Uncertainty theories applied to the analysis of CO2 plume extension during geological storage

We use the IRS (Independent Random Set) method to combine both aleatory and epistemic uncertainties in the prediction, by means of an analytical model, of CO2 plume extension during geological storage. While some model parameters can be handled within a classical probability framework, due to the availability of data, other parameters are dealt with using possibility theory, due to the imprecise/incomplete nature of the available information. Results of calculated CO2 plume extension are presented in terms of distributions of the upper and lower probability that plume migration distance lies below a certain value. In a decision-making framework, these results could be combined into a single distribution, referred to here as a “confidence index”, such as a weighted average of upper (optimistic) and lower (pessimistic) probabilities that migration distance is below a certain value. The selected weight reflects the decision-maker’s degree of “risk aversion”

Bijective counting of plane bipolar orientations and Schnyder woods

A bijection Φ is presented between plane bipolar orientations with prescribed numbers of vertices and faces, and non-intersecting triples of upright lattice paths with prescribed extremities. This yields a combinatorial proof of the following formula due to Baxter for the number Θij of plane bipolar orientations with i non-polar vertices and j inner faces: Θij=2(i+j)!(i+j+1)!(i+j+2)!i!(i+1)!(i+2)!j!(j+1)!(j+2)!. In addition, it is shown that Φ specializes into the bijection of Bernardi and Bonichon between Schnyder woods and non-crossing pairs of Dyck words.This is the extended and revised journal version of a conference paper with the title “Bijective counting of plane bipolar orientations”, which appeared in Electr. Notes in Discr. Math. pp. 283–287 (Proceedings of Eurocomb’07, 11–15 September 2007, Sevilla)

Mid-term results of right axillary incision for the repair of a wide range of congenital cardiac defects☆

OBJECTIVE: We evaluated the mid-term results of the right axillary incision used for the repair of various congenital heart defects. METHODS: All the patients who were operated with this incision between March 2001 and December 2007 were reviewed. There were 123 patients (median age 4.7 {0.4-19.4} years and median weight 16.6 {3.8-62} kg) undergoing atrial septal defect (ASD) closure (62), repair of partial anomalous pulmonary venous connection (PAPVC) (22), correction of partial atrioventricular septal defect (AVSD) (19), and restrictive perimembranous ventricular septal defect (VSD) (20). Additional procedures involved tricuspid valve plasty (10), mitral annuloplasty (3), reduction plasty of the aortic sinus (2), resuspension of the aortic valve cusp (2), sub aortic membrane resection (1), or reimplantation of Scimitar vein (1). The surgical technique involved peripheral (groin) and central (SVC+/-aorta) cannulation for institution of cardiopulmonary bypass. Fibrillatory arrest was used for repair of ASDs and cardioplegic arrest for repairs involving the atrioventricular valves as well as VSDs. The median CPB and aortic clamp times were 72 (35-232) and 0 (0-126) min, respectively. RESULTS: There was no need for conversion to another approach in any patient. Early morbidity included transient paresis of left upper arm (1), stenting of SVC after repair of a sinus venosus defect (1) and revision for bleeding (1). Follow-up echo showed no residual defect in 116 patients and minor residual defects in 7 patients: tiny ASD (2), tiny VSD (1) and mitral regurgitation (4). One patient developed stenosis in the right external iliac artery used for cannulation, necessitating surgical intervention. All the patients are in excellent condition after a median follow-up of 4.1 (0.4-7.1) years. The incision healed well and the thorax and the breast showed no deformity on follow-up. CONCLUSIONS: The right axillary incision provides a quality of repair for various congenital defects similar to that obtained by using standard surgical approaches. Because of its deceitful location, and the camouflaging effect of being hidden by the resting arm, it has superior cosmetic appeal compared to conventional incisions. The incision does not interfere with subsequent development of the thorax or the breast (in case of females)

Results of the double switch operation for congenitally corrected transposition of the great arteries☆

Congenitally corrected TGA (CC-TGA) is characterized by discordant atrioventricular and ventriculo arterial connections. In absence of right ventricular outflow tract obstruction (RVOTO), repair by atrial and arterial switches remains a challenging procedure for which long term follow-up is uncertain.From 1995 to 2007, 20 patients (median age: 26 months) with CC-TGA had double switch procedure. Segmental anatomy was {SLL} in all patients, dextrocardia in two patients, mesocardia in two patients. Ventricular septal defect was present in 17 patients, aortic coarctation in 2 patients and interrupted aortic arch (IAoA) in 1 patient. Five patients had tricuspid valve regurgitation. Six patients had AV blocks, 4 patients had pacemaker implantation prior to repair. Pulmonary artery banding was performed in 17 patients, for congestive heart failure (14 patients) or left ventricular retraining (3 patients). Three patients, including one patient with IAoA had primary repair. After LV retraining, repair was performed when indexed LV mass to LV volume ratio was above 1.5. A median follow-up of 60 months was achieved in all.There were no deaths. Postoperative pacemaker implantation was required in four patients. Reoperation for Senning obstruction was necessary in one patient, and pacemaker battery replacement in another patient. One patient had mild neoaortic insufficiency, two had mild tricuspid regurgitation and two had mild mitral regurgitation. All were in NYHA I-II. Actuarial survival at 10 years was 100% and freedom from reoperation at 5 and 10 years were 93% and 77.4%, respectively.Double switch for CC-TGA without RVOTO can be performed with no mortality and low morbidity. Since these results seem to last for several years, it should be considered as the optimal procedure.

Totally endoscopic lobectomy and segmentectomy for congenital bronchial atresia

Congenital bronchial atresia is a congenital obliteration of a segmental or lobar bronchus resulting in an inflation of the correspondent parenchyma. It may lead to infectious complications and in the long-term to alteration of the adjacent lung parenchyma. As it usually occurs in young and healthy patients with normal lungs, this disorder is particularly suitable for a full endoscopic pulmonary resection. We report our recent experience of two lobectomies and one segmentectomy in three patients.

Giant aneurysmal dilation of an intralobar pulmonary sequestration artery

Bronchopulmonar intralobar sequestrations receive their arterial blood supply through anomalous arteries from the systemic circulation. Usually the lumen of the aberrant artery can be oversized, but it is unusual to find a true arterial aneurysm. Here, we report a case of a 40-year-old woman with this unusual evolution. Because of the potential risk of rupture, she was treated with a lobectomy associated with a resection of the aneurysm.

Anomalous partial pulmonary venous drainage

An 80-year-old man underwent a thoracoscopic right upper lobectomy for cT2N0 lung carcinoma. A partial anomalous drainage of the right superior pulmonary veins to the superior vena cava was discovered (Fig. 1). It was visible on computed tomography (CT) scan (Fig. 2a) and volume-rendering reconstruction (Fig. 2b). No other cardiac abnormality was found on echocardiography. Fig. 2. (a) The diagnosis could have been suspected on the axial slices of CT scan. (b) Volume-rendering reconstruction confirms diagnosis.

Surgical glues: are they really adhesive?

The aim of this study is to create a standard test to approve the efficacy of a surgical sealant. An industrial test, the bulge-and-blister test, which is very convenient for measuring adhesion energy, is applied to the surgical field to quantify adhesion of bioadhesives.

Unusual presentation of catamenial pneumothorax

The importance of chromosome studies in Roberts syndrome/SC phocomelia and other cohesinopathies

Roberts syndrome/SC phocomelia is a rare, autosomal recessive syndrome characterised by pre- and postnatal growth retardation, microcephaly, craniofacial anomalies, mental retardation, and tetraphocomelia in varying degrees of severity. The clinical diagnosis can be challenging in phenotypically mild cases. In the extremely mild case presented here, specific mitotic abnormalities were detected and proved to be very helpful, since Roberts syndrome/SC phocomelia could be diagnosed after finding premature centromere separation and somatic aneuploidy at routine karyotyping. We discuss these and other mitotic cytogenetic abnormalities that can be of significant diagnostic importance, but which will be missed if only array studies are performed. We also discuss the difference between premature centromere separation and premature (sister) chromatid separation.