Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mean=27.3years), with previous vascular surgery (reversed saphenous vein grafting) for sub-inguinal penetrating injuries complicated with infection and bleeding were admitted and managed surgically in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City Teaching Complex, Baghdad. These patients were studied retrospectively regarding their demographic and clinical features as well as details of the operative procedures and surgical outcome.
All patients received emergency wound debridement, arterial ligation and extra-anatomic synthetic (PTFE) bypass grafts (External iliac or common femoral to distal superficial femoral or popliteal artery, six routed laterally and four routed medially in the thigh away from the original surgical field).
Results: Excellent results were obtained in nine patients who saved amputation while one patient ended with above knee amputation. No mortality recorded.
Conclusion: Extra-anatomic bypass is a useful approach in dealing with infected and disrupted vascular anastomosis and can be used in emergency as well as elective situations as mentioned in most literatures.
In the last two decades, networks had been changed according to the rapid changing in its requirements. The current Data Center Networks have large number of hosts (tens or thousands) with special needs of bandwidth as the cloud network and the multimedia content computing is increased. The conventional Data Center Networks (DCNs) are highlighted by the increased number of users and bandwidth requirements which in turn have many implementation limitations. The current networking devices with its control and forwarding planes coupling result in network architectures are not suitable for dynamic computing and storage needs. Software Defined networking (SDN) is introduced to change this notion of traditional networks by decoupling control and
... Show MoreBackground: Significant advancements have been observed in the additive manufacturing (AM) technology industry in recent decades. Due to the inherent variations among each AM manufacturing technique, new areas of investigation continually arise and require consideration. Additionally, the novel applications of additive manufacturing present new difficulties and possibilities for targeted focus. The aim of this manuscript is to conduct a comprehensive literature review that describes the various processing methods, precision levels, types of materials utilized, and potential applications of 3D printing technology in the field of dentistry. Data: An online search was conducted on databases including Research Gate, Google Scholar, and
... Show MoreThe Immanence in S. Abdu; Saboor Poetry
تعد مجالات الصورة وعلاماتها الحركية حضوراً دلالياً للاتصال العلامي واتساعاً في الرابطة الجدلية ما بين الدوال ومداليها، التي تقوم بها الرؤية الاخراجية لإنتاج دلالات اخفائية تمتلك جوهرها الانتقالي عبر الافكار بوصفها معطيات العرض، ويسعى التشفير الصوري الى بث ثنائية المعنى داخل الحقول المتعددة للعرض المسرحي، ولفهم المعنى المنبثق من هذه التشفيرات البصرية، تولدت الحاجة لبحث تشكيل هذه التشفيرات وكيفية تح
... Show MoreBackground: The transcriptional control of various cell types, especially in the development or functioning of immune system cells involved in either promoting or inhibiting the immune response against cancer, is significantly influenced by DNA or RNA methylation. Multifaceted interconnections exist between immunological or cancer cell populations in the tumor's microenvironment (TME). TME alters the fluctuating DNA (as well as RNA) methylation sequences in these immunological cells to change their development into pro- or anti-cancer cell categories (such as T cells, which are regulatory, for instance). Objective: This review highlights the impact of DNA and RNA methylation on myeloid and lymphoid cells, unraveling their intricate
... Show MoreThe question of motherhood seems to haunt the works of Kate Chopin, a
nineteenth century American writer. Though a mother-woman herself, Chopin
gives a paradoxical portrait of motherhood in her works. She implies that
motherhood might be a liberating experience for some women as it is constricting
for others. This paper tackles the paradoxical nature of motherhood in Chopin's
novel, The Awakening and other four short stories. In The Awakening, A Pair of
Silk Stockings and Desiree's Baby, motherhood is depicted as a tool of selfdestruction,
while in Athénaise and Regret, it is a source of life-giving.
Many drilling problems (lost circulation, hurdle in running casing, poor cement jobs, high torque and drag and the necessity of re-drilling and, mechanical stuck caused by cutting accumulation in the wellbore) can be avoided by good hole cleaning during drilling operation especially in directional wells.
In this experimental work, the cutting transport ratio (CTR) in hole inclined (60 degree) from vertical was estimated by using three values of drilling mud viscosities, three annular velocities, two types of cuttings size and two rotation speed of inner pipe (RPM). Note that the rig consisted from PVC outer casing 4 1/2 inch as OD diameter and inner dri