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Summary Aim of the study Delayed hemorrhage, though rare, remains a significant source of morbidity and mortality after pancreaticoduodenectomy (PD). An important cause of this delayed hemorrhage is erosion or pseudoaneurysm formation of the gastroduodenal artery (GDA) by pancreatic enzymes and adjacent intra-abdominal sepsis. So protection of the GDA stump may avoid this devastating complication. Patients and methods This is a retrospective observational study. All patients, who underwent a PD between August 2007 and December 2014, were included in the study. We used pedicled falciform ligament flap to protect the GDA stump. After PD, pedicled falciform ligament flap was spread widely over the skeletonized hepatic artery including the GDA stump and was fixed to the surrounding retroperitoneal connective tissue. This procedure allowed complete separation of the GDA stump from the pancreatic stump. Results We performed 182 cases of PD during the study period. Although, 27 (15%) patients developed pancreatic fistula and six patients developed intra-abdominal abscess, no one experienced hemorrhage due to erosion or pseudoaneurysm formation of the GDA. Conclusion The present surgical option seems to be an effective measure for the prevention of erosion and pseudoaneurysm formation of the GDA after PD.

This is a study of 5595 head and neck cancer patients treated during 1987-89 at TMH, Mumbai. The study included 1970 oral cancers (ICD 140-145), 1495 oropharyngeal cancers (ICD 1410, 1453, 146), 1255 hypopharyngeal cancers (ICD 148), 125 nasopharyngeal cancers (ICD 147) and 750 laryngeal cancers (ICD 161). The clinical extent of disease at presentation was based on TNM group staging (UICC 1978). For the majority of sites, patients attended the hospital during stage III and stage IV of the disease; the only exception was for cancers of the lower lip, anterior tongue and vocal cord when between 46.2% and 56.5% of patients with localized cancer (stage I and II) were seen. Generally, surgery either alone or with radiation has been administered for oral cancer patients whereas radiation either alone or in combination with chemotherapy was administered for other head and neck sites. The overall 5-year survival rate was in the range of 20-43% for oral cancer, 8-25% for pharyngeal cancers and 25-62% for laryngeal cancer. The 5-year relative survival rates were more or less in agreement with the results published by the Eurocare study for head and neck cancers. The importance of primary prevention in head and neck cancer is stressed.

Derailment is a business risk for rail operators. However, most of the derailments are due to a combination of several causes. This paper presents a derailment study, focusing on Australia, that categorizes a comprehensive set of factors causing derailment and current mitigation techniques. Finally, a risk gap is analysed and integrated model is proposed. Further, the opportunities to incorporate remote monitoring and data analysis technologies to ensure an eMaintenance management of derailment are discussed. A case study on eMaintenance of rail lubrication, which is highly related to derailment, is also demonstrated in this paper.

SuperSpec is an innovative, fully planar, compact spectrograph for mm/sub-mm astronomy. SuperSpec is based on a superconducting filter-bank consisting of a series of planar half-wavelength filters to divide up the incoming, broadband radiation. The power in each filter is then coupled into titanium nitride lumped element kinetic inductance detectors, facilitating the read out of a large number of filter elements. We will present electromagnetic simulations of the different components that will make up an R = 700 prototype instrument. Based on these simulations, we discuss optimisation of the coupling between the antenna, transmission line, filters and detectors.

A prospective randomized trial compared post-anal repair (n = 12), anterior levatorplasty (n = 12) and total pelvic floor repair (TPFR) (n = 12) for women with post-obstetric neuropathic faecal incont

The presence of neuroendocrine cells (NEC) in the anorectum is well documented. However, the density of the endocrine cells in different regions of the anal canal has not been determined. Our aim was

Intensive livestock operations are often the source of odour complaints from neighbouring residential or commercial facilities. In Australia, the expansion of the population has resulted in the blending of suburban and rural areas, increasing the potential for odour related complaints to local authorities. The varied Australian climate almost exclusively dictates the use of mechanically ventilated poultry houses in order to sustain profitable agricultural practices, and these sheds produce a significant VOC and dust emissions, impacting upon the surrounding environment.