy, posted in elective OT and identified Rouviere’s sulcus during laparoscopy. Table visual inspection and analysis was done. And the collected data was analyzed for different types of sulcus, its position, morphology and content.Results: Of 160 cases, 147 cases had Rouviere’s sulcus. 13 cases did not have a sulcus. Open type sulcus was present in 99 cases, 35 had closed type, whereas 19 had slit type and only 7 had a scar like sulcus. The study showed 92% of our patients had Rouviere’s sulcus and of them 61.9% had an open type which was the most common type of sulcus of them 18 cases had a visible pulsating vessel in the floor of the sulcus i.e. posterior sectional pedicle in the sulcus.Conclusions: Present study showed, in 92% cases it is easy and approachable to visualise the Rouvier’s sulcus. So, it is feasible and beneficial to identify the sulcus and keep the dissection above this level to avoid common bile duct injury and further complication thereof. 

scholarly journals A Successful Model for Laparoscopic Training in Mongolia

2013 ◽  
Vol 97 (4) ◽  
pp. 363-371 ◽  
Author(s):  
Gabriela Vargas ◽  
Raymond R. Price ◽  
Orgoi Sergelen ◽  
Byadran Lkhagvabayar ◽  
Pandaan Batcholuun ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Gallbladder Disease ◽  
Operating Experience ◽  
Medical Community ◽  
Duodenal Injury ◽  
Common Bile Duct Injury ◽  
Successful Model

Abstract The benefits of laparoscopic surgery have not been available to the majority of Mongolians. Mongolian surgical leaders requested assistance in expanding laparoscopy. A capacity-building approach for teaching laparoscopic cholecystectomy throughout Mongolia is reviewed. A laparoscopic cholecystectomy training program was developed. The program included a didactic course and an intensive 2-week practical operating experience. Courses were taught in Ulaanbataar and at 3 of the 4 regional diagnostic referral and treatment centers from 2006 to 2010. During this training period, a total of 303 teaching laparoscopic cholecystectomies were performed. There was one common bile duct injury and one duodenal injury. The conversion rate was 2.0%. This program has been successful in creating a self-sustaining practice of training. The traditional surgical approach to gallbladder disease in Mongolia has been challenged and has, in turn, been a stimulus for improvement in the medical community.

Les représentations des enfants de 5-6 ans sur la fusion et la solidification du sel, comme support pour le déploiement des activités didactiques

2015 ◽  
Vol 6 (3) ◽  
pp. 943-947 ◽  
Author(s):  
Konstantinos Ravanis
Keyword(s):  
Young Children ◽  
Empirical Research ◽  
School Children ◽  
Physical World ◽  
Scientific Model ◽  
Open Type ◽  
Different Types ◽  
Individual Conversations ◽  
Melting And Solidification

The representation of the properties and phenomena of the physical world exists from the beginning of life, as a first datum of reality. In several studies focused on children's representations we find that these representations these representations are critical to education and are often incompatible with the scientific model. This article presents the results of an empirical research on the representations of young children for melting and solidification of salt. The research sample consisted of 79 pre-school children (five to six years old) from one state kindergarten in Greece. Data were collected through expanded, open type, semi-structured individual conversations between a child of the sample and one researcher. The results of the interviews show that these children use different types of representations, the majority dominated by the nature of the substance under study.

Knowledge representation in graph-models of complex technical systems

2020 ◽  
pp. 12-16
Author(s):  
Evgenia R. Muntyan
Keyword(s):  
Analytical Study ◽  
Level Structure ◽  
Graph Models ◽  
Level Data ◽  
Knowledge Formation ◽  
Different Types ◽  
Level Information ◽  
Complex Technical Systems ◽  
Technical Systems ◽  
Structure Of Knowledge

The article analyzes a number of methods of knowledge formation using various graph models, including oriented, undirected graphs with the same type of edges and graphs with multiple and different types of edges. This article shows the possibilities of using graphs to represent a three-level structure of knowledge in the field of complex technical systems modeling. In such a model, at the first level, data is formed in the form of unrelated graph vertices, at the second level – information presented by a related undirected graph, and at the third level – knowledge in the form of a set of graph paths. The proposed interpretation of the structure of knowledge allows to create new opportunities for analytical study of knowledge and information, their properties and relationships.

Analytical Study on Different Types of Tool Traces in Some Ancient Symbols Discovered at Sinca Veche - Temple, Romania

2009 ◽  
Vol 59 (12) ◽  
Author(s):  
Valentin Ghisa ◽  
Ion V. Popescu ◽  
Marius Belc
Keyword(s):  
Analytical Study ◽  
Different Types

In order to characterize and classify the composition of metallic trace sample that were extracted from religious inscriptions of Sinca Veche Temple, several elementary analytical determinations of certain metals were performed by AAS technique to certify their oldness. This study was focused on the composition diversity, especially for the areas in which we try to identify the origins of the tools in the religious representations. Samples were withdrawn artefacts.

Evaluation of Small Wastewater Treatment Plants in the County of Århus – Denmark

1993 ◽  
Vol 28 (10) ◽  
pp. 33-41
Author(s):  
Jes la Cour Jansen ◽  
Bodil Mose Pedersen ◽  
Erik Moldt
Keyword(s):  
Wastewater Treatment ◽  
Constructed Wetlands ◽  
Biological Treatment ◽  
Wastewater Treatment Plants ◽  
Chemical Precipitation ◽  
Common Type ◽  
Treatment Efficiency ◽  
Effluent Quality ◽  
Different Types

Influent and effluent data from about 120 small wastewater treatment plants (100 - 2000 PE) have been collected and processed. Seven different types of plants are represented. The effluent quality and the treatment efficiency have been evaluated. The most common type of plant is mechanical/biological treatment plants. Some of them are nitrifying and some are also extended for chemical precipitation of phosphorus. Constructed wetlands and biological sandfilters are also represented among the small wastewater treatment plants.

scholarly journals A paradigm shift: Adoption of disruptive learning innovations in an ODL environment: The case of the University of South Africa

2015 ◽  
Vol 16 (3) ◽  
Author(s):  
Blessing Mbatha
Keyword(s):  
Paradigm Shift ◽  
Teaching And Learning ◽  
Qualitative Approach ◽  
Transactional Distance ◽  
Focus Group Interviews ◽  
Disruptive Innovations ◽  
Different Types ◽  
Group Interviews ◽  
Axial Coding ◽  
The University

<p class="norm">The aim of this article is to shed some light on patterns of and major motives for the adoption of different types of disruptive learning innovations by Unisa academics. To realise the aim of the study, the following questions were addressed: What are the reasons for adopting disruptive learning innovations? What is the level of interaction with disruptive innovations? What training do Unisa academics require on disruptive innovations? A qualitative approach was adopted by conducting focus group interviews with 76 Unisa academics. The data was analysed using open and axial coding, where dominant themes from the discussions were identified and discussed in detail. The findings show that the interaction of Unisa lecturers with different technologies varied from technology to technology. The study also found that disruptive innovations play a pivotal role in opening avenues and collapsing the transactional distance in an ODL institution. Some lecturers lack skill in using some technology, which is a cause for concern. Therefore, lecturers need to be trained in using technology and develop a good understanding of it to improve teaching and learning.</p>

scholarly journals Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

2005 ◽  
Vol 33 (3) ◽  
pp. 360-363 ◽  
Author(s):  
A Polychronidis ◽  
AK Tsaroucha ◽  
AJ Karayiannakis ◽  
S Perente ◽  
E Efstathiou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Large Bowel ◽  
Thermal Injury ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Hepatic Flexure ◽  
Temporary Ileostomy ◽  
Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

scholarly journals Numerical and Experimental Study of the Impeller of a Liquid Pump of a Truck Cooling System and the Development of a New Open-Type Impeller

2020 ◽  
Vol 14 (2) ◽  
pp. 135-142
Author(s):  
Rishat Salakhov ◽  
Andrey Ermakov ◽  
Elvira Gabdulkhakova
Keyword(s):  
Cooling System ◽  
Cost Effective ◽  
Pump Efficiency ◽  
Numerical Computations ◽  
Open Type ◽  
Maximum Value ◽  
Closed Type ◽  
Ansys Cfx ◽  
Wheel Model ◽  
Liquid Pump

Typically, closed-type impellers are more efficient than open-type impellers, but in the manufacture of closed-type impellers, cost of wheels is higher. This paper describes the development of cost-effective and simple impeller wheel for a fluid pump in the truck cooling system. To perform this task, the numerical computations of a standard impeller wheel were carried out, its characteristics were also obtained from a test bench, the standard impeller wheel model was verified. The open-type impeller wheel was developed according to the current dimensions of standard impeller wheel and then analyzed with the numerical computations by the software ANSYS CFX (Academic license) computational fluid dynamics. The developed open-type impeller wheel works very effectively in spite of performance degradation by 5% in comparison to the closed-type impeller wheel. When working as a part of engine, the pump efficiency is 0.552-0.579. The maximum value of the pump efficiency is 0.579, it can be achieved at the highest speed of the pump (4,548 rpm and 655 l/min).

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