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.
Most vegetation’s are Land cover (LC) for the globe, and there is an increased attention to plants since they represent an element of balance to natural ecology and maintain the natural balance of rapid changes due to systematic and random human uses, including the subject of the current study (Bassia eriophora ) Which represent an essential part of the United Nations system for land cover classification (LCCS), developed by the World Food Organization (FAO) and the world Organization for environmental program (UNEP), to observe basic environmental elements with modern techniques. Although this plant is distributed all over Iraq, we found that this plant exists primarily in the middle
... Show MoreAn experimental and numerical study has been carried out to investigate the heat transfer by natural convection and radiation in a two dimensional annulus enclosure filled with porous media (glass beads) between two horizontal concentric cylinders. The outer cylinders are of (100, 82 and70mm) outside diameters and the inner cylinder of 27 mm outside diameter with (or without) annular fins attached to it. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at a low temperature inside a freezer. The experiments were carried out for an annulus filled with
glass beads at a range of modified Rayleigh number (4.9 ≤ Ra≤ 69), radiation
The Frequency-hopping Spread Spectrum (FHSS) systems and techniques are using in military and civilianradar recently and in the communication system for securing the information on wireless communications link channels, for example in the Wi-Fi 8.02.X IEEE using multiple number bandwidth and frequencies in the wireless channel in order to hopping on them for increasing the security level during the broadcast, but nowadays FHSS problem, which is, any Smart Software Defined Radio (S-SDR) can easily detect a wireless signal at the transmitter and the receiver for the hopping sequence in both of these, then duplicate this sequence in order to hack the signal on both transmitter and receiver messages using the order of the se
... Show MoreLaser scanning has become a popular technique for the acquisition of digital models in the field of cultural heritage conservation and restoration nowadays. Many archaeological sites were lost, damaged, or faded, rather than being passed on to future generations due to many natural or human risks. It is still a challenge to accurately produce the digital and physical model of the missing regions or parts of our cultural heritage objects and restore damaged artefacts. The typical manual restoration can become a tedious and error-prone process; also can cause secondary damage to the relics. Therefore, in this paper, the automatic digital application process of 3D laser modelling of arte
Despite extensive investigations, an effective treatment for sepsis remains elusive and a better understanding of the inflammatory response to infection is required to identify potential new targets for therapy. In this study we have used RNAi technology to show, for the first time, that the inducible lysophosphatidylcholine acyltransferase 2 (LPCAT2) plays a key role in macrophage inflammatory gene expression in response to stimulation with bacterial ligands. Using siRNA- or shRNA-mediated knockdown, we demonstrate that, in contrast to the constitutive LPCAT1, LPCAT2 is required for macrophage cytokine gene expression and release in response to TLR4 and TLR2 ligand stimulation but not for TLR-independent stimuli. In addition, cells transfe
... Show MoreActivation of farnesoid X receptor (FXR) markedly attenuates development of atherosclerosis in animal models. However, the underlying mechanism is not well elucidated. Here, we show that the FXR agonist, obeticholic acid (OCA), increases fecal cholesterol excretion and macrophage reverse cholesterol transport (RCT) dependent on activation of hepatic FXR. OCA does not increase biliary cholesterol secretion, but inhibits intestinal cholesterol absorption. OCA markedly inhibits hepatic cholesterol 7α‐hydroxylase (
Online service is used to be as Pay-Per-Use in Cloud computing. Service user need not be in a long time contract with cloud service providers. Service level agreements (SLAs) are understandings marked between a cloud service providers and others, for example, a service user, intermediary operator, or observing operators. Since cloud computing is an ongoing technology giving numerous services to basic business applications and adaptable systems to manage online agreements are significant. SLA maintains the quality-of-service to the cloud user. If service provider fails to maintain the required service SLA is considered to be SLA violated. The main aim is to minimize the SLA violations for maintain the QoS of their cloud users. In this res
... Show MoreAccurate prediction and optimization of morphological traits in Roselle are essential for enhancing crop productivity and adaptability to diverse environments. In the present study, a machine learning framework was developed using Random Forest and Multi-layer Perceptron algorithms to model and predict key morphological traits, branch number, growth period, boll number, and seed number per plant, based on genotype and planting date. The dataset was generated from a field experiment involving ten Roselle genotypes and five planting dates. Both RF and MLP exhibited robust predictive capabilities; however, RF (R² = 0.84) demonstrated superior performance compared to MLP (R² = 0.80), underscoring its efficacy in capturing the nonlinear genoty
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