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RISS 인기검색어
- 검색키워드
- 저자 : Wert, Eric C. (검색결과 3 건)
- 무료
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Predictors of Failed Laparoscopic Appendectomy in Perforated Appendicitis
Sean Martin,Yijin Wert,Zach Lyon,Leonardo Geraci 대한외상중환자외과학회 2018 Journal of Acute Care Surgery Vol.8 No.2
Purpose: A recent internal review of a community-based hospital system revealed a 19.19% rate of conversion from a laparoscopic appendectomy to an open procedure. This study examined the preoperative risk factors for failed laparoscopic appendectomy requiring a conversion to a laparotomy.Methods: A total of 198 patients presented with perforated appendicitis. Perforation was defined as a computed tomography (CT) scan interpretation, pathology findings, or surgical findings. Of these patients, 161 underwent a laparoscopic appendectomy or laparoscopy converted to an open procedure. The preoperative risk factors in the two groups were compared through a retrospective chart review.Results: Through multivariant analysis, age greater than 45 was the greatest risk factor for the need to convert to an open procedure with an odds ratio (OR) of 3.51. A CT scan read of perforation was associated with a significant 2.65 OR. The C-reactive protein was 19.82 mg/L in the failed laparoscopic cases and 9.96 mg/L in the laparoscopic cases.Conclusion: Patients older than 45 years old with a CT radiologist’s read of a perforation in multivariant analysis have an increased risk of failed laparoscopic surgery requiring conversion to open surgery.
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Lee, Yunho,Gerrity, Daniel,Lee, Minju,Bogeat, Angel Encinas,Salhi, Elisabeth,Gamage, Sujanie,Trenholm, Rebecca A.,Wert, Eric C.,Snyder, Shane A.,von Gunten, Urs American Chemical Society 2013 Environmental science & technology Vol.47 No.11
<P>Ozonation is effective in improving the quality of municipal wastewater effluents by eliminating organic micropollutants. Nevertheless, ozone process design is still limited by (i) the large number of structurally diverse micropollutants and (ii) the varying quality of wastewater matrices (especially dissolved organic matter). These issues were addressed by grouping 16 micropollutants according to their ozone and hydroxyl radical (<SUP>•</SUP>OH) rate constants and normalizing the applied ozone dose to the dissolved organic carbon concentration (i.e., g O<SUB>3</SUB>/g DOC). Consistent elimination of micropollutants was observed in 10 secondary municipal wastewater effluents spiked with 16 micropollutants (∼2 μg/L) in the absence of ozone demand exerted by nitrite. The elimination of ozone-refractory micropollutants was well predicted by measuring the <SUP>•</SUP>OH exposure by the decrease of the probe compound <I>p</I>-chlorobenzoic acid. The average molar <SUP>•</SUP>OH yields (moles of <SUP>•</SUP>OH produced per mole of ozone consumed) were 21 ± 3% for g O<SUB>3</SUB>/g DOC = 1.0, and the average rate constant for the reaction of <SUP>•</SUP>OH with effluent organic matter was (2.1 ± 0.6) × 10<SUP>4</SUP> (mg C/L)<SUP>−1</SUP> s<SUP>–1</SUP>. On the basis of these results, a DOC-normalized ozone dose, together with the rate constants for the reaction of the selected micropollutants with ozone and <SUP>•</SUP>OH, and the measurement of the <SUP>•</SUP>OH exposure are proposed as key parameters for the prediction of the elimination efficiency of micropollutants during ozonation of municipal wastewater effluents with varying water quality.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/esthag/2013/esthag.2013.47.issue-11/es400781r/production/images/medium/es-2013-00781r_0008.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/es400781r'>ACS Electronic Supporting Info</A></P>
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