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Percutaneous Mesh Expansion and Fixation at the Retro-Rectus Plane without Stabs by Using redirecting Suture Hook in Midline Hernias Repair

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Surgical Science 2011年第4期2卷 177-182页

作者： Ahmed E Lasheen Alaa N. El Sadek Adel M Tolba Emad Salah Ayman F Mehanna 不详

Background: Mesh expansion and fixation at retro-rectus plane through multiples stabs produces good results. But these stabs cause cosmetic disorders for the patients and doctors. So, we find some modification to do this procedure without these stabbing wounds in midline hernial repair. Patients and methods: This technique was used to fix the mesh at retro-rectus plane in 50 patients suffering from midline hernias, from January 2008 through January 2010 at Zagazig university Hospital, Egypt. Laparotomy incision was done over the hernial sac or at old incision;the contents were then released and reduced into peritoneal cavity without much subcutaneous dissection. The suitable sheet of polypropylene mesh to cover the hernial defect and any weak area was prepared and fixed at retro-rectus plane percutaneously without stabbing wounds by using redirecting suture hook. The mean period of follow up was 26 months. Results: There was no recurrence during the period of follow up. Five patients developed subcutaneous bluish discoloration at the site of some stitches, which disappear within two weeks with conservative treatment. Conclusion: Percutaneous mesh expansion and fixation at retro-rectus plane by using redirecting suture hook procedure has good results in recurrence rate and cosmetic appearance.

关键词： Percutaneous Fixation Retro-Rectus Mesh redirecting Suture Hook

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Evolution and challenges of DNS-based GDMs

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Digital Communications and Networks 2018年第4期4卷 235-243页

作者： Zheng Wang Jim Huang Scott Rose Advanced Network Technologies Division^National Institute of Standards and Technology USA School of Computer Science Chongqing University of Posts and TelecommunicationsChina

DNS-based server redirecting is considered the most popular means of deploying CDNs. However, with the inaeasing use of i"emol:e DNS, DNS-based CDNs face a great challenge in performance degradation. To address this issue, encouraging progress has been made in both industry and research communities. In this article,state-of- art solutions for the remote DNS problem are discussed at first. Next, privacy concerns about DNS-based CDNs, including client location as well as redirection privacy, are identified and a representative solution is summarized. Finally, the solution is compared to those in prior works under different measures, and a discussion on DNS-based CDN applications is provided. A model is also established to deepen the underst;anding of CDN performance. We believe that this survey will shed light on the application of DNS-based CDNs, and it is expected to provide design guidelines to CDN service providers.

关键词： Index terms Content delivery network DNS-Based server redirecting Remote DNS DNS privacy

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