The Lichtenstein open "tension-free" mesh repair of inguinal hernias

All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and thus accounts for an unacceptable number of failures. A total reinforcement of the inguinal floor with a sheet of suitable biomaterial and the employment of a "tension-free" technique is a more effective approach. Since June of 1984, 4,000 primary inguinal hernias have been repaired on an outpatient basis and under local anesthesia at the Lichtenstein Hernia Institute by the open "tension-free" technique using Marlex mesh. The patients were followed from one to 11 years (mean of 5 years) by physician examination. The follow-up rate was 87%. There were four recurrences. The causes of recurrence and how to avoid them are discussed herein. Three of the recurrences occurred at the public tubercle and were caused by placing the mesh in juxtaposition to the tubercle. This error has since been corrected by overlapping the mesh at the public bone. One recurrence was caused by disruption of the lower edge of the mesh from the shelving margin of Poupart's ligament. The error here was the utilization of a patch that was too narrow and therefore under tension. It became apparent that a wider patch, fixed in place with an appropriate degree of taxity, was required.     

The effect of low doses of nakom on the hormonal secretion of the hypothalamo-hypophyseal-adrenal system in patients with infantile cerebral palsy

The levels of hormones of hypothalamo-hypophyseal-adrenal system were measured in 14 10-14 year old children with infantile cerebral paralysis (ICP) with central catecholaminergic motor insufficiency. Contents of adrenocorticotropic hormone (ACTH), hydrocortisone (HC), somatotropic hormone, prolactin (P) were examined before and during Nacome administration (62.5 mg once daily in the morning). 110 patients of the same age with ICP and 18 children with acquired encephalopathy (EP) formed the control group. The elevations of ACTH, HC and P were revealed in spastic forms of ICP. Meanwhile nearly normal hormonal levels were observed in hyperkinetic forms of ICP and EP. The more pronounced effect was noted in "dopamine-dependent" children in which the drug's administration resulted in normalization of clinical and biochemical indices. Hyperkinetic phenomena revealed the connection between the character of neuromotor dyskinesias and the state of hypothalamo-hypophyseal-adrenal axis which is regulated by dopamine. The data obtained show hypofunction of dopaminergic neurotransmitter cerebral systems in patients with ICP that plays important pathogenetic role in development of disease with systemic manifestations.     

Spark Plasma Sintering (SPS) of NASICON Ceramics

Spark plasma sintering (SPS) method was used to obtain dense NASICON ceramics with a high-electrical conductivity, which was compared with conventional solid-state sintering. The fully dense NASICON was achieved at a relatively low-sintering temperature of 1100°C, whereas the apparent density of the specimen prepared by conventional sintering was 74% of the theoretical density. The highest conductivity of 1.8 × 10⁻³ Scm⁻¹ at 25°C, which is comparable to the best value reported, was achieved using the SPS process. Considering the phase, density, and microstructure, it appears that there is more room for improved conductivity by controlling the amount of monoclinic zirconia and the resistive grain-boundary glass phase.     

Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial

BACKGROUND: Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-related groin pain in athletes. METHODS: 68 athletes with long-standing (median 40 weeks) adductor-related groin pain--after examination according to a standardised protocol--were randomly assigned to AT or PT. The treatment period was 8-12 weeks. 4 months after the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome measure was full return to sports at the same level without groin pain. Analyses were by intention to treat. FINDINGS: 23 patients in the AT group and four in the PT group returned to sports without groin pain (odds ratio, multiple-logistic-regression analysis, 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p=0.006) linear trend towards a better effect in the AT group. A per-protocol analysis did not show appreciably different results. INTERPRETATION: AT with a programme aimed at improving strength and coordination of the muscles acting on the pelvis, in particular the adductor muscles, is very effective in the treatment of athletes with long-standing adductor-related groin pain. The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, clinical trials.     

Development of technology for preparing blowing partitions for intermediate ladles

The construction of a multislotted insert is developed for an intermediate ladle partition. Model tests of blowing inserts are performed and their optimum construction is determined. Blowing partitions are prepared and industrial testing is successful under the acid-converter shop working conditions at OAO Magnitogorsk Metallurgical Combine. Blowing partitions with inserts having four rows of channels are recommended for industrial application from the test results. Translated from Novye Ogneupory, No. 8, pp. 16–17, August 2008.     

Domain structure and miscibility studies of blends of styrene–butadiene–styrene block copolymers (SBS) and styrene–glycidyl methacrylate statistical copolymers (PS‐GMA) using SAXS and DMTA

The domain structure and miscibility in the solid state of a series of blends of styrene‐butadiene‐styrene (SBS) block copolymers and styrene‐glycidyl methacrylate (PS‐GMA) statistical copolymers with varying molecular weights and compositions were studied using small angle X‐ray scattering and dynamic mechanical thermal analysis. Depending on the molecular characteristics of each component, different types and degrees of solubilization of PS‐GMA in SBS were found which, in addition to the initially SBS phase morphology, lead to materials with multiphase domain morphologies with differences in size and structure. The degree of solubilization of PS‐GMA into the PS domains of SBS was found to be higher for blends containing PS‐GMA with lower molecular weight (M_w = 18 100 g mol^?1) and lower GMA content (1 wt%) and/or for SBS with higher PS content (39 wt%) and longer PS blocks (M_w = 19 600 g mol^?1). Localized solubilization of PS‐GMA in the middle of PS domains of SBS was found to be the most probable to occur for the systems under study, causing swelling of PS domains. However, uniform solubilization was also observed for SBS/PS‐GMA blends containing SBS with composition in the range of a morphological transition (PS block M_w = 19 600 g mol^?1 and 39 wt% of PS) causing a morphological transition in the SBS copolymer (cylinder to lamella). Copyright © 2006 Crown in the right of Canada. Published by John Wiley & Sons, Ltd     

Profiling care and benchmarking best practice in care of hospitalized elderly: the Geriatric Institutional Assessment Profile

This article reports on a new instrument, the Geriatric Institutional Assessment Profile (GIAP), developed to assess (1) hospital workers' knowledge, attitudes, and perceptions regarding care of geriatric patients, and (2) the perceived adequacy of an institutional environment to serve geriatric patients' needs. Findings are reported from 303 questionnaires completed by health care employees from a 658-bed academic medical center. Internal consistency estimates were consistently high for the various components of the GIAP. Factor analysis was performed to examine underlying dimensions of knowledge and institutional environment. The GIAP has the potential to narrow the gap between actual and best practice in geriatric care by identifying staff information needs and concerns, as well as institutional barriers and facilitators to providing quality geriatric hospital care.     

Study of curing of UG-2D dieneurethane sealant

The results of studying the curing of oligodieneurethanes are reported. The kinetics of the initial stage of curing was studied by the IR spectroscopy and viscometry. It is shown that the rate constant of isocyanate-amine reaction is considerably dependent on the type of base oligomer. The results of measuring the mechanical properties of the elastomer produced are given. Variations in the content of gel fraction and degree of polymer swelling in the course of curing are investigated. It is found that sealants obtained from peroxide and anionic oligobutadienes are characterized by reduced strength properties. Some dispersion of mechanical characteristics is observed for each batch of the materials tested, which is related to the variable composition of a curing agent, an eutectic mixture of some chloramines. The results obtained make it possible to optimize the characteristics of the dieneurethane sealant at a rather high level according to the consumer’s requirements.