Recently, besides regression analysis, artificial neural networks (ANNs) are increasingly used to predict the state of tools. Nevertheless, simulations trained by cutting modes, material type and the ...method of sharpening twist drills (TD) and the drilling length from sharp to blunt as input parameters and axial drilling force and torque as output ANN parameters did not achieve the expected results. Therefore, in this paper a family of artificial neural networks (FANN) was developed to predict the axial force and drilling torque as a function of a number of influencing factors. The formation of the FANN took place in three phases, in each phase the neural networks formed were trained by drilling lengths until the drill bit was worn out and by a variable parameter, while the combinations of the other influencing parameters were taken as constant values. The results of the prediction obtained by applying the FANN were compared with the results obtained by regression analysis at the points of experimental results. The comparison confirmed that the FANN can be used as a very reliable method for predicting tool condition.
Aim The aim of the study was to investigate function and quality of life after different types of intersphincteric resection (ISR).
Method Between January 2006 and February 2008, 45 patients (34 ...men and 11 women) with distal third rectal cancer underwent curative ISR. Function was evaluated using the Memorial Sloan Kettering Cancer Center bowel function questionnaire and Wexner score, anal manometry and measurements of rectal capacity were also performed. Quality of life was assessed using the Serbian version of the European Organisation for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ‐C30) and the translated version of the fecal incontinence quality of life scale (FIQL).
Results There were no postoperative deaths. Partial ISR was performed in 22 (48.9%) patients, subtotal ISR was performed in 19 (42.2%) patients and total ISR was performed in four (8.9%) patients. Anastomotic leakage occurred in nine (20%) patients. Five (11.1%) of 45 patients had major (complete) incontinence and a further six (13.3%) patients had continuing frequent faecal leakage 12 months after ileostomy reversal. There was no significant difference in quality of life between the groups in the EORTC QLQ‐C30 scale, but this was significantly altered by internal anal sphincter resection in two of the FIQL scales (coping/behaviour and depression/self‐perception).
Conclusion Although ISR does not affect quality of life in general, the extent of internal anal sphincter resection has a negative impact on symptom‐specific quality of life owing to faecal incontinence.
Aim
The purpose of this study was to investigate the safety and feasibility of autologous adipose‐derived regenerative cells (ADRC) in the treatment of chronic anal fissure.
Method
A prospective ...pilot study was conducted in six patients with chronic anal fissures at the First Surgical Clinic, Clinical Center of Serbia and at the BelPrime Clinic, Belgrade, Serbia. All patients were candidates for surgical treatment. The average duration of symptoms was 24 months. Pain assessment was quantified using a visual analogue scale and bowel continence was assessed using the Wexner incontinence score. Both were assessed before treatment and during each postoperative outpatient visit. Liposuction was performed under local or general anaesthesia. Extraction of ADRC was achieved with a closed automated medical device. The fat and ADRC were injected subcutaneously into the edge of the fissure. The rest of the pellet was infiltrated into the internal anal sphincter. The study has been registered at ClinicalTrials.gov (NCT02628522).
Results
Complete healing of the anal fissure and the disappearance of symptoms was achieved in all patients. The average time to complete pain cessation was 33.7 ± 15.0 days. All fissures healed after 3 months and remained healed 12 months after the procedure. There were no complications related to the procedure.
Conclusion
The application of ADRC may be an alternative to lateral sphincterotomy and a reliable procedure which avoids faecal incontinence.
It is very rare situation when surgeon can virtually expect a curative operation after revealing distal metastases of colorectal carcinoma. In case of isolated splenic metastases, splenectomy can ...result with good five year survival rate. There are no more than 15 cases of isolated splenic metastases publish in English speaking literature. This article reveals our case along with a literature review and brief discussion of diagnostic and therapeutic options.
For the first time, the tradeoffs between higher mobility (smaller bandgap) channel and lower band-to-band tunneling (BTBT) leakage have been investigated. In particular, through detailed experiments ...and simulations, the transport and leakage in ultrathin (UT) strained germanium (Ge) MOSFETs on bulk and silicon-on-insulator (SOI) have been examined. In the case of strained Ge MOSFETs on bulk Si, the resulting optimal structure obtained was a UT low-defect 2-nm fully strained Ge epi channel on relaxed Si, with a 4-nm Si cap layer. The fabricated device shows very high mobility enhancements >3.5/spl times/ over bulk Si devices, 2/spl times/ mobility enhancement and >10/spl times/ BTBT reduction over 4-nm strained Ge, and surface channel 50% strained SiGe devices. Strained SiGe MOSFETs having UT (T/sub Ge/<3 nm) very high Ge fraction (/spl sim/ 80%) channel and Si cap (T/sub Si cap/<3 nm) have also been successfully fabricated on thin relaxed SOI substrates (T/sub SOI/=9 nm). The tradeoffs in obtaining a high-mobility (smaller bandgap) channel with low tunneling leakage on UT-SOI have been investigated in detail. The fabricated device shows very high mobility enhancements of >4/spl times/ over bulk Si devices, >2.5/spl times/ over strained silicon directly on insulator (SSDOI; strained to 20% relaxed SiGe) devices, and >1.5/spl times/ over 60% strained SiGe (on relaxed bulk Si) devices.
To evaluate the role of pelvic MRI in diagnosis and assesment of combined surgical and infliximab treatment of perianal Crohn's disease (PACD).
24 patients with signs of PACD were prospectively ...evaluated. They were previously treated with azathyoprin for a period of 6 months to 7 years and antibiotics and than started on Infliximab 5 mg/kg (IFX) at 0, 2 and 6 weeks induction protocol. Luminal CD activity was assesed by colonoscopy. Perianal Disease Activity Index (PDAI) was calculated to evaluate perianal fistulae activity. Surgical examination under anesthesia (EUA) was performed and non-cutting seton placed where appropriate. Pelvic MRI was performed in each patient before Infliximab treatment, and in half of the patients after IFX. MRI criteria were used to asses activity and remission of PACD.
14/24 (58.5%) patients had ileocolitis, 10/24 (41.5%) colitis, and in 22/24 (91.7%) rectum was affected. Median disease duration was 5.5 +/- 2.5 years. MRI revealed simple fistula in 4/24 (16.7%) and complex fistula in 20/24 (83.3%) patients. Abscess was present in 19/24 (79%) patients. Enterocutaneous and recto-vaginal fistula was found in 2 (8.3%) and 3 (12.5%) patients, respectively. Median PDAI before and 8 weeks after IFX treatment was 8.3 +/- 2.08 and 3.5 +/- 1.03, respectively (p = 0.00064). Incomplete response (reduction fistulae drainage by 50%) was found in 10/24 (42%) patients, complete response (no drainage) in 11/24 (46%) patients, while in 3/24 (12.5%) new fistula opened. Control pelvic MRI was performed in 13/24 (54%) patients. Of those, 9/13 (69%) had complete remission according to MRI criteria. Seton was removed after second IFX dose in 15/24 (62.5%) patients and placed again in 2/24 (8%) patients 4 months after completion of IFX treatment.
In patients with PACD, pelvic MRI before and after IFX treatment is an important diagnostic tool to asses fistula tract localisation, reveal abscess, planning adequate treatment approach and assess the effect of treatment. Surgical decision to remove seton was in accordance with MRI criteria for remission in PACD.
Lipomatosis is an excessive local or general accumulation of fat in the body. It is usually asymptomatic, but depending on localization and size it can cause the patient to experience various ...difficulties. It can occur within digestive system as a benign mass. We report a case of a 50 year old female presented with mild intestinal symptoms and anemia. She had a lipomatous change of ileocecal valve and due to positive fecal occult blood test, barium enema and incompletely performed colonoscopy was misdiagnosed as a malignant tumor and was treated accordingly.
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