scholarly journals Clinical Application of a Modified Local Transposition Flap Surgery in Repairing Fingertip Defects

2021 ◽  
Author(s):  
YingKai Zhang ◽  
Yao Wang ◽  
Rongbo Wu ◽  
Jiaqi Zhou ◽  
Mingdong Zhao
Keyword(s):  
Work Performance ◽  
Hand Function ◽  
Operation Time ◽  
Mean Value ◽  
Active Movement ◽  
Flap Surgery ◽  
Transposition Flap ◽  
Transfer Distance ◽  
Healthy Side ◽  
Qualification Rate

Abstract Purpose: A modified local transposition flap surgery was performed for fingertip injuries. Given the shape of the flap turnover resembling a parallelogram, we called it a parallelogram flap. This transposition flap surgery allows a more significant transfer distance with good outcomes.Method: The study collected patients who underwent parallelogram transposition flaps to repair fingertip defects from 2017 to 2020. 32 cases (32 fingers) were included in our study, including 20 males and 12 females, aged 17 to 60 years, with an average age of 36 years. The causes of injury were crush injury in 13 cases, punch injury in 11 cases and sharp cutting injury in 8 cases. There were 6 cases in thumbs, 6 cases in index fingers, 14 cases in middle fingers, 4 cases in ring fingers and 2 cases in little fingers. The area of fingertip defects was 1.2 cm × 2~3 cm × 4 cm, with bone exposure. The interval between the injury and operation was 5.78 h (the mean value was 4.7-8.4 h). All operations were performed by one surgical team, and the average operation time was 31.2 min.Record The length and width of the finger，two-point discrimination（2PD），Total Active Movement (TAM)and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.Results: all our parallelogram flaps had survived postoperatively.，At last follow-up,There was no difference between the length and width of the reconstructed finger and that of the healthy side（P>0.05）. The qualification rate of the static 2PD of the flaps were 84.37% .The qualification rate of the TAM of injured figures were 100% . Evaluation of the MHQ subscale performance showed that the score of the overall hand function is 93.71, activities of daily living is 95.22, work performance is 94.23,pain score is 4.34 , aesthetics is 92.15 and satisfaction score is 92.45.All of these were perform well.Conclusion: This transposition flap surgery allows a more significant transfer distance with good outcomes.

scholarly journals Clinical Application of a Modified Local Transposition Flap Surgery in Repairing Fingertip Defects

2021 ◽  
Author(s):  
Yingkai Zhang ◽  
Yao Wang ◽  
Rongbo Wu ◽  
Jiaqi Zhou
Keyword(s):  
Work Performance ◽  
Hand Function ◽  
Operation Time ◽  
Mean Value ◽  
Active Movement ◽  
Flap Surgery ◽  
Transposition Flap ◽  
Group A ◽  
Group B

Abstract Background: A modified local transposition flap surgery was performed for fingertip injuries, which allows a more significant transfer distance with good outcomes.Methods: The study collected patients who underwent parallelogram transposition flaps and V-Y flaps to repair fingertip defects from 2017 to 2020. 122 cases (122 fingers) were included in our study, The interval between the injury and operation was 5.78 h (the mean value was 4.7-8.4 h). All operations were performed by one surgical team, and the average operation time was 31.2 min.Record the operation time，two-point discrimination（2PD），Total Active Movement (TAM)and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.Results: All parallelogram （Group A）and V-Y flaps （Group B）had survived postoperatively. There was no difference with operative duration and follow-up time in two groups. At last follow-up, there was no difference with the 2PD of the palmar part of the flaps and the TAM of injured figures in Group A and Group B . The MHQ summary scores in Group A were much higher than in Group B . Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences, but aesthetics and satisfaction score was higher in Group A .Conclusions: The reconstruction using parallelogram flaps is a easier and more versatile treatment with better functions, less morbidity and better aesthetics. This method is a better choice for reconstruction of fingertip injury.

scholarly journals Preliminary Research on a Comparison and Evaluation of FY-4A LMI and ADTD Data through a Moving Amplification Matching Algorithm

2020 ◽  
Vol 13 (1) ◽  
pp. 11
Author(s):  
Pengfei Li ◽  
Guofu Zhai ◽  
Wenjing Pang ◽  
Wen Hui ◽  
Wenjuan Zhang ◽  
...  
Keyword(s):  
Detection Efficiency ◽  
Spherical Surface ◽  
Operation Time ◽  
Mean Value ◽  
China Meteorological Administration ◽  
Matching Algorithm ◽  
Lightning Detection ◽  
Spatial Differences ◽  
System Data ◽  
Spatial Threshold

In this study, a new moving amplification matching algorithm was proposed, and then the temporal and spatial differences and correlation were analysed and evaluated by comparing the FengYun-4A Lightning Mapping Imager (FY-4A LMI) data and the China Meteorological Administration Lightning Detection Network Advanced TOA and Direction (CMA-LDN ADTD) system data of southwest China in July 2018. The results are as follows. Firstly, the new moving amplification matching algorithm could effectively reduce the number of invalid operations and save the operation time in comparison to the conventional ergodic algorithms. Secondly, LMI has less detection efficiency during the daytime, using ADTD as a reference. The lightning number detected by ADTD increased from 5:00 AM UTC (13:00 PM BJT, Beijing Time) and almost lasted for a whole day. Thirdly, the trends of lightning data change of LMI and ADTD were the same as the whole. The average daily lightning matching rate of the LMI in July was 63.23%. The average hourly lightning matching rate of the LMI in July was 75.08%. Lastly, the mean value of the spherical surface distance in the matched array was 35.49 km, and roughly 80% of the matched distance was within 57 km, indicating that the spatial threshold limit was relatively stable. The correlation between LMI lightning radiation intensity and ADTD lighting current intensity was low.

Review of recent developments on improvement of estimated regulatory documentation for road works

2021 ◽  
Vol 2021 (23) ◽  
pp. 31-42
Author(s):  
Anatolii Tsynka ◽  
◽  
Andrii Hrinchuk ◽  
Ivan Rakovych ◽  
◽  
...  
Keyword(s):  
Work Performance ◽  
New Technologies ◽  
Operation Time ◽  
Road Construction ◽  
Labor Costs ◽  
The Road ◽  
Regulatory Documents ◽  
Road Work ◽  
Investment Process ◽  
The Cost

Introduction. In the modern conditions of the pricing system in the construction of Ukraine, the key value have the estimated norms, which are presented in separate collections, the main purpose of which is to determine the standard quantity of resources required to perform a particular type of work as a basis for the transition to the cost indicators. In order to determine the cost of road work objectively and accurately, it is essential that the indicators of estimated norms meet the requirements of regulatory documents and modern methods of execution of road works.Problematics. In connection with the active improvement of the regulatory base of the road construction industry, permanent upgrade of road organizations technique fleet, the introduction of new technologies and materials in construction and operation of roads, improving the methods of work there is a discrepancy between the existing resource element of estimated norms and the actual conditions of work in terms of built-up labor costs, the operation time of machines and mechanisms and the range of materials. Accordingly, it affects the reliability and accuracy of determining the cost of road works.Purpose. Improvement and harmonization with actual working conditions and requirements of regulatory documents of industry regulatory and estimate base of resource elementary estimated norms for work performed during construction, reconstruction, repair and operational maintenance of roads and bridges to ensure reliable and valid technical, economic and estimated calculations.Materials and methods. During work performance the analysis of the regulatory documentation, establishing the requirements to the technology of road works and materials has been carried out. A number of chronometric observations with the measurement of time of road works in full-scale conditions was carried out. The obtained data were summarized, averaged and on their basis the indicators of the resource element of the estimated norms were estimated.Results. A review of the main amendments and additions, which came into force after the approval of Amendment No 2 SOU 42.1-37641918-035:2018 [1] and Amendment No 2 SOU 42.1-37641918-071:2018 [2], which were developed to improve the regulatory-estimate base for the calculation of road works, taking into account the requirements and provisions of existing regulatory documents taking into account the current state of scientific and technological progress in the road sector.Conclusions. The above analysis of the amendments that came into force with the approval of [1]. and [2] will systematize the innovations provided by the requirements of current regulatory documents on the calculation of the cost of road works and the development of relevant documents at all stages of the investment process, planning and organization of road works, as well as the writing-off of material resources. Review and systematization of recent improvements in the estimated regulatory documents for road works will provide an opportunity to optimally plan the use of available material, labor and financial resources, often limited.Keywords: public road, operational maintenance, investment documentation, overhaul and current repairs, machine, mechanism, regulatory document, resource element estimate norm, Standard of Organization of Ukraine.

Oculoplastic Surgery with a Contact Nd:YAG Laser Silica Scalpel. A Case Report

1995 ◽  
Vol 5 (3) ◽  
pp. 160-167
Author(s):  
F. Fankhauser ◽  
J.-M. Piffaretti ◽  
P.-D. Henchoz ◽  
C. England ◽  
S. Kwasniewska ◽  
...  
Keyword(s):  
Wound Healing ◽  
Operation Time ◽  
Postoperative Hemorrhage ◽  
The Other ◽  
Flap Surgery ◽  
Pedicle Flap ◽  
Wound Healing Response ◽  
Laser Scalpel ◽  
Contact Nd:Yag Laser ◽  
Oculoplastic Surgery

Baso-cellular carcinomas involving the medial canthal regions of both eyes were resected using a 10 W cw-Nd: YAG laser scalpel. The wound bed was repaired one side by a free, split-thickness graft and on the other by a frontal pedicle flap. Surgery was, for the most part, virtually bloodless. Since laser radiation immediately seals both capillaries and lymphatics, the incidence of postoperative hemorrhage and edema was significantly less than after cold scalpel surgery. Healing was uneventful. The advantages of laser-assisted surgery are worthy of consideration: not only is the operation time markedly curtailed, but the wound healing response is excellent, with only a minimal inflammatory reaction.

scholarly journals Adsorption capacity of GAC pilot filter-adsorber and postfilter- adsorber for individual THMs from drinking water, Athens

2013 ◽  
Vol 13 (1) ◽  
pp. 50-58
Keyword(s):  
Drinking Water ◽  
Adsorption Capacity ◽  
Operation Time ◽  
Freundlich Isotherm ◽  
Physicochemical Characteristics ◽  
Mean Value ◽  
Laboratory Animals ◽  
Residual Chlorine ◽  
Uniformity Coefficient ◽  
Regular Sampling

Trihalomethanes are a major class of chlorination by-products in drinking water. They are formed when chlorine reacts with bromide (Br-) and natural organic matter (NOM) in source waters. Toxicology studies have shown all THMs to be carcinogenic or to cause adverse reproductive or developmental effects in laboratory animals. THMs are small volatile molecules, which are hydrophobic, non biodegradable and adsorbable on granular activated carbon (GAC). The objective of this pilot study is to evaluate the adsorption capacity for individual THMs of a GAC filter-adsorber (A) and a GAC postfilter-adsorber (B), both fed with chlorinated natural water. For this purpose, a GAC pilot plant was operated as a filter-adsorber and a postfilter-adsorber in Galatsi WTP, Athens (GTP) until the removal of individual THMs by GAC was eliminated (breakthrough). Regular sampling was performed during operation and the parameters measured were: THMs, DOC, free residual chlorine, bromide, turbidity, pH and temperature. From the experimental data, GAC bed life, GAC usage rate, GAC loading and operation time to breakthrough were calculated for most THMs. TBM was almost not detected. Some desorption of THMs, especially TCM and BDCM, was noticed during the operation of both adsorbers. Near breakthrough for THMs, equilibrium between adsorbed and dissolved THMs was considered to have been established. The GAC equilibrium loading of individual THMs was assumed to depend on the mean value of their influent concentration, which was not constant. By correlating the equilibrium data by linear regression to conform to the Freundlich isotherm, the Freundlich constants 1/n and k were determined for each of THMs. They are related to the physicochemical characteristics and background organics of water and the specific GAC used. The strength of the adsorption bond and the GAC capacity was higher for DBCM, lower for BDCM and even lower for TCM for both adsorbers. In addition, the GAC(B) capacity for BDCM and DBCM was higher than that of GAC(A), probably due to larger surface area and surface chemistry of GAC(B). Also, the lower particle size and the higher uniformity coefficient of GAC(B), along with the lower flow rate may have attributed to that by enhancing GAC equilibration. However, TCM was less adsorbed by GAC(B), probably due to the stronger competition effect by BDCM and DBCM, being in much higher mean influent concentration. The DOC content of influent water seems also to reduce significantly the adsorption of THMs (especially of TCM), as the comparison of our results with the isotherm results with distilleddeionized water by other researchers showed.

Helicopter Landing Ship: Undercarriage Strength and the Role of the Human Factor

2009 ◽  
Vol 132 (1) ◽  
Author(s):  
E. Suhir
Keyword(s):  
Human Factor ◽  
Operation Time ◽  
Extreme Value Distribution ◽  
Mean Value ◽  
Helicopter Landing ◽  
The Times ◽  
The Moment ◽  
Normal Law ◽  
Time Required

We address, using probabilistic modeling and the extreme-value-distribution technique, the helicopter undercarriage strength in a helicopter-landing-ship situation. Our analysis contains an attempt to quantify, on the probabilistic basis, the role of the human factor in the situation in question. This factor is important from the standpoint of the operation time that affects the likelihood of safe landing during the lull period in the sea condition. The operation time includes (1) the time required for the officer-on-ship-board and the helicopter pilot to make their go-ahead decisions and (2) the time of actual landing. It is assumed, for the sake of simplicity, that both these times could be approximated by Rayleigh’s law, while the lull duration follows the normal law with a high enough ratio of the mean value to the standard deviation. Safe landing could be expected if the probability that it occurs during the lull time is sufficiently high. The probability that the helicopter undercarriage strength is not compromised can be evaluated as a product of the probability that landing indeed occurs during the lull time and the probability that the relative velocity of the helicopter undercarriage with respect to the ship’s deck at the moment of encounter does not exceed the allowable level. This level is supposed to be determined for the helicopter-landing-ground situation. The developed model can be used when developing specifications for the undercarriage strength, as well as guidelines for personnel training. Particularly, the model can be of help when establishing the times to be met by the two humans involved to make their go-ahead decisions for landing and to actually land the helicopter. Plenty of additional risk analyses (associated with the need to quantify various underlying uncertainties) and human psychology related efforts will be needed, of course, to make such guidelines practical.

Outcomes of infants undergoing laparoscopic pyeloplasty: A single-center experience

2018 ◽  
Vol 86 (1) ◽  
pp. 27-31 ◽  
Author(s):  
İbrahim Erol ◽  
Kaan Karamık ◽  
Mahmut Ekrem İslamoğlu ◽  
Mutlu Ateş ◽  
Murat Savaş
Keyword(s):  
Operation Time ◽  
Significant Degree ◽  
Stent Migration ◽  
Mean Value ◽  
Laparoscopic Pyeloplasty ◽  
Mean Values ◽  
Single Center Experience ◽  
The Mean ◽  
Split Function

Purpose: The aim of this study was to evaluate the outcomes of laparoscopic pyeloplasty in children less than 12 months of age. Materials and methods: The records of 20 infants, who had pelviureteric junction obstruction and subsequently underwent LP from January 2013 to November 2016 with at least 1 year of follow-up, were retrospectively reviewed. Patients demographics, the results of preoperative and postoperative imaging studies, perioperative details, complications, and results were noted. Results: The mean age of 20 infants was 4.75 months. The gender of cases was 5 females (25%) and 15 males (75%). Of that, 13 (65%) laparoscopic pyeloplasties were in left side and 7 (35%) were in right side. No cases needed open conversation. Aberrant crossing vessel was observed in three patients (15%). The mean operation time was 79.35 min (45–128 min). The mean hospital stay was 2.9 ± 0.308 days (2–3 days). There were complications in three children (15%); two patients developed stent migration and one child had fever over 38°. Three children with complications did not require a second intervention. In one child, the kidney was non-functioning in follow-up and nephrectomy was performed. The anteroposterior diameter significantly reduced. Preoperative mean value was 24.305 ± 5.6157 and postoperative mean value was 15.40 ± 6.030 (p = 0.000, p < 0.05). There was a significant degree of improvement in renal split function for all patients. Preoperative mean values were 45.53 ± 11.512, while postoperative values were 47.850 ± 13.347 (p = 0.029, p < 0.05). Conclusion: Although there are doubts about the reliability and efficacy of results for pyeloplasty in children less 12 months, many studies including this study show that laparoscopic pyeloplasty is an effective and reliable method for infants.

Reliability of Various Predictors for Preoperative Diagnosis of Infraclavicular Brachial Plexus Lesions with Shoulder and/or Elbow Paresis

2020 ◽  
Vol 36 (06) ◽  
pp. 445-449
Author(s):  
Shan Shan Qiu ◽  
Tommy Nai-Jen Chang ◽  
Johnny Chuieng-Yi Lu ◽  
David Chwei-Chin Chuang
Keyword(s):  
Brachial Plexus ◽  
Odds Ratio ◽  
Preoperative Diagnosis ◽  
Nerve Conduction Velocity ◽  
Postoperative Morbidity ◽  
Hand Function ◽  
Operation Time ◽  
Pectoralis Major ◽  
Scapular Fracture ◽  
Preoperative Predictors

Abstract Background The distinction between supraclavicular and infraclavicular acute brachial plexus injuries (BPIs) could be challenging in cases of combined shoulder and elbow paresis. The reliability of several preoperative predictors was investigated to avoid unnecessary dissection, prolonged operation time, increased postoperative morbidity, and long scars. Methods Between 2004 and 2013, 75 patients, who sustained acute BPI and presented with motor paresis of shoulder and elbow with preservation of hand function, were included and studied retrospectively. Various predictors including muscles function, sensation, fractures, Tinel's sign and nerve conduction velocity (NCV) studies were reviewed. Results The highest odds ratio (OR) values for infraclavicular BPI were healthy clavicular head of pectoralis major and biceps, presenting with OR = 36.5 and 31.76, respectively, which were identified the most important predictors. Conclusion A combination of functioning pectoralis major or biceps, scapular fracture, an infraclavicular Tinel's sign, and normal NCV in the musculocutaneous nerve was highly predictive of an infraclavicular level.

scholarly journals Surgical Treatment of Sacrococcygeal Pilonidal Sinus with a Leaf Flap

2021 ◽  
Vol 17 (2) ◽  
pp. 102-107
Author(s):  
Jun Hyun Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Han Gyu Cha
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Complication Rates ◽  
Flap Surgery ◽  
Easy Method ◽  
Transposition Flap ◽  
Young Males ◽  
Minimal Incision ◽  
Flap Procedure ◽  
Time Required

Background: Pilonidal sinus, occurring in 7% of the population, is a disease found in the cleavage of the buttocks, typically in young males after puberty. This study explored the utility of the leaf flap, a unilobed fasciocutaneous transposition flap, as a reconstructive method for treating pilonidal sinus on the sacrococcygeal area.Methods: We present cases of eight patients with pilonidal sinus who underwent unilobed fasciocutaneous transposition flap surgery. Patients complaining of an abscess in the sacrococcygeal region were initially treated with a minimal incision to drain the abscess, and 14 days of antibiotics administration. Afterwards, the patients were re-evaluated at the outpatient clinic and scheduled for a leaf flap procedure 4 weeks after drainage. Hospitalization, the time required for full activity, and complication rates were recorded.Results: Minor postoperative complications were observed in one patient (12.5%). The patient required re-suturing of his wound due to an infection and wound dehiscence. The mean hospitalization was 10 days (range, 5–23 days), and the period required to return to daily activities was 4 weeks.Conclusion: The leaf flap procedure is recommended because it is a relatively easy method for surgeons, and also because the flap has abundant perfusion. This surgical method was used as the first treatment of choice for sacrococcygeal pilonidal sinus, with the advantages of less patient discomfort, fast healing of the site and short hospitalization. Our results support the leaf flap surgery as a favored treatment for pilonidal sinus.

scholarly journals Development of an Operation Skill-Training Simulator for Double-Front Construction Machinery – Training Effect for a House Demolition Work –

2008 ◽  
Vol 20 (4) ◽  
pp. 602-609 ◽  
Author(s):  
Mitsuhiro Kamezaki ◽  
◽  
Hiroyasu Iwata ◽  
Shigeki Sugano ◽  
Keyword(s):  
Work Performance ◽  
Skill Training ◽  
Operation Time ◽  
Building Construction ◽  
Training Simulator ◽  
Positioning Accuracy ◽  
Construction Machinery ◽  
Construction Tasks ◽  
High Level ◽  
Repeated Training

This paper reports a newly developed simulator for operation skill training in Double-Front Construction Machinery (DFCM) that allows novices to virtually experience tough operations repeatedly using DFCM under various conditions, including dangerous congestion. First, we selected several situations targeted where the DFCM needs to be used to provide a high level of operation skills: sorted dismantling for recycling and reusing resources, rescue and recovery work in disaster areas, and building construction. In addition, we developed an operation skill-training simulator that enables novice operators to repeatedly train with the high level of operation skills needed to easily and safely handle the DFCM in even more complicated works. This simulator system has two joysticks (set in front of a monitor) to dependently control the two fronts of the animated DFCM on the monitor. Several modes involving basic construction tasks are provided and the effects of improvement in operability achieved by the training simulator can be verified. Evaluation experiments indicated that repeated training using the simulator successfully decreased the operation time to complete a task and enhanced positioning accuracy in cooperative transportation with the two fronts. The results confirm the effectiveness of the developed simulator. Futhermore, it was confirmed that informational or operational support based on knowledge provided from experiment results enabled work performance greatly improved.

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