The efficacy of ERCP in detecting and treating post-laparoscopic cholecystectomy problems was examined in a series of consecutive patients undergoing directed examination of the biliary tree over a two-year period. Three major diagnostic groups were identified: leaks and bile duct injuries (n = 9), retained common bile duct stones (n = 18), and post-cholecystectomy pain (n = 13). These diagnost...

The cystic dilatation of the common bile duct is a rare disease in Europe and in the USA; even rarer in adults. In fact less than 30% of cases are described in the over 20's. There are some reports in the elderly. When observed in adults the diagnosis is usually due to the onset of symptoms of associated pathologies or to complications such as cholangitis or cancer. Ultrasound, CT and ERCP allo...

Currently laparoscopic cholecystectomy (LC) and common bile duct exploration (LCBDE) has become the standard surgical procedure for cholecystolithiasis and choledocholithiasis. During the operation cystic duct and vessels are usually controlled by Hem-o-lok clips. However, recently we found clips dropping into CBD in 8 patients during fiberoptic choledochoscope 2-3 months after operation. There...

A 29 year old morbidly obese patient suffered injury to his common bile duct during cholecystectomy. Subsequent access to the biliary tree was obtained by using a long heavy gauge needle after first opacifying the system with contrast injection through a nasobiliary tube. It is now twenty six months after initial percutaneous biliary drainage placement and eighteen months after removal of all b...

The idea of Component-based software development (CBSD) is to build large software system by assembling a set of previously developed software components that can be independently deployed, configured and connected together. The basic foundation of this approach is that common parts should be written once rather writing them again and again from scratch and that common system should be assemble...

PURPOSE T-tube is a major procedure that prevents complication by biliary decompression, but which is accompanied by complications. Therefore, several procedures such as ENBD, PTBD, and antegrade biliary stent have been attempted, but with controversies as to which procedure is superior. Also, there are no standard procedures after laparoscopic CBD exploration. We performed this study to ascert...

Architecture Description Languages (ADLs) provide formality in the description of software architectures, but are not easily reconciled with day-to-day development concerns, thus hampering their adoption by a larger community. UML, on the other hand, has become widespread throughout industry and academia and can be used as a bridge from architectural to design elements. In this paper we use the...

The United Nations declared 2010 to be the International Year of Biodiversity to celebrate biodiversity, increase understanding about how biodiversity is critical for sustaining life on Earth, and to highlight the ongoing and increasing loss of biodiversity. The emphasis of this campaign is on people and biodiversity, and the monetary value of biodiversity in terms of goods and services, rather...

There is a developing trend to change the flow configuration in urban downtown or central business districts CBD from one way to two way. However, it has been difficult to reasonably estimate the traffic flow resulting from the two-way conversion. This paper presents a multiple resolution simulation and assignment approach to estimate traffic and environmental impacts due to different flow conf...

There are numerous examples of approximately degenerate states of opposite parity in molecular physics. Theory indicates that these doubles can occur in molecules that are reflection-asymmetric. Such parity doubles occur in nuclear physics as well, among nuclei with odd A ∼ 219-229. We have also suggested elsewhere that such doubles occur in particle physics for baryons made up of cbu and cbd q...