Minimally Invasive Repair of Pediatric Morgagni Hernias Using Transfascial Sutures with Extracorporeal Knot Tying.

BACKGROUND: Morgagni hernias are rare, with a reported incidence of 2% to 5% of congenital diaphragmatic hernias. OBJECTIVES: To review a laparoscopic technique to repair Morgagni hernias in pediatric patients. METHODS: Retrospective chart review of pediatric patients who underwent minimally invasive repair of a Morgagni hernia from November 2009 to September 2017 within a defined population. RESULTS: During an 8-year period, 15 patients with Morgagni hernias were identified. Four patients with Morgagni hernias were excluded because they had open repairs. Eleven Morgagni hernias were repaired through a completely minimally invasive approach. Three repairs were completed using a soft-tissue patch (Gore-Tex patch, W L Gore & Associates Inc, Flagstaff, AZ). All minimally invasive repairs were completed with transfascial sutures using an endoscopic suturing device (Endo Close, Covidien/Medtronic, Fridley, MN) and 2-0 nonabsorbable synthetic sutures with extracorporeal knot tying. Median follow-up was 40 months (range = 2.6 months to 7.3 years). No patients had postoperative pectus excavatum defects. There were no recurrences. CONCLUSION: Morgagni hernias are amenable to minimally invasive repair with this simple technique. With large defects, synthetic patches should be used. Recurrences are rare, and morbidity is low.

Time-resolved characteristics of deuteron-beam generated by plasma focus discharge.

The plasma focus device discussed herein is a Z-pinch pulsed-plasma arrangement. In this, the plasma is heated and compressed into a cylindrical column, producing a typical density of > 1025 particles/m3 and a temperature of (1-3) × 107 oC. The plasma focus has been widely investigated as a radiation source, including as ion-beams, electron-beams and as a source of x-ray and neutron production, providing considerable scope for use in a variety of technological situations. Thus said, the nature of the radiation emission depends on the dynamics of the plasma pinch. In this study of the characteristics of deuteron-beam emission, in terms of energy, fluence and angular distribution were analyzed. The 2.7 kJ plasma focus discharge has been made to operate at a pressure of less than 1 mbar rather than at its more conventional operating pressure of a few mbar. Faraday cup were used to determine deuteron-beam energy and deuteron-beam fluence per shot while CR-39 solid-state nuclear track detectors were employed in studying the angular distribution of deuteron emission. Beam energy and deuteron-beam fluence per shot have been found to be pressure dependent. The largest value of average deuteron energy measured for present conditions was found to be (52 ± 7) keV, while the deuteron-beam fluence per shot was of the order of 1015 ions/m2 when operated at a pressure of 0.2 mbar. The deuteron-beam emission is in the forward direction and is observed to be highly anisotropic.

Low-energy plasma focus device as an electron beam source.

A low-energy plasma focus device was used as an electron beam source. A technique was developed to simultaneously measure the electron beam intensity and energy. The system was operated in Argon filling at an optimum pressure of 1.7 mbar. A Faraday cup was used together with an array of filtered PIN diodes. The beam-target X-rays were registered through X-ray spectrometry. Copper and lead line radiations were registered upon usage as targets. The maximum electron beam charge and density were estimated to be 0.31 µC and 13.5 × 10(16)/m(3), respectively. The average energy of the electron beam was 500 keV. The high flux of the electron beam can be potentially applicable in material sciences.

Acceptance of information and communication technologies for healthcare delivery: a SingHealth Polyclinics study.

OBJECTIVE: This study aimed to determine the prevalence of short message system (SMS) and internet usage in patients visiting the SingHealth Polyclinics and to measure patients' acceptance of using these technologies in healthcare delivery. MATERIALS AND METHODS: A representative sample of patients visiting the 9 SingHealth Polyclinics were interviewed in-person by trained medical students. Collected information included demographic characteristics, access to and usage of mobile phone/SMS and internet, as well as acceptance and concerns on using these technologies in primary healthcare delivery. RESULTS: Among 705 patients surveyed (mean age: 54.6 years, female: 50.6%, response rate: 92%), 407 (57.7%) were SMS users and 158 (22.4%) were internet users. Two hundred and eighty-four of 412 SMS and/or internet users (40.3% of the entire sample) were comfortable with the use of these technologies in healthcare delivery. Malay or Indian ethnicity, better education, and visiting the clinic for acute symptoms or screening were factors positively associated with willingness to use such technologies. The main concerns associated with the use of SMS and internet in healthcare delivery were preference for in-person consultation with a doctor (23.5%), reduced patient-doctor interaction (23.0%), and increased healthcare cost (20.8%). CONCLUSION: The present prevalence of SMS and internet usage among patients visiting the SingHealth Polyclinics and their concerns towards use of these technologies in healthcare delivery do not support current widespread implementation of services entailing SMS and internet in the study sites.

Comparison of three DNA marker systems for assessing genetic diversity in Asian arowana (Scleropages formosus).

Three DNA marker systems -- random amplified polymorphic DNA (RAPD), amplified fragment length polymorphism (AFLP) and microsatellites -- were used to estimate the genetic diversity in Asian arowana (Scleropages formosus) by genotyping fish individuals from three different sources. Parallel application of the three DNA marker systems allowed us to compare their utility for the analysis of genetic diversity. Microsatellites displayed the highest expected heterozygosity, whereas the values obtained by RAPD and AFLP were much lower. Multiplex ratio and marker index were higher for AFLP than for RAPD or microsatellites. Weak correlation was detected between genetic similarity estimated from data obtained with the three DNA marker systems: estimates from RAPD and AFLP data turned out to be higher than those from microsatellites. On the other hand genetic similarity was higher in the red variety than in the green one, especially when tested with microsatellites. Based on the genetic distance matrices calculated from microsatellite analysis, all red individuals were clustered into one group, whereas only a subset of them was clustered when either RAPD or AFLP was used. This indicated that the microsatellite system detected population subdivision more efficiently than either RAPD or AFLP.