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At least 325 records · Page 18Linked to original sources

PubMed1994

High-voltage electrical injury: a role for mandatory exploration of deep muscle compartments.

Patients sustaining high-voltage electrical burns involving the upper extremities were evaluated for deep muscle compartment necrosis by early surgical exploration. Following resuscitation, patients were taken to the operating room where mandatory exploration of volar and extensor forearm and hand compartments was done to evaluate muscle viability. It was observed that deep muscle layers sustained the greatest thermal injury and that extended fasciotomies were required to obviate compartment syndrome and the potential for continued ischemia. Although 10 emergency amputations were required for six patients, those who underwent extensive exploration of their forearms and hands did not require subsequent amputation for nonviable extremities during second-look operations. These observations support the role for early exploration with generous exposure of deep muscle compartments to access and treat the thermal injury that results from high-voltage burns.

Adolescent↗

PubMed1996

Laparoscopic exploration of the contralateral groin in children: an improved technique.

Repair of inguinal hernias are among the most frequently performed operative procedures in children. Bilateral inguinal hernias (BIH) are common, especially in patients under the age of 2 years, and present both synchronously and metachronously. Most pediatric surgeons perform open exploration of the contralateral groin in infants and young children with symptomatic unilateral inguinal hernias to avoid missing the potential metachronous presentation of BIH. The practice of contralateral groin exploration is controversial because of the increased cost, morbidity, and potentially serious complications associated with open groin exploration. We have developed a technique for laparoscopic exploration of the contralateral groin (LECG) to assess the internal inguinal ring in the asymptomatic groin and to measure the depth of a patent processus vaginalis. A pneumoperitoneum is produced by insufflation through a 14-gauge intravenous catheter placed into the hernia sac of the operated side. A 1.2-mm laparoscope is then passed through another 14-gauge intravenous catheter inserted through the abdominal wall of the contralateral side providing a direct, "in line" view of the internal ring. Depth of patency of >1.5 cm was considered positive and a standard operative repair was performed. In 110 children who underwent LECG the incidence of bilaterality was 21%. This technique is rapid, accurate and was associated with no complications.

Female↗

PubMed1996

[A new approach of functional recto-anal exploration: the compliance of the rectum and the anal canal].

We have developed an original method of determining the rectal and the anal compliance. The rectum must serve as a fecal reservoir. This storage function requires that the rectum must be distensible. The anal canal must become easily looser for defecation. These features are not explored by the usual rectoanal manometric recordings. Very few investigations about the compliance are carried out. In our procedure, exploration balloons are connected via polyethylene tubes to pressure transducers, direct-writing electrical recorder and pump under the command of the computer. The pressure generated is as high as the distensibility is poor, as the compliance is decreased. The pressure/volume curve shows the compliance. The procedure is different for the rectum on the one hand, and for the anal canal on the other. The rectal device consists of a balloon at the end of the tube. It shall be inflated until only 60 ml., and then deflated at the same rythm, which is constant during each test. The first test takes place at the speed of 30 ml. per minute; so the inflation lasts 2 mn and the deflation the same time, afterwards the second test lasts one mn for each one, and finally the third one 40 seconds in the same way. For the anal canal, the balloon, ring shaped around the tube, measuring an inch in length, is inflated at only 12 ml. For the first test the inflation and deflation rate of speed is 3 ml per mn, afterwards 6 ml./mn then 9 ml./mn. and thereafter 12 ml./mn/; these series are done in randomized order. In both procedures, an additional relaxation test at the maximum of inflation takes place for 2 minutes. We have explored ten healthy volunteers and 120 patients suffering from various digestive diseases. The curves show the rectal compliance, and in the case of the anus a relaxation, which seems to be an active opening, occurs for a distension of 5-8 ml, i.e. 19-21 mn in diameter. In pathology, the excess of compliance is observed in patients with incontinence, whereas an inadequate compliance is seen in the dyschesia, descending perineum and prolapse, traumatic or surgical injuries, etc. This exploration will be a useful guide for the choice of the convenient treatment and the follow-up.

Adult↗

PubMed1996

Concept development: exploring undocumentedness.

Concept development involves multiple processes, one of which is concept exploration. The purpose of this paper is to present the process of concept exploration as exemplified in the case of undocumentedness. This particular exploration of undocumentedness was grounded in the discipline of nursing and approached from a feminist perspective. The exploratory process of the concept included personal reflexivity, the construction of definitions, examination of the historical, social, political, and legislative context of undocumented immigration in the United States, exploration of the meanings and implications of the concept, discussion of the relationship of undocumentedness to nursing and health, and identification of the needs for research to further develop the concept of undocumentedness for nursing.

Concept Formation↗

PubMed1997

[Value of scintigraphic explorations by radiomarkers others than iodine radioisotope in differentiated thyroid cancer].

Radioiodine scintigraphy is the gold standard exploration for imaging metastases of differentiated thyroid cancer and enables the decision of therapy with 131 radioactive iodine to be made. However, other approaches may be of use for diagnosis when there is no visible uptake after the administration of 131I, while elevated thyroblobulin levels suggest the presence of metastatic tissue in one third of metastatic patients. In order to detect recurrences or metastases, in conjunction with conventional imaging techniques (cervical and hepatic ultrasonography, lung CT scan..), other scintigraphic explorations with various radiopharmaceutics may be used, although none of them has any specificity towards thyroid cancer. Tl201 and MIBI which are used as perfusion tracers for myocardial explorations, are also used for detection of various tumors and for metastatic thyroid cancer. The performances of both radiopharmaceutics in imaging metastases are differently evaluated between investigators with a sensitivity ranging from 45 to 94% while the specificity varies less (82-97%). 18-Fluoro-deoxyglucose is retained in malignant tissue depending on the grade of malignancy. It has been shown to accumulate in thyroid cancer and metastases. Its detection by whole body PETscan represents a limitation for use which will be modified by new techniques. 111In-octreotide which binds to somatostatin receptors located on tumor cell membranes is able to show thyroid cancer metastases in some instances. We report on the very preliminary results of these combined scintigraphic approaches, performed in a limited number of patients who had no radioiodine uptake and elevated Tg levels, in order to determine the most appropriate exploration in terms of performance and cost.

Adenocarcinoma↗

PubMed2005

Validation of a method to replace frozen section during parathyroid exploration by using the rapid parathyroid hormone assay on parathyroid aspirates.

HYPOTHESIS: The parathyroid hormone (PTH) content of tissue aspirates is an accurate indicator of parathyroid tissue and can replace frozen section during parathyroid surgery. DESIGN AND SETTINGS: Prospective data collection in a tertiary care hospital with a single surgeon. PATIENTS: One hundred sixty-seven consecutive patients completing limited parathyroid explorations. INTERVENTIONS: Parathyroid adenomas removed during limited parathyroid exploration were aspirated through a 22-gauge needle into 0.5 mL isotonic sodium chloride solution and the solution held on ice in a purple-top tube. Aspirates of in situ thyroid tissue were also taken for comparison. Samples were then assessed to monitor the physiologic impact of the surgery. MAIN OUTCOME MEASUREMENTS: The PTH content of tissue aspirates was compared with histologic identification of removed putative parathyroid tissue. RESULTS: Elevated tissue PTH content was associated with the identification of origin as parathyroid in every case. Tissue aspirates from pathologically proven parathyroid tissue had a mean PTH level of at least 1691 pg/mL, with 160 having values exceeding the upper limit of the assay. This measure was significantly higher than values obtained from thyroid aspirates, which had a mean PTH level of 88 pg/mL (P<.01), reflective of blood levels at the time of aspiration. Using the 99% confidence interval of histologically confirmed parathyroid glands as the lower limit of a positive test result at 1610 pg/mL, tissue aspirate PTH assay has a sensitivity of 97% and a specificity of 100%. CONCLUSIONS: Positive identification of removed tissue as parathyroid is necessary adjunct to limited parathyroid exploration, where decreases in false positive blood PTH levels can be a result of operative manipulation of the neck. Analysis of tissue PTH content during the same assay that is being used for assessing blood PTH concentration is an efficient and accurate method for identifying the tissue with certainty. This measure also prevents the occasional ambiguity in frozen sections of parathyroid tissue that apparently contain thyroidlike colloid material.

Adenoma↗

PubMed2005

Age differences in neophilia, exploration, and innovation in family groups of callitrichid monkeys.

The prevailing assumption in the primate literature is that young or juvenile primates are more innovative than adult individuals. This innovative tendency among the young is frequently thought to be a consequence, or side effect, of their increased rates of exploration and play. Conversely, Reader and Laland's [International Journal of Primatology 22:787-806, 2001] review of the primate innovation literature noted a greater reported incidence of innovation in adults than nonadults, which they interpreted as (in part) a reflection of the greater experience and competence of older individuals. Within callitrichids there is contradictory evidence for age differences in response to novel objects, foods, and foraging tasks. By presenting novel extractive foraging tasks to family groups of callitrichid monkeys in zoos, we examined, in a large sample, whether there are positive or negative relationships of age with neophilia, exploration, and innovation, and whether play or experience most facilitates innovation. The results indicate that exploration and innovation (but not neophilia) are positively correlated with age, perhaps reflecting adults' greater manipulative competence. To the extent that there was evidence for play in younger individuals, it did not appear to contribute to innovation. The implications of these findings for the fields of innovation and conservation through reintroduction are considered.

Age Factors↗

PubMed1976

Operative cholangiography: criteria which make exploration of the common bile duct desirable.

The purpose of this study was to evaluate the individual criteria and combination of criteria examined by operative cholangiography which make exploration of the common bile duct desirable. The overall accuracy of exploration of the common bile duct (89 per cent) was similar to that of previous series. In the normal group the accuracy of the criteria established by Le Quesne (1960) is confirmed. The most reliable criteria in the abnormal cholangiograms were the presence of single or multiple filling defects in the common bile duct, the absence of free flow of contrast medium into the duodenum and an abnormality of the terminal narrow segment. Measurements to aid assessment of free flow into the duodenum are suggested. In 34 of 40 positive explorations the common bile duct diameter was 14 mm or less; 10 common bile ducts which contained stones were less than 10 mm in diameter. Excess filling of the intrahepatic ducts was often impossible to judge in the abnormal group and was the least valuable criterion. Attention is drawn to the advantage of an immediate radiological report.

Cholangiography↗

PubMed1987

Morbidity and mortality of common bile duct exploration.

This retrospective study reviews the complications which occurred in 257 patients who had supraduodenal exploration of the common bile duct in one hospital during a 15-year period. One hundred and eighteen patients (46 per cent) developed complications: septic and cardiorespiratory complications were most common, occurring in 19.5 per cent and 16.7 per cent of patients respectively. Postoperative retained stones were detected in 37 patients (14 per cent), causing complications in 54 per cent. Peroperative postexploratory cholangiography did not significantly reduce the incidence of this problem. None of the 12 patients who had postexploratory choledochoscopy had retained stones. Five patients (1.9 per cent) died, three of whom had duct procedures in addition to supraduodenal exploration and two of whom had retained stones. It is concluded that common bile duct exploration has a high associated morbidity, particularly due to sepsis and retained stones.

Adult↗

PubMed1990

Operative choledochoscopy: common bile duct exploration is incomplete without it.

This paper reviews the reported experience of operative choledochoscopy. Development of choledochoscopes to the currently available rigid and flexible instruments is described. The collected results of both rigid and flexible choledochoscopy are reported. Retained stones occurred in 97 of 2712 stone-positive explorations with the rigid choledochoscope (3.6 per cent) and in 35 of 1726 stone-positive explorations with the flexible choledochoscope (2.0 per cent). Choledochoscopy should now be a mandatory part of common bile duct exploration.

Choledochostomy↗

PubMed2006

Spatial exploration induces ARC, a plasticity-related immediate-early gene, only in calcium/calmodulin-dependent protein kinase II-positive principal excitatory and inhibitory neurons of the rat forebrain.

Active behavior, such as exploring a novel environment, induces the expression of the immediate-early gene Arc (activity-regulated cytoskeletal associated protein, or Arg 3.1) in many brain regions, including the hippocampus, neocortex, and striatum. Arc messenger ribonucleic acid and protein are localized in activated dendrites, and Arc protein is required for the maintenance of long-term potentiation and memory consolidation. Although previous evidence suggests that Arc is expressed in neurons, there is no direct demonstration that only neurons can express Arc. Furthermore, there is no characterization of the main neuronal types that express Arc. The data reported here show that behavior- or seizure-induced Arc expression in the hippocampus, primary somatosensory cortex, and dorsal striatum of rats colocalizes only with neuronal (NeuN-positive) and not with glial (GFAP-positive) cells. Furthermore, Arc was found exclusively in non-GABAergic alpha-CaMKII-positive hippocampal and neocortical neurons of rats that had explored a novel environment. Some GAD65/67-positive neurons in these regions were observed to express Arc, but only after a very strong stimulus (electroconvulsive seizure). In the dorsal striatum, spatial exploration induced Arc only in GABAergic and alpha-CaMKII-positive neurons. Combined, these results show that although a very strong stimulus (seizure) can induce Arc in a variety of neurons, behavior induces Arc in the CaMKII-positive principal neurons of the hippocampus, neocortex, and dorsal striatum. These results, coupled with recent in vitro findings of interactions between Arc and CaMKII, are consistent with the hypothesis that Arc and CaMKII act as plasticity partners to promote functional and/or structural synaptic modifications that accompany learning.

Animals↗

PubMed2005

Individual differences in biobehavioral organization during problem-solving in toddlers: the influence of maternal behavior, infant-mother attachment, and behavioral inhibition on the attachment-exploration balance.

The aim of the study was to investigate the influence of maternal behavior, infant-mother attachment, and behavioral inhibition on the biobehavioral organization of toddlers during a primary non-attachment-related challenging context. In a sample of 76 toddlers, quality of attachment (secure, avoidant, ambivalent, disorganized) was assessed at 12 months. At 22 months, the subjects were observed in a challenging task according to [Matas et al. (1978) Child Development 49: 547-556], and salivary cortisol was assessed before and afterwards. Behavioral analyses included child task orientation and exploration, help seeking, proximity seeking, and attachment-exploration-balance as well as maternal supportive presence and quality of assistance. Behavioral inhibition was assessed from maternal reports. Findings from concurrent analyses indicate relations between toddler behavior and adrenocortical function and the importance of concurrent maternal support for toddler behavior. Longitudinal analyses showed that quality of attachment predicted task orientation, help seeking behavior, and the quality of the attachment-exploration-balance, while behavioral inhibition was related to approach to the task. In line with previous findings, adrenocortical activation was found only in insecure infants with high behavioral inhibition indicating the function of attachment security as a social buffer against less adaptive temperamental dispositions. Finally, within-group analyses indicated a social regulation pattern in secure toddlers while the behavior of insecure ones was additionally linked to behavioral inhibition and physiological reactivity.

Adaptation, Psychological↗

PubMed1978

Exploration, distraction, and habituation in rats reared in isolation.

Rats reared in isolation have been reported to show increased motor activity; the purpose of the present experiment was to establish whether they also show enhanced exploratory and orienting responses. Rats were reared in isolation or in social groups from Day 20 to Day 45. Subgroups of each rearing condition were either left undisturbed, received daily handling, or received daily handling and were given objects in their cages. From Day 45 all the rats were rehoused in groups of 6, and testing began at Day 73. In a 1st test exploration was measured by the number of contacts with objects placed in the home cage; and a 2nd test exploration was measured by responses to a holeboard; and in a 3rd test orienting was measured by the distraction produced by the presentation of a tone. When tested in novel situations, in contrast to their enhanced motor activity, isolates showed reduced exploration and orienting. This may have been due to a discrepancy between their adaptation level (established during rearing) and their current level of sensory input. In all the tests the isolates showed normal habituation, both within sessions and between sessions. An inability to habituate is not, as has been claimed, a general characteristic of isolates.

Age Factors↗

PubMed1978

Exploration in immature rats: effects of drugs.

The effects of d-amphetamine (4 mg/kg), scopolamine (1 mg/kg), methylscopolamine (1 mg/kg), and parachlorophenylalanine (400 mg/kg) on exploration were studied in male rats at 16, 21, and 28 days of age. Amphetamine elicited stereotypy at all ages tested, reduced exploration (measured by the time spent head-dipping during a 10-min trial in a holeboard) from Day 21, but did not significantly increase rearing at the ages tested. (Reduced head-dipping, accompanied by stereotypy, is the pattern of results previously seen in adult rats with this dose of amphetamine.) An interesting difference emerged with scopolamine, which reduced head-dipping at all the ages tested, whereas in adults it produced an increase. The age-related difference in drug effects suggests that muscarinic pathways are functioning from Day 16, but that the system concerned with exploration functions differently in mature and immature rats. Both scopolamine and methylscopolamine reduced rearing which suggests that the change is due to peripheral actions of the drugs. Parachlorophenylalanine, which decreases serotonin levels, increased head-dipping, as it has been found to do in adult rats.

Aging↗

PubMed2003

Rest: a qualitative exploration of the phenomenon.

The founders of occupational therapy perceived rest as one of the performance areas of the profession. They believed that an optimal balance between work, play and rest was crucial in obtaining maximal function and health. However, few occupational therapy theorists or researchers have explored the phenomenon. The authors explored the phenomenon of rest as reported in the literature and through a qualitative study. The results of the literature review showed that rest is differentiated from sleep; rest is equated with interrupting physical and mental activity resulting in a relaxed state. Rest can be achieved by listening to music, hypnosis, reading, walking and sitting quietly. In this exploratory study, seven individuals working at Tel Aviv University were interviewed regarding their definitions of rest. The results indicated that rest was defined as an activity that was personal, quiet and effortless, experienced alone or with friends, and helped in doing daily activities. It is concluded that there is a need for occupational therapists to explore further the phenomenon of rest as it relates to occupational performance, ergonomics and health maintenance. Examining the concept of rest is a challenge that involves returning to the theoretical origins of the profession.

Humans↗

PubMed2002

Explorative laparoscopy prior to exenterative surgery.

OBJECTIVE: The objective of this study was to identify the advantages and limits of laparoscopy for assessment of eligibility for exenterative procedures in patients with gynecologic malignancies. METHODS: Between April 1998 and April 2001, 41 consecutive patients with primary or recurrent gynecologic malignancy underwent explorative laparoscopy to detect eligibility for exenteration. RESULTS: Mean age of patients was 54 years (range, 31-80 years). Twenty out of 41 (48.7%) patients underwent exclusively explorative laparoscopy due to unresectable disease or intraabdominal spread of disease. Median operative time for this cohort of patients was 69.1 min (range, 10-278), median blood loss was 30 cc (range 10-60) and no complications occurred. Based on findings of explorative laparoscopy 21 out of 41 (51.2%) patients were eligible for exenteration. Evaluation of extension of disease was correctly done by laparoscopy and was not corrected at laparotomy. One patient out of 21 (4.76%) had extension of disease missed at both laparoscopy and laparotomy and discovered only at an advanced phase of exenteration. Histology of exenterative specimens confirmed laparoscopic evaluation in 20 out of 21 patients (95.25%). CONCLUSIONS: Laparoscopy proved effective for evaluation of patients who were candidates for exenteration and helped to avoid unnecessary laparotomy in half of the candidate patients.

Adult↗

PubMed1996

Age differences in adolescent identity exploration and commitment in urban and rural environments

Sociocultural context may play an important role in identity development by shaping the opportunities adolescents are facing. To examine this, adolescents living in urban and rural environments were compared in terms of age differences in identity exploration and commitment. Younger (13-14-year-olds) and older (16-17-year-olds) males and females from urban and rural areas in both Australia (n=367) and Finland (n=316) were investigated. The participants completed the Exploration and Commitment Questionnaire which includes items concerning future education, occupation and family. The results showed that the older youths living in Australian urban environments showed higher levels of exploration and commitment concerning both their future education and occupation than the younger ones, whereas there was an age-related decrease in these variables among adolescents living in Australian rural areas. No urban vs. rural differences were found for Finnish adolescents.

Journal Article↗

PubMed2000

Possible selves as a mechanism for identity exploration.

This study examined one possible mechanism involved in the identity exploration process. From a constructivist perspective identity is conceptualized as a self-theory. Using self-theory as a model of identity, it was proposed that the exploration process involves the production of hypotheses or possibilities about the self. A total of 277 participants were given the EOM-EIS-2 in order to make identity status classifications, and the close-ended possible selves questionnaire in order to measure aspects of their possible selves. Because the Moratorium status is defined by active exploration, it was predicted that this status group would be associated with a greater number of possible selves. This prediction was confirmed, partly because of the greater number of negative possible selves that were endorsed, which could signify increased anxiety, balance, and motivation for change. Distinctions between the committed identity status groups and the Diffusion status group also emerged. The pattern of responses exhibited by the Diffusion group appears to reflect a lack of thought and confidence regarding positive prospects for the future.

Adolescent↗