P023 MANAGEMENT OF MASSIVE INCISIONAL HERNIA WITH LOSS OF DOMAIN

Aim Large incisional hernia treatment is challenging for surgeons especially when there is loss of domain. Its management require an appropiate preoperative optimization of the patient. We present a complex case that provides an exhaustive review of different measures in order to treat this type of hernias. Material and Methods A 61-year-old, smoker and diabetic patient consulted because of a large ventral hernia. He underwent an umbilical hernia surgery which recurred three more times. The patient had a M1-M5 W3 hernia with active suppuration through fistulous orifices. The abdominal wall planning CT scan showed a large eventration with 23 cm of transverse defect diameter and a Tanaka index of 92%. Results The patient received support to quit smoking and he lost weight due to an intragastric balloon. Botulinum toxin was administered six weeks before surgical intervention. An andominal pneumeperitoneum catheter was placed, reaching 12.400 liters of ambient air insufflated during 13 days. Finally, surgery was performed, finding a 27 x 35 cm wall defect that required the performance of: After these maneuvers, the posterior abdominal wall could be completely closed. A double preperitoneal mesh (BioA and polypropylene) was placed. After 16 days, he was discharged without mayor complications. Conclusions Loss of domain hernias are a complex entity which requires a multidisciplinary approach and abdominal wall experienced surgeons since it may require extreme measures.

Detection of Transverse Defects in Rails Using Noncontact Laser Ultrasound

Rail inspections are required and used to ensure safety and preserve the availability of railway infrastructure. According to the statistics published by railroad administrations worldwide, the transverse fissure appearing in railhead is the principal cause of rail accidents. These particular defects are initiated inside the railhead. Detection of these cracks has always been challenging because a defect signature remains mostly small until the defect size reaches a significant value. The present work deals with the theoretical analysis of an integrated contact-less system for rail diagnosis, which is based on ultrasounds. The generation of these waves was performed through non-ablative laser sources. Rotational laser vibrometry was used to achieve the reception of the echoes. Detection of flaws in the rail was monitored by considering special ultrasound wave signal based indicators. Finite element modeling of the rail system was performed, and transverse defect detection of the rail was analyzed.

Crack identification using piezoelectric testing on carbon steel pipe for transverse, longitudinal and hole defects with low excitation frequency

AC excitation signal is most widely used in Non Destructed Testing (NDT) devices for Piezoelectric Technique (PZT) method in an inspec-tion. This paper is presenting the application of piezoelectric with end to end method for defect identification for Carbon Steel Pipe (CSP) where the frequency is used around 1kHz until 6kHz for standard pipe, transverse defect pipe, longitudinal defect pipe and hole defect pipe. From here, the identification of defect signal by based on the signal pick value and different pick signal between ordinary pipe (without defect) and defects pipe are analysis. The result shows that the standard pipe will give the high amplitude of signal compare the defect pipe by based on the type of defect, size of defect and depth of defect. Findings from the comparative study, validate the application of piezoelec-tric show that the different amplitude of the signal is directly proportional with excitation signal frequency and through the experiment, the longitudinal defect is contributed the different high signal until 79.7% compared to the hole and transverse defect 74.4 %.

Macular Electroretinography and Methods of Retina Visualization in Diagnostics of Standard Stargardt Disease, Verified by Molecular Genetic Methods

The aim of the study was to assess the data concerning the modern methods of retina visualization (optical coherence tomography and autofluorescence) and its interrelation with the data concerning the modern elec-troretinographic methods for research of Stargardt desease, verified with the help of molecular genetic methods. It was found that the shift of macular electroretinogramm to the red stimulus correlates with the parameters of optic coherent tomography: inverse high correlation between the "transverse defect" and a-wave amplitude of macular electroretinogramm (r=-0,83, p<0,01), thus indicating interconnection between lowering of photoreceptor function and structural changes of junction between outer and inner photoreceptor segments. Correlation between the "transverse defect" and b-wave amplitude of macular electroretinogramm (r=-0,37, p<0,01) proves the existence of interrelation between electrogenesis of middle retina layers (bipolar cells) in fovea and biometrical markers of structural changes in photoreceptors caused by Stargardt desease. The hallmarks of Stargardt desease, revealed by the optical coherence tomography, are the hyperreflective spots, localized in retinal pigment epithelium and reaching the outer nuclear layer, together with the damaged interface line of the outer and inner photoreceptors segments. Autofluoresence caused by Stargardt desease demonstrates combination of hypofluorescence in fovea with hypofluorescence in the posterior pole. For the first time the following etiologic mutations of ABCA4 gene, associated with Stargardt desease were revealed in Russian population: rsl800553 (Glyl961Glu), rs61752418 (Aspl093Gly), rs61751374 (Alal038Val), rs201471607 (Asn965Ser), rsl801581 (Arg943Gln), rs75197161 (Gly863Ala delG863), rs76157638 (Arg653Cys) и rs61751392 (Leu541Pro) ABCA4.