The efficacy of transnasal palatal transillumination for the diagnosis of submucous cleft palate

Background Submucous cleft palate (SMCP) is a congenital abnormality with various clinical and anatomical features. Submucous cleft pathologies may be unrecognized during routine examinations. Current diagnostic techniques are constrained and unrevealing in presurgical patients. This prospective study aimed to evaluate transnasal palatal transillumination technique in diagnosis of SMCP at our institute hospital, during period from 2005-2020. Patients and methods Twenty-one cases with SMCP were recruited with age range from 2-60 months. Transnasal palatal transillumination with controllable light intensity endoscope used to evaluate SMCP and cases were photo and video recorded. Results In this study, 21 cases (13 males and 8 females) with SMCP were detected or confirmed by intranasal transnasal palatal transillumination. Frequency of SMCP patients at our institute was 3.39%. All patients presented with symptomatic complaints at diagnosis time, apart from 5 patients (23.8%) were diagnosed during cleft lip repair operations. Presenting symptoms were hypernasality (23.8%), delayed speech (23.8%), perforated palate with nasal escape of milk and food (14.3%), feeding difficulties (14.3%), and otitis media (4.8%). During intra-oral examination, all cases had a bifid uvula accompanied SMCP. Submucous cleft palate appeared as thin palate with central lucency. According to operative findings, operations done for repair were mostly two long palatal flaps (n = 13, 61.9%), von Langenbeck (n = 5, 23.8%), simple repair with lateral release incisions (n = 2, 9.6%), and simple repair without lateral release incision (n = 1, 4.8%). Conclusions Intraoperative assessment of submucous cleft palate with transnasal palatal transillumination is easy and cheap method to avoid missing cases of SMCP.

THE ANTI-CORROSIVE REPAIR METHODS FOR DEGRADED WEATHERING STEEL BRIDGES

The existing rust with heavy amounts of salinity or anti-freezing agents on the weathering steel bridge surface can lead to serious durability issues. In the event that the anticorrosion functions of weathering steel bridges do not perform satisfactorily, it is necessary to eliminate the cause or to consider the repair coating and the life extension process. In order to achieve the expected life of the repair coating, it is important to perform the correct surface treatment, appropriate surface preparation (near-white blast cleaning, ISO standard Sa2 1/2 equivalent), and the certain removal of rust containing salinity (50 mg/m2 or below). This study provides state-of-the-art techniques on repair method, which is two repair coating methods and one simple repair method for weathering steel bridges. In 2015, some repair methods, with considerable effectiveness, were carried out to actual weathering steel bridges with undesired rust generation. The investigation of three years after repair coating shows that both repair coating film is confirmed to exhibit good corrosion resistance. The weathering steel surface repaired by simple repair method is also in a good state.

A simple repair mechanism can alleviate computational demands of pragmatic reasoning: simulations and complexity analysis

How can people communicate successfully while keeping resource costs low in the face of ambiguity? We present a principled theoretical analysis comparing two strategies fordisambiguation in communication: (i) pragmatic reasoning, where communicators reason about each other, and (ii) other-initiated repair, where communicators signal and resolve trouble interactively. Using agent-based simulations and computational complexity analyses, we compare the efficiency of these strategies in terms of communicative success, computation cost and interaction cost. We show that agents with a simple repair mechanism can increase efficiency, compared to pragmatic agents, by reducing their computational burden at the cost of longer interactions. We also find that efficiency is highly contingent on the mechanism, highlighting the importance of explicit formalisation and computational rigour.

Laparoscopic repair of a Morgagni hernia with extra-abdominal transfascial sutures

Morgagni hernia is a congenital diaphragmatic hernia. It is rare, usually asymptomatic, and most of the times incidentally discovered during adulthood. A 77-year-old female patient was incidentally diagnosed with Morgagni hernia. Meanwhile, because of abdominal pain she resorted to the emergency department. A CT scan was performed. A laparoscopic repair with extra-abdominal transfascial sutures was conducted. At 3-month follow-up, the patient is asymptomatic. Surgical repair of Morgagni hernia is always indicated because of the risk of strangulation of hernia contents. Minimal invasive surgery is the gold standard, and laparoscopy is the preferred approach. Morgagni hernia does not have an anterior rim, which makes it technically difficult to close the defect. Extra-abdominal transfascial technique was used to repair the defect, eliminating the need for intracorporeal sutures. For small defects, simple repair with non-absorbable sutures using extra-abdominal transfascial technique is easy and efficient.