Duhamel operation for children with distal colonic dysmotility

Abstract

Purpose

To report outcomes of children with constipation refractory to medical management and manometrically proven distal colonic dysmotility, managed with rectosigmoidectomy followed by Duhamel operation (Duhamel).

Methods

Children who underwent a Duhamel from 2009 onwards for intractable constipation and left colonic dysmotility were retrospectively reviewed. The primary end point was resolution of constipation, and secondary end point was postoperative complications. Continuous data were median (range).

Results

11 patients (4 males) had Duhamel at 11 years (5–16) with constipation started from 2 years (1–8). Hirschsprung's disease was excluded. All Duhamels were performed with a covering ileostomy: 9 following a Hartmann procedure, one following a previously failed reversal of Hartmann, and one Duhamel performed with a pre-existing ileostomy. All ileostomies were subsequently closed. Median resection length was 22 cm (11–31). Length of stay was 8 days (5–23). Follow-up was 5 years (0.5–7). Age at final review was 15 years (10–18). Resolution of constipation occurred in nine patients (4 required antegrade continence enemas (ACE), 5 with laxative); two had persistent constipation and faecal incontinence despite ACE, ultimately requiring an ileostomy. Two postoperative small bowel obstructions required laparotomy.

Conclusion

Duhamel performed in children with manometrically proven distal colonic dysmotility yielded 82% resolution of refractory constipation; half of them subsequently needed ACE.

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Electronic structure and optical properties of iron based chalcogenide FeX 2 (X = S, Se, Te) for photovoltaic applications: a first principle study

Abstract

In present work, the electronic structure and optical properties of the FeX₂ (X = S, Se, Te) compounds have been evaluated by the density functional theory based on the scalar-relativistic full potential linear augmented plane wave method via Wien2K. From the total energy calculations, it has been found that all the compounds have direct band nature, which determined by iron 3d states at valance band edge and anion p dominated at conduction band at Γ-point and the fundamental band gap between the valence band and conduction band are estimated 1.40, 1.02 and 0.88 eV respectively with scissor correction for FeS₂, FeSe₂ and FeTe₂ which are close to the experimental values. The optical properties such as dielectric tensor components and the absorption coefficient of these materials are determined in order to investigate their usefulness in photovoltaic applications.

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Relativistic and noise effects on multiplayer Prisoners’ dilemma with entangling initial states

Abstract

Three-players Prisoners' dilemma (Alice, Bob and Colin) is studied in the presence of a single collective environment effect as a noise. The environmental effect is coupled with final states by a particular form of Kraus operators \(K_0\) and \(K_1\) through amplitude damping channel. We introduce the decoherence parameter \(0\le p\le 1\) to the corresponding noise matrices, in order to controling the rate of environment influence on payoff of each players. Also, we consider the Unruh effect on the payoff of player, who is located at a noninertial frame. We suppose that two players (Bob and Colin) are in Rindler region I from Minkowski space-time, and move with same uniform acceleration ( \(r_b=r_c\) ) and frequency mode. The game is begun with the classical strategies cooperation (C) and defection (D) accessible to each player. Furthermore, the players are allowed to access the quantum strategic space (Q and M). The quantum entanglement is coupled with initial classical states by the parameter \(\gamma \in [0,\pi /2]\) . Using entangled initial states by exerting an unitary operator \(\hat{J}\) as entangling gate, the quantum game (competition between Prisoners, as a three-qubit system) is started by choosing the strategies from classical or quantum strategic space. Arbitrarily chosen strategy by each player can lead to achieving profiles, which can be considered as Nash equilibrium or Pareto optimal. It is shown that in the presence of noise effect, choosing quantum strategy Q results in a winning payoff against the classical strategy D and, for example, the strategy profile (Q, D, C) is Pareto optimal. We find that the unfair miracle move of Eisert from quantum strategic space is an effective strategy for accelerated players in decoherence mode ( \(p=1\) ) of the game.

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Analytical investigation for Lorentz forces effect on nanofluid Marangoni boundary layer hydrothermal behavior using HAM

Abstract

In this paper, semi analytical approach is applied to investigate nanofluid Marangoni convection in presence of magnetic field. Koo–Kleinstreuer–Li model is taken into account to simulate nanofluid properties. Homotopy analysis method is utilized to solve the final ordinary equations which are obtained from similarity transformation. Roles of Hartmann number and nanofluid volume fraction are presented graphically. Results show that temperature augments with rise of nanofluid volume fraction. Impact of nanofluid volume fraction on normal velocity is more than tangential velocity. Temperature gradient enhances with rise of magnetic number.

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The effect of emodin on Staphylococcus aureus strains in planktonic form and biofilm formation in vitro

Abstract

Staphylococcus aureus (S. aureus) is a Gram-positive pathogen and forms biofilm easily. Bacteria inside biofilms display an increased resistance to antibiotics and disinfectants. The objective of the current study was to assess the antimicrobial activities of emodin, 1,2,8-trihydroxy-6-methylanthraquinone, an anthraquinone derivative isolated from Polygonum cuspidatum and Rheum palmatum, against S. aureus CMCC26003 grown in planktonic and biofilm cultures in vitro. In addition, a possible synergistic effect between emodin and berberine chloride was evaluated. As quantified by crystal violet method, emodin significantly decreased S. aureus biofilm growth in a dose-dependent manner. The above findings were further supported by scanning electron microscopy. Moreover, the present study demonstrated that sub-MICs emodin obviously intervened the release of extracellular DNA and inhibited expression of the biofilm-related genes (cidA, icaA, dltB, agrA, sortaseA and sarA) by real-time RT-PCR. These results revealed a promising application for emodin as a therapeutic agent and an effective strategy to prevent S. aureus biofilm-related infections.

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Life-threatening posterior reversible encephalopathy syndrome in the cerebellum treated by posterior fossa decompression

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome associated with various clinical conditions, such as headache, encephalopathy, and seizures. It is reversible if a prompt diagnosis is made and treatment undertaken. We report a 52-year-old male with hypertensive crisis. Progressing somnolence and an unresponsive left pupil occurred. MRI revealed an intra-axial hyperintensity of the cerebellum and brainstem and occlusive hydrocephalus suggestive of encephalitis or a tumor. Because of the life-threatening clinical picture, posterior fossa decompression was performed. Histopathology failed to identify any pathology. After decompression, the edema improved immediately. Under life-threatening conditions, a decompressive craniectomy in PRES seems to achieve the same results as supportive treatment.

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Kurt Goldstein and his nonlocationist thoughts on aphasia—a pioneer of early network theories at the beginning of the twentieth century?

Abstract

In between Carl Wernicke's locationist aphasia concept from 1874 and Norman Geschwind's new connectionist model of human brain functions in 1965, little notice was taken of the historical debate on aphasia and brain plasticity. Interestingly, Kurt Goldstein made long-forgotten, but highly relevant remarks on the connectionist model and thereby served as an important connecting link between Wernicke and Geschwind. With the original contributions of Goldstein and contemporary authors, we analyzed the historical background of the aphasia debate in the time period between Wernicke and Geschwind, which still influences current aphasia concepts and neurosurgical practice of today.

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