Pub Date : 2021-12-06DOI: 10.1515/9783110729320-004
A. Watson, L. Jenkinson, C. Ball, A. Barlow, T. Norris
The incidence of mechanical complications associated with the Nissen fundoplication has prompted evaluation of an anti-reflux procedure designed to be simpler and more physiological, and encompassing a broader view of the many factors involved in the anti-reflux mechanism. Preliminary assessment of the first 100 patients with a mean follow-up of 3.5 years showed symptomatic improvement in 96 per cent and complete relief in 85 per cent. A further 100 patients were studied using formal symptom scoring, endoscopy, manometry and p H monitoring performed before operation and 3 months after operation. Similar clinical results were accompanied by improvement in endoscopic oesophagitis in 95 per cent, complete healing in 74 per cent and restoration of the pH profile to physiological levels in 84 per cent. Troublesome mechanical complications comprised a 2 per cent incidence of dysphagia, but there was no gas bloat or inability to belch or vomit, which ma): relate to the restoration of lower oesophageal sphincter characteristics close to those of 30 asymptomatic controls. The procedure is simpler to perform than total fundoplication, is well tolerated and is applicable to patients with reflux stricture and impaired oesophageal body motility. The results of this study support the hypotheses that effective reflux control can be achieved without total fundoplication by attention to several factors of known relevance to the anti-rejux mechanism, and that restoration of characteristics of the lower oesophageal sphincter close to physiological levels results in a lower incidence of mechanical complications.
{"title":"A","authors":"A. Watson, L. Jenkinson, C. Ball, A. Barlow, T. Norris","doi":"10.1515/9783110729320-004","DOIUrl":"https://doi.org/10.1515/9783110729320-004","url":null,"abstract":"The incidence of mechanical complications associated with the Nissen fundoplication has prompted evaluation of an anti-reflux procedure designed to be simpler and more physiological, and encompassing a broader view of the many factors involved in the anti-reflux mechanism. Preliminary assessment of the first 100 patients with a mean follow-up of 3.5 years showed symptomatic improvement in 96 per cent and complete relief in 85 per cent. A further 100 patients were studied using formal symptom scoring, endoscopy, manometry and p H monitoring performed before operation and 3 months after operation. Similar clinical results were accompanied by improvement in endoscopic oesophagitis in 95 per cent, complete healing in 74 per cent and restoration of the pH profile to physiological levels in 84 per cent. Troublesome mechanical complications comprised a 2 per cent incidence of dysphagia, but there was no gas bloat or inability to belch or vomit, which ma): relate to the restoration of lower oesophageal sphincter characteristics close to those of 30 asymptomatic controls. The procedure is simpler to perform than total fundoplication, is well tolerated and is applicable to patients with reflux stricture and impaired oesophageal body motility. The results of this study support the hypotheses that effective reflux control can be achieved without total fundoplication by attention to several factors of known relevance to the anti-rejux mechanism, and that restoration of characteristics of the lower oesophageal sphincter close to physiological levels results in a lower incidence of mechanical complications.","PeriodicalId":308586,"journal":{"name":"Müllers Großes Deutsches Ortsbuch 2021","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125201919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-06DOI: 10.1515/9783110729320-006
A. Mandell, Korey Haynes, E. Sinukoff, N. Madhusudhan, A. Burrows, D. Deming
Multi-dimensional instabilities have become an important ingredient in core-collapse supernova (CCSN) theory. Therefore, it is necessary to understand the driving mechanism of the dominant instability. We compare our parameterized three-dimensional CCSN simulations with other buoyancy-driven simulations and propose scaling relations for neutrino-driven convection. Through these comparisons, we infer that buoyancy-driven convection dominates post-shock turbulence in our simulations. In support of this inference, we present four major results. First, the convective fluxes and kinetic energies in the neutrino-heated region are consistent with expectations of buoyancy-driven convection. Second, the convective flux is positive where buoyancy actively drives convection, and the radial and tangential components of the kinetic energy are in rough equipartition (i.e., Kr ∼ Kθ + Kφ). Both results are natural consequences of buoyancy-driven convection, and are commonly observed in simulations of convection. Third, buoyant driving is balanced by turbulent dissipation. Fourth, the convective luminosity and turbulent dissipation scale with the driving neutrino power. In all, these four results suggest that in neutrino-driven explosions, the multi-dimensional motions are consistent with neutrino-driven convection.
{"title":"C","authors":"A. Mandell, Korey Haynes, E. Sinukoff, N. Madhusudhan, A. Burrows, D. Deming","doi":"10.1515/9783110729320-006","DOIUrl":"https://doi.org/10.1515/9783110729320-006","url":null,"abstract":"Multi-dimensional instabilities have become an important ingredient in core-collapse supernova (CCSN) theory. Therefore, it is necessary to understand the driving mechanism of the dominant instability. We compare our parameterized three-dimensional CCSN simulations with other buoyancy-driven simulations and propose scaling relations for neutrino-driven convection. Through these comparisons, we infer that buoyancy-driven convection dominates post-shock turbulence in our simulations. In support of this inference, we present four major results. First, the convective fluxes and kinetic energies in the neutrino-heated region are consistent with expectations of buoyancy-driven convection. Second, the convective flux is positive where buoyancy actively drives convection, and the radial and tangential components of the kinetic energy are in rough equipartition (i.e., Kr ∼ Kθ + Kφ). Both results are natural consequences of buoyancy-driven convection, and are commonly observed in simulations of convection. Third, buoyant driving is balanced by turbulent dissipation. Fourth, the convective luminosity and turbulent dissipation scale with the driving neutrino power. In all, these four results suggest that in neutrino-driven explosions, the multi-dimensional motions are consistent with neutrino-driven convection.","PeriodicalId":308586,"journal":{"name":"Müllers Großes Deutsches Ortsbuch 2021","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131174003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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