Sample records for abdominal circulatory pump

  1. The ‘abdominal circulatory pump’: an auxiliary heart during exercise?

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    Barbara eUva


    Full Text Available Apart from its role as a flow generator for ventilation the diaphragm has a circulatory role. The cyclical abdominal pressure variations from its contractions cause swings in venous return from the splanchnic venous circulation. During exercise the action of the abdominal muscles may enhance this circulatory function of the diaphragm. Eleven healthy subjects (25±7yr, 70±11kg, 1.78±0.1m, 3F performed plantar flexion exercise at ∼4 METs. Changes in body volume (ΔVb and trunk volume (ΔVtr were measured simultaneously by double body plethysmography. Volume of blood shifts between trunk and extremities (Vbs was determined non-invasively as ΔVtr-ΔVb. Three types of breathing were studied: spontaneous (SE, rib cage (RCE, voluntary emphasized inspiratory rib cage breathing and abdominal (ABE, voluntary active abdominal expiration breathing.. During SE and RCE blood was displaced from the extremities into the trunk (on average 0.16± 0.33L and 0.48±0.55L, p<0.05 SE vs RCE, while during ABE it was displaced from the trunk to the extremities (0.22±0.20L p<0.001, p<0.05 RCE and SE vs ABE respectively. At baseline, Vbs swings (maximum to minimum amplitude were bimodal and averaged 0.13±0.08L. During exercise, Vbs swings consistently increased (0.42±0.34L, 0.40±0.26L, 0.46±0.21L, for SE, RCE and ABE respectively, all p<0.01 vs. baseline. It follows that during leg exercise significant bi-directional blood shifting occurs between the trunk and the extremities. The dynamics and partitioning of these blood shifts strongly depend on the relative predominance of the action of the diaphragm, the rib cage and the abdominal muscles. Depending on the partitioning between respiratory muscles for the act of breathing, the distribution of blood between trunk and extremities can vary by up to 1 L. We conclude that during exercise the abdominal muscles and the diaphragm might play a role of an ‘auxiliary heart’.


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    G. P. Itkin


    Full Text Available In a review of the comparative analysis of methods and tools for long-term mechanical circulatory support with continuous flow and pulsatile flow implantable pumps. Particular attention is paid to the choice of the optimal modes of the operation of pumps based on the physical principles of the interaction between a the steady flow of blood to the pulsatile mechanics of the heart chambers. 


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    A. M. Chernyavskiy


    Full Text Available The need of circulatory support systems in the treatment of chronic heart failure is increasing constantly, as 20% of the patients on the waiting list die every year. Despite the great need for mechanical heart support systems, the use of available systems is limited by its expensiveness. In addition, there is no one system that is 100% responsible to all medical and technical requirements and that would be completely safe for patient. Therefore, further research in the field of circulatory support systems considering health and technical requirements is relevant. One of the new directions in the study are disc pumps of viscous friction for liquid transporting, based on the Tesla pump principle. The operation principle of such pumps is based on the phenomenon of the boundary layer which is formed on the disk rotating in a fluid. There are experimental studies of models with different variants of the rotor suspension, various forms and numbers of the disks, forms of the pump housing. However, none of the above samples was brought to clinical trials. Furthermore, despite the potential of that model there have been no pumps of similar type used so far in circulatory support systems. Published data provide a basis for further development and testing of the pump model and allow hoping for leveling a number of significant shortcomings of modern left ventricular bypass systems. 

  4. Optimization of Centrifugal Pump Characteristic Dimensions for Mechanical Circulatory Support Devices. (United States)

    Korakianitis, Theodosios; Rezaienia, Mohammad A; Paul, Gordon M; Rahideh, Akbar; Rothman, Martin T; Mozafari, Sahand


    The application of artificial mechanical pumps as heart assist devices impose power and size limitations on the pumping mechanism, and therefore requires careful optimization of pump characteristics. Typically new pumps are designed by relying on the performance of other previously designed pumps of known performance using concepts of fluid dynamic similarity. Such data are readily available for industrial pumps, which operate in Reynolds numbers region of 10. Heart assist pumps operate in Reynolds numbers of 10. There are few data available for the design of centrifugal pumps in this characteristic range. This article develops specific speed versus specific diameter graphs suitable for the design and optimization of these smaller centrifugal pumps concentrating in dimensions suitable for ventricular assist devices (VADs) and mechanical circulatory support (MCS) devices. A combination of experimental and numerical techniques was used to measure and analyze the performance of 100 optimized pumps designed for this application. The data are presented in the traditional Cordier diagram of nondimensional specific speed versus specific diameter. Using these data, nine efficient designs were selected to be manufactured and tested in different operating conditions of flow, pressure, and rotational speed. The nondimensional results presented in this article enable preliminary design of centrifugal pumps for VADs and MCS devices.

  5. Antithrombogenic properties of a monopivot magnetic suspension centrifugal pump for circulatory assist. (United States)

    Yamane, Takashi; Maruyama, Osamu; Nishida, Masahiro; Kosaka, Ryo; Chida, Takahiro; Kawamura, Hiroshi; Kuwana, Katsuyuki; Ishihara, Kazuhiko; Sankai, Yoshiyuki; Matsuzaki, Mio; Shigeta, Osamu; Enomoto, Yoshiharu; Tsutsui, Tatsuo


    The National Institute of Advanced Industrial Science and Technology (AIST) monopivot magnetic suspension centrifugal pump (MC105) was developed for open-heart surgery and several weeks of circulatory assist. The monopivot centrifugal pump has a closed impeller of 50 mm in diameter, supported by a single pivot bearing, and is driven through a magnetic coupling to widen the fluid gap. Design parameters such as pivot length and tongue radius were determined through flow visualization experiments, and the effectiveness was verified in preliminary animal experiments. The maximum overall pump efficiency reached 18%, and the normalized index of hemolysis tested with bovine blood was as low as 0.0013 g/100 L. Animal experiments with MC105 were conducted in sheep for 3, 15, 29, and 35 days in a configuration of left ventricle bypass. No thrombus was formed around the pivot bearing except when the pump speed was reduced by 20% of normal operational speed, which reduced the pump flow by 40% to avoid inlet suction. Subsequently, the antithrombogenic design was verified in animal experiments for 5 weeks at a minimum rotational speed of greater than 1500 rpm and a minimum pump flow greater than 1.0 L/min; no thrombus formation was observed under these conditions.

  6. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices. (United States)

    Schibilsky, David; Lenglinger, Matthias; Avci-Adali, Meltem; Haller, Christoph; Walker, Tobias; Wendel, Hans Peter; Schlensak, Christian


    The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme-linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time-dependent activation of the coagulation (thrombin-antithrombin complexes [TAT]), complement (SC5b-9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P centrifugal CM device showed significantly lower activation of coagulation and inflammation than that of the HM II axial flow pump. Both HM II and CM have demonstrated an acceptable hemocompatibility profile in patients. However, there is a great opportunity to gain a clinical benefit by developing techniques to lower the blood surface interaction within both pump technologies and a magnetically levitated centrifugal pump design might be superior.

  7. Emergency Abdominal Aortic Aneurysm Repair in a Patient with Failing Heart: Axillofemoral Bypass Using a Centrifugal Pump Combined with Levosimendan for Inotropic Support

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    Pavel Michalek


    Full Text Available We describe the case of an 83-year-old patient requiring repair of a large symptomatic abdominal aortic aneurysm (AAA. The patient was known to have coronary artery disease (CAD with symptoms and signs of significant myocardial dysfunction, left-heart failure, and severe aortic insufficiency. The procedure was performed with the help of both mechanical and pharmacological circulatory support. Distal perfusion was provided by an axillofemoral bypass with a centrifugal pump, with dobutamine and levosimendan administered as pharmacological inotropic support. The patient's hemodynamic status was monitored with continuous cardiac output monitoring and transesophageal echocardiography. No serious circulatory complications were recorded during the perioperative and postoperative periods. This paper suggests a potential novel approach to combined circulatory support in patients with heart failure, scheduled for open abdominal aortic aneurysm repair.

  8. A new method of providing pulsatile flow in a centrifugal pump: assessment of pulsatility using a mock circulatory system. (United States)

    Herreros, Jesús; Berjano, Enrique J; Sales-Nebot, Laura; Más, Pedro; Calvo, Irene; Mastrobuoni, Stefano; Mercé, Salvador


    Previous studies have demonstrated the potential advantages of pulsatile flow as compared with continuous flow. However, to date, physiologic pumps have been technically complex and their application has therefore remained in the experimental field. We have developed a new type of centrifugal pump, which can provide pulsatile as well as continuous flow. The inner wall of a centrifugal pump is pulsed by means of a flexible membrane, which can be accurately controlled by means of either a hydraulic or pneumatic driver. The aim of this study was to assess the hydraulic behavior of the new pump in terms of surplus hemodynamic energy (SHE). We conducted experiments using a mock circulatory system including a membrane oxygenator. No differences were found in the pressure-flow characteristics between the new pump and a conventional centrifugal pump, suggesting that the inclusion of the flexible membrane does not alter hydraulic performance. The value of SHE rose when systolic volume was increased. However, SHE dropped when the percentage of ejection time was reduced and also when the continuous flow (programmed by the centrifugal console) increased. Mean flow matched well with the continuous flow set by the centrifugal console, that is, the pulsatile component of the flow was exclusively controlled by the pulsatile console, and was therefore independent of the continuous flow programmed by the centrifugal console. The pulsatility of the new pump was approximately 25% of that created with a truly pulsatile pump.

  9. Optical Dynamic Analysis of Thrombus Inside a Centrifugal Blood Pump During Extracorporeal Mechanical Circulatory Support in a Porcine Model. (United States)

    Fujiwara, Tatsuki; Sakota, Daisuke; Ohuchi, Katsuhiro; Endo, Shu; Tahara, Tomoki; Murashige, Tomotaka; Kosaka, Ryo; Oi, Keiji; Mizuno, Tomohiro; Maruyama, Osamu; Arai, Hirokuni


    Complications due to pump thrombus remain the weak point of mechanical circulatory support (MCS), such as the use of a left ventricular assist device (LVAD) or extracorporeal membrane oxygenation, leading to poor outcomes. Hyperspectral imaging (HSI) is an effective imaging method using a hyperspectral (HS) camera, which comprises a spectrophotometer and a charge-coupled device camera to discriminate thrombus from whole blood. Animal experiments were conducted to analyze dynamic imaging of thrombus inside a prototype of a hydrodynamically levitated centrifugal blood pump using an HSI system. Six pigs were divided into a venous circulation group (n = 3) and an arterial circulation group (n = 3). Inflow and outflow cannulae were inserted into the jugular veins in the venous circulation group. The latter simulated an LVAD application. To create thrombogenic conditions, pump flow was maintained at 1 L/min without anticoagulation. An image of the bottom surface of the pump was captured by the HS camera every 4 nm over the wavelength range of 608-752 nm. Real-time dynamic images of the inside of the pump were displayed on the monitor. Appearance of an area displaying thrombus was detected within 24 h after the start of the circulation in every experiment. This imaging system also succeeded in determining the origins of pump thrombus: from inside the pump in two cases, and from outside in four cases. Two main possible sources of pump thrombus originating outside the pump were identified on autopsy: wedge thrombus around the inflow cannula; and string-like thrombus at the junction between the pump inlet and circuit tube. The results of this study from close observation of the changing appearance of pump thrombus may contribute to improvements in the safety of extracorporeal MCS.

  10. Periodic abdominal pumping supports leg development during metamorphosis in tenebrionid beetle Zophobas atratus. (United States)

    Ichikawa, Toshio


    Rhythmic abdominal pumping movements in a pupa of giant mealworm beetle Zophobas atratus caused large hemolymph pressure pulses of approximately 20 mmHg. The abdominal pumping movements were completely blocked by transecting the ventral nerve cord (VNC) between the first and second abdominal ganglia. Transection of the VNC until 2 days after pupation caused a developmental defect of adult legs: morphogenesis of the tibial and tarsal segments was severely retarded, and the segments remained covered with a thick pupal cuticle. The developmental defect was rescued by artificially inducing rhythmic abdominal bending for 3 days after transection of VNC. Blocking of the abdominal pump did not increase the amount of water loss during the pupal period. The transplanted tibial segments lacking active tracheal ventilation could form a thick adult cuticle. The results suggest that abdominal pumping movements during the pupal period support the development of adult legs by facilitating hemolymph circulation.

  11. Frequency of seal disruption with the sarns centrifugal pump in postcardiotomy circulatory assist. (United States)

    Curtis, J J; Boley, T M; Walls, J T; Demmy, T L; Schmaltz, R A


    We have used the Sarns centrifugal pump for uni- or biventricular assist in 58 patients with postcardiotomy cardiogenic shock. This device utilizes a spinning impeller pump that is magnetically coupled to a motor imparting rotary motion to incoming perfusate. Nine patients (16%) experienced 22 device failures, which consisted of a nonvisible disruption of the seal within the pumphead. This allowed fluid to accumulate between the pumphead and the motor necessitating change of the pumphead. The time to seal disruption was 10-149 h (median 48). Of the 22 seal disruptions, 18 occurred in 73 left ventricular pumps (25%), and 4 occurred in 38 right ventricular pumps (11%) p = 0.015. Left ventricular pumps failed at 10-144 h (median 48), and right ventricular pumps failed at 48-149 h (median 83) p = 0.02. The Sarns centrifugal pump is dependable for its intended use of cardiopulmonary perfusion. However, when used for postcardiotomy assist, seal disruption should be expected. It occurs sooner and is more common during left ventricular assist. We recommend inspection of the magnet chamber for evidence of seal disruption every 12 h with left ventricular assist and every 24 h with right ventricular assist.

  12. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant

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    Keisuke Nakanishi


    Full Text Available Extracorporeal membrane oxygenation (ECMO with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m 2 , who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients.


    Directory of Open Access Journals (Sweden)

    S. V. Gautier


    Full Text Available The paper describes the first clinical experience in RF of successful application of domestic circulatory support device based on implantable axial pump for two stage heart transplantation. This case demonstrate the effec- tiveness and safety of our device (АВК-Н for a longtime (270 days left ventricular bypass and the ability to perform a successful transplantation of donor,s heart after application of this system. 



    S. V. Gautier; G. P. Itkin; S. Yu. Shemakin; R. Sh. Saitgareev; V. N. Poptsov; V. M. Zakharevich; G. A. Akopov; A. Ya. Kormer; T. A. Khalilulin; O. P. Shevchenko; А. М. Nevzorov; I. А. Filatov; S. V. Selishev


    The paper describes the first clinical experience in RF of successful application of domestic circulatory support device based on implantable axial pump for two stage heart transplantation. This case demonstrate the effec- tiveness and safety of our device (АВК-Н) for a longtime (270 days) left ventricular bypass and the ability to perform a successful transplantation of donor,s heart after application of this system. 

  15. Centrifugal pump or pneumatic ventricle for short-term mechanical circulatory support? (United States)

    Deleuze, P H; Liu, Y; Tixier, D; Okude, J; Leandri, J; Gouault, M; Galacteros, F; Cachera, J P; Loisance, D


    Two comparable groups of four Holstein calves were implanted with different left ventricle assist devices: the Centrimed centrifugal pump (CP) (Sarns Inc.) or the UTAH 85 VAD pneumatic ventricle (University of Utah). Operative procedure, inflow and outflow cannulae, monitoring, heparinization, were identical in both groups. No transfusion was ever required. The study was terminated after three days and autopsy was performed on the calves. Left ventricular unloading provided by both devices was complete (LVEDP less than 1 mmHg) and identical. LV bypassed flow rate was higher in CP (0.045 L/min/kg) than in UTAH 85 VAD (0.035 L/min/kg) but with no statistical difference. Blood trauma was comparable in the two groups. Daily blood samples did not show any significant changes from baseline values in creatinine, hematocrit, fibrinogen. Platelet loss from initial level was 30%; serum lactate dehydrogenase rose 150% with no significant difference in the two groups; plasma free hemoglobin never reached significant values. At autopsy, thrombotic deposits on cannuale and renal infarction rate were similar. CP housing had to be changed every day, whereas no technical failure was ever observed with the UTAH 85 VAD. Clinical response and blood damage of the two pumps used as LVAD were the same. Considering the CP has to be replaced every 24 h, the cost of three CP's would be comparable to one Utah UVAD-85 if polyurethane tricusp semi-lunar valves are used in the latter. Until the UTAH-85 VAD becomes commercially available, simple valveless low-cost CP are very attractive for short-term mechanical support.

  16. Feasibility of a TinyPump system for pediatric CPB, ECMO, and circulatory assistance: hydrodynamic performances of the modified pump housing for implantable TinyPump. (United States)

    Yokoyama, Naoyuki; Suzuki, Masaaki; Hoshi, Hideo; Ohuchi, Katsuhiro; Fujimoto, Tetsuo; Takatani, Setsuo


    The TinyPump is a miniature centrifugal blood pump with an extremely small priming volume of 5 ml, allowing blood transfusion free cardiopulmonary bypass as well as extracorporeal membrane oxygenation in pediatric patients. In this study, a new pump housing with the angled inlet port (25 degrees toward impeller center with respect to the flow axis) was designed to optimize the pump displaced volume and to extend the application of the TinyPump to implantable support The fluid dynamic performance analysis revealed that the head pressure losses increased from 3 to 17 mm Hg in comparison with straight port design as the pump rotational speed increased from 2,000 to 4,000 rpm. This was probably caused by perturbed flow patterns at the site of the inlet bent port area and streamline hitting the off-center of the impeller. No significant effect on pumping efficiency was observed because of modification in inlet port design. Modification in the inflow and outflow port designs together with the drive mechanism reduces the height of the pump system, including the motor, to 27 mm yielding the displaced volume of 68 ml in comparison with 40 mm of the paracorporeal system with the displaced volume of 105 ml. Further analysis in terms of hemolytic as well as antithrombogenic performance will be carried out to finalize the housing design for the implantable version of the TinyPump.

  17. MedTech Mag-Lev, single-use, extracorporeal magnetically levitated centrifugal blood pump for mid-term circulatory support. (United States)

    Nagaoka, Eiki; Fujiwara, Tatsuki; Kitao, Takashi; Sakota, Daisuke; Shinshi, Tadahiko; Arai, Hirokuni; Takatani, Setsuo


    Short- to mid-term extracorporeal ventricular assist devices (VADs) are recommended for critical cardiogenic shock patients. We have designed a preclinical, single-use MedTech Mag-Lev VAD for one-month extracorporeal use. The impeller-rotor of the pump was suspended by a two degree-of-freedom active magnetic bearing in a 300 μm fluid gap, where the computational fluid dynamics analysis predicted a secondary flow of about 400-500 ml/min at a pump speed of 1800-2200 rpm. Three eddy current sensors were employed to implement noise- and drift-free magnetic levitation. The pump components were injection molded using polycarbonate for smooth surfaces as well as improved reproducibility, followed by coating with a biocompatible 2-methacryloyl-oxyethyl phosphorylcholine polymer. Chronic animal experiments were performed in nine calves. Three of the nine calves were excluded from analysis for problems with the circuit. Five of the six (83.3%) completed the 60 day duration of the study, while one prematurely died of massive bleeding due to inflow port detachment. The pump did not stop due to magnetic-levitation malfunction. Neither pump thrombosis nor major organ infarction was observed at autopsy. In comparison to machined surfaces, the injection-molded pump surfaces were thrombus-free after 60 day implantation. This study demonstrates the feasibility of MedTech Mag-Lev VAD for 60 day circulatory support.

  18. Baclofen pump catheter leakage after migration of the abdominal catheter in a pediatric patient with spasticity. (United States)

    Dastgir, Amer; Ranalli, Nathan J; MacGregor, Theresa L; Aldana, Philipp R


    The authors report an unusual case of intrathecal baclofen withdrawal due to the perforation and subsequent leakage of a baclofen pump catheter in a patient with spastic cerebral palsy. A 15-year-old boy underwent an uncomplicated placement of an intrathecal baclofen pump for the treatment of spasticity due to cerebral palsy. After excellent control of symptoms for 3 years, the patient presented to the emergency department with increasing tremors following a refill of his baclofen pump. Initial evaluation consisted of radiographs of the pump and catheter, which appeared normal, and a successful aspiration of CSF from the pump's side port. A CT dye study revealed a portion of the catheter directly overlying the refill port and extravasation of radiopaque dye into the subfascial pocket anterior to the pump. During subsequent revision surgery, a small puncture hole in the catheter was seen to be leaking the drug. The likely cause of the puncture was an inadvertent perforation of the catheter by a needle during the refilling of the pump. This case report highlights a unique complication in a patient with an intrathecal baclofen pump. Physicians caring for these patients should be aware of this rare yet potential complication in patients presenting with baclofen withdrawal symptoms.

  19. How should an infected perinephric haematoma be drained in a tetraplegic patient with baclofen pump implanted in the abdominal wall? – A case report

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    Watt John WH


    Full Text Available Abstract Background We present a case to illustrate controversies in percutaneous drainage of infected, perinephric haematoma in a tetraplegic patient, who had implantation of baclofen pump in anterior abdominal wall on the same side as perinephric haematoma. Case presentation A 56-year-old male with C-4 tetraplegia had undergone implantation of programmable pump in the anterior abdominal wall for intrathecal infusion of baclofen to control spasticity. He developed perinephric haematoma while he was taking warfarin as prophylactic for deep vein thrombosis. Perinephric haematoma became infected with a resistant strain of Pseudomonas aeruginosa, and required percutaneous drainage. Positioning this patient on his abdomen without anaesthesia, for insertion of a catheter from behind, was not a realistic option. Administration of general anaesthesia in this patient in the radiology department would have been hazardous. Results and Conclusion Percutaneous drainage was carried out by anterior approach under propofol sedation. The site of entry of percutaneous catheter was close to cephalic end of baclofen pump. By carrying out drainage from anterior approach, and by keeping this catheter for ten weeks, we took a risk of causing infection of the baclofen pump site, and baclofen pump with a resistant strain of Pseudomonas aeruginosa. The alternative method would have been to anaesthetise the patient and position him prone for percutaneous drainage of perinephric collection from behind. This would have ensured that the drainage track was far away from the baclofen pump with minimal risk of infection of baclofen pump, but at the cost of incurring respiratory complications in a tetraplegic subject.

  20. Unexplained abdominal pain as a driver for inappropriate therapeutics: an audit on the use of intravenous proton pump inhibitors

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    Pauline Siew Mei Lai


    Full Text Available Background. Proton pump inhibitors (PPIs are currently the most effective agents for acid-related disorders. However, studies show that 25–75% of patients receiving intravenous PPIs had no appropriate justification, indicating high rates of inappropriate prescribing.Objective. To examine the appropriate use of intravenous PPIs in accordance with guidelines and the efficacy of a prescribing awareness intervention at an Asian teaching institution.Setting. Prospective audit in a tertiary hospital in Malaysia.Method. Every 4th intravenous PPI prescription received in the pharmacy was screened against hospital guidelines. Interventions for incorrect indication/dose/duration were performed. Patients’ demographic data, medical history and the use of intravenous PPI were collected. Included were all adult inpatients prescribed intravenous PPI.Main Outcome Measure. Proportion of appropriate IV PPI prescriptions.Results. Data for 106 patients were collected. Most patients were male [65(61.3%], Chinese [50(47.2%], with mean age ± SD = 60.3 ± 18.0 years. Most intravenous PPI prescriptions were initiated by junior doctors from the surgical [47(44.3%] and medical [42(39.6%] departments. Only 50/106(47.2% patients had upper gastrointestinal endoscopy/surgery performed to verify the source of bleeding. Unexplained abdominal pain [81(76.4%] was the main driver for prescribing intravenous PPIs empirically, out of which 73(68.9% were for suspected upper gastrointestinal bleed. Overall, intravenous PPI was found to be inappropriately prescribed in 56(52.8% patients for indication, dose or duration. Interventions on the use of intravenous PPI were most effective when performed by senior doctors (100%, followed by clinical pharmacists (50%, and inpatient pharmacists (37.5%, p = 0.027.Conclusion. Inappropriate intravenous PPI usage is still prevalent despite the enforcement of hospital guidelines. The promotion of prescribing awareness and evidence

  1. Transfusion associated circulatory overload

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    Naveen Agnihotri


    Full Text Available Transfusion associated circulatory overload (TACO is an established, but grossly under diagnosed and underreported complication of blood transfusion. We present the case of a 46-year-old diabetic and hypertensive patient admitted to our hospital for recurrent episodes of urinary retention. Over initial 3 days of the admission, the patient received multiple units of packed red blood cells (RBC and fresh frozen plasma, uneventfully. However, the patient developed signs and symptoms suggestive of TACO with only small amount of the 4 th unit of RBC. The patient had to be shifted to the Intensive Care Unit for further management of this complication. Etiology of TACO is more complex than a mere circulatory overload and is still not completely understood. TACO leads to a prolonged hospital stay and morbidity in the patients developing this complication. TACO thus needs to be suspected in patients at risk for this complication.

  2. PUMPS (United States)

    Thornton, J.D.


    A pump is described for conveving liquids, particure it is not advisable he apparatus. The to be submerged in the liquid to be pumped, a conduit extending from the high-velocity nozzle of the injector,and means for applying a pulsating prcesure to the surface of the liquid in the conduit, whereby the surface oscillates between positions in the conduit. During the positive half- cycle of an applied pulse liquid is forced through the high velocity nozzle or jet of the injector and operates in the manner of the well known water injector and pumps liquid from the main intake to the outlet of the injector. During the negative half-cycle of the pulse liquid flows in reverse through the jet but no reverse pumping action takes place.

  3. Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support


    Pacholewicz, Jerzy; Zakliczyński, Michał; Kowalik, Violetta; Nadziakiewicz, Paweł; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian


    Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware®) and a pulsatile pump (POLVAD MEV®), which allow regeneration of the native heart....

  4. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Løgstrup, Brian B; Vase, Henrik; Gjedsted, Jakob;


    Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements...... in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support....

  5. Dispositivo de assistência circulatória mecânica intraventricular de fluxo axial: estudo in vitro In vitro evaluation of an intraventricular axial flow pump for mechanical circulatory support

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    Luiz Fernando KUBRUSLY


    Full Text Available É apresentado estudo in vitro de um dispositivo de assistência circulatória totalmente implantável no ventrículo esquerdo, de fluxo axial e de tamanho pequeno (30 cc - 7 cm comprimento. Apesar dessas características foi capaz de gerar fluxos entre 5 - 8 l/min com motor, operando em 8 W, sem causar hemólise em período de até 12 horas. O custo de produção, excetuando-se o sistema de baterias, foi projetado entre 5 - 8 mil dólares, o que o torna viável para utilização clínica rotineira em nosso país.We are currently studying an intraventricular axial flow blood pump in vitro. It is designed for long term left ventricular support. The small (30 cc, 7 cm length was capable of producing flows of 5 - 8 l/min on a 8 W motor, with no device related hemolysis throughout the 12 h of the study. The cost of production, except for the batteries, has been estimated at between 5 - 8 thousand dollars, a reasonable amount for routine clinical use in Brazil.

  6. Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. (United States)

    Valenta, Ines; Dilsizian, Vasken; Quercioli, Alessandra; Jüngling, Freimut D; Ambrosio, Giuseppe; Wahl, Richard; Schindler, Thomas H


    Increases in intra-abdominal visceral adipose tissue have been widely appreciated as a risk factor for metabolic disorders such as dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, whereas this is not the case for peripheral or subcutaneous obesity. While the underlying mechanisms that contribute to these differences in adipose tissue activity remain uncertain, increases in visceral fat commonly induce metabolic dysregulation, in part because of increased venous effluent of fatty acids and/or adipokines/cytokines to the liver. Increased body weight, paralleled by an increase in plasma markers of the insulin-resistance syndrome and chronic inflammation, is independently associated with coronary circulatory dysfunction. Recent data suggest that plasma proteins originating from the adipose tissue, such as endocannabinoids (EC), leptin, and adiponectin (termed adipocytes) play a central role in the regulation and control of coronary circulatory function in obesity. Positron emission tomography (PET) in concert with tracer kinetic modeling is a well established technique for quantifying regional myocardial blood flow at rest and in response to various forms of vasomotor stress. Myocardial flow reserve assessed by PET provides a noninvasive surrogate of coronary circulatory function. PET also enables the monitoring and characterization of coronary circulatory function in response to gastric bypass-induced weight loss in initially morbidly obese individuals, to medication and/or behavioral interventions related to weight, diet, and physical activity. Whether the observed improvement in coronary circulatory dysfunction via weight loss may translate to diminution in cardiovascular events awaits clinical confirmation.

  7. [Oral contraception and circulatory risks]. (United States)

    Wingrave, S J


    The longterm prospective study of health effects of oral contraceptives (OCs) conducted by the Royal College of General Practitioners compared 23,000 OC users with 23,000 controls matched for age and marital status. As of 1981, 55 deaths attributable to circulatory problems had occurred in ever-users of OCs, ciompared to 10 in controls, giving a relative risk of 4.2 for OC users. No relation was found between duration of use and mortality risk among users, although mortality risks were greater at all durations of use than for nonusers. Parity was related to mortality risk among users but not among controls. The most significant factors affecting the relation between pill use and circulatory risk were age and smoking. Among users who smoked, the risk ratios were 3.4 for those aged 25-34, 4.2 for those aged 35-44, 7.4 for those aged 45 and over, and 5.1 for the entire group. Among nonsmoking pill users, the ratios were 1.6 for those aged 25-34, 3.3 for those aged 35-44, 4.6 for those 45 and over, and 3.2 for the total sample. Among smokers, the rates of excess deaths were 1 in 10,000 for users aged 15-34, 1 in 2000 for those aged 35-44, and 1 in550 for those aged 45 and over. Among nonsmokers, the rates were 1 in 50,000 users for those aged 25-34, 1 in 6700 for those aged 35-44, and 1 in 2500 for those aged 45 and over. The majority of deaths were attributed to ischemic cardiac problems and to sub-arachnoid hemorrhages, and risks appeared to be elevated in former as well as current users. The total incidence of circulatory effects in former users appears to be elevated only for cerebrovascular disorders, but the suggestion of residual effects requires further study before conclusions can be drawn. Smokers who developed cardiovascular or cerebrovascular problems were at 2-3 times greater risk of dying than were other women. The percentages of fatal cases of ischemic heart and cerebrovascular diseases were 22.8% among ever-users who smoked, 10.9% among controls who

  8. Is our heart a well-designed pump? The heart along animal evolution. (United States)

    Bettex, Dominique A; Prêtre, René; Chassot, Pierre-Guy


    A carrier system for gases and nutrients became mandatory when primitive animals grew larger and developed different organs. The first circulatory systems are peristaltic tubes pushing slowly the haemolymph into an open vascular tree without capillaries (worms). Arthropods developed contractile bulges on the abdominal aorta assisted by accessory hearts for wings or legs and by abdominal respiratory motions. Two-chamber heart (atrium and ventricle) appeared among mollusks. Vertebrates have a multi-chamber heart and a closed circulation with capillaries. Their heart has two chambers in fishes, three chambers (two atria and one ventricle) in amphibians and reptiles, and four chambers in birds and mammals. The ventricle of reptiles is partially divided in two cavities by an interventricular septum, leaving only a communication of variable size leading to a variable shunt. Blood pressure increases progressively from 15 mmHg (worms) to 170/70 mmHg (birds) according to the increase in metabolic rate. When systemic pressure exceeds 50 mmHg, a lower pressure system appears for the circulation through gills or lungs in order to improve gas exchange. A four-chamber heart allows a complete separation of systemic and pulmonary circuits. This review describes the circulatory pumping systems used in the different classes of animals, their advantages and failures, and the way they have been modified with evolution.

  9. Haemodynamic and respiratory effects of an abdominal compression binder

    DEFF Research Database (Denmark)

    Toft, Mette Helene; Bülow, Jens; Simonsen, Lene


    In order to elucidate the circulatory and respiratory effects of a newly developed abdominal compression binder 25 healthy, normal weight subjects were studied. In supine position the central haemodynamics were measured and estimated with a Finapress device. Lower extremity venous haemodynamics w...

  10. Mechanical Circulatory Support Devices for Pediatric Patients With Congenital Heart Disease. (United States)

    Chopski, Steven G; Moskowitz, William B; Stevens, Randy M; Throckmorton, Amy L


    The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assist devices, cavopulmonary assist devices, and total artificial heart pumps continue to gain acceptance as viable treatment strategies for both adults and pediatric patients as bridge-to-transplant, bridge-to-recovery, and longer-term circulatory support alternatives. We present a review of the current and future MCS devices for patients having congenital heart disease (CHD) with biventricular or univentricular circulations. Several devices that are specifically designed for patients with complex CHD are in the development pipeline undergoing rigorous animal testing as readiness experiments in preparation for future clinical trials. These advances in the development of new blood pumps for patients with CHD will address a significant unmet clinical need, as well as generally improve innovation of the current state of the art in MCS technology.

  11. 77 FR 16038 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting (United States)


    ... by HeartWare, Inc. The HVAS is an implantable electrically powered centrifugal-flow rotary blood pump... require the creation of an abdominal pump pocket. The HVAS is indicated for use as a bridge to cardiac... Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) System sponsored by Cameron Health, Inc. The...

  12. Abdominal pain (United States)

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  13. Abdominal actinomycosis. (United States)

    Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K


    Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.

  14. [Circulatory failure in chronic glomerulo- and pyelonephritis]. (United States)

    Kulakov, G P; Melikian, A M; Seĭsembekov, T Z


    The frequency and degree of circulatory insufficiency depending on the stage of the disease are analyzed in 404 patients with chronic glomerulonephritis and 145 patients with chronic pyelonephritis aged 15 to 74 years. When the renal function is still preserved different degrees of circulatory insufficiency are diagnosed in 29.4% of patients. Circulatory insufficiency complicates more often chronic glomerulonephritis than pyelonephritis and is more common in the aged. Latent cardiac insufficiency is more common. In the period of chronic renal insufficiency cardiac decompensation is seen in 78.1% of cases, its frequency is practically the same in glomerulonephritis and pyelonephritis. The mechanisms of development of cardiac insufficiency and the principles of treatment depending on the functional state of the kidneys are discussed.

  15. Mechanical circulatory devices in acute heart failure. (United States)

    Teuteberg, Jeffrey J; Chou, Josephine C


    Cardiogenic shock remains a leading cause of mortality despite advances in the treatment of myocardial infarction and advanced heart failure. Medical therapy can be inadequate, and patients may need mechanical circulatory support (MCS). The proper application of MCS requires knowledge of the underlying cause of acute heart failure, familiarity with the circulatory support devices, and the potential benefits and limitations of device therapy. This article describes the most commonly used temporary ventricular assist devices and their use in the various causes of cardiogenic shock.

  16. Abdominal Sepsis. (United States)

    De Waele, Jan J


    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.

  17. An extended computational model of the circulatory system for designing ventricular assist devices. (United States)

    Hsu, Po-Lin; Cheng, Sean J; Saumarez, Richard C; Dawes, William N; McMahon, Richard A


    An extended computational model of the circulatory system has been developed to predict blood flow in the presence of ventricular assist devices (VADs). A novel VAD, placed in the descending aorta, intended to offload the left ventricle (LV) and augment renal perfusion is being studied. For this application, a better understanding of the global hemodynamic response of the VAD, in essence an electrically driven pump, and the cardiovascular system is necessary. To meet this need, a model has been established as a nonlinear, lumped-parameter electrical analog, and simulated results under different states [healthy, congestive heart failure (CHF), and postinsertion of VAD] are presented. The systemic circulation is separated into five compartments and the descending aorta is composed of three components to accurately yield the system response of each section before and after the insertion of the VAD. Delays in valve closing time and blood inertia in the aorta were introduced to deliver a more realistic model. Pump governing equations and optimization are based on fundamental theories of turbomachines and can serve as a practical initial design point for rotary blood pumps. The model's results closely mimic established parameters for the circulatory system and confirm the feasibility of the intra-aortic VAD concept. This computational model can be linked with models of the pump motor to provide a valuable tool for innovative VAD design.

  18. Abdominal Aortic Aneurysm (AAA) (United States)

    ... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  19. Pathophysiological roles of peroxynitrite in circulatory shock. (United States)

    Szabó, Csaba; Módis, Katalin


    Peroxynitrite is a reactive oxidant produced from nitric oxide and superoxide, which reacts with proteins, lipids, and DNA, and promotes cytotoxic and proinflammatory responses. Here, we overview the role of peroxynitrite in various forms of circulatory shock. Immunohistochemical and biochemical evidences demonstrate the production of peroxynitrite in various experimental models of endotoxic and hemorrhagic shock both in rodents and in large animals. In addition, biological markers of peroxynitrite have been identified in human tissues after circulatory shock. Peroxynitrite can initiate toxic oxidative reactions in vitro and in vivo. Initiation of lipid peroxidation, direct inhibition of mitochondrial respiratory chain enzymes, inactivation of glyceraldehyde-3-phosphate dehydrogenase, inhibition of membrane Na+/K+ ATPase activity, inactivation of membrane sodium channels, and other oxidative protein modifications contribute to the cytotoxic effect of peroxynitrite. In addition, peroxynitrite is a potent trigger of DNA strand breakage, with subsequent activation of the nuclear enzyme poly(ADP-ribose) polymerase, which promotes cellular energetic collapse and cellular necrosis. Additional actions of peroxynitrite that contribute to the pathogenesis of shock include inactivation of catecholamines and catecholamine receptors (leading to vascular failure) and endothelial and epithelial injury (leading to endothelial and epithelial hyperpermeability and barrier dysfunction), as well as myocyte injury (contributing to loss of cardiac contractile function). Neutralization of peroxynitrite with potent peroxynitrite decomposition catalysts provides cytoprotective and beneficial effects in rodent and large-animal models of circulatory shock.

  20. Energy transmission and power sources for mechanical circulatory support devices to achieve total implantability. (United States)

    Wang, Jake X; Smith, Joshua R; Bonde, Pramod


    Left ventricular assist device therapy has radically improved congestive heart failure survival with smaller rotary pumps. The driveline used to power today's left ventricular assist devices, however, continues to be a source of infection, traumatic damage, and rehospitalization. Previous attempts to wirelessly power left ventricular assist devices using transcutaneous energy transfer systems have been limited by restrictions on separation distance and alignment between the transmit and receive coils. Resonant electrical energy transfer allows power delivery at larger distances without compromising safety and efficiency. This review covers the efforts to wirelessly power mechanical circulatory assist devices and the progress made in enhancing their energy sources.

  1. Circulatory Shock. Volume 27, Number 4, 1989 (United States)


    23 pg/ml by 180 min and plasma TNFct increased 852 ± 187 by 90 min, then rapidly returned to baseline. Following 45 min of eccentric exercise , which...sham operation (SO). Four weeks following AC, cardiac hypertrophy was evidenced by significantly elevated (pɘ.001) heart weight-to-body weight ratios...ratio of BE/BLPH during circulatory stress (i.e., hypertrophy ). The ratio of BE/BLPH in the heart varies independently of that in the plasma in AC

  2. Ruptured abdominal aortic aneurysm and aortoiliac vein fistula. (United States)

    Gyoten, Takayuki; Doi, Toshio; Yamashita, Akio; Fukahara, Kazuaki; Kotoh, Keiju; Yoshimura, Naoki


    A 67-year-old man was admitted with severe abdominal pain and back pain. Computed tomography showed an infrarenal abdominal aortic aneurysm (8.4 × 8.3 cm) and a large retroperitoneal hematoma. Immediately afterwards, the patient suffered circulatory collapse and was rushed to the operating theater. A fistula communicating with the left iliac vein was found. It was repaired with a Dacron patch while balloon-tipped catheters controlled the bleeding. The abdominal aortic aneurysm was replaced with a bifurcated graft. The postoperative course was uneventful. There have been few reports of successful repair of a ruptured abdominal aortic aneurysm associated with aortoiliac arteriovenous fistula.

  3. A note on circulatory systems: Old and new results

    DEFF Research Database (Denmark)

    Kliem, Wolfhard; Pommer, Christian


    repeat this result in order to emphasize that the criterion is sufficient but not necessary for stability. Afterwards we concentrate on circulatory systems with purely imaginary eigenvalues and investigate the influence of indefinite damping. Finally the possibility of stabilizing circulatory systems...

  4. The artificial ventricle: A conceptual design for a novel mechanical circulatory support system. (United States)

    Sherif, Hisham M F


    We describe a novel design for a new mechanical circulatory support pump which can be utilized for single or biventricular support in a completely internal configuration. The device has a long projected service life, a totally implantable, readily available and off-the-shelf energy source. The proposed device is a pulsatile, positive-displacement blood pump composed of a conically-shaped compliance chamber, constructed of a biocompatible material and attached to two bioprosthetic valves (an inlet valve and an outlet valve), surrounded by radially-arranged contractile elements, made of an electro-active polymer and connected to a common stimulating electrode connected to an implantable permanent pacemaker. The entire assembly is housed in a hermetically sealed biologically inert shell. The energy output from the pacemaker will cause the deformation of the contractile elements and thus compression of the compliance chamber, effecting ejection of the blood through the outlet valve. Based on a design emulating the natural anatomic configuration, the device shall be able to provide clinically significant mechanical assistance and/or replacement of the native heart function and thus a means of supporting the failing ventricle(s) or replacing the failing heart for an extended period of time. The proposed design offers a new pulsatile, positive displacement mechanical circulatory support or replacement for one or both ventricles, is completely implantable, is composed of readily available materials, has minimal energy requirements and an extended service life on internal power supply.

  5. [Temporary use of centrifugal pump for pump thrombosis in patients with paracorporeal ventricular assist device]. (United States)

    Kimura, Mitsutoshi; Kinoshita, Osamu; Nawata, Kan; Yamauchi, Haruo; Itoda, Yoshifumi; Hoshino, Yasuhiro; Kashiwa, Koichi; Kubo, Hitoshi; Kurosawa, Hideo; Takahashi, Mai; Koga, Sayaka; Ono, Minoru


    Nipro paracorporeal ventricular assist device( VAD) is often associated with pump thrombosis which causes severe complications such as brain infarction, often requiring pump change. However, Nipro VAD pump is an expensive device and it is difficult to change pumps frequently at a short interval. We have temporarily used Rotaflow centrifugal pump for recurrent pump thrombosis in patients with Nipro VADs. From January 2012 through December 2013, 19 patients underwent Nipro VADs implantation at our institution, and 9 of them underwent pump change from Nipro pumps to Rotaflow centrifugal pumps. A total of 25 Rotaflow centrifugal pumps were used in these 9 patients, with the total circulatory support duration of 526 days. The median support period was 15 days (range;2-128 days). There were 2 cerebrovascular accidents and 1 Rotaflow pump circuit thrombosis during this period. Change from Rotaflow to Nipro VAD pump resulted in decrease in hematocrit by about 3 point. There was no difference in liver or renal function between before and after the pump change. Our results suggest that temporary use of Rotaflow centrifugal pump for recurrent pump thrombosis in patients with Nipro VADs may be a promising alternative.

  6. A multiple disk centrifugal pump as a blood flow device. (United States)

    Miller, G E; Etter, B D; Dorsi, J M


    A multiple disk, shear force, valveless centrifugal pump was studied to determine its suitability as a blood flow device. A pulsatile version of the Tesla viscous flow turbine was designed by modifying the original steady flow pump concept to produce physiological pressures and flows with the aid of controlling circuitry. Pressures and flows from this pump were compared to a Harvard Apparatus pulsatile piston pump. Both pumps were connected to an artificial circulatory system. Frequency and systolic duration were varied over a range of physiological conditions for both pumps. The results indicated that the Tesla pump, operating in a pulsatile mode, is capable of producing physiologic pressures and flows similar to the Harvard pump and other pulsatile blood pumps.

  7. Haemodynamic and respiratory effects of an abdominal compression binder

    DEFF Research Database (Denmark)

    Toft, M.H.; Bulow, J.; Simonsen, L.


    In order to elucidate the circulatory and respiratory effects of a newly developed abdominal compression binder 25 healthy, normal weight subjects were studied. In supine position the central haemodynamics were measured and estimated with a Finapress device. Lower extremity venous haemodynamics...... with or without the abdominal compression binder. The results show that the compression binder significantly increases the venous volume in the lower extremities as showed by a reduction in the venous capacitance in the lower extremities and a reduction in the stroke volume and cardiac output, while it does...... not influence the pulmonary volumes. It is concluded that the applied abdominal binder significantly affects peripheral and central haemodynamics. It should therefore be used with caution when in the supine position for longer periods, as the pooling of blood it induces in the lower extremities may have...

  8. State of the Art of Mechanical Circulatory Support


    Mallidi, Hari R.; Anand, Jatin; Cohn, William E.


    Mechanical circulatory support of the failing heart has become an important means of treating end-stage heart disease. This rapidly growing therapeutic field has produced impressive clinical outcomes and has great potential to help thousands of otherwise terminal patients worldwide. In this review, we examine the state of the art of mechanical circulatory support: current practice, totally implantable systems of the future, evolving biventricular support mechanisms, the potential for myocardi...

  9. The CIHR Circulatory and Respiratory Health Institute

    Directory of Open Access Journals (Sweden)

    Malcolm King


    Full Text Available The Canadian Institutes of Health Research (CIHR was officially established on June 7, 2000. Among the 13 institutes that were created, the Institute for Circulatory and Respiratory Health (C&R or CnR, which brings together researchers in the fields of heart, stroke, lung and blood research, has become the principal outlet for respiratory research in this country. Although this large, combined institute was not the first choice of our society or of the respiratory research community at large, we must respect this choice within the context of the new direction for Canadian health research and help to make it work. Over this past summer, the process of recruiting the scientific directors and advisory board members for each CIHR institute has proceeded at a rapid pace. As we go to press, the decisions on the appointment of the 13 inaugural scientific directors are being made. In addition, over the next few weeks, the institute advisory boards will be appointed. The CIHR Governing Council has the ultimate responsibility for these appointments. The Council represents a very broad cross-section of the health research community in Canada; all of us on the Council sincerely wish to see the very best team of directors and board members selected to fulfill these roles.

  10. Abdominal radiation - discharge (United States)

    Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...

  11. Abdominal aortic aneurysm (United States)

    ... this page: // Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  12. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...

  13. Post trauma abdominal cocoon. (United States)

    Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev


    Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  14. A straight path centrifugal blood pump concept in the Capiox centrifugal pump. (United States)

    Kijima, T; Oshiyama, H; Horiuchi, K; Nogawa, A; Hamasaki, H; Amano, N; Nojiri, C; Fukasawa, H; Akutsu, T


    This article describes comparative studies of a newly developed "straight path" centrifugal pump (Capiox centrifugal pump) targeted for open-heart surgery and circulatory support. A unique straight path design of the rotor was very effective in reducing the pump's rotational speed and prime volume. This pump was evaluated for hydraulics, hemolysis, depriming characteristics, cavitation, and heat generation. Two commercially available centrifugal pumps, the Biomedicus cone-type pump and the Sarns 3M impeller-type pump, were used as controls. The new pump required the lowest pump speed to produce the same flow rates under the same pressure loads and demonstrated the lowest hemolysis and the lowest temperature rise with the outlet clamped. The air volume required to deprime the new pump was one-third to one-half that for the other pumps, and no sign of cavitation was observed even if a small amount of air was introduced to the pump inlet under a negative pressure of 200 mm Hg.

  15. Circular pump support of blood circulation in the human body (United States)

    Medvedev, A. E.; Fomin, V. M.; Prikhodko, Yu. M.; Cherniavskiy, A. M.; Fomichev, V. P.; Fomichev, A. V.; Chekhov, V. P.; Ruzmatov, T. M.


    The need of circulatory support systems in the treatment of chronic heart failure is increasing constantly, as 20% of patients in the waiting list die every year. Despite the great need for mechanical heart support systems, using of available systems is limited by the expensiveness. In addition, there is no one system that is 100% responsible to all medical and technical requirements, and would be completely safe for patient. Therefore, further research in the field of circu-latory support systems, considering health and technical requirements is relevant. One of the new directions in the study are disc pumps of viscous friction for liquid transporting, based on the Tesla pump principle. The operation principle of pumps based on the phenomenon of the boundary layer which is formed on the disk rotating in a fluid. There are experimental studies results of models with different variants of the rotor suspension, the various forms and the number of disks, forms the pump housing. However, none of the above samples was not brought to clinical trials. Furthermore, despite the promise of this model is still used today in some circulatory support systems are no similar type pump. Published data provide a basis for further development and testing of the pump model and allow to hope for leveling a number of significant shortcomings of modern left ventricular bypass systems.

  16. Assessment of left heart and pulmonary circulation flow dynamics by a new pulsed mock circulatory system (United States)

    Tanné, David; Bertrand, Eric; Kadem, Lyes; Pibarot, Philippe; Rieu, Régis


    We developed a new mock circulatory system that is able to accurately simulate the human blood circulation from the pulmonary valve to the peripheral systemic capillaries. Two independent hydraulic activations are used to activate an anatomical-shaped left atrial and a left ventricular silicon molds. Using a lumped model, we deduced the optimal voltage signals to control the pumps. We used harmonic analysis to validate the experimental pulmonary and systemic circulation models. Because realistic volumes are generated for the cavities and the resulting pressures were also coherent, the left atrium and left ventricle pressure-volume loops were concordant with those obtained in vivo. Finally we explored left atrium flow pattern using 2C-3D+T PIV measurements. This gave a first overview of the complex 3D flow dynamics inside realistic left atrium geometry.

  17. The margin of safety in the use of a straight path centrifugal blood pump. (United States)

    Kijima, T; Nojiri, C; Oshiyama, H; Horiuchi, K; Nogawa, A; Hamasaki, H; Ogihara, M; Katsuda, H S; Amano, N; Fukasawa, H


    A new centrifugal blood pump with a rotor that arranges 6 straight paths radially was developed for open heart surgery and temporary circulatory support. We describe comparative studies of the margin of safety in the practical use of the new pump. This pump was evaluated for temperature increase, cavitation, and pressure sensitivity. Two commercially available centrifugal pumps, the Biomedicus cone type and the Sarns 3M impeller type, were used as control pumps. The temperature increase in the new pump was four times slower than in the impeller pump when the outlet and the inlet of the pump was clamped. No sign of cavitation was observed when 0.1 ml air was introduced to the pump inlet under a negative pressure of 200 mm Hg in fresh bovine blood. As for pressure sensitivity of centrifugal pumps in practical applications, circuit resistance was a more essential factor than flow-pressure curves of the pump.

  18. Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support. (United States)

    Pacholewicz, Jerzy; Zakliczyński, Michał; Kowalik, Violetta; Nadziakiewicz, Paweł; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian


    Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware(®)) and a pulsatile pump (POLVAD MEV(®)), which allow regeneration of the native heart. Patients were qualified as INTERMACS level 3-4 for elective implantation of an LVAD. Implantations were performed without complications. The postoperative course was uncomplicated. In the HeartWare patient the follow-up was complicated by episodes of epistaxis and recurrent GIB as well as driveline infection. The follow-up of the POLVAD MEV patient was uneventful. Recurrent GIB forced us to withdraw aspirin and warfarin therapy and maintain only clopidogrel in the HeartWare patient.. In mid-February 2013 the patient was admitted due to dysfunction of the centrifugal pump with a continuous low-flow alarm and increase power consumption. Under close monitoring of the patient a decision was made to stop the pump immediately and evaluate cardiac function. The serial echocardiography studies showed significant improvement in LVEF up to 45% and no significant valvular pathology. In February 2013 LVAD explant was performed by left thoracotomy without complications. At six-month follow-up the patient was in a good clinical condition, in NYHA class I/II, and on pharmacological treatment.

  19. Circulatory death determination in uncontrolled organ donors: a panel viewpoint. (United States)

    Bernat, James L; Bleck, Thomas P; Blosser, Sandralee A; Bratton, Susan L; Capron, Alexander M; Cornell, Danielle; DeVita, Michael A; Fulda, Gerard J; Glazier, Alexandra K; Gries, Cynthia J; Mathur, Mudit; Nakagawa, Thomas A; Shemie, Sam D


    One barrier for implementing programs of uncontrolled organ donation after the circulatory determination of death is the lack of consensus on the precise moment of death. Our panel was convened to study this question after we performed a similar analysis on the moment of death in controlled organ donation after the circulatory determination of death. We concluded that death could be determined by showing the permanent or irreversible cessation of circulation and respiration. Circulatory irreversibility may be presumed when optimal cardiopulmonary resuscitation efforts have failed to restore circulation and at least a 7-minute period has elapsed thereafter during which autoresuscitation to restored circulation could occur. We advise against the use of postmortem organ support technologies that reestablish circulation of warm oxygenated blood because of their risk of retroactively invalidating the required conditions on which death was declared.


    Directory of Open Access Journals (Sweden)

    G. P. Itkin


    Full Text Available The paper presents a review of the problems of mechanical circulatory support with left ventricular bypass in total cardiac failure. Dysfunction of right ventricular defines the high mortality on left ventricular device. One of the effective methods for solving this problem is the use of right ventricular assisted devices. There are considered of the basic physiological mechanisms of interaction between the right and left ventricles of the heart, affecting on the function of the right heart. Shows the need to assess right ventricular function before deciding on mechanical circulatory support. Provides examples of the estimation the predictors of the right ventricular failure. The basic methods and devices of biventricular circulatory support were con- sidered. 

  1. Abdominal epilepsy in chronic recurrent abdominal pain

    Directory of Open Access Journals (Sweden)

    V Y Kshirsagar


    Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9

  2. Centrifugal pumps

    CERN Document Server

    Anderson, HH


    Centrifugal Pumps describes the whole range of the centrifugal pump (mixed flow and axial flow pumps are dealt with more briefly), with emphasis on the development of the boiler feed pump. Organized into 46 chapters, this book discusses the general hydrodynamic principles, performance, dimensions, type number, flow, and efficiency of centrifugal pumps. This text also explains the pumps performance; entry conditions and cavitation; speed and dimensions for a given duty; and losses. Some chapters further describe centrifugal pump mechanical design, installation, monitoring, and maintenance. The

  3. Off-pump replacement of the INCOR implantable axial-flow pump. (United States)

    Nakashima, Kuniki; Kirsch, Matthias E W; Vermes, Emmanuelle; Rosanval, Odile; Loisance, Daniel


    Owing to the actual increase of mechanical circulatory support durations, total or partial replacement of ventricular assist devices (VADs) will most certainly have to be performed with increasing frequency. Herein we report the case of a patient in whom an INCOR (Berlin Heart AG, Berlin) implantable axial-flow pump was replaced without the use of cardiopulmonary bypass (CPB), underscoring some of the unique features provided by this system.

  4. [The diseases of circulatory system in employees of railway transport]. (United States)

    Molodtsov, R N; Shemetova, G N


    The article presents the epidemiologic and medical social aspects of diseases of circulatory system in employees of railway transport in 2000-2010 exemplified by Privolzhskiy railroad. The established tendencies in prevalence of pathology of cardio-vascular system in railroad workers makes the issues of practical implementation of priority of prevention in the organization of medical care to this group of patients to come to foreground. The main directions for complex prevention of diseases of circulatory system in employees of railway transport are presented.

  5. Abdominal Decompression in Children

    Directory of Open Access Journals (Sweden)

    J. Chiaka Ejike


    Full Text Available Abdominal compartment syndrome (ACS increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH by intra-abdominal pressure (IAP monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

  6. Pumping life

    DEFF Research Database (Denmark)

    Sitsel, Oleg; Dach, Ingrid; Hoffmann, Robert Daniel


    of membrane proteins: P-type ATPase pumps. This article takes the reader on a tour from Aarhus to Copenhagen, from bacteria to plants and humans, and from ions over protein structures to diseases caused by malfunctioning pump proteins. The magazine Nature once titled work published from PUMPKIN ‘Pumping ions......’. Here we illustrate that the pumping of ions means nothing less than the pumping of life....

  7. Abdominal Compartment Syndrome


    Ovchinnikov V.А.; Sokolov V.А.


    We considered one of the most complicated problems of surgery and intensive care — abdominal compartment syndrome. It is a severe, and in some cases lethal complication developing in major injuries and pathology of abdominal cavity and retroperitoneal space, as well as in extra-abdominal pathology. In addition, compartment syndrome can be the complication of a number of surgical procedures accompanied primarily by laparotomy wound closure with tissue tension. We demonstrated the classificatio...

  8. Abdominal Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Pınar Zeyneloğlu


    Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

  9. Post trauma abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Supreet Kaur


    Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.

  10. Negative pressure device for intra-abdominal pressure reduction

    Energy Technology Data Exchange (ETDEWEB)

    David, M; Geido, D; Pracca, F; Sanchez, G; Simini, F; Zoppolo, C [Nucleo de Ingenierfa Biomedica, Universidad de la Republica O. del Uruguay, Hospital de ClInicas, Av. Italia S/N, 11600, Montevideo (Uruguay)


    A device that generates negative extra-abdominal pressure (ABDOPRE) for treatment of patients with high intra-abdominal pressure was developed. It includes pressure sensors for transducing intra-abdominal pressure through an intra-vesical catheter and negative pressure in the vacuum bell which is placed over the abdomen. By means of a control system, a pattern for reducing IAP is set, according to a clinical protocol. The external negative pressure is generated using a vacuum pump connected to the bell. The system registers the values of interest for the medical history. The system is being tested over ICU patients, registering a satisfactory IAP reduction.

  11. Physiologic benefits of pulsatile perfusion during mechanical circulatory support for the treatment of acute and chronic heart failure in adults. (United States)

    Guan, Yulong; Karkhanis, Tushar; Wang, Shigang; Rider, Alan; Koenig, Steven C; Slaughter, Mark S; El Banayosy, Aly; Undar, Akif


    A growing population experiencing heart failure (100,000 patients/year), combined with a shortage of donor organs (less than 2200 hearts/year), has led to increased and expanded use of mechanical circulatory support (MCS) devices. MCS devices have successfully improved clinical outcomes, which are comparable with heart transplantation and result in better 1-year survival than optimal medical management therapies. The quality of perfusion provided during MCS therapy may play an important role in patient outcomes. Despite demonstrated physiologic benefits of pulsatile perfusion, continued use or development of pulsatile MCS devices has been widely abandoned in favor of continuous flow pumps owing to the large size and adverse risks events in the former class, which pose issues of thrombogenic surfaces, percutaneous lead infection, and durability. Next-generation MCS device development should ideally implement designs that offer the benefits of rotary pump technology while providing the physiologic benefits of pulsatile end-organ perfusion.

  12. Biological evaluation of mechanical circulatory support systems in calves

    NARCIS (Netherlands)

    Rakhorst, G; VanDerMeer, J; Kik, C; Mihaylov, D; Havlik, P; Trinkl, J; Monties, [No Value


    Data from animal experiments with mechanical circulatory support systems (MCSS) performed in Groningen and Marseille over the past years were used to obtain normal values of hematological, coagulation, rheological and blood chemistry parameters in calves. These parameters were divided between two gr

  13. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

    DEFF Research Database (Denmark)

    de By, Theo M M H; Mohacsi, Paul; Gummert, Jan


    other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry...

  14. Recurrent Abdominal Pain (United States)

    Banez, Gerard A.; Gallagher, Heather M.


    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  15. [Abdominal pregnancy, institutional experience]. (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q


    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  16. Fluid Dynamics in Rotary Piston Blood Pumps. (United States)

    Wappenschmidt, Johannes; Sonntag, Simon J; Buesen, Martin; Gross-Hardt, Sascha; Kaufmann, Tim; Schmitz-Rode, Thomas; Autschbach, Ruediger; Goetzenich, Andreas


    Mechanical circulatory support can maintain a sufficient blood circulation if the native heart is failing. The first implantable devices were displacement pumps with membranes. They were able to provide a sufficient blood flow, yet, were limited because of size and low durability. Rotary pumps have resolved these technical drawbacks, enabled a growing number of mechanical circulatory support therapy and a safer application. However, clinical complications like gastrointestinal bleeding, aortic insufficiency, thromboembolic complications, and impaired renal function are observed with their application. This is traced back to their working principle with attenuated or non-pulsatile flow and high shear stress. Rotary piston pumps potentially merge the benefits of available pump types and seem to avoid their complications. However, a profound assessment and their development requires the knowledge of the flow characteristics. This study aimed at their investigation. A functional model was manufactured and investigated with particle image velocimetry. Furthermore, a fluid-structure interaction computational simulation was established to extend the laboratory capabilities. The numerical results precisely converged with the laboratory measurements. Thus, the in silico model enabled the investigation of relevant areas like gap flows that were hardly feasible with laboratory means. Moreover, an economic method for the investigation of design variations was established.

  17. Relationship of spontaneous retinal vein pulsation with ocular circulatory cycle.

    Directory of Open Access Journals (Sweden)

    Mijin Kim

    Full Text Available PURPOSE: To determine the timing of spontaneous venous pulsation (SVP relative to the ocular circulatory cycle by using the movie tool of confocal scanning laser ophthalmoloscope. METHODS: A video recording of the fundus was obtained using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany at 8 frames/s in 47 eyes (15 glaucoma patients and 32 glaucoma suspects with visible pulsation of both the central retinal artery (CRA and vein (CRV. The timing of the maximum and minimum diameters of the CRA (CRA(max and CRAmin, respectively and CRV (CRV(max and CRV(min, respectively was identified during four pulse cycles. The interval between CRV(min and CRA(min, and between CRV(max and CRA(max was expressed as the number of frames and as a percentage of the ocular circulatory cycle. RESULTS: The ocular circulatory cycle (from one CRA(max to the next lasted 7.7 ± 1.0 frames (958.8 ± 127.2 ms, mean ± SD, with a mean pulse rate of 62.6 beats/min. The diameter of the CRA was increased for 2.4 ± 0.5 frames (301.9 ± 58.8 ms and decreased for 5.3 ± 0.9 frames (656.9 ± 113.5 ms. CRV(max occurred 1.0 ± 0.2 frames after CRA(max (equivalent to 13.0% of the ocular circulatory cycle, while CRV(min occurred 1.1 ± 0.4 frames after CRA(min (equivalent to 14.6% of the ocular circulatory cycle. CONCLUSIONS: During SVP, the diameter of the CRV began to decrease at early diastole, and the reduction persisted until early systole. This finding supports that CRV collapse occurs during ocular diastole.

  18. Gastrointestinal causes of abdominal pain. (United States)

    Marsicano, Elizabeth; Vuong, Giao Michael; Prather, Charlene M


    Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.

  19. Functional Abdominal Pain in Children (United States)

    ... functional abdominal pain. Functional abdominal pain can be intermittent (recurrent abdominal pain or RAP) or continuous. Although ... tests are needed or whether a trial of diet changes, stress management or medication may be started. ...

  20. Magnetocaloric pump (United States)

    Brown, G. V.


    Very cold liquids and gases such as helium, neon, and nitrogen can be pumped by using magnetocaloric effect. Adiabatic magnetization and demagnetization are used to alternately heat and cool slug of pumped fluid contained in closed chamber.

  1. Heat pumps

    CERN Document Server

    Macmichael, DBA


    A fully revised and extended account of the design, manufacture and use of heat pumps in both industrial and domestic applications. Topics covered include a detailed description of the various heat pump cycles, the components of a heat pump system - drive, compressor, heat exchangers etc., and the more practical considerations to be taken into account in their selection.

  2. [Inflammatory abdominal aortic aneurysm]. (United States)

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T


    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  3. Abdominal wall endometriosis. (United States)

    Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S


    Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

  4. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels


    complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  5. Heat pumps

    CERN Document Server

    Brodowicz, Kazimierz; Wyszynski, M L; Wyszynski


    Heat pumps and related technology are in widespread use in industrial processes and installations. This book presents a unified, comprehensive and systematic treatment of the design and operation of both compression and sorption heat pumps. Heat pump thermodynamics, the choice of working fluid and the characteristics of low temperature heat sources and their application to heat pumps are covered in detail.Economic aspects are discussed and the extensive use of the exergy concept in evaluating performance of heat pumps is a unique feature of the book. The thermodynamic and chemical properties o

  6. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail:; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)


    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.

  7. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  8. [The abdominal catastrophe]. (United States)

    Seiler, Christian A


    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  9. Abdominal ultrasound (image) (United States)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  10. Abdominal x-ray (United States)

    ... are, or may be, pregnant. Alternative Names Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also ...

  11. Current Status of Mechanical Circulatory Support: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos


    Full Text Available Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.

  12. [Design of a testing system for antithrombotic pressure circulatory equipment]. (United States)

    Zhou, Xun; Cui, Haipo; Shang, Kun; Li, Zhelong; Cheng, Enqing


    A new type of testing system used for antithrombotic pressure circulatory equipment has been developed, which realized a new method for the calibration of pressure sensor. Multi-path control and acquisition functions are achieved by this method based on human-computer interaction testing system. The precision of pressure sensor is ob tained by polynomial fitting for each test point using linear interpolation method. The result showed that the precision test of pressure sensor could be realized easily and efficiently, using the developed testing system, and the parameters of pressure sensor could be calibrated effectively, so that it could be accurately used in the antithrombotic pressure circulatory equipment. The developed testing system has a prosperous future in the aspects of promotion and application.

  13. [Caffeine and adaptive changes in the circulatory system during pregnancy]. (United States)

    Cendrowska-Pinkosz, Monika; Dworzański, Wojciech; Krauze, Magdalena; Burdan, Franciszek


    Adaptive physiological changes that occur in pregnant women can fluctuate with the intake of substances with proven, adverse biological effect on the body. Due to the fact that caffeine is one of the most chronically used xenobiotics, the impact of consuming caffeine on adaptive processes in the circulatory system of a pregnant women required a research. Many researchers emphasise its negative effect on the circulatory system of the mother and her offspring. However, in spite of years of observation, there is no clear answer to what extent dose or in what period of time the caffeine modulates the adaptive processes during pregnancy. Because of the potential risk the supply of caffeine during pregnancy should be subjected to considerable restrictions.

  14. Linear abdominal trauma. (United States)

    Danto, L A; Wolfman, E F


    Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.

  15. Antibiotics can ameliorate circulatory complications of liver cirrhosis

    DEFF Research Database (Denmark)

    Madsen, Bjørn Stæhr; Schaffalitzky de Muckadell, Ove B


    Livercirrhosis can be complicated by a hyperdynamic circulatory syndrome. This is due to translocation of bacteria and bacterial product (bacterial DNA and endotoxins), which stimulate the splanchnic nitric oxide synthase and leads to splanchnic vasodilatation and haemodynamic derangement....... This review focuses on how broad spectrum antibiotics can ameliorate the haemodynamic consequences of bacterial translocation. It is possible that the use of broad spectrum antibiotics in the future may be used to prevent other complications of liver cirrhosis than spontaneous bacterial peritonitis...

  16. Towards a Fast Dynamic Model of the Human Circulatory System (United States)


    4.5m for the pulmonary vascular tree. According to Guyton & Hall (2000), about 5 L is considered normal for an adult human, and the area distribution...decreases further, and even falls below the equilibrium pressure. Guyton & Hall (2000) reports that normal mean pressures are 100 mmHg in the arteries, 20...the order of 100 times faster than realtime. Five liters is considered a normal volume for an adult human circulatory system ( Guyton & Hall, 2000

  17. Postnatal circulatory adaptation in healthy term and preterm neonates.


    N J Evans; Archer, L N


    Thirty seven healthy infants (18 born at full term and 19 preterm) were studied serially with cross sectional and Doppler echocardiography to compare their postnatal circulatory adaptation. Pulmonary artery pressure was assessed by its inverse relationship with the ratio of pulmonary artery time to peak velocity and right ventricular ejection time measured from Doppler waveform. Patency of the ductus arteriosus and interatrial shunting were assessed by imaging and Doppler ultrasound. The rati...

  18. Towards a Fast Dynamic Model of the Human Circulatory System (United States)

    Kaplan, Carolyn; Green, Melissa; Boris, Jay; Oran, Elaine


    We describe a model for systems-level transport in the human circulatory system that is based on a set of equations for a one-dimensional unsteady elastic pipe flow circuit. The system is collapsed from three spatial dimensions and time to one spatial dimension and time by assuming axisymmetric vessel geometry and a parabolic velocity profile across the cylindrical vessels. To drive the fluid, the contractions of a beating heart are modeled as periodic area changes of the elastic vessels. Two different models are compared, both including and neglecting fluid acceleration. Time-resolved distributions of pressure, velocity and area compare reasonably well with reference data. Increasing the rigidity of the vasculature is found to increase peak arterial pressures on the order of ten percent, and including a distributed vascular contraction to model distributed skeletal muscle contractions monotonically increases time-averaged blood flow in the veins, consistent with human physiological response. The circulatory system model presented here simulates the circulatory system on the order of one hundred times faster than real-time; that is, we can compute thousands of heartbeats per minute of CPU time.

  19. Centrifugal pumps

    CERN Document Server

    Gülich, Johann Friedrich


    This book gives an unparalleled, up-to-date, in-depth treatment of all kinds of flow phenomena encountered in centrifugal pumps including the complex interactions of fluid flow with vibrations and wear of materials. The scope includes all aspects of hydraulic design, 3D-flow phenomena and partload operation, cavitation, numerical flow calculations, hydraulic forces, pressure pulsations, noise, pump vibrations (notably bearing housing vibration diagnostics and remedies), pipe vibrations, pump characteristics and pump operation, design of intake structures, the effects of highly viscous flows, pumping of gas-liquid mixtures, hydraulic transport of solids, fatigue damage to impellers or diffusers, material selection under the aspects of fatigue, corrosion, erosion-corrosion or hydro-abrasive wear, pump selection, and hydraulic quality criteria. As a novelty, the 3rd ed. brings a fully analytical design method for radial impellers, which eliminates the arbitrary choices inherent to former design procedures. The d...

  20. Effect of Kampo formulations (traditional Chinese medicine) on circulatory parameters. (United States)

    Xu, F H; Uebaba, K


    The pharmacological action of 6 main Kampo formulations (1.Mao -to: [Japanese pictograph see text] MA HUANG TANG; 2. Shimbu -to: [Japanese pictograph see text]: ZHEN WU TANG; 3. Ninjin -to: [Japanese pictograph see text] : REN SHEN TANG; 4.Shigyaku-san: [Japanese pictograph see text] : SI NI SAN; 5.Keishi-to: Japanese pictograph see text] : GUI ZHI TANG; 6. Shimotsu - to: [Japanese pictograph see text] : SI WU TANG) on circulatory and autonomic nervous system were studied. 7 healthy adult males( age, 22.3 +/- 1.8 years old ) had 6 basic Kampo formulations, followed by noninvasive measurement of systolic blood pressure (SBP), mean blood pressure (MBP), diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO ), cardiacindex (CI), total peripheral resistance (TPR) by means of systolic area method of brachialsphygmography, every 30 minutes for 2 hours. As results, Mao - to induced an increase of BP,HR,SV,CO and CI, but a decrease of TPR. Keishi - to induced an increase of SBP and SV, and Shimotsu-to induced an increase of DBP and MBP, HR was slowed during former period after oral administration of Shigyaku - san, and later period after oral administration of Shimbu-to and Shimotsu-to. Regarding autonomic activity, Mao-to(former period of experiment ), Shimbu - to and Shimotsu-to induced supression of sympathetic activity, on the other hand, Mao-to (later period of experiment ) and Shiyaku - san showed a tendency of parasympathomimetic action. Mao -to induced the strongest activation of circulatory system of 6 main farmulations, and showed change of autonomic nervous activity, however, the change of circulatory and automonic nervous activity were not coincident each other. It was speculated that comprehensive mechanism of Mao-to were not only dependent of ephedrin, main active constituent of Mao, but also dependent on Keishi's vasodilatory action in it. Ninjin -to showed no actions on circulatory or autonomic system. This is indicated

  1. Early Results of the “Clamp and Sew” Fontan Procedure Without the Use of Circulatory Support (United States)

    Shinkawa, Takeshi; Anagnostopoulos, Petros V.; Johnson, Natalie C.; Presnell, Laura; Watanabe, Naruhito; Sapru, Anil; Azakie, Anthony


    Background A modification of the Fontan operation was recently applied, which includes anastomoses of the extra-cardiac conduit to the right pulmonary artery and inferior vena cava using simple clamping with no additional circulatory support, venous shunting, pulmonary artery preparation, or prior maintenance of azygos vein patency. The objective of this study is to assess the outcomes of this novel off-pump “clamp and sew” Fontan procedure. Methods This is a retrospective review of all patients having a Fontan procedure between January 2009 and October 2010 at a single institution. Results Twelve patients had a Fontan procedure with the use of cardiopulmonary bypass (CPB group), and 12 had an off-pump Fontan procedure (off-pump group). Preoperative demographic and hemodynamic data were similar except for higher mean pulmonary artery pressure in the CPB group (12.2 ± 1.6 mm Hg versus 9.9 ± 2.4 mm Hg; p = 0.02). No patients in the off-pump group required conversion to CPB. The mean inferior vena cava clamp time in the off-pump group patients was 10 ± 3 minutes. There were no early or midterm deaths. No patients exhibited postoperative hepatic or renal dysfunction. Postoperative maximal serum creatinine and aspartate transaminase were significantly lower in the off-pump group compared with the CPB group (0.59 ± 0.12 versus 0.77 ± 0.22 mg/dL; p = 0.03 and 35.5 ± 8.3 versus 53.1 ± 19.0 U/L; p = 0.02, respectively). At median follow-up of 13 months (range, 1 to 20 months), all but 1 patient in the CPB group are in New York Heart Association class I with unobstructed Fontan circulation. Conclusions The clamp and sew technique for completion of an extracardiac conduit Fontan procedure appears safe and feasible for selected patients. PMID:21524454

  2. Abdominal emergencies in pediatrics. (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E


    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  3. Ferroelectric Pump (United States)

    Jalink, Antony, Jr. (Inventor); Hellbaum, Richard F. (Inventor); Rohrbach, Wayne W. (Inventor)


    A ferroelectric pump has one or more variable volume pumping chambers internal to a housing. Each chamber has at least one wall comprising a dome shaped internally prestressed ferroelectric actuator having a curvature and a dome height that varies with an electric voltage applied between an inside and outside surface of the actuator. A pumped medium flows into and out of each pumping chamber in response to displacement of the ferroelectric actuator. The ferroelectric actuator is mounted within each wall and isolates each ferroelectric actuator from the pumped medium, supplies a path for voltage to be applied to each ferroelectric actuator, and provides for positive containment of each ferroelectric actuator while allowing displacement of the entirety of each ferroelectric actuator in response to the applied voltage.

  4. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)


    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  5. Abdominal paracentesis and thoracocentesis. (United States)

    Lee, Ser Yee; Pormento, James G; Koong, Heng Nung


    Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.

  6. [Abdominal actinomycosis with IUD]. (United States)

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A


    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  7. Development of a miniature intraventricular axial flow blood pump. (United States)

    Yamazaki, K; Umezu, M; Koyanagi, H; Outa, E; Ogino, S; Otake, Y; Shiozaki, H; Fujimoto, T; Tagusari, O; Kitamura, M


    A new intraventricular axial flow blood pump has been designed and developed as a totally implantable left ventricular assist device (LVAD). This pump consists of an impeller combined with a guide-vane, a tube housing, and a DC motor. The pump is introduced into the LV cavity through the LV apex, and the outlet cannula is passed antegrade across the aortic valve. Blood is withdrawn from the LV through the inlet ports at the pump base, and discharged to the ascending aorta. Our newly developed axial flow pump system has the following advantages: 1) it is a simple and compact system, 2) minimal blood stasis both in the device and the LV cavity, 3) minimal blood contacting surface of the pump, 4) easy accessibility with a less invasive surgical procedure, and 5) low cost. A pump flow > 5 L/min was obtained against 100 mmHg differential pressure in the mock circulatory system. The pump could produce a passive pulsatile flow effect with a beating heart more efficiently than other non-pulsatile pumps because of minimal pressure drop and inertia along the bypass tract. Anatomic fit studies using dissected hearts of dilated cardiomyopathy (DCM) cadavers showed that this pump could smoothly pass through the aortic valve without any interference with mitral valve function. Recently, a dynamic pressure groove bearing and a miniature lip seal have been developed. The dynamic pressure groove bearing has a simple structure and acts as a pressure resistant sealing mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Peristaltic flow in non-uniform vessels of the micro-circulatory system

    CERN Document Server

    Maiti, S


    Of concern in the paper is generalized a theoretical study concerning the peristaltic flow of blood in the micro-circulatory system. The vessel is considered to be of non-uniform cross-section and blood to be a non-Newtonian fluid. The progressive wave front of the peristaltic flow is supposed sinusoidal/straight section dominated (SSD) (expansion/contraction type); Reynolds number is considered to be small with reference to the flow of physiological fluids. The non-Newtonian behaviour of blood is illustrated by considering the Herschel-Bulkley fluid model. The objective of the study has been to examine the effect of the effects of amplitude ratio, mean pressure gradient, yield stress and the power law index on the velocity distribution, wall shear stress, streamline pattern and trapping. Considerable quantitative differences between the results obtained for transport in two dimensional channel and an axisymmetric circular tube are noticed. The study shows that peristaltic pumping, flow velocity and wall shea...


    Directory of Open Access Journals (Sweden)

    G. P. Itkin


    Full Text Available The article brings up for the discussion main problems standing in the way of development of the mechanical circulatory support (MCS technology. We give a short historical overview of the development of this technology in our country. Classifi cation of MCS systems for medical indications is given; methods and techniques for short-term and long-term therapy with MCS systems are considered. Main directions of the development of MCS methods are discussed. Using the example of personal experience the methods of design and research of MCS systems are investigated.

  10. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl


    -angiotensin-aldosterone system, and elevated circulating vasopressin, endothelin-1 may also be implicated in the hemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the hemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction influencing...... resistance are decreased. A peripheral arterial vasodilatation may be of pathogenic importance to the low systemic vascular resistance as it directly correlates to the degree of central hypovolemia. It may therefore be an important element in the development of the low arterial blood pressure...

  11. A Simulink model for the human circulatory system. (United States)

    Wabel, P; Leonhardt, S


    This paper presents the mathematical simulation of the human circulatory system. The model is based on the former work of Coleman and co-workers and has been redesigned for simulation with the Matlab toolbox "Simulink". It includes the heart and the peripheral circulation, the respiratory system, the kidneys and the major neural and hormonal control mechanisms, which are necessary for maintaining homeostasis. The model contains more than 30 blocks with over 200 physiological variables, which can be accessed and plotted during the simulation.

  12. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    Murphy, Kevin P


    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  13. Screening for Abdominal Aortic Aneurysm (United States)

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...

  14. Abdominal aortic aneurysm repair - open (United States)

    ... this page: // Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  15. Computational Hemodynamic Simulation of Human Circulatory System under Altered Gravity (United States)

    Kim. Chang Sung; Kiris, Cetin; Kwak, Dochan


    A computational hemodynamics approach is presented to simulate the blood flow through the human circulatory system under altered gravity conditions. Numerical techniques relevant to hemodynamics issues are introduced to non-Newtonian modeling for flow characteristics governed by red blood cells, distensible wall motion due to the heart pulse, and capillary bed modeling for outflow boundary conditions. Gravitational body force terms are added to the Navier-Stokes equations to study the effects of gravity on internal flows. Six-type gravity benchmark problems are originally presented to provide the fundamental understanding of gravitational effects on the human circulatory system. For code validation, computed results are compared with steady and unsteady experimental data for non-Newtonian flows in a carotid bifurcation model and a curved circular tube, respectively. This computational approach is then applied to the blood circulation in the human brain as a target problem. A three-dimensional, idealized Circle of Willis configuration is developed with minor arteries truncated based on anatomical data. Demonstrated is not only the mechanism of the collateral circulation but also the effects of gravity on the distensible wall motion and resultant flow patterns.

  16. Penis Pump (United States)

    ... claim that they can be used to increase penis size, but there's no evidence that they work for ... circumstances, using a penis pump might help your penis maintain its natural size and shape after prostate surgery or if you ...

  17. Concept designs of nonrotating-type centrifugal blood pump and basic study on output characteristics of the oscillating disk-type centrifugal pump. (United States)

    Kabei, N; Tuichiya, K; Sakurai, Y


    When designing a turbo-type blood pump as an artificial heart, the gap between a rotating shaft and a pump housing should be perfectly sealed to prevent any leakage or contamination through a seal. In addition, blood coagulation in a blood chamber must be avoided. To overcome these problems, we proposed five different nonrotating-type turbo pumps: a caudal-fin-type axial-flow pump, a caudal-fin-type centrifugal pump, a nutating-column-type centrifugal pump, a nutating-collapsible-tube-type centrifugal pump, and an oscillating-disk-type centrifugal pump. We selected and developed the oscillating-disk-type centrifugal pump that consists of a disk, a driving rod, a seal, an oscillation mechanism, and a pump housing. The disk is mounted on the end of the rod, which is connected to a high-speed DC motor through an oscillation mechanism. The rod and the disk do not rotate, but they oscillate in the pump housing. This movement of the disk generates forward fluid flow around the axis (i.e., the rotational fluid flow). Centrifugal force due to fluid rotation supports the pressure difference between the outlet and the inlet. The diameter of the disk is 39 mm, the maximum inner diameter of the pump housing is 40 mm, and the volume of the blood chamber for 25 degrees' oscillation is 16.9 ml. The performance of the pump was tested in a mock circulatory system.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Comparative hemolysis study of clinically available centrifugal pumps. (United States)

    Naito, K; Suenaga, E; Cao, Z L; Suda, H; Ueno, T; Natsuaki, M; Itoh, T


    Centrifugal pumps have become important devices for cardiopulmonary bypass and circulatory assistance. Five types of centrifugal pumps are clinically available in Japan. To evaluate the blood trauma caused by centrifugal pumps, a comparative hemolysis study was performed under identical conditions. In vitro hemolysis test circuits were constructed to operate the BioMedicus BP-80 (Medtronic, BioMedicus), Sarns Delphin (Sarns/3M Healthcare), Isoflow (St. Jude Medical [SJM]), HPM-15 (Nikkiso), and Capiox CX-SP45 (Terumo). The hemolysis test loop consisted of two 1.5 m lengths of polyvinyl chloride tubing with a 3/8-inch internal diameter, a reservoir with a sampling port, and a pump head. All pumps were set to flow at 6 L/min against the total pressure head of 120 mm Hg. Experiments were conducted simultaneously for 6 h at room temperature (21 degrees C) with fresh bovine blood. Blood samples for plasma-free hemoglobin testing were taken, and the change in temperature at the pump outlet port was measured during the experiment. The mean pump rotational speeds were 1,570, 1,374, 1,438, 1,944, and 1,296 rpm, and the normalized indexes of hemolysis were 0.00070, 0.00745, 0.00096, 0.00066, 0.00090 g/100 L for the BP-80, Sarns, SJM, Nikkiso, and Terumo pumps, respectively. The change in temperature at the pump outlet port was the least for the Nikkiso pump (1.8 degrees C) and the most with the SJM pump (3.8 degrees C). This study showed that there is no relationship between the pump rotational speed (rpm) and the normalized index of hemolysis in 5 types of centrifugal pumps. The pump design and number of impellers could be more notable factors in blood damage.

  19. Donation after circulatory death: current practices, ongoing challenges, and potential improvements. (United States)

    Morrissey, Paul E; Monaco, Anthony P


    Organ donation after circulatory death (DCD) has been endorsed by the World Health Organization and is practiced worldwide. This overview examines current DCD practices, identifies problems and challenges, and suggests clinical strategies for possible improvement. Although there is uniform agreement on DCD donor candidacy (ventilator-dependent individuals with nonrecoverable or irreversible neurologic injury not meeting brain death criteria), there are variations in all aspects of DCD practice. Utilization of DCD organs is limited by hypoxia, hypotension, reduced--then absent--organ perfusion, and ischemia/reperfusion syndrome. Nevertheless, DCD kidneys exhibit comparable function and survival to donors with brain death kidneys, although they have higher rates of primary graft nonfunction, delayed graft function, discard, and retrieval associated injury. Concern over ischemic organ injury underscores the reluctance to recover extrarenal DCD organs since lack of medical therapy to support inadequate allograft function limits their acceptability. Nevertheless, limited results with DCD pancreas, liver, and lung allografts (but not heart) are now approaching that of donors with brain death organs. Pretransplant machine perfusion of DCD kidneys (vs. static storage) may reduce delayed graft function but has no effect on long-term organ function and survival. Normothermic regional perfusion used during DCD abdominal organ retrieval may reduce ischemic organ injury and increase the number of usable organs, although critical confirmative studies have yet to be done. Minor increases in usable DCD kidneys could accrue from increased use of pediatric DCD kidneys and from selective use of DCD/ECD kidneys, whereas a modest increase could result through utilization of donors declared dead beyond 1 hr from withdrawal of life support therapy. A significant increase in transplantable kidneys could be achieved by extension of the concept of living kidney donation in relation to

  20. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    John, Gade; Peter, Kruse; Andersen, Ole Trier


    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...

  1. Sizable variations in circulatory disease mortality by region and country of birth in six European countries

    DEFF Research Database (Denmark)

    Rafnsson, Snorri B; Bhopal, Raj S; Agyemang, Charles;


    . RESULTS: South Asians in Denmark, England and Wales and France experienced excess circulatory disease mortality (MRRs 1.37-1.91). Similar results were seen for Eastern Europeans in these countries as well as in Sweden (MRRs 1.05-1.51), for those of Middle Eastern origin in Denmark (MRR = 1.49) and France......BACKGROUND: Circulatory disease mortality inequalities by country of birth (COB) have been demonstrated for some EU countries but pan-European analyses are lacking. We examine inequalities in circulatory mortality by geographical region/COB for six EU countries. METHODS: We obtained national death...... sizes. The pattern for IHD mortality was similar to that for circulatory disease mortality. Two- to three-fold excess cerebrovascular disease mortality was found for several foreign-born groups compared with the local-born populations in some countries. CONCLUSIONS: Circulatory disease mortality varies...

  2. Ruptured abdominal aortic aneurysm. (United States)

    Sachs, T; Schermerhorn, M


    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  3. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)


    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  4. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik


    Patients with cirrhosis exhibit characteristic hemodynamic changes with a hyperkinetic circulation and an abnormal distribution of the blood volume and neurohumoral regulation. Their plasma and noncentral blood volumes are increased, and the central and arterial blood volume and systemic vascular...... and hyperkinetic circulation in cirrhosis. Various vasodilators such as atrial natriurectic peptide, calcitonin gene-related peptide, adrenomedullin, and nitric oxide are among potential candidates in the arterial vasodilatation in cirrhosis. Besides enhanced sympathetic nervous activity, activation of the renin......-angiotensin-aldosterone system, and elevated circulating vasopressin, endothelin-1 may also be implicated in the hemodynamic counter-regulation in cirrhosis. Recent research has focused on the assertion that the hemodynamic and neurohumoral abnormalities in cirrhosis are part of a general circulatory dysfunction influencing...

  5. Deep hypothermic circulatory arrest: real-life suspended animation. (United States)

    Chau, Katherine H; Ziganshin, Bulat A; Elefteriades, John A


    Deep hypothermic circulatory arrest (DHCA) is a cerebral protection technique that was developed in the 1950s and popularized in the 1970s. It has become one of the three most common cerebral protection techniques currently used in aortic arch surgeries, with the other two being antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). At our institution, DHCA has been the cerebral protection technique of choice for over a quarter century. Our clinical experience with DHCA has been very positive, and our clinical studies have shown DHCA to have outcomes equal to (and sometimes better than) those of ACP and RCP, and DHCA to be very effective at preserving neurocognitive function. Other institutions, however, prefer ACP or RCP to DHCA. Each technique has its own set of pros and cons, and the question regarding which technique is the superior method for cerebral protection is hotly debated.

  6. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie D'intervention). (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas


    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  7. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention). (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas


    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  8. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention. (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas


    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  9. [Mechanical circulatory assist using a miniaturized Archimedes screw]. (United States)

    von Segesser, L K; Bisang, B; Leskosek, B; Turina, M


    An axial flow blood pump (Archimedes screw) for intraarterial left ventricular assist was evaluated in comparison to standard roller pump left heart bypass (LHBP) in 13 bovine experiments (bodyweight 74 +/- 15 kg). Full systemic heparinization (ACT greater than 500 s) was used for LHBP in comparison to limited systemic heparinization (ACT greater than 180 s) for axial. A standard battery of blood samples was taken before and at regular intervals throughout perfusion: (table; see text) Transarterial access and relatively limited blood trauma appear to be the main advantages of the evaluated axial flow blood pump. However, the impossibility to assess the pump flow may be a major problem for the management of the failing left ventricle.

  10. [Differential diagnosis of abdominal pain]. (United States)

    Frei, Pascal


    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  11. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B


    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  12. Lower Abdominal Pain. (United States)

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S


    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.

  13. Dolor abdominal recurrente .

    Directory of Open Access Journals (Sweden)

    Rodrigo De Vivero


    Full Text Available El dolor abdominal recurrente (DAR es un problema frecuente en la consulta médica y en la subespecialidad médica y quirúrgica. El DAR es frecuentemente funcional, es decir, sin una causa orgánica aparente. El diagnóstico diferencial debe incluir pérdida de peso, sangrado gastrointestinal, fiebre persistente, diarrea crónica y vómito importante. En este artículo se revisa el diagnóstico y tratamiento, pruebas diagnósticas y manejo farmacológico y ambiental.

  14. Abdominal perfusion computed tomography. (United States)

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit


    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  15. On the dynamic suction pumping of blood cells in tubular hearts

    CERN Document Server

    Battista, Nicholas A; Miller, Laura A


    Around the third week after gestation in embryonic development, the human heart consists only of a valvless tube, unlike a fully developed adult heart, which is multi-chambered. At this stage in development, the heart valves have not formed and so net flow of blood through the heart must be driven by a different mechanism. It is hypothesized that there are two possible mechanisms that drive blood flow at this stage - Liebau pumping (dynamic suction pumping or valveless pumping) and peristaltic pumping. We implement the immersed boundary method with adaptive mesh refinement (IBAMR) to numerically study the effect of hematocrit on the circulation around a valveless. Both peristalsis and dynamic suction pumping are considered. In the case of dynamic suction pumping, the heart and circulatory system is simplified as a flexible tube attached to a relatively rigid racetrack. For some Womersley number (Wo) regimes, there is significant net flow around the racetrack. We find that the addition of flexible blood cells ...

  16. Abdominal pregnancy- a case report. (United States)

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc


    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  17. Types of Breast Pumps (United States)

    ... Devices Consumer Products Breast Pumps Types of Breast Pumps Share Tweet Linkedin Pin it More sharing options ... used for feeding a baby. Types of Breast Pumps There are three basic types of breast pumps: ...

  18. The physiology of dinosaurs: circulatory and respiratory function in the largest animals ever to walk the earth. (United States)

    Pierson, David J


    The cardiopulmonary physiology of dinosaurs-and especially of the long-necked sauropods, which grew much larger than any land animals before or since-should be inherently fascinating to anyone involved in respiratory care. What would the blood pressure be in an animal 12 m (40 ft) tall? How could airway resistance and dead space be overcome while breathing through a trachea 9 m (30 ft) long? The last decade has seen a dramatic increase in evidence bearing on these questions. Insight has come not only from new fossil discoveries but also from comparative studies of living species, clarification of evolutionary relationships, new evaluation techniques, computer modeling, and discoveries about the earth's ancient atmosphere. Pumping a vertical column of blood 8 m (26 ft) above the heart would probably require an arterial blood pressure > 600 mm Hg, and the implications of this for cardiac size and function have led to the proposal of several alternative cardiopulmonary designs. Diverse lines of evidence suggest that the giant sauropods were probably warm-blooded and metabolically active when young, but slowed their metabolism as they approached adult size, which diminished the load on the circulatory system. Circulatory considerations leave little doubt that the dinosaurs had 4-chambered hearts. Birds evolved from dinosaurs, and the avian-type air-sac respiratory system, which is more efficient than its mammalian counterpart, may hold the answer to the breathing problems posed by the sauropods' very long necks. Geochemical and other data indicate that, at the time the dinosaurs first appeared, the atmospheric oxygen concentration was only about half of what it is today, and development of the avian-type respiratory system may have been key in the dinosaurs' evolutionary success, enabling them to out-compete the mammals and dominate the land for 150 million years.

  19. Mean circulatory filling pressure during splanchnic nerve stimulation and whole-body hypoxia in the anaesthetized cat. (United States)

    Bower, E A; O'Donnell, C P


    1. Mean circulatory filling pressure (MCFP) was measured in cats under chloralose anaesthesia by obstruction of blood flow in the pulmonary artery. Pressures in the aorta, hepatic portal vein and right atrium were recorded, and MCFP was estimated from the value at which all three pressures became equal when blood was pumped from aorta to vena cava during circulatory arrest. Simultaneous equality was not attained at MCFP values below 5 mmHg. 2. In cats ventilated by positive pressure after administration of gallamine, MCFP was 9.7 +/- 0.3 mmHg (n = 14). The values of MCFP measured in six cats before and after administration of gallamine did not differ significantly. Change of blood volume altered MCFP linearly over the range 5-21 mmHg. Noradrenaline (7.5 micrograms kg-1 min-1) increased MCFP from 9.3 +/- 0.9 to 16.5 +/- 0.6 mmHg (n = 4), and phentolamine (2 mg kg-1) reduced it to 5.6 +/- 0.3 mmHg (n = 5). 3. Changes in MCFP were evoked at different circulating blood volumes by stimulation of the splanchnic sympathetic nerves and by whole-body hypoxia. Ablation of all splanchnic nerves reduced MCFP from 9.4 +/- 0.5 to 7.1 +/- 0.3 mmHg (n = 5) and stimulation of their distal ends at 10 Hz increased it by 4.1 +/- 0.4 mmHg (n = 4); similar increments were obtained at different blood volumes and initial values of MCFP. 4. Hypoxia increased MCFP by 0.23 mmHg per 1 mmHg fall in arterial oxygen tension below Pa,O2 56 mmHg (r = -0.86; n = 24). Similar increments were obtained at different blood volumes and initial values of MCFP. Ablation of all splanchnic nerves reduced the increments by 60%, and administration of phentolamine abolished them.

  20. Axial and centrifugal continuous-flow rotary pumps: a translation from pump mechanics to clinical practice. (United States)

    Moazami, Nader; Fukamachi, Kiyotaka; Kobayashi, Mariko; Smedira, Nicholas G; Hoercher, Katherine J; Massiello, Alex; Lee, Sangjin; Horvath, David J; Starling, Randall C


    The recent success of continuous-flow circulatory support devices has led to the growing acceptance of these devices as a viable therapeutic option for end-stage heart failure patients who are not responsive to current pharmacologic and electrophysiologic therapies. This article defines and clarifies the major classification of these pumps as axial or centrifugal continuous-flow devices by discussing the difference in their inherent mechanics and describing how these features translate clinically to pump selection and patient management issues. Axial vs centrifugal pump and bearing design, theory of operation, hydrodynamic performance, and current vs flow relationships are discussed. A review of axial vs centrifugal physiology, pre-load and after-load sensitivity, flow pulsatility, and issues related to automatic physiologic control and suction prevention algorithms is offered. Reliability and biocompatibility of the two types of pumps are reviewed from the perspectives of mechanical wear, implant life, hemolysis, and pump deposition. Finally, a glimpse into the future of continuous-flow technologies is presented.

  1. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)


    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  2. Outline of the International Organization for Standardization Standard for Circulatory Support Devices (ISO 14708-5). (United States)

    Imachi, Kou; Mussivand, Tofy


    The rapid progress of artificial heart and circulatory support devices enables us to apply them to severe heart failure patients. Many types of circulatory support devices have been developed in the United States, Europe, and Japan. This situation urged the establishment of an International Organization for Standardization (ISO) Standard for the circulatory support devices. A new work, "Cardiac Ventricular Assist Devices," was proposed to the ISO/TC150/SC6 (TC150: Technical Committee of Implants for Surgery, SC6: Sub-committee of Active Implants) in 2000, and the work was finalized for publication at a 2009 meeting of the ISO/TC150 in Kyoto. In this article, the authors would like to introduce the ISO system and the outline of the ISO Standard for Circulatory Support Devices.

  3. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael


    a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION: Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women...

  4. Abdominal Complications after Severe Burns (United States)


    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  5. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal


    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective....... The acceptance rate was 77%, and 95% accept control scans. Furthermore, persons at the highest risk of having an AAA attend screening more frequently. We found that 97% of the interval cases developed from aortas that initially measured 2.5-2.9 cm - i.e. approx. only 5% attenders need re-screening at 5-year...... methods for measuring the degree of wall calcification must be developed and validated....

  6. Mortality from Circulatory System Diseases and Malformations in Children in the State of Rio de Janeiro (United States)

    Salim, Thais Rocha; Soares, Gabriel Porto; Klein, Carlos Henrique; de Oliveira, Glaucia Maria Moraes


    Background The epidemiological profile of mortality in a population is important for the institution of measures to improve health care and reduce mortality Objective To estimate mortality rates and the proportional mortality from cardiovascular diseases and malformations of the circulatory system in children and adolescents. Methods This is a descriptive study of mortality from cardiovascular diseases, malformations of the circulatory system, from all causes, ill-defined causes and external causes in children and adolescents in the state of Rio de Janeiro from 1996 to 2012. Populations were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and deaths obtained from the Department of Informatics of the Unified Health System (DATASUS)/Ministry of Health. Results There were 115,728 deaths from all causes, 69,757 in males. The annual mortality from cardiovascular diseases was 2.7/100,000 in men and 2.6/100,000 in women. The annual mortality from malformations of the circulatory system was 7.5/100,000 in men and 6.6/100,000 in women. Among the specific causes of circulatory diseases, cardiomyopathies had the highest rates of annual proportional mortality, and from malformations of the circulatory system, it occurred due to unspecified malformations of the circulatory system, at all ages and in both genders. Conclusion Mortality from malformations of the circulatory system was most striking in the first years of life, while cardiovascular diseases were more relevant in adolescents. Low access to prenatal diagnosis or at birth probably prevented the proper treatment of malformations of the circulatory system. PMID:27192384

  7. Endoglin regulates mural cell adhesion in the circulatory system. (United States)

    Rossi, Elisa; Smadja, David M; Boscolo, Elisa; Langa, Carmen; Arevalo, Miguel A; Pericacho, Miguel; Gamella-Pozuelo, Luis; Kauskot, Alexandre; Botella, Luisa M; Gaussem, Pascale; Bischoff, Joyce; Lopez-Novoa, José M; Bernabeu, Carmelo


    The circulatory system is walled off by different cell types, including vascular mural cells and podocytes. The interaction and interplay between endothelial cells (ECs) and mural cells, such as vascular smooth muscle cells or pericytes, play a pivotal role in vascular biology. Endoglin is an RGD-containing counter-receptor for β1 integrins and is highly expressed by ECs during angiogenesis. We find that the adhesion between vascular ECs and mural cells is enhanced by integrin activators and inhibited upon suppression of membrane endoglin or β1-integrin, as well as by addition of soluble endoglin (SolEng), anti-integrin α5β1 antibody or an RGD peptide. Analysis of different endoglin mutants, allowed the mapping of the endoglin RGD motif as involved in the adhesion process. In Eng (+/-) mice, a model for hereditary hemorrhagic telangectasia type 1, endoglin haploinsufficiency induces a pericyte-dependent increase in vascular permeability. Also, transgenic mice overexpressing SolEng, an animal model for preeclampsia, show podocyturia, suggesting that SolEng is responsible for podocytes detachment from glomerular capillaries. These results suggest a critical role for endoglin in integrin-mediated adhesion of mural cells and provide a better understanding on the mechanisms of vessel maturation in normal physiology as well as in pathologies such as preeclampsia or hereditary hemorrhagic telangiectasia.

  8. Postnatal circulatory adaptation in healthy term and preterm neonates. (United States)

    Evans, N J; Archer, L N


    Thirty seven healthy infants (18 born at full term and 19 preterm) were studied serially with cross sectional and Doppler echocardiography to compare their postnatal circulatory adaptation. Pulmonary artery pressure was assessed by its inverse relationship with the ratio of pulmonary artery time to peak velocity and right ventricular ejection time measured from Doppler waveform. Patency of the ductus arteriosus and interatrial shunting were assessed by imaging and Doppler ultrasound. The ratio rose after birth in all infants; it rose more slowly in the preterm infants. After 6 hours of age the mean was significantly less in the preterm group, the greatest difference being between 25 and 36 hours. By 73 to 96 hours the difference was no longer significant. There was a trend towards later ductal closure in the preterm infants but this was not significant. Atrial shunting level varied, but some left to right shunting was seen in all infants satisfactorily studied. Pulmonary artery pressure seems to fall more slowly after preterm birth even in the absence of respiratory problems, but ductal shunting persisting for more than three days is unusual in healthy preterm infants.

  9. Adhesion Molecules: Master Controllers of the Circulatory System. (United States)

    Schmidt, Eric P; Kuebler, Wolfgang M; Lee, Warren L; Downey, Gregory P


    This manuscript will review our current understanding of cellular adhesion molecules (CAMs) relevant to the circulatory system, their physiological role in control of vascular homeostasis, innate and adaptive immune responses, and their importance in pathophysiological (disease) processes such as acute lung injury, atherosclerosis, and pulmonary hypertension. This is a complex and rapidly changing area of research that is incompletely understood. By design, we will begin with a brief overview of the structure and classification of the major groups of adhesion molecules and their physiological functions including cellular adhesion and signaling. The role of specific CAMs in the process of platelet aggregation and hemostasis and leukocyte adhesion and transendothelial migration will be reviewed as examples of the complex and cooperative interplay between CAMs during physiological and pathophysiological processes. The role of the endothelial glycocalyx and the glycobiology of this complex system related to inflammatory states such as sepsis will be reviewed. We will then focus on the role of adhesion molecules in the pathogenesis of specific disease processes involving the lungs and cardiovascular system. The potential of targeting adhesion molecules in the treatment of immune and inflammatory diseases will be highlighted in the relevant sections throughout the manuscript.

  10. Abdominal migraine in the differential diagnosis of acute abdominal pain. (United States)

    Cervellin, Gianfranco; Lippi, Giuseppe


    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.


    Directory of Open Access Journals (Sweden)

    Nevein Mohammed Mohammed Gharib


    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  12. Left heart bypass support with the Rotaflow Centrifugal Pump® as a bridge to decision and recovery in an adult. (United States)

    Kashiwa, Koichi; Nishimura, Takashi; Saito, Aya; Kubo, Hitoshi; Fukaya, Aoi; Tamai, Hisayoshi; Yambe, Tomoyuki; Kyo, Shunei; Ono, Minoru


    Since left heart bypass or biventricular circulatory assist with an extracorporeal centrifugal pump as a bridge to decision or recovery sometimes requires long-time support, the long-term durability of extracorporeal centrifugal pumps is crucial. The Rotaflow Centrifugal Pump(®) (MAQUET Cardiopulmonary AG, Hirrlingen, Germany) is one of the centrifugal pumps available for long-term use in Japan. However, there have been few reports of left heart bypass or biventricular circulatory support over the mid-term. This is a case report of left heart bypass support with the Rotaflow Centrifugal Pump(®) as a bridge to decision and recovery for an adult patient who could not be weaned from cardiopulmonary bypass and percutaneous cardiopulmonary support after cardiac surgery. We could confirm that the patient's consciousness level was normal; however, the patient could not be weaned from the left heart bypass support lasting 1 month. Therefore, the circulatory assist device was switched to the extracorporeal Nipro ventricular assist device (VAD). This time, left heart bypass support could be maintained for 30 days using a single Rotaflow Centrifugal Pump(®). There were no signs of hemolysis during left heart bypass support. The Rotaflow Centrifugal Pump(®) itself may be used as a device for a bridge to decision or recovery before using a VAD in cardiogenic shock patients.

  13. Economics of abdominal wall reconstruction. (United States)

    Bower, Curtis; Roth, J Scott


    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias.

  14. [Clinical experience of mechanical ventricular support with centrifugal pump for severe ventricular failure after open heart surgery]. (United States)

    Matsuwaka, R; Matsuda, H; Kaneko, M; Masai, T; Fudemoto, Y; Kobayashi, T; Imagawa, H; Miyamoto, K; Morisaki, H; Kawashima, Y


    Five adult patients (pts) with age 15-67 (mean 43) received mechanical circulatory support with centrifugal pump (Biomedicus, BP-80, Sarns centrifugal pump) for postcardiotomy profound shock. Three pts underwent left ventricular support (LVS) alone, and the other 2 required biventricular support (BVS). Duration of the LVS ranged from 33 to 240 hours (mean 126 hours) and the right ventricular support 92, 120 hrs. Pump flow rate was 1.1 to 2.5 (mean 1.9) L/min/m2. Sixteen pumps were used and the pump exchange was performed 9 times in five pts and an average perfusion time per pump was 57 hrs. Two of 3 pts with LVS alone survived and one died of multiorgan failure associated with right heart dysfunction. In two pts with BVS, one survived and the other died of persistent low cardiac output early after pump removal. As the complication during mechanical support, bleeding was seen in 3 pts and cerebral infarction in one. Although centrifugal pump has potential limitation in antithrombogenicity and durability, this device provides a simple and effective mechanical circulatory support.

  15. Pump characteristics and applications

    CERN Document Server

    Volk, Michael


    Providing a wealth of information on pumps and pump systems, Pump Characteristics and Applications, Third Edition details how pump equipment is selected, sized, operated, maintained, and repaired. The book identifies the key components of pumps and pump accessories, introduces the basics of pump and system hydraulics as well as more advanced hydraulic topics, and details various pump types, as well as special materials on seals, motors, variable frequency drives, and other pump-related subjects. It uses example problems throughout the text, reinforcing the practical application of the formulae

  16. Calcification in Chronically-Implanted Blood Pumps: Experimental Results and Review of the Literature


    Turner, Stephen A.; Bossart, Mattie I.; Milam, John D.; Fuqua, John M.; Igo, Stephen R.; McGee, Michael G.; Frazier, O. Howard


    Blood compatibility is a major objective in the development of long-term, implantable circulatory assist (left ventricular assist devices) and replacement (total artificial heart) devices. An important problem in experimental studies in animals has been the propensity for calcification to occur at the blood/material interface. Presented is a summary of our experience (27 studies) with blood pump calcification and a review of the current literature regarding this complication.

  17. Organ donation after circulatory death in a university teaching hospital. (United States)

    Sidiropoulos, S; Treasure, E; Silvester, W; Opdam, H; Warrillow, S J; Jones, D


    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; P<0.001), and 95 additional patients received organ transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.

  18. Donation after cardio-circulatory death liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Hieu Le Dinh; Arnaud de Roover; Abdour Kaba; Séverine Lauwick; Jean Joris; Jean Delwaide; Pierre Honoré


    The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families.Since then,DCD organ procurement and transplantation activities have rapidly expanded,particularly for nonvital organs,like kidneys.In liver transplantation (LT),DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction,more frequent vascular and ischemia-type biliary lesions,higher rates of re-listing and re-transplantation and lower graft survival,which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process.Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results,and some of them have found their way from pre-clinical success into clinical reality.The future of DCD-LT is promising.Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category Ⅲ DCD donors),better donor and recipient matching (high risk donors to low risk recipients),use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion,normothermic machine perfusion,venous systemic oxygen persufflation),and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT.

  19. Micromanaging Abdominal Aortic Aneurysms

    Directory of Open Access Journals (Sweden)

    Lars Maegdefessel


    Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to “fine tune” the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.

  20. Abdominal aortic feminism. (United States)

    Mortimer, Alice Emily


    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  1. Intra-abdominal tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)


    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of ... examinations do not use ionizing radiation (as used in x-rays ), thus there is no radiation exposure ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed to evaluate ... for ultrasound examinations. top of page What does the equipment look like? Ultrasound scanners consist of a ...

  5. Anatomic considerations for abdominally placed permanent left ventricular assist devices. (United States)

    Parnis, S M; McGee, M G; Igo, S R; Dasse, K; Frazier, O H


    To determine anatomic parameters for a permanent, electrically actuated left ventricular assist device (LVAD), the effects of abdominal placement of pneumatic LVADs used as temporary support for patients awaiting heart transplantation was studied. Understanding the anatomic constraints imposed by the abdominal viscera in LVAD placement is crucial, because improper placement can result in compression or obstruction of adjacent structures. Anatomic compatibility was assessed in four men (age 22-48 years) who were supported by the LVAD for over 1 month (range 35-132 days). The pump was intraperitoneally placed in the left upper quadrant. Radiographic techniques were employed, including CT scanning (with patients supine) and contrast imaging (patients in anatomical position), and the pump and conduits appeared to be properly positioned, with minimal compression of the body of the stomach, and no obstruction of adjacent organs. Three patients returned to a solid food diet and exercised daily by stationary cycling and walking. No signs of migration or erosion of the pump were present at the time of LVAD removal and cardiac transplantation. Successful clinical experience with short-term use of the LVAD suggests that the electrically actuated device can be well tolerated in patients requiring permanent left ventricular assistance.

  6. Updates on abdominal desmoid tumors

    Institute of Scientific and Technical Information of China (English)


    Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequentiy after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.

  7. Common abdominal emergencies in children. (United States)

    D'Agostino, James


    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  8. User's instructions for the Guyton circulatory dynamics model using the Univac 1110 batch and demand processing (with graphic capabilities) (United States)

    Archer, G. T.


    The model presents a systems analysis of a human circulatory regulation based almost entirely on experimental data and cumulative present knowledge of the many facets of the circulatory system. The model itself consists of eighteen different major systems that enter into circulatory control. These systems are grouped into sixteen distinct subprograms that are melded together to form the total model. The model develops circulatory and fluid regulation in a simultaneous manner. Thus, the effects of hormonal and autonomic control, electrolyte regulation, and excretory dynamics are all important and are all included in the model.

  9. A fast building and effective hydraulic pediatric mock circulatory system for the evaluation of a left ventricular assist device. (United States)

    Huang, Feng; Ruan, Xiaodong; Zou, Jun; Qian, Wenwei; Fu, Xin


    A mock circulatory system (MCS) has been proven a useful tool in the development of a ventricular assist device. Nowadays a MCS aimed at the evaluation of pediatric blood pumps, which require many different considerations compared with that of adults, has become an urgent need. This article presents the details on how the dynamic process of the left ventricle, which is described in terms of the pressure-volume loop (P-V loop), and the properties of the circulation such as compliance and resistance are simulated by hydraulic elements. A simple control method is introduced to reproduce the physiological afterload and preload sensitivities of the mock ventricle for the first time. Hemodynamic performance of the system is obtained by medical sensors to validate the similarity of the device to the native cardiovascular system. The actual sensitivities of the mock ventricle are obtained intuitively from the changes of the P-V loops. The aortic input impedance of the MCS is also obtained and compared with the data from previous medical reports. At last a pediatric left ventricular assist device (LVAD) prototype is introduced for testing to further verify the effectiveness of the MCS. The experimental results indicate that this pediatric MCS is capable of reproducing basic hemodynamic characteristics of a child in both normal and pathological conditions and it is sufficient for testing a pediatric LVAD. Besides, most components constituting the main hydraulic part of this MCS are inexpensive off-the-shelf products, making the MCS easy and fast to build.

  10. In vitro evaluation of the TandemHeart pediatric centrifugal pump. (United States)

    Svitek, Robert G; Smith, Douglas E; Magovern, James A


    The pediatric TandemHeart pump is being developed for short-term circulatory support of patients varying in size from 2 to 40 kg. The pump withdraws blood from the left atrium via cannula inserted percutaneously, either through the right internal jugular vein or transhepatically, and pumps the blood back into the arterial system via the carotid or femoral artery. High resolution stereolithography (SLA) was used to create an upper housing and impeller design, which were assembled into a functional pump prototype. Pressure-flow characteristics of the pump were determined in a blood analogue solution and compared with the pressure-flow requirements of the intended cannulation. At 5,500 rpm, the pump was able to generate 0.4 L/min of flow with a pressure rise of 325 mm Hg and 2.0 L/min with a pressure rise of 250 mm Hg. The hydraulic performance of the pump will enable at least 50% of cardiac output when the arterial cannula is placed in the carotid artery. The hemolysis of the TandemHeart pediatric pump at 5,500 rpm was compared with the BP-50 pediatric centrifugal pump in vitro using bovine blood flowing at 0.4 L/min against 250 mm Hg. The TandemHeart pump produced a similar increase in plasma free hemoglobin levels during the duration of the 6 hour test.

  11. LMFBR with booster pump in pumping loop (United States)

    Rubinstein, H.J.


    A loop coolant circulation system is described for a liquid metal fast breeder reactor (LMFBR) utilizing a low head, high specific speed booster pump in the hot leg of the coolant loop with the main pump located in the cold leg of the loop, thereby providing the advantages of operating the main pump in the hot leg with the reliability of cold leg pump operation.

  12. Heat pump technology

    CERN Document Server

    Von Cube, Hans Ludwig; Goodall, E G A


    Heat Pump Technology discusses the history, underlying concepts, usage, and advancements in the use of heat pumps. The book covers topics such as the applications and types of heat pumps; thermodynamic principles involved in heat pumps such as internal energy, enthalpy, and exergy; and natural heat sources and energy storage. Also discussed are topics such as the importance of the heat pump in the energy industry; heat pump designs and systems; the development of heat pumps over time; and examples of practical everyday uses of heat pumps. The text is recommended for those who would like to kno

  13. Abdominal neurenteric cyst

    Institute of Scientific and Technical Information of China (English)

    Radoje (C)olovi(c); MarJan Micev; Miodrag Jovanovi(c); Slavko Mati(c); Nikica Grubor; Henry Dushan E Atkinson


    immunoexpression, and the respiratory epithelium revealed a CK8 and CK18 immunoprofile without CK 10/13 positive elements, though neither CEA or AFP positive cells were found. To our knowledge, this is the first reported case of an abdominally located neurenteric cyst with no associated spinal anomalies.

  14. Dry vacuum pumps (United States)

    Sibuet, R.


    For decades and for ultimate pressure below 1 mbar, oil-sealed Rotary Vane Pumps have been the most popular solution for a wide range of vacuum applications. In the late 80ies, Semiconductor Industry has initiated the development of the first dry roughing pumps. Today SC applications are only using dry pumps and dry pumping packages. Since that time, pumps manufacturers have developed dry vacuum pumps technologies in order to make them attractive for other applications. The trend to replace lubricated pumps by dry pumps is now spreading over many other market segments. For the Semiconductor Industry, it has been quite easy to understand the benefits of dry pumps, in terms of Cost of Ownership, process contamination and up-time. In this paper, Technology of Dry pumps, its application in R&D/industries, merits over conventional pumps and future growth scope will be discussed.

  15. The Diagnosis and Hemodynamic Monitoring of Circulatory Shock: Current and Future Trends

    Directory of Open Access Journals (Sweden)

    Hendy Adham


    Full Text Available Circulatory shock is a complex clinical syndrome encompassing a group of conditions that can arise from different etiologies and presented by several different hemodynamic patterns. If not corrected, cell dysfunction, irreversible multiple organ insufficiency, and death may occur. The four basic types of shock, hypovolemic, cardiogenic, obstructive and distributive, have features similar to that of hemodynamic shock. It is therefore essential, when monitoring hemodynamic shock, to making accurate clinical assessments which will guide and dictate appropriate management therapy. The European Society of Intensive Care has recently made recommendations for monitoring hemodynamic shock. The present paper discusses the issues raised in the new statements, including individualization of blood pressure targets, prediction of fluid responsiveness, and the use of echocardiography as the first means during the initial evaluation of circulatory shock. Also, the place of more invasive hemodynamic monitoring techniques and future trends in hemodynamic and metabolic monitoring in circulatory shock, will be debated.

  16. Diseases of the circulatory system among adult people diagnosed with infantile autism as children

    DEFF Research Database (Denmark)

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben


    frequently among people in the comparison group (p=0.02). CONCLUSIONS AND IMPLICATIONS: It is argued that diseases of the circulatory system may be underdiagnosed in people with IA because of the difficulties they face with respect to identifying and communicating symptoms of ill health. Bearing in mind......BACKGROUND: Research dealing with adult people with autism spectrum disorders (ASD) noticeably lags behind studies of children and young individuals with ASD. AIMS: The objective of this study was to compare the prevalence and types of diseases of the circulatory system in a clinical sample of 118......, and mean age at follow-up was 49.6 years. OUTCOMES AND RESULTS: Of the 118 people with IA, 11 (9.3%) were registered with at least one disease of the circulatory system against 54 (16.1%) in the comparison group (p=0.09; OR=0.54; 95% CI 0.3-1.2). Ischemic heart diseases occurred significantly more...

  17. Artificial blood circulatory and special Ultrasound Doppler probes for detecting and sizing gaseous embolism

    Directory of Open Access Journals (Sweden)

    Stark Philipp


    Full Text Available This paper presents a special designed artificial blood circulatory (ABC for studying gaseous embolism based on detection of gaseous emboli and their sizing using ultrasound (US spectral Doppler. Blood mimicking fluid (BMF was used in the circulatory to get valid results without using human blood. The additional necessary degassing circulatory shows a promising effect of decontaminating the BMF from air bubbles. This offers the base for detecting and sizing microemboli using special algorithms and finally leads to reliable calculations of dangerous embolism and its air volume. Standard US probes at an integrated tissue model and a new 8-MHz central catheter ultrasound (CCUS probe inside a superior vena cava model (SVCM are used and deliver the Doppler spectrogram as input for automatic emboli detection and further signal analysis. First results using the newly developed 8-MHz CCUS probe inside the SVCM and its Doppler spectrogram characteristics show promising results but need more detailed studies.

  18. A clinical dilemma: abdominal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Oya Uygur-Bayramicli; G(u)l Dabak; Resat Dabak


    AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis.METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital,Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests,Mantoux skin test, chest X-ray and abdominal ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed.RESULTS: The median age of patients (14 females, 17males) was 34.2 years (range 15-65 years). The most frequent symptoms were abdominal pain and weight loss.Eleven patients had active pulmonary TB. The most common abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2 %). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 (45 %), nodules in 2 (10 %)and, stricture, polypoid lesions, granulomatous findings in terminal ileum and rectal fistula each in one patient (5 %).Laparoscopy on 4 patients showed dilated bowel loops,thickening in the mesentery, multiple ulcers and tubercles on the peritoneum. Patients with abdominal TB were divided into three groups according to the type of involvement.Fifteen patients (48 %) had intestinal TB, L1 patients (35.2 %) had tuberculous peritonitis and 5 (16.8 %)tuberculous lymphadenitis. The diagnosis of abdominal TB was confirmed microbiologically in 5 (16 %) and histopathologically in 19 patients (60.8 %). The

  19. [Abdominal pregnancy care. Case report]. (United States)

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino


    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  20. Centrifugal pump handbook

    CERN Document Server

    Pumps, Sulzer


    This long-awaited new edition is the complete reference for engineers and designers working on pump design and development or using centrifugal pumps in the field. This authoritative guide has been developed with access to the technical expertise of the leading centrifugal pump developer, Sulzer Pumps. In addition to providing the most comprehensive centrifugal pump theory and design reference with detailed material on cavitation, erosion, selection of materials, rotor vibration behavior and forces acting on pumps, the handbook also covers key pumping applications topics and operational

  1. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

    Jensen, K K; Henriksen, N A; Jorgensen, L N


    PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  2. Abdominal actinomycosis mimicking acute appendicitis. (United States)

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis


    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  3. Pharyngeal pumping in Caenorhabditis elegans depends on tonic and phasic signaling from the nervous system (United States)

    Trojanowski, Nicholas F.; Raizen, David M.; Fang-Yen, Christopher


    Rhythmic movements are ubiquitous in animal locomotion, feeding, and circulatory systems. In some systems, the muscle itself generates rhythmic contractions. In others, rhythms are generated by the nervous system or by interactions between the nervous system and muscles. In the nematode Caenorhabditis elegans, feeding occurs via rhythmic contractions (pumping) of the pharynx, a neuromuscular feeding organ. Here, we use pharmacology, optogenetics, genetics, and electrophysiology to investigate the roles of the nervous system and muscle in generating pharyngeal pumping. Hyperpolarization of the nervous system using a histamine-gated chloride channel abolishes pumping, and optogenetic stimulation of pharyngeal muscle in these animals causes abnormal contractions, demonstrating that normal pumping requires nervous system function. In mutants that pump slowly due to defective nervous system function, tonic muscle stimulation causes rapid pumping, suggesting tonic neurotransmitter release may regulate pumping. However, tonic cholinergic motor neuron stimulation, but not tonic muscle stimulation, triggers pumps that electrophysiologically resemble typical rapid pumps. This suggests that pharyngeal cholinergic motor neurons are normally rhythmically, and not tonically active. These results demonstrate that the pharynx generates a myogenic rhythm in the presence of tonically released acetylcholine, and suggest that the pharyngeal nervous system entrains contraction rate and timing through phasic neurotransmitter release. PMID:26976078

  4. Blunt abdominal trauma in sports. (United States)

    Rifat, Sami F; Gilvydis, Rimas P


    Abdominal injuries are rare in sports, but when they do occur it is important that the physician recognize the warning signs of potentially life-threatening injury to the liver, spleen, or hollow abdominal viscera. Though the sports medicine physician may not always provide definitive treatment of many of these conditions, he or she should be familiar with the preferred diagnostic modalities and latest treatment options. This information is not only essential to appropriately participate in treatment decisions, but is also important in order to make return-to-play determinations.

  5. [Gallstone ileus. Abdominal CT usefulness]. (United States)

    Sukkarieh, F; Brasseur, P; Bissen, L


    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  6. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W.-K., E-mail: [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)


    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  7. Diagnosis in acute abdominal pain and ongoing abdominal sepsis

    NARCIS (Netherlands)

    Kiewiet, J.J.S.


    Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that surgeo

  8. Blacks' Death Rate Due to Circulatory Diseases Is Positively Related to Whites' Explicit Racial Bias: A Nationwide Investigation Using Project Implicit



    Perceptions of racial bias have been linked to poorer circulatory health among Blacks compared with Whites. However, little is known about whether Whites' actual racial bias contributes to this racial disparity in health. We compiled racial-bias data from 1,391,632 Whites and examined whether racial bias in a given county predicted Black-White disparities in circulatory-disease risk (access to health care, diagnosis of a circulatory disease; Study 1) and circulatory-disease-related death rate...

  9. Optimization of vaporization flue circulatory system for converter in Anyang Iron and Steel Group Co., Ltd%安钢转炉汽化烟道循环系统优化

    Institute of Scientific and Technical Information of China (English)

    罗大春; 周友军; 李军强; 马正锋


    The vaporization flue circulatory systems were reformed to solve the leakage problems of the fixed chimney cap and the tail flue of the 150 t converter in Anyang Iron & Steel Group Co. , Ltd. An extra pump was added into the old high - pressure pump system to enhance the circulatory cooling water flow, and the natural circulation system of the tail flue was changed for the forced high-pressure circulation system and combined with the forced circulation system of the fixed chimney cap. This optimization measure extended the service life of the fixed chimney cap for more than six months, and decreased the water leakage of tail flue by almost 80%.%针对安钢150 t转炉汽化烟道循环系统固定烟罩、尾部烟道频繁漏水问题,安钢对转炉汽化烟道循环系统进行改造.将原系统设计的l用1备高压泵改为2用1备增加循环冷却水量,并将尾部烟道高压自然循环改为强制循环并入固定烟罩强制循环系统,延长固定烟罩使用寿命6个月以上,减少尾部烟道漏水80%以上.

  10. Hepatic Mitochondrial Redox Potential in Patients with Liver Metastatic Cancers and Circulatory Insufficiency

    Directory of Open Access Journals (Sweden)

    Marek Jarecki


    Full Text Available Arterial ketone body ratio (AKBR, which reflects hepatic intramitochodrial redox potential, was measured in 20 patients with Carcinoma hepatis metastaticum and good circulatory condition (group A, and 16 patients with Carcinoma hepatis metastaticum and chronic cardiogenic circulatory insufficiency (group B. Total ketone body concentration (TKB and arterial oxygen tension (PaO2 was simultaneously determined. We have stated that AKBR values in both groups of patients were decreased below the normal level. AKBR values in group B were significantly lower than in group A. At the same time TKB values in both groups were statistically equal and significantly increased above the normal level. The levels of arterial oxygen tension (PaO2 in group A were physiologically high, whereas in group B were significantly decreased. Furthermore arterial oxygen tension of patients in group B correlated with AKBR values significantly. In group A we found statistically significant negative correlation between TKB and AKBR values. Our study indicate that the main mechanism which may explain the decrease of intrahepatic mitochondrial redox potential in patients with liver metastatic cancers and good circulatory condition, is the enhanced beta-oxidation of fatty acids, when the efficiency of NAD+ to NADH reduction in beta-oxidation pathway and tricarboxylic acid cycle is higher than re-oxidation of NADH to NAD+ in the oxidative phosphorylation. In patients with coexisting chronic cardiogenic circulatory insufficiency deprivation of blood oxygen supply initiate the irreversible dysfunction of oxidative phosphorylation.

  11. 'In parallel' interconnectivity of the dorsal longitudinal anastomotic vessels requires both VEGF signaling and circulatory flow. (United States)

    Zygmunt, Tomasz; Trzaska, Sean; Edelstein, Laura; Walls, Johnathon; Rajamani, Saathyaki; Gale, Nicholas; Daroles, Laura; Ramírez, Craig; Ulrich, Florian; Torres-Vázquez, Jesús


    Blood vessels deliver oxygen, nutrients, hormones and immunity factors throughout the body. To perform these vital functions, vascular cords branch, lumenize and interconnect. Yet, little is known about the cellular, molecular and physiological mechanisms that control how circulatory networks form and interconnect. Specifically, how circulatory networks merge by interconnecting 'in parallel' along their boundaries remains unexplored. To examine this process we studied the formation and functional maturation of the plexus that forms between the dorsal longitudinal anastomotic vessels (DLAVs) in the zebrafish. We find that the migration and proliferation of endothelial cells within the DLAVs and their segmental (Se) vessel precursors drives DLAV plexus formation. Remarkably, the presence of Se vessels containing only endothelial cells of the arterial lineage is sufficient for DLAV plexus morphogenesis, suggesting that endothelial cells from the venous lineage make a dispensable or null contribution to this process. The discovery of a circuit that integrates the inputs of circulatory flow and vascular endothelial growth factor (VEGF) signaling to modulate aortic arch angiogenesis, together with the expression of components of this circuit in the trunk vasculature, prompted us to investigate the role of these inputs and their relationship during DLAV plexus formation. We find that circulatory flow and VEGF signaling make additive contributions to DLAV plexus morphogenesis, rather than acting as essential inputs with equivalent contributions as they do during aortic arch angiogenesis. Our observations underscore the existence of context-dependent differences in the integration of physiological stimuli and signaling cascades during vascular development.

  12. Circulatory effects of electrical stimulation of the carotid sinus nerves in man: A physiological study

    NARCIS (Netherlands)

    Borst, C.


    The aims of this investigation were 1) to study the time course of the reflex circulatory changes evoked by carotid sinus nerves (CSN) stimulation in unsedated man (chapters IV - VII), and 2) to establish the optimal frequency of CSN stimulation for the relief of angina pectoris (chapters VIII and I

  13. Clinical management of abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    FANG Guo-en; LUO Tian-hang; DU Cheng-hui; BI Jian-wei; XUE Xu-chao; WEI Guo; WENG Zhao-zhang; MA Li-ye; HUA Ji-de


    Objective: To improve the prognosis of patients with abdominal trauma. Methods: Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years ranging from 3-82 years. All abdominal traumas consisted of closed traumas 360 cases, 86.7% and open traumas 55 cases, 13.3%. Results: Atotal of 407 cases 98.1% were fully recovered from trauma and the other 8 cases 1.9% died of multiple injuries. The mean injury severity score ISS of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds 6 cases, pancreatic fistula 2 cases and intestinal fistula 1 case. All these postoperative complications were cured by the conservative treatment. Conclusion: Careful case history inquisition and physical examination are the basic methods to diagnose abdomi- nal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.

  14. Chronic Abdominal Pain in Children

    NARCIS (Netherlands)

    C.F.M. Gijsbers (Carolien)


    textabstractRecurrent abdominal pain (RAP) was first defined in 1958 by Apley as “at least 3 bouts of pain, severe enough to affect activities, over a period of at least 3 months” (1). This was a landmark publication with great impact, showing, that emotional disturbances played a role in many patie

  15. Economic costs of abdominal obesity

    DEFF Research Database (Denmark)

    Højgaard, Betina; Olsen, Kim Rose; Søgaard, Jes


    BACKGROUND: To examine the relationship between waist circumference and future health care costs across a broad range of waist circumference values based on individual level data. METHOD: A prospective cohort of 31,840 subjects aged 50-64 years at baseline had health status, lifestyle and socio-e...... be a potential for significant resource savings through prevention of abdominal obesity....

  16. Alternative backing up pump for turbomolecular pumps (United States)

    Myneni, Ganapati Rao


    As an alternative to the use of a mechanical backing pump in the application of wide range turbomolecular pumps in ultra-high and extra high vacuum applications, palladium oxide is used to convert hydrogen present in the evacuation stream and related volumes to water with the water then being cryo-pumped to a low pressure of below about 1.e.sup.-3 Torr at K. Cryo-pumping is achieved using a low cost Kleemenco cycle cryocooler, a somewhat more expensive thermoelectric cooler, a Venturi cooler or a similar device to achieve the required minimization of hydrogen partial pressure.

  17. Abdominal aortic aneurysm repair - open - discharge (United States)

    ... this page: // Abdominal aortic aneurysm repair - open - discharge To use the sharing features ... References Orandi BJ, Black JH. Open repair of abdominal aortic aneurysms. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  18. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;


    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  19. Abdominal Compartment Syndrome: pathophysiology and definitions


    Cheatham Michael L


    Abstract "Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous ...

  20. Analysis of Dose Response for Circulatory Disease After Radiotherapy for Benign Disease

    Energy Technology Data Exchange (ETDEWEB)

    Little, Mark P., E-mail: [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Kleinerman, Ruth A. [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Stovall, Marilyn; Smith, Susan A. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mabuchi, Kiyohiko [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States)


    Purpose: To assess the shape of the dose-response for various circulatory disease endpoints, and modifiers by age and time since exposure. Methods and Materials: This was an analysis of the US peptic ulcer data testing for heterogeneity of radiogenic risk by circulatory disease endpoint (ischemic heart, cerebrovascular, other circulatory disease). Results: There were significant excess risks for all circulatory disease, with an excess relative risk Gy{sup -1} of 0.082 (95% CI 0.031-0.140), and ischemic heart disease, with an excess relative risk Gy{sup -1} of 0.102 (95% CI 0.039-0.174) (both p = 0.01), and indications of excess risk for stroke. There were no statistically significant (p > 0.2) differences between risks by endpoint, and few indications of curvature in the dose-response. There were significant (p < 0.001) modifications of relative risk by time since exposure, the magnitude of which did not vary between endpoints (p > 0.2). Risk modifications were similar if analysis was restricted to patients receiving radiation, although the relative risks were slightly larger and the risk of stroke failed to be significant. The slopes of the dose-response were generally consistent with those observed in the Japanese atomic bomb survivors and in occupationally and medically exposed groups. Conclusions: There were excess risks for a variety of circulatory diseases in this dataset, with significant modification of risk by time since exposure. The consistency of the dose-response slopes with those observed in radiotherapeutically treated groups at much higher dose, as well as in lower dose-exposed cohorts such as the Japanese atomic bomb survivors and nuclear workers, implies that there may be little sparing effect of fractionation of dose or low-dose-rate exposure.

  1. Large electromagnetic pumps. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kilman, G.B.


    The development of large electromagnetic pumps for the liquid metal heat transfer systems of fission reactors has progressed for a number of years. Such pumps are now planned for fusion reactors and solar plants as well. The Einstein-Szilard (annular) pump has been selected as the preferred configuration. Some of the reasons that electromagnetic pumps may be preferred over mechanical pumps and why the annular configuration was selected are discussed. A detailed electromagnetic analysis of the annular pump, based on slug flow, is presented. The analysis is then used to explore the implications of large size and power on considerations of electromagnetic skin effect, geometric skin effect and the cylindrical geometry.

  2. Superman play and pediatric blunt abdominal trauma. (United States)

    Machi, J M; Gyuro, J; Losek, J D


    Two pediatric patients with life-threatening intra-abdominal injuries associated with Superman play are presented. The cases illustrate the importance of knowing the mechanism of injury in the assessment of children with blunt abdominal trauma. The diagnostic value of liver enzymes and the controversies surrounding the radiographic assessment of pediatric blunt abdominal trauma are presented.

  3. A miniature intraventricular axial flow blood pump that is introduced through the left ventricular apex. (United States)

    Yamazaki, K; Umezu, M; Koyanagi, H; Kitamura, M; Eishi, K; Kawai, A; Tagusari, O; Niinami, H; Akimoto, T; Nojiri, C


    A new intraventricular axial flow blood pump has been designed and developed as an implantable left ventricular assist device (LVAD). The pump consists of a tube housing (10 cm in length and 14 mm in diameter), a three-vane impeller combined with a guide vane, and a DC motor. This pump is introduced into the LV cavity through the LV apex, and the outlet cannula is passed antegrade across the aortic valve. Blood is withdrawn from the LV through the inlet ports at the pump base, and discharged into the ascending aorta. A pump flow of > 8 L/min was obtained against 90 mmHg differential pressure in the mock circulatory system. In an acute dog model, this pump could produce a sufficient output of 200 ml/kg/min. In addition, the pump flow profile demonstrated a pulsatile pattern, although the rotation speed was fixed. This is mainly due to the changes in flow rate during a cardiac cycle--that is, during systole, the flow rate increases to the maximum, while the differential pressure between the LV and the aorta decreases to the minimum. Thus, this simple and compact axial flow blood pump can be a potential LVAD, with prompt accessibility and need for less invasive surgical procedures.

  4. Evaluation of a multiple disk centrifugal pump as an artificial ventricle. (United States)

    Miller, G E; Sidhu, A; Fink, R; Etter, B D


    A multiple-disk centrifugal pump based on the Tesla Turbine design has been modified for potential use as an artificial ventricle or ventricular assist device. The pump consists of a series of interconnected parallel disks placed within a spiral volute housing. This pump normally operates as a continuous flow device; however, a controller circuit has been developed to also allow for pulsatile operation. Frequency, systolic duration, systolic rise time, and diastolic decay time can be independently controlled to produce a wide range of pulsatile pressures and flows. This pumping system was tested in vitro on a mock circulatory system using a blood analogue. Inlet and outlet pressures, outlet flow, and motor rotations per minute were continually monitored over a wide range of physiologic operating conditions. The disk pump output was compared with that of other artificial ventricles and produced favorable results. Direct experimental comparisons were made with a Harvard Apparatus pulsatile piston pump. Unlike the Harvard pump, the disk pump does not use valves. Rather, a slight forward rotation of the disks is used to offset the adverse diastolic pressure gradient, which avoids backflow through the device.

  5. A suction detection system for rotary blood pumps based on the Lagrangian support vector machine algorithm. (United States)

    Wang, Yu; Simaan, Marwan A


    The Left Ventricular Assist Device (LVAD) is a rotary mechanical pump that is implanted in patients with congestive heart failure to help the left ventricle in pumping blood in the circulatory system. However, using such a device may result in a very dangerous event, called ventricular suction that can cause ventricular collapse due to overpumping of blood from the left ventricle when the rotational speed of the pump is high. Therefore, a reliable technique for detecting ventricular suction is crucial. This paper presents a new suction detection system that can precisely classify pump flow patterns, based on a Lagrangian Support Vector Machine (LSVM) model that combines six suction indices extracted from the pump flow signal to make a decision about whether the pump is in suction, approaching suction, or not in suction. The proposed method has been tested using in vivo experimental data based on two different pumps. The simulation results show that the system can produce superior performance in terms of classification accuracy, stability, learning speed, and good robustness compared to three other existing suction detection methods and the original SVM-based algorithm. The ability of the proposed algorithm to detect suction provides a reliable platform for the development of a feedback control system to control the speed of the pump while at the same time ensuring that suction is avoided.

  6. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    Directory of Open Access Journals (Sweden)

    Ali Ridha


    Full Text Available Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003. This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.

  7. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease (United States)

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel


    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  8. Proton pump inhibitors (United States)

    Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by ... Proton pump inhibitors are used to: Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD). This ...

  9. Critical heart disease and mechanical circulatory support%重症心脏与心脏机械辅助装置:现状与未来

    Institute of Scientific and Technical Information of China (English)

    孙仁华; 刘景全


    机械循环支持(mechanical circulatory support,MCS)已广泛应用于ICU心源性休克及重度心力衰竭患者的救治,为心脏功能恢复的过渡发挥着重要的作用,可纠正患者的血流动力学状态,保障组织灌注,提高生存率。目前,对于MCS应用于重症心脏领域仍有很多值得进一步探索问题,如MCS适应证、应用时机及应用效果等,有待大规模临床研究验证。近年来MCS领域取得了令人欣喜的进步,如小型便携式心脏泵。未来MCS发展方向是体积小、微创、置入和撤离方便、组织相容性好及辅助效果确切。%Mechanical circulatory support (MCS) plays an important role in the treatment of cardiogenic shock and heart failure in the ICU. It is able to correct hemodynamic disorders, improve tissue perfusion and increase survival rate. But problems exist in the application of MCS in patients with critical heart disease including its indications, timing and effect, and RCTs are needed. Remarkable achievements have been made in MCS such as the application of small, portable heart pump. In future, MCS would be smaller, minimally invasive, convenient for placement and removal, and have better histocompatibility and auxiliary effectiveness.

  10. The Diagnostic Value of Intra-abdominal Pressure in Patients with Blunt Acute Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Huseyin Narci


    Full Text Available Purpose:The objective of this study was to determine the diagnostic value of intra-abdominal pressure measurement in blunt abdominal trauma patients. Method: A prospective study was performed in 49 patients with blunt trauma in our university hospital for 1 years. Patients were randomly into two groups as intra-abdominal trauma (n=28 and extraabdominal trauma (n=21 groups. Intra-abdominal pressures was measured an classified as normal (10 cm H2O or less, elevated (more than 10 cm H2O determined indirectly. Results: No significant differences were found between abdominal trauma and extra-abdominal trauma groups from the point of intra-abdominal pressure (IAP. One the other hand, in abdominal trauma group; significant differences were observed between operated patients. Intra-abdominal bleeding was found in 10 patients and all of them elevated IAP values (exceeding 16 cm H2O. For determining the intra-abdominal injury, IAP had a sensitivity of 93%, specificity 38% in patients. Conclusion: IAP exceeding 16 cm H2O with blunt abdominal trauma patients abdominal trauma can be detected. It is thought that IAP, indirect monitoring of abdominal trauma patients is a reproducible, scientific guide and simple method.To determine the efficacy of the measurement of intra-abdominal pressure in blunt abdominal trauma patients, further studies should be done. [Cukurova Med J 2012; 37(3.000: 157-161

  11. Acupuncture Treatment of Abdominal Pain

    Institute of Scientific and Technical Information of China (English)



    @@ Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.

  12. Pump for Saturated Liquids (United States)

    Elliott, D. G.


    Boiling liquids pumped by device based on proven components. Expanding saturated liquid in nozzle and diverting its phases along separate paths in liquid/vapor separator raises pressure of liquid. Liquid cooled in process. Pump makes it unnecessary to pressurize cryogenic liquids in order to pump them. Problems of introducing noncondensable pressurizing gas avoided.

  13. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF


    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  14. Observation of a Flowing Duct in the Abdominal Wall by Using Nanoparticles. (United States)

    Jang, HyunSuk; Yoon, Joohwan; Gil, HyunJi; Jung, Sharon Jiyoon; Kim, Min-Suk; Lee, Jin-Kyu; Kim, Young-Jae; Soh, Kwang-Sup


    The primo vascular system (PVS) is being established as a circulatory system that corresponds to acupuncture meridians. There have been two critical questions in making the PVS accepted as a novel liquid flowing system. The first one was directly to show the flow of liquid in PVS and the second one was to explain why it was not observed in the conventional histological study of animal tissues. Flow in the PVS in the abdominal cavity was previously verified by injecting Alcian blue into a primo node. However, the tracing of the dye to other subsystems of the PVS has not been done. In the current work we injected fluorescent nanoparticles (FNPs) into a primo node and traced them along a primo vessel which was inside a fat tissue in the abdominal wall. Linea alba is a white middle line in the abdominal skin of a mammal and a band of fat tissue is located in parallel to the linea alba in the parietal side of the abdominal wall of a rat. In this fat band a primo vessel runs parallel to the prominent blood vessels in the fat band and is located just inside the parietal peritoneum. About the second question on the reason why the PVS was not in conventional histological study the current work provided the answer. Histological analysis with hematoxyline and eosine, Masson's trichrome, and Toluidine blue could not discriminate the primo vessel even when we knew the location of the PVS by the trace of the FNPs. This clearly explains why the PVS is hard to observe in conventional histology: it is not a matter of resolution but the contrast. The PVS has very similar structure to the connective tissues that surround the PVS. In the current work we propose a method to find the PVS: Observation of mast cell distribution with toluidine blue staining and the PN has a high density of mast cells, while the lymph node has low density.

  15. Observation of a Flowing Duct in the Abdominal Wall by Using Nanoparticles.

    Directory of Open Access Journals (Sweden)

    HyunSuk Jang

    Full Text Available The primo vascular system (PVS is being established as a circulatory system that corresponds to acupuncture meridians. There have been two critical questions in making the PVS accepted as a novel liquid flowing system. The first one was directly to show the flow of liquid in PVS and the second one was to explain why it was not observed in the conventional histological study of animal tissues. Flow in the PVS in the abdominal cavity was previously verified by injecting Alcian blue into a primo node. However, the tracing of the dye to other subsystems of the PVS has not been done. In the current work we injected fluorescent nanoparticles (FNPs into a primo node and traced them along a primo vessel which was inside a fat tissue in the abdominal wall. Linea alba is a white middle line in the abdominal skin of a mammal and a band of fat tissue is located in parallel to the linea alba in the parietal side of the abdominal wall of a rat. In this fat band a primo vessel runs parallel to the prominent blood vessels in the fat band and is located just inside the parietal peritoneum. About the second question on the reason why the PVS was not in conventional histological study the current work provided the answer. Histological analysis with hematoxyline and eosine, Masson's trichrome, and Toluidine blue could not discriminate the primo vessel even when we knew the location of the PVS by the trace of the FNPs. This clearly explains why the PVS is hard to observe in conventional histology: it is not a matter of resolution but the contrast. The PVS has very similar structure to the connective tissues that surround the PVS. In the current work we propose a method to find the PVS: Observation of mast cell distribution with toluidine blue staining and the PN has a high density of mast cells, while the lymph node has low density.

  16. Urgent Abdominal Re-Explorations

    Directory of Open Access Journals (Sweden)

    Peskersoy Mustafa


    Full Text Available Abstract Background Treatment of a number of complications that occur after abdominal surgeries may require that Urgent Abdominal Re-explorations (UARs, the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing UARs, outcomes of relaparotomies (RLs and factors that affect mortality. Methods Demographic characteristics; initial diagnoses; information from and complications of the first surgery received; durations and outcomes of UAR(s performed in patients who received early RLs because of complicated abdominal surgeries in our clinic between 01.01.2000 and 31.12.2004 were investigated retrospectively. Statistical analyses were done using the chi-square and Fisher exact tests. Results Early UAR was performed in 81 out of 4410 cases (1.8%. Average patient age was 50.46 (13–81 years with a male-to-female ratio of 60/21. Fifty one (62.96% patients had infection, 41 (50.61% of them had an accompanying serious disease, 24 (29.62% of them had various tumors and 57 (70.37% patients were operated under emergency conditions during first operation. Causes of urgent abdominal re-explorations were as follows: leakage from intestinal repair site or from anostomosis (n:34; 41.97%; hemorrhage (n:15; 18.51%; intestinal perforation (n:8; 9.87%; intraabdominal infection or abscess (n:8; 9.87%; progressive intestinal necrosis (n:7; 8.64%; stomal complications (n:5; 6.17%; and postoperative ileus (n:4; 4.93%. Two or more UARs were performed in 18 (22.22% cases, and overall mortality was 34.97% (n:30. Interval between the first laparotomy and UAR averaged as 6.95 (1–20 days, and average hospitalization period was 27.1 (3–78 days. Mortality rate was found to be higher among the patients who received multiple UARs. The most common (55.5% cause of mortality was sepsis/multiple organ failure (MOF. The rates for common mortality and sepsis/MOF-dependent mortality that occured following UAR were

  17. Radiation and risk of circulatory diseases in the German uranium miners cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Kreuzer, M.; Kreisheimer, M.; Kandel, M.; Tschense, A.; Grosche, B. [Federal Office for Radiation Protection, Neuherberg (Germany)


    Full text of publication follows: Objectives: Little and inconsistent evidence is available on the relation between the exposure to ionizing radiation at lo w doses and circulatory diseases. While among the atomic bomb survivors of Hiroshima and Nagasaki a clear linear increase in risk for stroke and heart diseases with increasing exposure to external radiation has been demonstrated, most other studies that investigated effects of circulatory diseases and radiation found no such relation (Mc Gale and Darby 2005). The aim of the present analysis is to evaluate the risk of circulatory diseases and radiation within the German uranium miners cohort study. Methods: The cohort includes 59,001 men who were employed for at least 6 months between 1946 and 1989 at the former Wismut uranium company in Eastern Germany. Exposure to radon and its progeny in Working Level Months (W.L.M.), long-lived radionuclides in kBq h/m3 and external gamma radiation in mSv was estimated by using a detailed job -exposure matrix. For 95% of the cohort members the vital status has been ascertained from the date of entry to 31 December 1998. 16,598 cohort members were deceased within this time period. For 88% of them, causes of death were identified from several sources and coded by I.C.D. 10. Poisson regression techniques applying linear models were used to estimate the excess relative risk (E.R.R.) for circulatory diseases per unit of cumulative exposure to radiation after adjusting for attained age and calendar period. Background rates were estimated internally. Smoking or other potential confounding factors were not considered, since no information was available. Results: The total number of person-years under observation was 1,801,630 with a mean duration of follow-up of 30 years. In this period a total of 5,417 circulatory diseases deaths (I.C.D. 10 'I') including 3,719 heart diseases (I.C.D. 10 'I00-I52')and 1,297 strokes (I.C.D. 'I60-69') occurred. 90% of the

  18. Mechanical circulatory support in cardiogenic shock – what every interventional cardiologist should know (United States)

    Pres, Damian; Przybylski, Roman; Pacholewicz, Jerzy; Poloński, Lech; Zembala, Marian; Gąsior, Mariusz


    Cardiogenic shock (CS) remains the main cause of death in patients with myocardial infarction. Conservative treatment alone does not sufficiently improve prognosis. Mortality in CS can only be significantly reduced with revascularization, both surgical and percutaneous. However some patients present with haemodynamic instability despite optimal medical treatment and complete revascularization, resulting in very high mortality rates. These patients require the implementation of mechanical circulatory support in order to increase systemic blood flow, protect against organ hypoperfusion and protect the myocardium through a decrease in oxygen consumption. In contemporary interventional cardiology it seems that every operator should be aware of all available mechanical circulatory support methods for their patients. This article aims to present the current state of knowledge and technical possibilities in this area. PMID:25489306



    M.O. Sunmonu; Odewole, M M; Obajemihi, O I; Ayodeji, A T


    A re-circulatory vegetable moisturizer for preventing wilting in vegetables was developed and its performance evaluation carried out. Freshly harvested Amaranthus vegetables were used for the experiments. The temperature and relative humidity were monitored daily. The vitamin A of this produce was determined at intervals of two days for 9 days. The effects of the storage parameters (temperature and relative humidity) on the nutritional value of the produce were determined using statistical an...

  20. Trends in death from circulatory diseases in Brazil between 1979 and 1996

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    Mansur Antonio de Padua


    Full Text Available OBJECTIVE: To analyze the trends in mortality due to circulatory diseases in men and women aged > or = 30 years in Brazil from 1979 to 1996. METHODS: We analyzed population count data obtained from the IBGE Foundation and mortality data obtained from the System of Information on Mortality of the DATASUS of the Ministry of Health. RESULTS: Circulatory diseases, ischemic heart disease, and cerebrovascular disease were the major causes of death in men and women in Brazil. The standardized age coefficient for circulatory disease in men aged > or = 30 years ranged from 620 to 506 deaths/100,000 inhabitants and in women from 483 to 383 deaths/100,000 inhabitants for the years 1979 and 1996, respectively. In men, the mean coefficient for the period was 586.25 deaths with a significant trend towards a decrease (P<0.001 and a decline of 8.25 deaths/year. In women, the mean coefficient for the period was 439.58 deaths, a significant trend towards a decrease (P<0.001 and a rate of decline of 7.53 deaths/year. The same significant trend towards a decrease in death (P<0.001 was observed for ischemic heart disease and cerebrovascular disease. Risk of death from these causes was always higher for men of any age group (P<0.001. Cerebrovascular disease was the primary cause of death in women. CONCLUSION: Although circulatory diseases have been the major cause of mortality in men and women in the Brazilian population, with a greater participation by cerebrovascular diseases, a trend towards a decrease in the risk of death from these causes is being observed.

  1. Use of Short-term Circulatory Support as a Bridge in Pediatric Heart Transplantation

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    Luiz Fernando Canêo


    Full Text Available Background: Heart transplantation is considered the gold standard therapy for the advanced heart failure, but donor shortage, especially in pediatric patients, is the main limitation for this procedure, so most sick patients die while waiting for the procedure. Objective: To evaluate the use of short-term circulatory support as a bridge to transplantation in end-stage cardiomyopathy. Methods: Retrospective clinical study. Between January 2011 and December 2013, 40 patients with cardiomyopathy were admitted in our Pediatric Intensive Care Unit, with a mean age of 4.5 years. Twenty patients evolved during hospitalization with clinical deterioration and were classified as Intermacs 1 and 2. One patient died within 24 hours and 19 could be stabilized and were listed. They were divided into 2 groups: A, clinical support alone and B, implantation of short-term circulatory support as bridge to transplantation additionally to clinical therapy. Results: We used short-term mechanical circulatory support as a bridge to transplantation in 9. In group A (n=10, eight died waiting and 2 patients (20% were transplanted, but none was discharged. In group B (n=9, 6 patients (66.7% were transplanted and three were discharged.The mean support time was 21,8 days (6 to 984h. The mean transplant waiting list time was 33,8 days. Renal failure and sepsis were the main complication and causeof death in group A while neurologic complications were more prevalent en group B. Conclusion: Mechanical circulatory support increases survival on the pediatric heart transplantation waiting list in patients classified as Intermacs 1 and 2.

  2. Chemotherapy with laparoscope-assisted continuous circulatory hyperthermic intraperitoneal perfusion for malignant ascites

    Institute of Scientific and Technical Information of China (English)


    AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparosco...

  3. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E


    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention.

  4. Effects of cryotherapy methods on circulatory, metabolic, inflammatory and neural properties: a systematic review


    Freire,Bruno; Geremia,Jeam; Baroni, Bruno Manfredini; Vaz, Marco Aurélio


    Abstract Introduction: The cooling therapy (cryotherapy) is commonly used in clinical environmental for the injuries treatment according to its beneficial effects on pain, local inflammation and the recovery time of patients. However, there is no consensus in the literature about the effects of cryotherapy in the physiological reactions of affected tissues after an injury. Objective: To realize a systematic review to analyze the cryotherapy effects on circulatory, metabolic, inflammatory an...

  5. Von Willebrand factor in patients on mechanical circulatory support – a double-edged sword between bleeding and thrombosis


    Hudzik, Bartosz; Kaczmarski, Jacek; Pacholewicz, Jerzy; Zakliczynski, Michal; Gasior, Mariusz; Zembala, Marian


    Mechanical circulatory support (MCS) is an umbrella term describing the various technologies used in both short- and long-term management of patients with either end-stage chronic heart failure (HF) or acute HF. Most often, MCS has emerged as a bridge to transplantation, but more recently it is also used as a destination therapy. Mechanical circulatory support includes left ventricular assist device (LVAD) or bi-ventricular assist device (Bi-VAD). Currently, 2- to 3-year survival in carefully...

  6. Scandinavian SSAI clinical practice guideline on choice of first‐line vasopressor for patients with acute circulatory failure


    Møller, M H; Claudius, C.; Junttila, E.; Haney, M.; Oscarsson‐Tibblin, A.; Haavind, A.; Perner, A


    Background Adult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant, evidence‐based treatment recommendations on this topic. Methods This guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of...

  7. Cardiovascular effects of NA+/H+ exchanger inhibition with BIIB513 following hypovolemic circulatory shock. (United States)

    Wu, Dongmei; Bassuk, Jorge; Arias, Jaqueline; Doods, Henri; Adams, Jose A


    Na(+)/H(+) exchange (NHE) is involved in the myocardial injury that occurs during ischemia and reperfusion. The goal of the present study was to investigate the role of NHE in hypovolemic circulatory shock by using a potent NHE-1 selective inhibitor BIIB513. Acute rapid hemorrhage was induced in 14 pigs by bleeding (30 mL/kg over 30 min). Seven pigs were used as saline control. Seven other pigs received 3 mg/kg BIIB513 at 30 min after hemorrhage. Each experiment consisted of 2 h of hypovolemia followed by 2 h of fluid resuscitation. One control animal died before the experiment was completed. Six other control animals survived the entire experiment. In contrast, all the BIIB513 treated animals survived the entire protocol. Acute rapid blood loss resulted in impaired myocardial performance as well as severe hemodynamic and metabolic alterations. NHE blockade attenuated the hypovolemic hypotension and improved myocardial performance. NHE blockade also attenuated the metabolic acidosis, improved tissue oxygen delivery, and improved cardiac function from resuscitation. The circulating levels of creatine phosphokinase (CPK) and cardiac troponin-I were significantly lower in the BIIB513 treatment group. These results suggest that NHE activation plays an important pathophysiological role in hypovolemic circulatory shock, and NHE-1 blockade is a powerful intervention to improve cardiovascular outcomes of resuscitation from prolonged hypovolemic circulatory shock.


    Directory of Open Access Journals (Sweden)

    E. G. Konysheva


    Full Text Available We analyzed the dynamics of the interaction of rotary pump, connected to the scheme «the left ventricle – aor- ta», and left ventricle in norms and heart failure, using data obtained on the mock circulatory system. Adverse pumping states such as suction and regurgitation can be detected. These limits depend on the degree of cardiac failure, which confirms the need to control the speed of rotation of the impeller in the range of the cardiac failure from pathology to normal. It has been shown that the pulsating pressure at the inlet of the pump modulates the flow of the pump, making it a pulsating, what positively affects on the dynamics of cardiac output. 

  9. Peritoneoscopy of the liver after abdominal surgery.

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    Full Text Available The incidence of intraperitoneal adhesion after abdominal surgery was studied. Peritoneoscopy was performed in 933 patients with liver diseases over the 6 year 5 month period from March 1974 to July 1980. Of the patients, 352 (37.7% had undergone an abdominal operation, and intraperitoneal adhesion was detected in 205 (58.2% of these patients. The liver was not observable in 5 out of 61 patients with adhesions after upper abdominal operations. Whereas, the liver was clearly observable in patients with lower abdominal operations in spite of adhesions. Out of the 581 patients without any abdominal operations, 30 patients (5.2% had adhesions in the abdominal cavity, and 6 of them had extensive adhesions that partially obscured the observation of liver surface. In all patients, peritoneoscopy was performed without complications by avoiding the surgical scar for puncture sites and ensuring a free air lumen before trocar puncture.

  10. Abdominal compartment syndrome. Interesting aspects.

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    Nicolás Rubio Silveira


    Full Text Available The management of the abdominal compartiment syndrome is still a controversial point nowadays. Its early diagnosis and treatment constitute a challenge for surgeons and physicians at the intensive care unit who have to face these cases . The physiopathologic changes that can occur can lead to the patients death, constituting pulmonary thromboembolism and multiorgan failure the principal causes of death. This paper presents the principal clinical parameters and technical procedures for its diagnosis and treatment with the aim of diminishing its morbi-mortality raits in our hospitals

  11. Severe fat embolism in perioperative abdominal liposuction and fat grafting

    Directory of Open Access Journals (Sweden)

    Rodrigo de Lima e Souza


    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Fat embolism syndrome may occur in patients suffering from multiple trauma (long bone fractures or plastic surgery (liposuction, compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe fat embolism syndrome after liposuction and fat grafting. CASE REPORT: SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis. Subjected to balanced general anesthesia with basic monitoring and controlled ventilation. After 45 min of procedure, there was a sudden and gradual decrease of capnometry, severe hypoxemia and hypotension. The patient was immediately monitored for MAP and central catheter, treated with vasopressors, inotropes, and crystalloid infusion, stabilizing her condition. Arterial blood sample showed pH = 7.21; PCO2 = 51 mmHg; PO2 = 52 mmHg; BE = -8; HCO3 = 18 mEq L-1, and lactate = 6.0 mmol L-1. Transthoracic echocardiogram showed PASP = 55 mmHg, hypocontractile VD and LVEF = 60%. Diagnosis of pulmonary embolism. After 24 h of intensive treatment, the patient developed anisocoria and coma (Glasgow coma scale = 3. A brain CT was performed which showed severe cerebral hemispheric ischemia with signs of fat emboli in right middle cerebral artery; transesophageal echocardiography showed a patent foramen ovale. Finally, after 72 h of evolution, the patient progressed to brain death. CONCLUSION: Fat embolism syndrome usually occurs in young people. Treatment is based mainly on the infusion of fluids and vasoactive drugs, mechanical ventilation, and triggering factor correction (early fixation of fractures or suspension of liposuction. The multiorgânico involvement indicates a worse prognosis.

  12. [Internationalization and innovation of abdominal acupuncture]. (United States)

    Wang, Yong-Zhou


    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.

  13. Clinical profile of abdominal tuberculosis in children


    Ira Shah; Ramya Uppuluri


    Aim: A retrospective study was conducted in children, suffering from abdominal TB, attending Pediatric TB clinic from 2007 to 2009. Materials And Methods: Age-wise distribution and type of abdominal TB were analyzed with clinical features. Results : Out of 285 children with TB, 32 (11.2%) had abdominal tuberculosis. Male: Female ratio was 2.1:1. 7 (21.9%) children were 10 years of age. The most comm...

  14. Abdominal Compartment Syndrome due to OHSS

    Directory of Open Access Journals (Sweden)

    Firoozeh Veisi


    Full Text Available Abdominal compartment syndrome is a dangerous clinical situation, usually following abdominal injuries&operations. It is seldom observed in patients with gynecologic and obstetric problems. Abdominalcompartment syndrome may be consequence ovarian hyperstimulation syndrome. A 28-year-old womanpresented as a sever ovarian hyperstimulation.The increased IAP indicated that OHSS may beconsidered a compartment syndrome. Abdominal compartment syndrome needs laparotomy orparacentesis for reduction of pressure.

  15. Abdominal Pain in the Geriatric Patient. (United States)

    Magidson, Phillip D; Martinez, Joseph P


    With an aging population, emergency department clinicians can expect an increase in geriatric patients presenting with abdominal pain. Compared with younger patients, this patient population is less likely to present with classic symptoms, physical examination findings, and laboratory values of abdominal disease. However, the morbidity and mortality associated with elderly patients presenting with abdominal pathologic conditions are significant. For this reason, the clinician must be familiar with some subtle and not so subtle differences when caring for the geriatric patient with abdominal pain to ensure timely diagnosis and appropriate treatment.

  16. Abdominal migraine in childhood: a review

    Directory of Open Access Journals (Sweden)

    Scicchitano B


    Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting

  17. Percutaneous drainage of abdominal abcess

    Energy Technology Data Exchange (ETDEWEB)

    Men, Sueleyman E-mail:; Akhan, Okan; Koeroglu, Mert


    The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that have been described to drain pelvic abscesses include transrectal or transvaginal approach with sonographic guidance, a transgluteal, paracoccygeal-infragluteal, or perineal approach through the greater sciatic foramen with CT guidance. Both the renal and the perirenal abscesses are amenable to percutaneous drainage. Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses as well.

  18. MR angiography in abdominal neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Squillaci, E. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Crecco, M. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Grandinetti, M.L. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Maspes, F. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Lo Presti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Squillaci, S. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Simonetti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy)


    The role of magnetic resonance angiography (MRA) in the evaluation of vascular involvement was studied in 55 patients with abdominal neoplasms. A 2-D time-of-flight (TOF) technique was used in all patients. All patients underwent CT and MR examinations before MRA. Also, MR angiograms were compared with digital subtraction angiography in 22 cases, with Doppler US in 13 cases, and with surgical findings in 20 cases. In all patients with liver neoplasms (n=29) MRA demonstrated the absence of flow in the infiltrated segments. Pericapsular neovascularization was observed in 12 patients. Portal vein involvement was correctly detected in 27 patients. In all cases MRA demonstrated in relationship between the tumor and venous structures. Portosystemic shunts were visualized in 20 of 21 patients with portal hypertension. Vena cava thrombosis (3 cases), compression (5 cases), and displacement (2 cases) were correctly demonstrated. In renal (n=6) and adrenal gland (n=3) tumors renal vein compression was correctly detected in 2 cases, displacement in 1 case, and thrombosis in 3 cases, with only 1 false-positive finding. In 7 patients with pancreatic tumors MRA demonstrated splenic vein thrombosis in 2 cases and compression in 2 cases, with one false-positive finding. Our results indicate that MRA provides precise information regarding venous vascular involvement in abdominal neoplasms, but preoperative arterial mapping is still problematic. (orig.)

  19. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

    Greene, R.H.; Casada, D.A.; Ayers, C.W. [and others


    This Phase II Nuclear Plant Aging Research study examines the methods of detecting pump degradation that are currently employed in domestic and overseas nuclear facilities. This report evaluates the criteria mandated by required pump testing at U.S. nuclear power plants and compares them to those features characteristic of state-of-the-art diagnostic programs and practices currently implemented by other major industries. Since the working condition of the pump driver is crucial to pump operability, a brief review of new applications of motor diagnostics is provided that highlights recent developments in this technology. The routine collection and analysis of spectral data is superior to all other technologies in its ability to accurately detect numerous types and causes of pump degradation. Existing ASME Code testing criteria do not require the evaluation of pump vibration spectra but instead overall vibration amplitude. The mechanical information discernible from vibration amplitude analysis is limited, and several cases of pump failure were not detected in their early stages by vibration monitoring. Since spectral analysis can provide a wealth of pertinent information concerning the mechanical condition of rotating machinery, its incorporation into ASME testing criteria could merit a relaxation in the monthly-to-quarterly testing schedules that seek to verify and assure pump operability. Pump drivers are not included in the current battery of testing. Operational problems thought to be caused by pump degradation were found to be the result of motor degradation. Recent advances in nonintrusive monitoring techniques have made motor diagnostics a viable technology for assessing motor operability. Motor current/power analysis can detect rotor bar degradation and ascertain ranges of hydraulically unstable operation for a particular pump and motor set. The concept of using motor current or power fluctuations as an indicator of pump hydraulic load stability is presented.

  20. Champagne Heat Pump (United States)

    Jones, Jack A.


    The term champagne heat pump denotes a developmental heat pump that exploits a cycle of absorption and desorption of carbon dioxide in an alcohol or other organic liquid. Whereas most heat pumps in common use in the United States are energized by mechanical compression, the champagne heat pump is energized by heating. The concept of heat pumps based on other absorption cycles energized by heat has been understood for years, but some of these heat pumps are outlawed in many areas because of the potential hazards posed by leakage of working fluids. For example, in the case of the water/ammonia cycle, there are potential hazards of toxicity and flammability. The organic-liquid/carbon dioxide absorption/desorption cycle of the champagne heat pump is similar to the water/ammonia cycle, but carbon dioxide is nontoxic and environmentally benign, and one can choose an alcohol or other organic liquid that is also relatively nontoxic and environmentally benign. Two candidate nonalcohol organic liquids are isobutyl acetate and amyl acetate. Although alcohols and many other organic liquids are flammable, they present little or no flammability hazard in the champagne heat pump because only the nonflammable carbon dioxide component of the refrigerant mixture is circulated to the evaporator and condenser heat exchangers, which are the only components of the heat pump in direct contact with air in habitable spaces.

  1. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

    Casada, D. [Oak Ridge National Lab., TN (United States)


    There are a variety of stressors that can affect the operation of centrifugal pumps. Although these general stressors are active in essentially all centrifugal pumps, the stressor level and the extent of wear and degradation can vary greatly. Parameters that affect the extent of stressor activity are manifold. In order to assure the long-term operational readiness of a pump, it is important to both understand the nature and magnitude of the specific degradation mechanisms and to monitor the performance of the pump. The most commonly applied method of monitoring the condition of not only pumps, but rotating machinery in general, is vibration analysis. Periodic or continuous special vibration analysis is a cornerstone of most pump monitoring programs. In the nuclear industry, non-spectral vibration monitoring of safety-related pumps is performed in accordance with the ASME code. Pump head and flow rate are also monitored, per code requirements. Although vibration analysis has dominated the condition monitoring field for many years, there are other measures that have been historically used to help understand pump condition; advances in historically applied technologies and developing technologies offer improved monitoring capabilities. The capabilities of several technologies (including vibration analysis, dynamic pressure analysis, and motor power analysis) to detect the presence and magnitude of both stressors and resultant degradation are discussed.

  2. Optically pumped atoms

    CERN Document Server

    Happer, William; Walker, Thad


    Covering the most important knowledge on optical pumping of atoms, this ready reference is backed by numerous examples of modelling computation for optical pumped systems. The authors show for the first time that modern scientific computing software makes it practical to analyze the full, multilevel system of optically pumped atoms. To make the discussion less abstract, the authors have illustrated key points with sections of MATLAB codes. To make most effective use of contemporary mathematical software, it is especially useful to analyze optical pumping situations in the Liouville spa

  3. Resonance wave pumping: wave mass transport pumping (United States)

    Carmigniani, Remi; Violeau, Damien; Gharib, Morteza


    It has been previously reported that pinching at intrinsic resonance frequencies a valveless pump (or Liebau pump) results in a strong pulsating flow. A free-surface version of the Liebau pump is presented. The experiment consists of a closed tank with a submerged plate separating the water into a free-surface and a recirculation section connected through two openings at each end of the tank. A paddle is placed at an off-centre position at the free-surface and controlled in a heaving motion with different frequencies and amplitudes. Near certain frequencies identified as resonance frequencies through a linear potential theory analysis, the system behaves like a pump. Particle Image Velocimetry (PIV) is performed in the near free surface region and compared with simulations using Volume of Fluid (VOF) method. The mean eulerian mass flux field (ρ) is extracted. It is observed that the flow is located in the vicinity of the surface layer suggesting Stokes Drift (or Wave Mass Transport) is the source of the pumping. A model is developped to extend the linear potential theory to the second order to take into account these observations. The authors would like to acknowledge the Gordon and Betty Moore Foundation for their generous support.

  4. Development of a disposable maglev centrifugal blood pump intended for one-month support in bridge-to-bridge applications: in vitro and initial in vivo evaluation. (United States)

    Someya, Takeshi; Kobayashi, Mariko; Waguri, Satoshi; Ushiyama, Tomohiro; Nagaoka, Eiki; Hijikata, Wataru; Shinshi, Tadahiko; Arai, Hirokuni; Takatani, Setsuo


    MedTech Dispo, a disposable maglev centrifugal blood pump with two degrees of freedom magnetic suspension and radial magnetic coupling rotation, has been developed for 1-month extracorporeal circulatory support. As the first stage of a two-stage in vivo evaluation, 2-week evaluation of a prototype MedTech Dispo was conducted. In in vitro study, the pump could produce 5 L/min against 800 mm Hg and the normalized index of hemolysis was 0.0054 +/- 0.0008 g/100 L. In in vivo study, the pump, with its blood-contacting surface coated with biocompatible 2-methacryloyloxyethyl phosphorylcholine polymer, was implanted in seven calves in left heart bypass. Pump performance was stable with a mean flow of 4.49 +/- 0.38 L/min at a mean speed of 2072.1 +/- 64.5 rpm. The maglev control revealed its stability in rotor position during normal activity by the calves. During 2 weeks of operation in two calves which survived the intended study period, no thrombus formation was seen inside the pump and levels of plasma free hemoglobin were maintained below 4 mg/dL. Although further experiments are required, the pump demonstrated the potential for sufficient and reliable performance and biocompatibility in meeting the requirements for cardiopulmonary bypass and 1-week circulatory support.

  5. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Juvenal da Rocha Torres Neto


    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  6. Mesh repair of hernias of the abdominal wall

    NARCIS (Netherlands)

    W.W. Vrijland (Wietske)


    textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are inci

  7. Demanding pump power; Krevende pumpekraft

    Energy Technology Data Exchange (ETDEWEB)

    Lie, Oeyvind


    The potential for pump power in Norway is huge, but it is difficult to exploit it. Norway has some pumping plants, but these are built for seasonal pumping (pumping up to the magazine in the summer, and production in the winter). Pump power plants for short periods do not exist in Norway. (AG)

  8. Noninvasive pulsatile flow estimation for an implantable rotary blood pump. (United States)

    Karantonis, Dean M; Cloherty, Shaun L; Mason, David G; Ayre, Peter J; Lovell, Nigel H


    A noninvasive approach to the task of pulsatile flow estimation in an implantable rotary blood pump (iRBP) has been proposed. Employing six fluid solutions representing a range of viscosities equivalent to 20-50% blood hematocrit (HCT), pulsatile flow data was acquired from an in vitro mock circulatory loop. The entire operating range of the pump was examined, including flows from -2 to 12 L/min. Taking the pump feedback signals of speed and power, together with the HCT level, as input parameters, several flow estimate models were developed via system identification methods. Three autoregressive with exogenous input (ARX) model structures were evaluated: structures I and II used the input parameters directly; structure II incorporated additional terms for HCT; and the third structure employed as input a non-pulsatile flow estimate equation. Optimal model orders were determined, and the associated models yielded minimum mean flow errors of 5.49% and 0.258 L/min for structure II, and 5.77% and 0.270 L/min for structure III, when validated on unseen data. The models developed in this study present a practical method of accurately estimating iRBP flow in a pulsatile environment.

  9. Pump element for a tube pump

    DEFF Research Database (Denmark)


    relative to the rod element so as to allow for a fluid flow in the tube through the first valve member, along the rod element, and through the second valve member. The tube comprises an at least partly flexible tube portion between the valve members such that a repeated deformation of the flexible tube...... portion acts to alternately close and open the valve members thereby generating a fluid flow through the tube. The invention further relates to a pump element comprising at least two non-return valve members connected by a rod element, and for insertion in an at least partly flexible tube in such tube...... pump as mentioned above, thereby acting to generate a fluid flow through the tube upon repeated deformation of the tube between the two valve members. The pump element may comprise a connecting part for coupling to another tube and may comprise a sealing part establishing a fluid tight connection...

  10. Well Leg Compartment Syndrome After Abdominal Surgery

    DEFF Research Database (Denmark)

    Christoffersen, Jens Krogh; Hove, Lars Dahlgaard; Mikkelsen, Kim Lyngby;


    BACKGROUND: Well leg compartment syndrome (WLCS) is a complication to abdominal surgery. We aimed to identify risk factors for and outcome of WLCS in Denmark and literature. METHODS: Prospectively collected claims to the Danish Patient Compensation Association (DPCA) concerning WLCS after abdominal...

  11. Actinomycosis mimicking abdominal neoplasm. Case report

    DEFF Research Database (Denmark)

    Waaddegaard, P; Dziegiel, Morten Hanefeld


    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...

  12. Thoraco-abdominal aortic aneurysm branched repair

    NARCIS (Netherlands)

    Verhoeven, E. L. G.; Tielliu, I. F. J.; Ferreira, M.; Zipfel, B.; Adam, D. J.


    Open thoraco-abdominal aortic aneurysm repair is a demanding procedure with high impact on the patient and the operating team. Results from expert centres show mortality rates between 3-21%, with extensive morbidity including renal failure and paraplegia. Endovascular repair of abdominal aortic aneu



    Vijaya; Sarbeshwar; Gogoi


    BACKGROUND: Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential . (1,2,3) CASE PRESENTATION: We report a female patient with desmoid tumor of the abdominal wall over appendicectomy scar w ho underwent primary resection. Preoperative evaluation incl uded abdominal ultrasound, and computed tomography. The histology of this cases revealed a desmoid tumor. CONCLUSION: ...

  14. Water Treatment Technology - Pumps. (United States)

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on pumps provides instructional materials for three competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: types of pumps in plant and distribution systems, pump…

  15. The Effect of Geometry on the Efficiency and Hemolysis of Centrifugal Implantable Blood Pumps. (United States)

    Mozafari, Sahand; Rezaienia, Mohammad A; Paul, Gordon M; Rothman, Martin T; Wen, Pihua; Korakianitis, Theodosios

    The application of centrifugal pumps as heart assist devices imposes design limitations on the impeller geometry. Geometry and operating parameters will affect the performance and the hemocompatibility of the device. Among all the parameters affecting the hemocompatibility, pressure, rotational speed, blade numbers, angle, and width have significant impact on the blood trauma. These parameters directly (pressure, speed) and indirectly (geometry) affect the efficiency of the pump as well. This study describes the experimental investigation on geometric parameters and their effect on the performance of small centrifugal pumps suitable for Mechanical Circulatory Support (MCS) devices. Experimental and numerical techniques were implemented to analyze the performance of 15 centrifugal impellers with different characteristics. The effect of each parameter on the pump performance and hemolysis was studied by calculating the normalized index of hemolysis (NIH) and the shear stress induced in each pump. The results show five and six blades, 15-35° outlet angle, and the lowest outlet width that meets the required pressure rise are optimum values for an efficient hemocompatible pump.

  16. Acute spontaneous isolated dissection of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Ali Akbar beigi


    Full Text Available

    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  17. Pulmonary complications of abdominal wall defects. (United States)

    Panitch, Howard B


    The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.

  18. The impact of arterial oxygen tension on venous oxygen saturation in circulatory failure. (United States)

    Ho, Kwok Ming; Harding, Richard; Chamberlain, Jenny


    Central and mixed venous oxygen saturations have been used to guide resuscitation in circulatory failure, but the impact of arterial oxygen tension on venous oxygen saturation has not been thoroughly evaluated. This observational study investigated the impact of arterial oxygen tension on venous oxygen saturation in circulatory failure. Twenty critically ill patients with circulatory failure requiring mechanical ventilation and a pulmonary artery catheter in an intensive care unit in a tertiary hospital in Western Australia were recruited. Samples of arterial blood, central venous blood, and mixed venous blood were simultaneously and slowly drawn from the arterial, central venous, and pulmonary artery catheter, respectively, at baseline and after the patient was ventilated with 100% inspired oxygen for 5 min. The blood samples were redrawn after a significant change in cardiac index (>or =10%) from the baseline, occurring within 24 h of study enrollment while the patient was ventilated with the same baseline inspired oxygen concentration, was detected. An increase in inspired oxygen concentration significantly increased the arterial oxygen tension from 12.5 to 38.4 kPa (93.8-288 mmHg) (mean difference, 25.9 kPa; 95% confidence interval [CI], 7.5-31.9 kPa; P arterial oxygen tension on venous oxygen saturation was more significant than the effect associated with changes in cardiac index (mean difference, 2.8%; 95% CI, -0.2% to 5.8%; P = 0.063). In conclusion, arterial oxygen tension has a significant effect on venous oxygen saturation, and this effect is more significant and consistent than the effect associated with changes in cardiac index.

  19. Mock Circulatory Loop Compliance Chamber Employing a Novel Real-Time Control Process. (United States)

    Taylor, Charles E; Miller, Gerald E


    The use of compliance chambers in mock circulatory loop construction is the predominant means of simulating arterial compliance. Utilizing mock circulatory loops as bench test methods for cardiac assist technologies necessitates that they must be capable of reproducing the circulatory conditions that would exist physiologically. Of particular interest is the ability to determine instantaneous compliance of the system, and the ability to change the compliance in real-time. This capability enables continuous battery testing of conditions without stopping the flow to change the compliance chamber settings, and the simulation of dynamic changes in arterial compliance. The method tested involves the use of a compliance chamber utilizing a circular natural latex rubber membrane separating the fluid and air portions of the device. Change in system compliance is affected by the airspace pressure, which creates more reaction force at the membrane to the fluid pressure. A pressure sensor in the fluid portion of the chamber and a displacement sensor monitoring membrane center deflection allow for real-time inputs to the control algorithm. A predefined numerical model correlates the displacement sensor data to the volume displacement of the membrane. The control algorithm involves a tuned π loop maintaining the volume distention of the membrane via regulation of the air space pressure. The proportional integral (PI) controller tuning was achieved by creating a computational model of the compliance chamber using Simulink™ Simscape(®) toolboxes. These toolboxes were used to construct a model of the hydraulic, mechanical, and pneumatic elements in the physical design. Parameter Estimation™ tools and Design Optimization™ methods were employed to determine unknown physical parameters in the system, and tune the process controller used to maintain the compliance setting. It was found that the resulting control architecture was capable of maintaining compliance along a

  20. Na+/H+ exchange inhibition delays the onset of hypovolemic circulatory shock in pigs. (United States)

    Wu, Dongmei; Arias, Jaqueline; Bassuk, Jorge; Doods, Henri; Seidler, Randolph; Adams, Jose A; Abraham, William M


    Severe blood loss is a major cause of death occurring within hours of traumatic injury. Na+/H+ exchange (NHE-1) activity is an important determinant of the extent of ischemic myocardial injury. The goal of the present study was to test the hypothesis that NHE-1 inhibition delays the onset of hypovolemic circulatory shock, thereby preventing early death due to severe hemorrhage in pigs. Severe hypovolemia was studied in 16 (25.2 kg) anesthetized male pigs in steps of 10-, 20-, 30-, 40-, and 50-mL kg(-1) blood loss, each in 30-min intervals. Shed blood resuscitation was started 30 min after 50 mL kg(-1) blood loss. The experiment was terminated after 3 h of resuscitation. Eight pigs were used as seline control. Eight pigs received 3 mg kg(-1) benzamide, N-(aminoiminomethyl)-4-[4-(2-furanylcarbonyl)-1-piperazinyl]-3-(methylsulfonyl), methanesulfonate (NHE-1 inhibitor) 15 min before hemorrhage. Seven control pigs died at 40- to 50-mL kg(-1) blood loss. One control pig survived initial resuscitation but died soon after. In contrast, all animals treated with NHE-1 inhibitor survived the entire protocol. In control animals, cardiac output and MAP gradually decreased at each step of blood loss with marked increase in heart rate. Cardiovascular decompensation occurred at 40 mL kg(-1) blood loss. Na+/H+ exchange inhibition increased oxygen delivery, attenuated cardiovascular decompensation, delayed the onset of irreversible hypovolemic circulatory shock, and enabled resuscitation to survival. Echocardiography analysis showed that myocardial hypercontracture gradually developed with each step of blood loss in control animals, but this hypercontracture was attenuated in the animals receiving the NHE-1 inhibitor. We conclude that NHE-1 inhibition attenuates ischemic myocardial hypercontracture, cardiovascular decompensation, delays the onset of hypovolemic circulatory shock, and prevents early death in severe hemorrhage.

  1. Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain

    DEFF Research Database (Denmark)

    Wewer, Anne Vibeke; Strandberg, C; Pærregaard, Anders;


    We report on our experience with routine abdominal ultrasonography in 120 children (aged 3-15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n...... = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. CONCLUSION: The diagnostic value of abdominal ultrasonography in unselected children with recurrent abdominal pain is low. However, the direct visualization...... of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain....

  2. Neurological and circulatory outcomes of cardiopulmonary resuscitation in progress: influence of pre-arrest and arrest factors. (United States)

    Jørgensen, E O


    Possible correlations between the circulatory and neurological responses to cardiopulmonary resuscitation (CPR) and the influence of pre-arrest factors (demographic data, medical history and aetiology of circulatory arrest) and arrest factors (location of arrest, ECG configurations, and duration of resuscitation) on the course of circulatory and neurological recovery were investigated in 111 victims of circulatory arrest. At the start of resuscitation 57 patients (Group I) had some brain function and 54 (Group II) had no brain function. Sixty nine patients (62%) had circulation restored but 54 (78%) were left with heart failure. Forty one patients (39%) survived the first day, 26 (63%) with heart failure; only 34 (31%) were alive after 48 h, 17 (50%) with heart failure. Half of the patients surviving 24 or 48 h had awakened. Consciousness returned in 32 patients (29%) during the first 48 h, more frequently in Group I than in Group II. Patients in Group I had a higher incidence of in-hospital arrest and had their circulation restored more often than those in Group II. Survival and post-resuscitation heart failure was alike in the groups. The pre-arrest factors explored did not modify the circulatory or neurological outcome whereas initial ventricular fibrillation was significantly related to recovery of consciousness. The revivability of spontaneous circulation and of neurological functions was found thus mainly to be determined by global ischaemia sustained prior to and during CPR.

  3. Effects of fluid restriction on measures of circulatory efficacy in adults with septic shock

    DEFF Research Database (Denmark)

    Hjortrup, P. B.; Haase, Nicolai; Wetterslev, Jørn


    , highest dose of noradrenaline, and the urinary output were recorded in five time frames in the first 24 h after randomisation. We used multiple linear mixed effects models to compare the two groups. RESULTS: We included all 151 randomised patients; the cumulated fluid resuscitation volume in the first 24......BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock...

  4. Burden of Circulatory System Diseases and Ignored Barriers ofKnowledge Translation

    Directory of Open Access Journals (Sweden)

    Hamed-Basir Ghafouri


    Full Text Available Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors.


    The objective of the investigation is the application of, and where necessary, extension of optimal control theory to the synthesis of controllers for such cardio-circulatory assist devices. In particular, the concept of set of attainability is extended to include linear, periodic, bounded control systems and the maximum principle applied to obtain necessary and sufficient conditions for various problems. In addition to several numerical examples, the results of a large-scale hybrid simulation for a cardiovascular model and particular assist device are presented.

  6. Circulatory responses to nasotracheal intubation: comparison of GlideScope(R) videolaryngoscope and Macintosh direct laryngoscope

    Institute of Scientific and Technical Information of China (English)

    XUE Fu-shan; LI Xuan-ying; LIU Qian-jin; LIU He-ping; YANG Quan-yong; XU Ya-chao; LIAO Xu; LIU Yi


    Background The GlideScope videolaryngoscope (GSVL) has been shown to have no special advantage over theMacintosh direct laryngoscope (MDL) in attenuating the circulatory responses to orotracheal intubation, but no study has compared the circulatory responses to nasotracheal intubation (NTI) using the two devices. This prospective randomized clinical study was designed to determine whether there was a clinically relevant difference between the circulatory responses to NTI with the GSVL and the MDL.Methods Seventy-six adult patients were randomly allocated equally to the GSVL group and the MDL group. After induction of anesthesia, NTI was performed. Non-invasive blood pressure (BP) and heart rate (HR) were recorded before induction (baseline values) and immediately before intubation (post-induction values), at intubation and every minute for a further five minutes. During the observation, times required to reach the maximum values of systolic BP (SBP) and HR, times required for recovery of SBP and HR to postinduction values and incidence of SBP and HR percent changes>30% of baseline values were also noted. The product of HR and systolic BP, I.e. Rate pressure product (RPP), and the areas under SBP and HR vs. Time curves (AUCSBP and AUCHR) were calculated.Results The NTI with the GSVL resulted in significant increases in BP, HR and RPP compared to postinduction values, but these circulatory changes did not exceed baseline values. BPs at all measuring points, AUCSBP, maximum values of BP and incidence of SBP percent increase>30% of baseline value during the observation did not differ significantly between groups. However, HR and RPP at intubation and their maximum values, AUCHR and incidence of HR percent increase > 30% of baseline value were significantly higher in the MDL group than in the GSVL group. -times required for recovery of SBP and HR to postinduction values were significantly longer in the MDL group than in the GSVL group.Conclusions The pressor response to

  7. Efficiency of Reflex Therapy in Complex Treatment of Circulatory Disturbances in Vertebrobasilar System

    Directory of Open Access Journals (Sweden)

    Goydenko V. S.


    Full Text Available The article deals with a complex examination and treatment of 198 patients (142 women and 56 men with circulatory disturbances in vertebrobasilar. Mean age of patients was 53.8±7.1 years. Reflex therapy including reflex therapy and biodynamic backbone correction was shown to increase the efficiency of complex therapy, allows to effect different chains of the developed pathological system, the fact confirmed by the dynamics of neurologic syndromes and dynamics of cerebrovascular reactivity at transcranial Doppler sonography.

  8. Mesh repair of hernias of the abdominal wall



    textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are incisional, umbilical, epigastric and Spigelian hernia. In chapter 1 an overview of hernias of the abdominal wall is described. The incidence, clinical implications and treatment options and their comp...

  9. Open abdomen in the treatment of intra-abdominal hypertension in patients with severe acute pancreatitis%重症急性胰腺炎的腹腔高压与腹腔开放治疗

    Institute of Scientific and Technical Information of China (English)



    @@ 早在20世纪初期,就有学者注意到腹腔高压对患者心血管、肾脏等的功能产生不利影响.重症急性胰腺炎(severe acute pancreatitis,SAP)常导致腹腔高压,不仅限制腹式呼吸,减少机体氧供,而且对泌尿、循环、消化和中枢神经系统等产生一系列严重影响,如不及时治疗,将导致腹腔间室综合征(abdominal compartment syndrome,ACS).%Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

  10. Pumping machinery theory and practice

    CERN Document Server

    Badr, Hassan M


    Pumping Machinery Theory and Practice comprehensively covers the theoretical foundation and applications of pumping machinery. Key features: Covers characteristics of centrifugal pumps, axial flow pumps and displacement pumpsConsiders pumping machinery performance and operational-type problemsCovers advanced topics in pumping machinery including multiphase flow principles, and two and three-phase flow pumping systemsCovers different methods of flow rate control and relevance to machine efficiency and energy consumptionCovers different methods of flow rate control and relevance to machine effi

  11. Radiologic findings of abdominal wall endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)


    To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.

  12. Traumatic abdominal hernia complicated by necrotizing fasciitis. (United States)

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa


    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  13. Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure

    DEFF Research Database (Denmark)

    Møller, M H; Claudius, C; Junttila, E


    BACKGROUND: Adult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant......, evidence-based treatment recommendations on this topic. METHODS: This guideline was developed according to standards for trustworthy guidelines, including a systematic review of the literature and use of the GRADE methodology for assessment of the quality of evidence and for moving from evidence...... to recommendations. We assessed the following subpopulations of patients with acute circulatory failure: 1) shock in general, 2) septic shock, 3) cardiogenic shock, 4) hypovolemic shock and 5) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality...

  14. Developing seventh grade students' systems thinking skills in the context of the human circulatory system. (United States)

    Raved, Lena; Yarden, Anat


    Developing systems thinking skills in school can provide useful tools to deal with a vast amount of medical and health information that may help learners in decision making in their future lives as citizen. Thus, there is a need to develop effective tools that will allow learners to analyze biological systems and organize their knowledge. Here, we examine junior high school students' systems thinking skills in the context of the human circulatory system. A model was formulated for developing teaching and learning materials and for characterizing students' systems thinking skills. Specifically, we asked whether seventh grade students, who studied about the human circulatory system, acquired systems thinking skills, and what are the characteristics of those skills? Concept maps were used to characterize students' systems thinking components and examine possible changes in the students' knowledge structure. These maps were composed by the students before and following the learning process. The study findings indicate a significant improvement in the students' ability to recognize the system components and the processes that occur within the system, as well as the relationships between different levels of organization of the system, following the learning process. Thus, following learning students were able to organize the systems' components and its processes within a framework of relationships, namely the students' systems thinking skills were improved in the course of learning using the teaching and learning materials.

  15. The use of VEPs for CNS monitoring during continuous cardiopulmonary bypass and circulatory arrest. (United States)

    Keenan, N K; Taylor, M J; Coles, J G; Prieur, B J; Burrows, F A


    Cerebral function was monitored with the use of visual evoked potentials (VEPs) in 16 infants (mean age 9.9 +/- 4.3 months) during surgery for congenital cardiac anomalies. While hypothermia was employed in all patients, half (8) remained on continuous cardiopulmonary bypass (CCB) while the rest were cooled to lower temperatures before the induction of circulatory stasis and venous exsanguination (CA), i.e., profound hypothermic circulatory arrest (PHCA). VEPs were recorded before, during and after surgical intervention. Latency changes occurred in both the N100 and P145 components of the VEP as a function of systemic temperature during cooling in both groups. Differences in the VEPs were found between the two groups post-operatively, with the most interesting result being a greater increase in P145 latency in the CA group after rewarming. To the extent that VEPs reflect neurological status, our findings suggested that CCB was associated with less perturbation in acute neurological status than PHCA, and shorter arrest times and lower temperatures during CA were associated with the most favourable post-operative VEPs. Hence, intraoperative monitoring of VEPs appeared to be useful as an objective measure of the short-term effects of various cardiopulmonary procedures on neurophysiological function.

  16. Changes in respiratory and circulatory functions during sequential invasive-noninvasive mechanical ventilation

    Institute of Scientific and Technical Information of China (English)

    商鸣宇; 王辰; 代华平; 杨媛华; 姜超美


    Objective To investigate the changes in respiratory and circulatory functions in chronic obstructive pulmonary disease (COPD) patients during sequential invasive-noninvasive mechanical ventilation therapy, and evaluate the effects of this new technique.Methods Twelve COPD patients with type Ⅱ respiratory failure due to severe pulmonary infection were ventilated through an endotracheal tube. When the pulmonary infection control window (PIC-Window) occurred, the patients were extubated and were ventilated with a facial mask using pressure support ventilation combined with positive end-expiratory pressure. The parameters of hemodynamics, oxygen dynamics, and esophageal pressure were measured at the PIC-Window during invasive mechanical ventilation, one hour after oxygen therapy via a naso-tube, and three hours after non-invasive mechanical ventilation. Results The variation in esophageal pressure was 20.0±6 cmH2O during naso-tube oxygen therapy, and this variation was higher than that during non-invasive mechanical ventilation (10±6 cmH2O, P0.05).Conclusions The respiratory and circulatory functions of COPD patients remained stable during sequential invasive-noninvasive mechanical ventilation therapy using PIC-Window as a switch point for early extubation. The COPD patients can tolerated the transition from invasive mechanical ventilation to noninvasive mechanical ventilation.

  17. Clinical experience with L-lysine escinate for acute and chronic cerebral circulatory disorders

    Directory of Open Access Journals (Sweden)

    N. V. Pizova


    Full Text Available Cerebrovascular diseases (CVD are major causes of disability and death in Russia. Stroke is the third significant cause of higher death rates after cardiovascular disease and cancer. The prevalence of circulatory diseases, such as atherosclerosis and hypertension, is on the rise. Therapy for CVD must be aimed at the underlying disease in which vascular catastrophe (atherosclerosis, hypertension, heart disease, etc. develops, at the regression of neurological and psychopathological syndromes, and at the improvement of cerebral blood flow and metabolic processes. Neuroprotective agents, whose efficacy has been established in uncontrolled and small placebo-controlled trials, are widely used in our country. The prescription of these medications is substantiated by the important role of the pathogenetic mechanisms underlying cerebral ischemia. This paper gives data on the clinical use of L-lysine escinate for ischemic stroke (IS, hypertensive crisis, and chronic cerebral circulatory disorders and discusses the mechanism of this drug's action and the pathogenetic mechanisms of cerebrovascular lesions. A number of investigations have shown it expedient to incorporate L-lysine escinate in the combined neuroprotective therapy of patients with IS, cerebral hypertensive crisis, and hypertensive encephalopathy, which is associated with its antiedematous effect, particularly in preventing vasogenic brain edema, in enhancing the tone of cerebral veins, and in improving venous outflow. It is stated that there is a need for an individualized approach to treating CVD, by taking into consideration the existing risk factors and somatic and neurological diseases. 

  18. Local regulator adrenomedullin contributes to the circulatory disturbance in cirrhotic rats

    Institute of Scientific and Technical Information of China (English)

    Shinya Sakurai; Hideyuki Kojima; Masahito Uemura; Hiroyasu Satoh; Hiroshi Fukui


    AIM: To investigate whether adrenomedullin, a potent vasodilator peptide, plays a role in the circulatory disturbance in cirrhosis.METHODS: Cirrhosis was induced in rats by weekly gavage of carbon tetrachloride. Hemodynamic studies were performed in vivo using radioactive microspheres andin vitro using isolated aortic rings.The adrenomedullin concentrations were measured by radioimmunoassay.RESULTS: Acute administration of adrenomedullin to the control rats reduced the systemic arterial pressure along with an increase of serum levels of the stable metabolite of nitric oxide (NOx), in a dose-dependent manner. Chronic infusion of adrenomedullin reduced the vascular resistance and increased the blood flow in the systemic and splanchnic circulation. Intravenous administration of anti-adrenomedullin antibody did not affect any hemodynamic parameters in the cirrhotic rats, whereas this antibody ameliorated the blunted contractile response to phenylephrine, a-adrenergic receptor agonist, in the aortic rings of the cirrhotic rats.The adrenomedullin concentrations in the aorta were higher in the cirrhotic rats than in the controls, and correlated with the mean arterial pressure in the cirrhotic rats. Moreover, adrenomedullin blunted the contractile response to phenylephrine in both of the control aorta and cirrhotic aorta, but not in the presence of NG-nitroL-arginine methyl ester, an NO synthase inhibitor.CONCLUSION: Adrenomedullin overproduced in the vascular wall may contribute to the circulatory disturbance in cirrhosis as a local regulator of the vascular tonus rather than a circulating hormone.

  19. Circulatory Support with Venoarterial ECMO Unsuccessful in Aiding Endogenous Diltiazem Clearance after Overdose

    Directory of Open Access Journals (Sweden)

    Erin N. Frazee


    Full Text Available Introduction. In cardiovascular collapse from diltiazem poisoning, extracorporeal membrane oxygenation (ECMO may offer circulatory support sufficient to preserve endogenous hepatic drug clearance. Little is known about patient outcomes and diltiazem toxicokinetics in this setting. Case Report. A 36-year-old woman with a history of myocardial bridging syndrome presented with chest pain for which she self-medicated with 2.4 g of sustained release diltiazem over the course of 8 hours. Hemodynamics and mentation were satisfactory on presentation, but precipitously deteriorated after ICU transfer. She was given fluids, calcium, vasopressors, glucagon, high-dose insulin, and lipid emulsion. Due to circulatory collapse and multiorgan failure including ischemic hepatopathy, she underwent transvenous pacing and emergent initiation of venoarterial ECMO. The peak diltiazem level was 13150 ng/mL (normal 100–200 ng/mL and it remained elevated at 6340 ng/mL at hour 90. Unfortunately, the patient developed multiple complications which resulted in her death on ICU day 9. Conclusion. This case describes the unsuccessful use of ECMO for diltiazem intoxication. Although past reports suggest that support with ECMO may facilitate endogenous diltiazem clearance, it may be dependent on preserved hepatic function at the time of cannulation, a factor not present in this case.

  20. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells (United States)

    Fan, Rong; Emery, Travis; Zhang, Yongguo; Xia, Yuxuan; Sun, Jun; Wan, Jiandi


    During cancer metastasis, circulating tumor cells constantly experience hemodynamic shear stress in the circulation. Cellular responses to shear stress including cell viability and proliferation thus play critical roles in cancer metastasis. Here, we developed a microfluidic approach to establish a circulatory microenvironment and studied circulating human colon cancer HCT116 cells in response to a variety of magnitude of shear stress and circulating time. Our results showed that cell viability decreased with the increase of circulating time, but increased with the magnitude of wall shear stress. Proliferation of cells survived from circulation could be maintained when physiologically relevant wall shear stresses were applied. High wall shear stress (60.5 dyne/cm2), however, led to decreased cell proliferation at long circulating time (1 h). We further showed that the expression levels of β-catenin and c-myc, proliferation regulators, were significantly enhanced by increasing wall shear stress. The presented study provides a new insight to the roles of circulatory shear stress in cellular responses of circulating tumor cells in a physiologically relevant model, and thus will be of interest for the study of cancer cell mechanosensing and cancer metastasis.

  1. [Abdominal tuberculosis in childhood: the clinical manifestations]. (United States)

    Rivera Medina, J; Almendras, M; Devoto, G; Martinez, E; Gonzales, J; Alarcón, P; Muñoz, S


    The authors reviewed the histories of 133 patients with abdominal tuberculosis in Instituto Nacional de Salud del Niño (Children's Hospital), Lima, Perú, between 1989 and 1991. We found morbidity higher in scholars (67.4%). Weight lost were present in all cases and malaise in 95.3%, abdominal distension in 83.72% and abdominal pain in 79.06%. Anaemia in 76.06%, ratio albumin/globulin were altered in 74.41% leukocytosis in 67.44%. Evidence of tuberculosis on chest X-ray were detected only in 62.5%.

  2. Diseases of the circulatory system: health status and perspectives for changes

    Directory of Open Access Journals (Sweden)

    V. I. Klimenko


    Full Text Available During last 20 years rates of incidence and prevalence of diseases of the circulatory system in Ukraine have been growing from year to year and became problems of current interest. According to the program of WHO, realization of diseases prevention is provided by using of scientific justification and monitoring of health indexes, including diseases of the circulatory system. Goal of our research was to analyze health status of population of Zaporozhye region concerning cardiovascular diseases. Data since 1995 to 2012 y. were taken in the Center of medical statistics of Zaporozhye region. Comparative analysis of obtained data was conducted in dynamics and with definition of specific weight of able to work population in structure of indexes and gender differences. In article we showed, that on the background of depopulation of Ukraine during last 20 years, prevalence of diseases of the circulatory system increased by 2 times, and level of mortality from them increased for 45%. Specific weight of mortality from diseases of the circulatory system among adult population (state for 01.2013 y. in Ukraine was 65,7%, in Zaporozhye region – 63,6%, among able to work population – 30,5%, in Zaporozhye region – 33,4%, but mortality among able to work men in Zaporozhye region was in 5,5 times higher than in women. Specific weight of the diseases of the circulatory system in structure of general morbidity in total population in Ukraine was 31,5%, among able to work population – 24,1%; among total population of Zaporozhye region – 36,6% (in town – 35,0%; in country region – 39,8%, among able to work population of Zaporozhye region – 24,6% (in town – 22,8%; in country region – 27,6%. Structure of general morbidity of the cardiovascular diseases during last 10 years in Ukraine and in Zaporozhye region is stable. Leading place belongs to arterial hypertension: 56,1%- in Ukraine, 57,7 % - in Zaporozhye region. Comparing to Ukraine, before 2005 y

  3. Detection of early central circulatory transits in patients with cirrhosis by gamma variate fit of indicator dilution profiles

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren; Fuglsang, Stefan;


    dilution curves, and the relations between flow, circulation times, and volumes were established according to kinetic principles. No significant very early central circulatory transits were identified. In contrast, early (i.e., 4 s to maximal) transits corresponding to a mean of 5.1% (vs. 0.8% in controls...... variate fit method (1.51 vs. 1.53 liter; not significant). In conclusion, no very early central circulatory transits were identified in cirrhotic patients. A significant part of the cardiac output undergoes an early transit, probably through pulmonary shunts or areas with low ventilation-perfusion ratios...

  4. [Churg-Strauss abdominal manifestation]. (United States)

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo


    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  5. High Voltage Charge Pump

    KAUST Repository

    Emira, Ahmed A.


    Various embodiments of a high voltage charge pump are described. One embodiment is a charge pump circuit that comprises a plurality of switching stages each including a clock input, a clock input inverse, a clock output, and a clock output inverse. The circuit further comprises a plurality of pumping capacitors, wherein one or more pumping capacitors are coupled to a corresponding switching stage. The circuit also comprises a maximum selection circuit coupled to a last switching stage among the plurality of switching stages, the maximum selection circuit configured to filter noise on the output clock and the output clock inverse of the last switching stage, the maximum selection circuit further configured to generate a DC output voltage based on the output clock and the output clock inverse of the last switching stage.

  6. Underground pumped hydroelectric storage (United States)

    Allen, R. D.; Doherty, T. J.; Kannberg, L. D.


    Underground pumped hydroelectric energy storage was conceived as a modification of surface pumped storage to eliminate dependence upon fortuitous topography, provide higher hydraulic heads, and reduce environmental concerns. A UPHS plant offers substantial savings in investment cost over coal-fired cycling plants and savings in system production costs over gas turbines. Potential location near load centers lowers transmission costs and line losses. Environmental impact is less than that for a coal-fired cycling plant. The inherent benefits include those of all pumped storage (i.e., rapid load response, emergency capacity, improvement in efficiency as pumps improve, and capacity for voltage regulation). A UPHS plant would be powered by either a coal-fired or nuclear baseload plant. The economic capacity of a UPHS plant would be in the range of 1000 to 3000 MW. This storage level is compatible with the load-velocity requirements of a greater metropolitan area with population of 1 million or more.

  7. Chiral Brownian heat pump


    Van Den Broek, Martijn; Van Den Broeck, Christian


    We present the exact analysis of a chiral Brownian motor and heat pump. Optimization of the construction predicts, for a nanoscale device, frequencies of the order of kHz and cooling rates of the order of femtojoule per second.

  8. Regenerative Hydride Heat Pump (United States)

    Jones, Jack A.


    Hydride heat pump features regenerative heating and single circulation loop. Counterflow heat exchangers accommodate different temperatures of FeTi and LaNi4.7Al0.3 subloops. Heating scheme increases efficiency.

  9. Chiral brownian heat pump. (United States)

    van den Broek, M; Van den Broeck, C


    We present the exact analysis of a chiral Brownian motor and heat pump. Optimization of the construction predicts, for a nanoscale device, frequencies of the order of kHz and cooling rates of the order of femtojoule per second.

  10. Nuclear-pumped lasers

    CERN Document Server

    Prelas, Mark


    This book focuses on Nuclear-Pumped Laser (NPL) technology and provides the reader with a fundamental understanding of NPLs, a review of research in the field, and exploration of large scale NPL system design and applications. Early chapters look at the fundamental properties of lasers, nuclear-pumping and nuclear reactions that may be used as drivers for nuclear-pumped lasers. The book goes on to explore the efficient transport of energy from the ionizing radiation to the laser medium and then the operational characteristics of existing nuclear-pumped lasers. Models based on Mathematica, explanations and a tutorial all assist the reader’s understanding of this technology. Later chapters consider the integration of the various systems involved in NPLs and the ways in which they can be used, including beyond the military agenda. As readers will discover, there are significant humanitarian applications for high energy/power lasers, such as deflecting asteroids, space propulsion, power transmission and mining....

  11. Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review

    DEFF Research Database (Denmark)

    Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue


    INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted....... The PubMed, EMBASE and Cochrane databases were searched for studies on the use of abdominal binders after abdominal surgery or abdominoplasty. All types of clinical studies were included. Two independent assessors evaluated the scientific quality of the studies. The primary outcomes were pain, seroma...... to reduce seroma formation after laparoscopic ventral herniotomy and a non-significant reduction in pain. Physical function was improved, whereas evidence supports a beneficial effect on psychological distress after open abdominal surgery. Evidence also supports that intra-abdominal pressure increases...

  12. Lunar Base Heat Pump (United States)

    Walker, D.; Fischbach, D.; Tetreault, R.


    The objective of this project was to investigate the feasibility of constructing a heat pump suitable for use as a heat rejection device in applications such as a lunar base. In this situation, direct heat rejection through the use of radiators is not possible at a temperature suitable for lde support systems. Initial analysis of a heat pump of this type called for a temperature lift of approximately 378 deg. K, which is considerably higher than is commonly called for in HVAC and refrigeration applications where heat pumps are most often employed. Also because of the variation of the rejection temperature (from 100 to 381 deg. K), extreme flexibility in the configuration and operation of the heat pump is required. A three-stage compression cycle using a refrigerant such as CFC-11 or HCFC-123 was formulated with operation possible with one, two or three stages of compression. Also, to meet the redundancy requirements, compression was divided up over multiple compressors in each stage. A control scheme was devised that allowed these multiple compressors to be operated as required so that the heat pump could perform with variable heat loads and rejection conditions. A prototype heat pump was designed and constructed to investigate the key elements of the high-lift heat pump concept. Control software was written and implemented in the prototype to allow fully automatic operation. The heat pump was capable of operation over a wide range of rejection temperatures and cooling loads, while maintaining cooling water temperature well within the required specification of 40 deg. C +/- 1.7 deg. C. This performance was verified through testing.

  13. Remotely Adjustable Hydraulic Pump (United States)

    Kouns, H. H.; Gardner, L. D.


    Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.


    NARCIS (Netherlands)



    Rotary blood pumps are used for cardiac assist and cardiopulmonary support since mechanical blood damage is less than with conventional roller pumps. The high shear rate in the rotary pump and the reduced anticoagulation of the patient during prolonged pumping enforces high demands on the biocompati

  15. Feasibility of the optical imaging of thrombus formation in a rotary blood pump by near-infrared light. (United States)

    Sakota, Daisuke; Murashige, Tomotaka; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu


    Blood coagulation is one of the primary concerns when using mechanical circulatory support devices such as blood pumps. Noninvasive detection and imaging of thrombus formation is useful not only for the development of more hemocompatible devices but also for the management of blood coagulation to avoid risk of infarction. The objective of this study is to investigate the use of near-infrared light for imaging of thrombus formation in a rotary blood pump. The optical properties of a thrombus at wavelengths ranging from 600 to 750 nm were analyzed using a hyperspectral imaging (HSI) system. A specially designed hydrodynamically levitated centrifugal blood pump with a visible bottom area was used. In vitro antithrombogenic testing was conducted five times with the pump using bovine whole blood in which the activated blood clotting time was adjusted to 200 s prior to the experiment. Two halogen lights were used for the light sources. The forward scattering through the pump and backward scattering on the pump bottom area were imaged using the HSI system. HSI showed an increase in forward scattering at wavelengths ranging from 670 to 750 nm in the location of thrombus formation. The time at which the thrombus began to form in the impeller rotating at 2780 rpm could be detected. The spectral difference between the whole blood and the thrombus was utilized to image thrombus formation. The results indicate the feasibility of dynamically detecting and imaging thrombus formation in a rotary blood pump.

  16. Pumping a playground swing. (United States)

    Post, Auke A; de Groot, Gert; Daffertshofer, Andreas; Beek, Peter J


    In mechanical studies of pumping a playground swing, two methods of energy insertion have been identified: parametric pumping and driven oscillation. While parametric pumping involves the systematic raising and lowering of the swinger's center of mass (CM) along the swing's radial axis (rope), driven oscillation may be conceived as rotation of the CM around a pivot point at a fixed distance to the point of suspension. We examined the relative contributions of those two methods of energy insertion by inviting 18 participants to pump a swing from standstill and by measuring and analyzing the swing-swinger system (defined by eight markers) in the sagittal plane. Overall, driven oscillation was found to play a major role and parametric pumping a subordinate role, although the relative contribution of driven oscillation decreased as swinging amplitude increased, whereas that of parametric pumping increased slightly. Principal component analysis revealed that the coordination pattern of the swing-swinger system was largely determined (up to 95%) by the swing's motion, while correlation analysis revealed that (within the remaining 5% of variance) trunk and leg rotations were strongly coupled.

  17. [Inflammatory aneurysms of the abdominal aorta]. (United States)

    Tovar Martín, E; Acea Nebril, B


    Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.

  18. Abdominal pain - children under age 12 (United States)

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... belly Has had a recent injury to the abdomen Is having trouble breathing Call your provider if ...

  19. Abdominal separation in an adult male patient with acute abdominal pain

    Institute of Scientific and Technical Information of China (English)


    We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine...

  20. Abdominal Wall Hernias: Various Imaging Features Correlated with the Anatomy of Abdominal Wall at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Shin Young; Shin, Hyeong Cheol; Kim, Sang Won; Kim, Il Young; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)


    Abdominal wall hernias are a common condition. However, they may develop acute complications and require surgical correction in most cases. Hence, the correct radiological examination is requisite for an accurate diagnosis. A multi-detector row CT (MDCT) provides an accurate identification of the anatomy of the abdominal wall, precise hernia type, and helps in the detection of early signs of complication. We report various imaging features of abdominal wall hernias via a MDCT.

  1. [Intestinal occlusion and abdominal compartment syndrome (ACS)]. (United States)

    Stagnitti, Franco


    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  2. A focus on intra-abdominal infections

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo


    Full Text Available Abstract Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug

  3. [Late primary abdominal pregnancy. Case report]. (United States)

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández


    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  4. Surveillance intervals for small abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Bown, Matthew J; Sweeting, Michael J; Brown, Louise C


    Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture.......Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....

  5. Hérnia traumática da parede abdominal Traumatic abdominal hernia

    Directory of Open Access Journals (Sweden)

    Alexandre Cruz Henriques


    Full Text Available A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.

  6. Abdominal epilepsy and foreign body in the abdomen--dilemma in diagnosis of abdominal pain. (United States)

    Topno, Noor; Gopasetty, Mahesh S; Kudva, Annappa; B, Lokesh


    There are many medical causes of abdominal pain; abdominal epilepsy is one of the rarer causes. It is a form of temporal lobe epilepsy presenting with abdominal aura. Temporal lobe epilepsy is often idiopathic, however it may be associated with mesial temporal lobe sclerosis, dysembryoplastic neuroepithelial tumors and other benign tumors, arterio-venous malformations, gliomas, neuronal migration defects or gliotic damage as a result of encephalitis. When associated with anatomical abnormality, abdominal epilepsy is difficult to control with medication alone. In such cases, appropriate neurosurgery can provide a cure or, at least, make this condition easier to treat with medication. Once all known intra-abdominal causes have been ruled out, many cases of abdominal pain are dubbed as functional. If clinicians are not aware of abdominal epilepsy, this diagnosis is easily missed, resulting in inappropriate treatment. We present a case report of a middle aged woman presenting with abdominal pain and episodes of unconsciousness. On evaluation she was found to have an intra-abdominal foreign body (needle). Nevertheless, the presence of this entity was insufficient to explain her episodes of unconsciousness. On detailed analysis of her medical history and after appropriate investigations, she was diagnosed with temporal lobe epilepsy which was treated with appropriate medications, and which resulted in her pain being relieved.

  7. Enhancement of hemocompatibility of the MERA monopivot centrifugal pump: toward medium-term use. (United States)

    Yamane, Takashi; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu; Yamamoto, Yoshihiro; Kuwana, Katsuyuki; Kawamura, Hiroshi; Shiraishi, Yasuyuki; Yambe, Tomoyuki; Sankai, Yoshiyuki; Tsutsui, Tatsuo


    The MERA monopivot centrifugal pump has been developed for use in open-heart surgery, circulatory support, and bridge-to-decision for up to 4 weeks. The pump has a closed-type, 50-mm diameter impeller with four straight paths. The impeller is supported by a monopivot bearing and is driven by a radial-flux magnet-coupling motor. Because flow visualization experiments have clarified sufficient pivot wash and stagnation at the sharp corner of the pivot support was suggested, sharp corners were removed in the design stage. The index of hemolysis of the pump operating at more than 200 mm Hg was found to be lower than that of a commercial pump. Four-week animal tests were then conducted two times; improvement of thrombus formation was seen in the female pivot through modification of female pivot geometry. Overall antithrombogenicity was also recorded. Finally, to assure mid-term use, an additional 4-week durability test revealed that the rate of the axial pivot wear was as small as 1.1 µm/day. The present in vitro and in vivo studies revealed that the MERA monopivot centrifugal pump has sufficient hemocompatibility and durability for up to 4 weeks.

  8. Description, validation, and modification of the Guyton model for space-flight applications. Part A. Guyton model of circulatory, fluid and electrolyte control. Part B. Modification of the Guyton model for circulatory, fluid and electrolyte control (United States)

    Leonard, J. I.


    The mathematical model that has been a cornerstone for the systems analysis of space-flight physiological studies is the Guyton model describing circulatory, fluid and electrolyte regulation. The model and the modifications that are made to permit simulation and analysis of the stress of weightlessness are described.

  9. Thermally Actuated Hydraulic Pumps (United States)

    Jones, Jack; Ross, Ronald; Chao, Yi


    Thermally actuated hydraulic pumps have been proposed for diverse applications in which direct electrical or mechanical actuation is undesirable and the relative slowness of thermal actuation can be tolerated. The proposed pumps would not contain any sliding (wearing) parts in their compressors and, hence, could have long operational lifetimes. The basic principle of a pump according to the proposal is to utilize the thermal expansion and contraction of a wax or other phase-change material in contact with a hydraulic fluid in a rigid chamber. Heating the chamber and its contents from below to above the melting temperature of the phase-change material would cause the material to expand significantly, thus causing a substantial increase in hydraulic pressure and/or a substantial displacement of hydraulic fluid out of the chamber. Similarly, cooling the chamber and its contents from above to below the melting temperature of the phase-change material would cause the material to contract significantly, thus causing a substantial decrease in hydraulic pressure and/or a substantial displacement of hydraulic fluid into the chamber. The displacement of the hydraulic fluid could be used to drive a piston. The figure illustrates a simple example of a hydraulic jack driven by a thermally actuated hydraulic pump. The pump chamber would be a cylinder containing encapsulated wax pellets and containing radial fins to facilitate transfer of heat to and from the wax. The plastic encapsulation would serve as an oil/wax barrier and the remaining interior space could be filled with hydraulic oil. A filter would retain the encapsulated wax particles in the pump chamber while allowing the hydraulic oil to flow into and out of the chamber. In one important class of potential applications, thermally actuated hydraulic pumps, exploiting vertical ocean temperature gradients for heating and cooling as needed, would be used to vary hydraulic pressures to control buoyancy in undersea research

  10. Electronic Unit Pump Test Bench Development and Pump Properties Research

    Institute of Scientific and Technical Information of China (English)

    LIU Bo-lan; HUANG Ying; ZHANG Fu-jun; ZHAO Chang-lu


    A unit pump test bench is developed on an in-line pump test platform. The bench is composed of pump adapting assembly, fuel supply subsystem, lubricating subsystem and a control unit. A crank angle domain injection control method is given out and the control accuracy can be 0.1° crank degree. The bench can test bot h mechanical unit pump and electronic unit pump. A test model-PLD12 electronic unit pump is tested. Full pump delivery map and some influence factors test is d one. Experimental results show that the injection quantity is linear with the de livery angle. The quantity change rate is 15% when fuel temperature increases 30℃. The delivery quantity per cycle increases 30mg at 28V drive voltage. T he average delivery difference for two same type pumps is 5%. Test results show that the bench can be used for unit pump verification.

  11. Predictors of Death and Transplant in Patients With a Mechanical Circulatory Support Device : A Multi-institutional Study

    NARCIS (Netherlands)

    Holman, William L.; Kormos, Robert L.; Naftel, David C.; Miller, Marissa A.; Pagani, Frank D.; Blume, Elizabeth; Cleeton, Timothy; Koenig, Steven C.; Edwards, Leah; Kirklin, James K.


    Background: INTERMACS is a registry of FDA-approved durable mechanical circulatory support (MCS) devices used for the strategies of destination therapy (DT) and bridge to transplantation (BTT) or recovery. This study identifies predictors for death and transplantation based on initial results from I

  12. The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor. (United States)

    Fan, Xiaoli; Chen, Zhiquan; Nasralla, David; Zeng, Xianpeng; Yang, Jing; Ye, Shaojun; Zhang, Yi; Peng, Guizhu; Wang, Yanfeng; Ye, Qifa


    Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes. A total of 19 brain death donors were supported by ECMO. The incidence rate of post-transplant liver primary non-function (PNF) was 10% (two of 20) in DBD-drug group and zero in DBD-ECMO group. Kidney function indicators, including creatinine clearance and urine production, were significantly better in DBD-ECMO group, as well as the kidney delayed graft function (DGF) rate was found to be decreased by the use of ECMO in our study. Donation success rate increased steadily from 47.8% in 2011 to 84.6% in 2014 after the ECMO intervention. The use of ECMO in assisting circulatory and respiratory function of DBD can reduce liver and kidney injury from vasoactive drugs, thereby improving organ quality and reducing the organ discard rates.

  13. Mechanical Circulatory Support Devices Improve Tissue Perfusion in Patients With End-Stage Heart Failure or Cardiogenic Shock

    NARCIS (Netherlands)

    C.A. den Uil; A.P. Maat; W.K. Lagrand; M. van der Ent; L.S.D. Jewbali; R.J. van Thiel; P.E. Spronk; M.L. Simoons


    Objectives: This study evaluated the effects of mechanical circulatory support (MCS) on sub-lingual microcirculation as a surrogate for splanchnic microvascular perfusion. Methods: Between May 2008 and April 2009, 10 consecutive patients received an MCS device or extracorporeal membrane oxygenation

  14. Second-hand Smoke, Cotinine Levels, and Risk of Circulatory Mortality in a Large Cohort Study of Never-Smokers

    NARCIS (Netherlands)

    Gallo, Valentina; Neasham, David; Airoldi, Luisa; Ferrari, Pietro; Jenab, Mazda; Boffetta, Paolo; Overvad, Kim; Tjonneland, Anne; Clavel-Chapelon, Francoise; Boeing, Heiner; Pala, Valeria; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Arriola, Larraitz; Lund, Eiliv; Bueno-De-Mesquita, Bas; Peeters, Petra H.; Melander, Olle; Hallmans, Goran; Riboli, Elio; Saracci, Rodolfo; Vineis, Paolo


    Background: Exposure to second-hand smoke has been shown to be associated with increased cardiovascular mortality in several, but not all, epidemiologic studies. Our aim was to investigate the risk of circulatory death associated with exposure to second-hand smoke in never-smokers in a very large pr

  15. Senescent Changes in Cerebrospinal Fluid Circulatory Physiology and Their Role in the Pathogenesis of Normal-tension Glaucoma

    NARCIS (Netherlands)

    Wostyn, Peter; De Groot, Veva; Van Dam, Debby; Audenaert, Kurt; De Deyn, Peter Paul


    PURPOSE: To evaluate the evidence supporting a role for senescent changes in cerebrospinal fluid (CSF) circulatory physiology in the pathogenesis of normal-tension glaucoma (NTG). DESIGN: Literature review and personal perspective of the authors. METHODS: Analysis of selected articles in the peer-re


    Directory of Open Access Journals (Sweden)

    A. V. Adaskin


    Full Text Available The article describes the technology of remote patient monitoring and the parameters of circulatory assist device AVK-N as well as the advantages of said technology to improve the efficiency of personalized medicine in diagnosis and treatment of patients with AVK-N in the postoperative period. Authors show the capabilities of remote monitoring technology to determine the location of the patient by satellite navigation in the case of emergency call for medical and technical services, and present the structure and modes of the displayed information for mobile devices and Web-server. Doctor-patient interaction based on remote monitoring technology via mobile/ satellite/wired Internet is also shown. 

  17. Biventricular Mechanical Circulatory Support Does Not Prevent Delayed Myocardial Ventricular Rupture following Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Yazhini Ravi


    Full Text Available Cardiogenic shock and myocardial rupture can complicate an acute myocardial infarction (AMI. A case is reported in which a 58-year-old male with an acute inferior myocardial infarction required placement of biventricular assist device for hemodynamic support eight days after the onset of his AMI; eleven days after his AMI, the patient developed abrupt onset of hemodynamic instability with massive bleeding from his chest tube due to delayed free wall myocardial rupture that was discovered when he was taking emergently to the operating room. Myocardial rupture in patients with a ventricular assist device should be considered in the differential diagnosis in the event of acute hemodynamic compromise. A high level of suspicion for such a complication should prompt aggressive and emergent actions including surgery. We present a case of delayed free wall myocardial rupture following an acute inferior wall myocardial infarction in a patient with biventricular mechanical circulatory support.

  18. [Evaluation of circulatory state using pulse oximeter: 2. PI (perfusion index) x PVI (pleth variability index)]. (United States)

    Kaneda, Toru; Suzuki, Toshiyasu


    Pulse oximeter expressed by SpO2 is used for monitoring respiratory state during operation and in ICU. Perfusion index (PI) and pleth variability index (PVI) as new indexes are calculated from pulse oximeter (Masimo SET Radical-7, Masimo Corp., USA, 1998) waveforms. And these indices were used as parameters to evaluate the circulatory state. For PI calculation, the pulsatile infrared signal is indexed against the nonpulsatile infrared signal and expressed as a percentage. It might thus be of future value in assessment of perioperative changes in peripheral perfusion. PVI is a measure of a dynamic change in PI that occurs during complete respiratory cycle. It might be thought that PVI, an index automatically derived from the pulse oximeter waveform analysis, had potentially clinical applications for noninvasive hypovolemia detection and fluid responsiveness monitoring.

  19. [Forming a community at risk for circulatory system diseases among workers engaged into underground mining]. (United States)

    Shliapnikov, D M; Shur, P Z; Kostarev, V G; Alexeyev, V B; Vlasova, E M; Uhabov, V M


    Forming a community at risk for circulatory system diseases will increase efficiency of medical and prophylactic measures on managing risk of arterial hypertension. Epidemiologic analysis helped to reveal reliable connection between arterial hypertension predictors and work conditions of mining machine operators and supported actualization of high occupational risk suggested in a priori evaluation. Mathematic modelling helped to forecast increase in the disease probability: with noise level of 94 dB after 10 years of work, 17.9% of workers are expected to have arterial hypertension preventing from further occupational activity. Forecasting results of arterial hypertension probability help to form risk groups for medical and preventive technologies managing occupational risk, and predictors enable to specify necessity of individual medical preventive measures.

  20. Long-term allergen exposure induces adipose tissue inflammation and circulatory system injury. (United States)

    Jung, Chien-Cheng; Su, Huey-Jen


    The purpose of this study was to study whether allergen exposure can induce inflammation and lower the anti-inflammation levels in serum and in adipose tissues, and further develop cardiovascular injury. Our data showed that heart rate was significantly higher in the OVA-challenged mice compared to control mice. Moreover, there were higher expressions of pro-inflammation genes in the OVA-challenged mice in adipose tissues, and the expressions of anti-inflammation genes were lower. The levels of inflammation mediators were associated in serum and adipose tissues. The level of circulatory injury lactate dehydrogenase was significantly associated with the levels of E-selectin, resistin and adiponectin in the serum. The hematoxylin and eosin and immunohistochemistry stains indicated the OVA-challenged mice had higher levels of inflammation. In summary, the current study demonstrated allergen exposure can cause cardiovascular injury, and inflammatory mediators in adipose tissues play an important role in the pathogenesis of cardiovascular injury.

  1. New classification of donation after circulatory death donors definitions and terminology. (United States)

    Thuong, Marie; Ruiz, Angel; Evrard, Patrick; Kuiper, Michael; Boffa, Catherine; Akhtar, Mohammed Z; Neuberger, James; Ploeg, Rutger


    In the face of a crisis in organ donation, the transplant community are increasingly utilizing donation after circulatory death (DCD) donors. Over the last 10 years, with the increasing usage of DCD donors, we have seen the introduction in a number of new terms and definitions. We report the results of the 6th International Conference in Organ Donation held in Paris in 2013 and report a consensus agreement of an established expert European Working Group on the definitions and terminology regarding DCD donation, including refinement of the Maastricht definitions. This document forms part of a special series where recommendations are presented for uncontrolled and controlled DCD donation and organ specific guidelines for kidney, pancreas, liver and lung transplantation. An expert panel formed a consensus on definitions and terms aiming to establish consistent usage of terms in DCD donation.

  2. A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans

    DEFF Research Database (Denmark)

    Vianna, Lauro C; Fadel, Paul J; Secher, Niels H


    A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response...... of the muscle is relatively small compared with the onset of leg cycling, where a marked increase in muscle blood flow rapidly occurs as a consequence of multiple redundant mechanisms. We recorded blood pressure (BP; brachial artery), stroke volume (pulse contour analysis), cardiac output, and systemic vascular...... resistance (SVR) in young healthy males, while performing either 20 s of isometric handgrip contraction at 40% maximum voluntary contraction (protocol 1; n = 9) or 20 s of low-intensity leg cycling exercise (protocol 2; n = 8, 42 ± 8 W). Exercise trials were conducted under control (no drug) conditions...

  3. Microsurgical clipping of a giant vertebrobasilar junction aneurysm under hypothermic circulatory arrest. (United States)

    Cıkla, Ulas; Uluç, Kutluay; Baskaya, Mustafa K


    Giant posterior circulation aneurysms pose a significant challenge to neurovascular surgeons. Among various treatment methods that have been applied individually or in combination, clipping under hypothermic circulatory arrest (HCA) is rarely used. We present a 62-year-old man who initially underwent coil occlusion of the right vertebral artery (VA) for a 2.5 cm giant vertebrobasilar junction (VBJ) aneurysm. His neurological condition had declined gradually and the aneurysm grew to 4 cm in size. The patient underwent clip reconstruction of giant VBJ aneurysm under HCA. His postoperative course was prolonged due to his preexisting neurological deficits. His preoperative Modified Rankin Score was 5, and improved postoperatively to 3 at three and six months, and to 2 at one year. The video can be found here:

  4. No evidence for an increase in circulatory disease mortality in astronauts following space radiation exposures (United States)

    Cucinotta, Francis A.; Hamada, Nobuyuki; Little, Mark P.


    Previous analysis has shown that astronauts have a significantly lower standardized mortality ratio for circulatory disease mortality compared to the U.S. population, which is consistent with the rigorous selection process and healthy lifestyles of astronauts, and modest space radiation exposures from past space missions. However, a recent report by Delp et al. estimated the proportional mortality ratio for ages of 55-64 y of Apollo lunar mission astronauts to claim a high risk of cardiovascular disease due to space radiation compared to the U.S. population or to non-flight astronauts. In this Commentary we discuss important deficiencies in the methods and assumptions on radiation exposures used by Delp et al. that we judge cast serious doubt on their conclusions.

  5. Long-term Mechanical Circulatory Support System reliability recommendation by the National Clinical Trial Initiative subcommittee. (United States)

    Lee, James


    The Long-Term Mechanical Circulatory Support (MCS) System Reliability Recommendation was published in the American Society for Artificial Internal Organs (ASAIO) Journal and the Annals of Thoracic Surgery in 1998. At that time, it was stated that the document would be periodically reviewed to assess its timeliness and appropriateness within 5 years. Given the wealth of clinical experience in MCS systems, a new recommendation has been drafted by consensus of a group of representatives from the medical community, academia, industry, and government. The new recommendation describes a reliability test methodology and provides detailed reliability recommendations. In addition, the new recommendation provides additional information and clinical data in appendices that are intended to assist the reliability test engineer in the development of a reliability test that is expected to give improved predictions of clinical reliability compared with past test methods. The appendices are available for download at the ASAIO journal web site at

  6. Deep hypothermic circulatory arrest for hemiarch replacement in a pediatric patient with moyamoya disease. (United States)

    Kuwajima, Ken; Yoshitani, Kenji; Kato, Shinya; Miyazaki, Atsushi; Kamei, Masataka; Ohnishi, Yoshihiko


    Moyamoya disease is a chronic cerebrovascular occlusive disease, occurring predominantly in young populations, that causes cerebral ischemia and hemorrhage. Patients with moyamoya disease are at high risk of neurological complications during cardiac surgery because of perioperative hemodynamic changes. However, there is no established evidence on temperature management during cardiopulmonary bypass. Previous reports described normothermia or mild to moderate hypothermia during cardiopulmonary bypass in patients with moyamoya disease; however, surgical conditions, such as not having enough space to clamp the aorta or a clean surgical field, sometimes force us to use deep hypothermic circuratory arrest. We report a successful case of a pediatric patient with moyamoya disease who underwent deep hypothermic circulatory arrest (18 °C) for hemiarch replacement without neurological complications. Deep hypothermia may be an alternative technique for achieving cerebral protection in the context of moyamoya disease.

  7. Heat driven pulse pump (United States)

    Benner, Steve M (Inventor); Martins, Mario S. (Inventor)


    A heat driven pulse pump includes a chamber having an inlet port, an outlet port, two check valves, a wick, and a heater. The chamber may include a plurality of grooves inside wall of the chamber. When heated within the chamber, a liquid to be pumped vaporizes and creates pressure head that expels the liquid through the outlet port. As liquid separating means, the wick, disposed within the chamber, is to allow, when saturated with the liquid, the passage of only liquid being forced by the pressure head in the chamber, preventing the vapor from exiting from the chamber through the outlet port. A plurality of grooves along the inside surface wall of the chamber can sustain the liquid, which is amount enough to produce vapor for the pressure head in the chamber. With only two simple moving parts, two check valves, the heat driven pulse pump can effectively function over the long lifetimes without maintenance or replacement. For continuous flow of the liquid to be pumped a plurality of pumps may be connected in parallel.

  8. Effect of increasing pump speed during exercise on peak oxygen uptake in heart failure patients supported with a continuous-flow left ventricular assist device. A double-blind randomized study

    DEFF Research Database (Denmark)

    Jung, Mette Holme; Hansen, Peter Bo; Sander, Kaare


    AIMS: Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains...... adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. METHODS AND RESULTS: In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed...... on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23...

  9. Numerical Models of Human Circulatory System under Altered Gravity: Brain Circulation (United States)

    Kim, Chang Sung; Kiris, Cetin; Kwak, Dochan; David, Tim


    A computational fluid dynamics (CFD) approach is presented to model the blood flow through the human circulatory system under altered gravity conditions. Models required for CFD simulation relevant to major hemodynamic issues are introduced such as non-Newtonian flow models governed by red blood cells, a model for arterial wall motion due to fluid-wall interactions, a vascular bed model for outflow boundary conditions, and a model for auto-regulation mechanism. The three-dimensional unsteady incompressible Navier-Stokes equations coupled with these models are solved iteratively using the pseudocompressibility method and dual time stepping. Moving wall boundary conditions from the first-order fluid-wall interaction model are used to study the influence of arterial wall distensibility on flow patterns and wall shear stresses during the heart pulse. A vascular bed modeling utilizing the analogy with electric circuits is coupled with an auto-regulation algorithm for multiple outflow boundaries. For the treatment of complex geometry, a chimera overset grid technique is adopted to obtain connectivity between arterial branches. For code validation, computed results are compared with experimental data for steady and unsteady non-Newtonian flows. Good agreement is obtained for both cases. In sin-type Gravity Benchmark Problems, gravity source terms are added to the Navier-Stokes equations to study the effect of gravitational variation on the human circulatory system. This computational approach is then applied to localized blood flows through a realistic carotid bifurcation and two Circle of Willis models, one using an idealized geometry and the other model using an anatomical data set. A three- dimensional anatomical Circle of Willis configuration is reconstructed from human-specific magnetic resonance images using an image segmentation method. The blood flow through these Circle of Willis models is simulated to provide means for studying gravitational effects on the brain

  10. Noninvasive optoacoustic system for rapid diagnostics and management of circulatory shock (United States)

    Esenaliev, Rinat O.; Petrov, Irene Y.; Petrov, Yuriy; Kinsky, Michael; Prough, Donald S.


    Circulatory shock is lethal, if not promptly diagnosed and effectively treated. Typically, circulatory shock resuscitation is guided by blood pressure, heart rate, and mental status, which have poor predictive value. In patients, in whom early goaldirected therapy was applied using central venous oxygenation measurement, a substantial reduction of mortality was reported (from 46.5% to 30%). However, central venous catheterization is invasive, time-consuming and often results in complications. We proposed to use the optoacoustic technique for noninvasive, rapid assessment of central venous oxygenation. In our previous works we demonstrated that the optoacoustic technique can provide measurement of blood oxygenation in veins and arteries due to high contrast and high resolution. In this work we developed a novel optoacoustic system for noninvasive, automatic, real-time, and continuous measurement of central venous oxygenation. We performed pilot clinical tests of the system in human subjects with different oxygenation in the internal jugular vein and subclavian vein. A novel optoacoustic interface incorporating highly-sensitive optoacoustic probes and standard ultrasound imaging probes were developed and built for the study. Ultrasound imaging systems Vivid i and hand-held Vscan (GE Healthcare) as well as Site-Rite 5 (C.R. Bard) were used in the study. We developed a special algorithm for oxygenation monitoring with minimal influence of overlying tissue. The data demonstrate that the system provides precise measurement of venous oxygenation continuously and in real time. Both current value of the venous oxygenation and trend (in absolute values and for specified time intervals) are displayed in the system. The data indicate that: 1) the optoacoustic system developed by our group is capable of noninvasive measurement of blood oxygenation in specific veins; 2) clinical ultrasound imaging systems can facilitate optoacoustic probing of specific blood vessels; 3) the

  11. A novel rat model of cardiopulmonary bypass for deep hypothermic circulatory arrest without blood priming

    Institute of Scientific and Technical Information of China (English)

    Zhang Weihua; Zhang Yanbo; Liu Donghai; Zhu Yaobin; Qiao Chenhui; Wang Jiaxiang; Xu Yulin


    Background Large animal cardiopulmonary bypass (CPB) models are expensive,and prevent assessment of neurocognitive function,and difficulties with long-term recovery.The purpose of this study was to establish a novel rat model of cardiopulmonary bypass for deep hypothermic circulatory arrest without blood priming.Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomized to CPB with deep hypothermic circulatory arrest (DHCA) and control groups,with 10 rats each.The experimental protocols,including blood and crystalloid fluid administration,anesthesia,orotracheal intubation,ventilation,cannulation,and heparinization were identical in both groups.After inducing cardiac arrest,the circuit was turned off and rats were left in a DHCA state for 15 minutes.Rats were rewarmed to 34℃ to 35℃ over a period of 36 to 42 minutes using CPB-assisted rewarming,a heating blanket,and a heating lamp along with administration of 0.1 mEq of sodium bicarbonate and 0.14 mEq of calcium chloride.The remaining priming volume was reinfused and animals were weaned from CPB.Results All CPB with DHCA processes were successfully achieved.Blood gas analysis and hemodynamic parameters were in the normal range.The vital signs of all rats were stable.Conclusions Our CPB circuit has several novel features,including a small priming volume,active cooling/rewarming processes,vacuum-assisted venous drainage,peripheral cannulation without thoracotomy or stemotomy,and an accurate means of monitoring peripheral tissue oxygenation.

  12. Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

    Directory of Open Access Journals (Sweden)

    Peek Giles J


    Full Text Available Abstract Background Veno-arterial extracorporeal membrane oxygenation (ECMO is a common modality of circulatory assist device used in children. We assessed the outcome of children who had ECMO following repair of congenital cardiac defects (CCD and identified the risk factors associated with hospital mortality. Methods From April 1990 to December 2003, 53 patients required ECMO following surgical correction of CCD. Retrospectively collected data was analyzed with univariate and multivariate logistic regression analysis. Results Median age and weight of the patients were 150 days and 5.4 kgs respectively. The indications for ECMO were low cardiac output in 16, failure to wean cardiopulmonary bypass in 13, cardiac arrest in 10 and cardio-respiratory failure in 14 patients. The mean duration of ECMO was 143 hours. Weaning off from ECMO was successful in 66% and of these 83% were survival to hospital-discharge. 37.7% of patients were alive for the mean follow-up period of 75 months. On univariate analysis, arrhythmias, ECMO duration >168 hours, bleeding complications, renal replacement therapy on ECMO, arrhythmias and cardiac arrest after ECMO were associated with hospital mortality. On multivariate analysis, abnormal neurology, bleeding complications and arrhythmias after ECMO were associated with hospital mortality. Extra and intra-thoracic cannulations were used in 79% and 21% of patients respectively and extra-thoracic cannulation had significantly less bleeding complications (p = 0.031. Conclusion ECMO provides an effective circulatory support following surgical repair of CCD in children. Extra-thoracic cannulation is associated with less bleeding complications. Abnormal neurology, bleeding complications on ECMO and arrhythmias after ECMO are poor prognostic indicators for hospital survival.

  13. Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey (United States)

    Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.


    Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

  14. Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review

    DEFF Research Database (Denmark)

    Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue


    INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted...

  15. Childhood abdominal pain in primary care : design and patient selection of the HONEUR abdominal pain cohort

    NARCIS (Netherlands)

    Spee, Leo A A; van den Hurk, Arjan P J M; van Leeuwen, Yvonne; Benninga, Marc A; Bierma-Zeinstra, Sita M A; Passchier, Jan; Berger, Marjolein Y


    BACKGROUND: Abdominal pain in children is a common complaint presented to the GP. However, the prognosis and prognostic factors of childhood abdominal pain are almost exclusively studied in referred children. This cohort study aims at describing prognosis and prognostic factors of childhood abdomina

  16. General Considerations of Ruptured Abdominal Aortic Aneurysm: Ruptured Abdominal Aortic Aneurysm


    Lee, Chung Won; Bae, Miju; Chung, Sung Woon


    Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

  17. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B; Nieuwenhuijs, V B; Hofker, H.S.; Zijlstra, J.G.


    INTRODUCTION: Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS

  18. Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis

    NARCIS (Netherlands)

    Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.


    Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particula

  19. Increased Plasma Levels of Heparin-Binding Protein on Admission to Intensive Care Are Associated with Respiratory and Circulatory Failure.

    Directory of Open Access Journals (Sweden)

    Jonas Tydén

    Full Text Available Heparin-binding protein (HBP is released by granulocytes and has been shown to increase vascular permeability in experimental investigations. Increased vascular permeability in the lungs can lead to fluid accumulation in alveoli and respiratory failure. A generalized increase in vascular permeability leads to loss of circulating blood volume and circulatory failure. We hypothesized that plasma concentrations of HBP on admission to the intensive care unit (ICU would be associated with decreased oxygenation or circulatory failure.This is a prospective, observational study in a mixed 8-bed ICU. We investigated concentrations of HBP in plasma at admission to the ICU from 278 patients. Simplified acute physiology score (SAPS 3 was recorded on admission. Sequential organ failure assessment (SOFA scores were recorded daily for three days.Median SAPS 3 was 58.8 (48-70 and 30-day mortality 64/278 (23%. There was an association between high plasma concentrations of HBP on admission with decreased oxygenation (p<0.001 as well as with circulatory failure (p<0.001, after 48-72 hours in the ICU. There was an association between concentrations of HBP on admission and 30-day mortality (p = 0.002. ROC curves showed areas under the curve of 0,62 for decreased oxygenation, 0,65 for circulatory failure and 0,64 for mortality.A high concentration of HBP in plasma on admission to the ICU is associated with respiratory and circulatory failure later during the ICU care period. It is also associated with increased 30-day mortality. Despite being an interesting biomarker for the composite ICU population it's predictive value at the individual patient level is low.

  20. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats. (United States)

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L


    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (PPregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy.

  1. Intra-abdominal pressure: an integrative review. (United States)

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino


    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  2. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol. (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R


    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  3. Heat pump planning handbook

    CERN Document Server

    Bonin, Jürgen


    The Heat Pump Planning Handbook contains practical information and guidance on the design, planning and selection of heat pump systems, allowing engineers, designers, architects and construction specialists to compare a number of different systems and options. Including detailed descriptions of components and their functions and reflecting the current state of technology this guide contains sample tasks and solutions as well as new model calculations and planning evaluations. Also economic factors and alternative energy sources are covered, which are essential at a time of rising heat costs. T

  4. Regenerative adsorbent heat pump (United States)

    Jones, Jack A. (Inventor)


    A regenerative adsorbent heat pump process and system is provided which can regenerate a high percentage of the sensible heat of the system and at least a portion of the heat of adsorption. A series of at least four compressors containing an adsorbent is provided. A large amount of heat is transferred from compressor to compressor so that heat is regenerated. The process and system are useful for air conditioning rooms, providing room heat in the winter or for hot water heating throughout the year, and, in general, for pumping heat from a lower temperature to a higher temperature.

  5. Molecular heat pump. (United States)

    Segal, Dvira; Nitzan, Abraham


    We propose a molecular device that pumps heat against a thermal gradient. The system consists of a molecular element connecting two thermal reservoirs that are characterized by different spectral properties. The pumping action is achieved by applying an external force that periodically modulates molecular levels. This modulation affects periodic oscillations of the internal temperature of the molecule and the strength of its coupling to each reservoir resulting in a net heat flow in the desired direction. The heat flow is examined in the slow and fast modulation limits and for different modulation wave forms, thus making it possible to optimize the device performance.

  6. Methods of patient warming during abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Li Shao

    Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

  7. Imaging the Abdominal Manifestations of Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    C. D. Gillespie


    Full Text Available Cystic fibrosis (CF is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis.

  8. Abdominal aorta transplantation after programmed cryopreservation

    Institute of Scientific and Technical Information of China (English)

    Song Gu; Chang-Jian Liu; Tong Qiao; Xue-Mei Sun; Jun-Hao Chen


    AIM: To study the morphologic and cellular immunologic changes after homologous transplantation of the abdominal aorta in rats after programmed cryopreservation (-196°C).METHODS: Abdominal aorta was harvested from anesthetized Spraque Dawley (SD) rats for cryopreservation (group B) or immediate implantation (group A). The survival rates and apoptotic rates of aortic endothelial cells (ECs)were examined. The patency rates, histology and cellular immunologic changes of the abdominal aorta were examined on days 1, 3, 7, 14, 30, 60 after transplantation respectively.RESULTS: The survival rate of ECs after programmed cryopreservation was 90.1±1.79%, about 3.4% lower than that of uncryopreservation (93.5±1.96%). The apoptotic rates of ECs was increased after cryopreservation (7.15%vs 4.86%, P<0.05). The patency rate of group B was significantly higher than that of group A (91.6±12.9% vs 62.5±26.2%, P<0.01). CD4/CD8 ratio, TCR αβ and CD11b/CD18 ratio of group B were significantly lower than those of group A (P<0.05). Revivification of the cryopreserved abdominal aorta showed normal adventitia and intact smooth muscle cells.CONCLUSION: Cryopreservation can reduce homologous abdominal aortic antigenecity. Even if without administration of immunosuppressive agents, it is still feasible to implement homologous artery grafting in rats.

  9. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua


    Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

  10. Transverse abdominal plane neurostimulation for chronic abdominal pain: a novel technique. (United States)

    Gupta, Mayank; Goodson, Robert


    Management of chronic abdominal pain can be challenging. Sometimes patients fail to get adequate response from multiple medications and nerve blocks. We present a patient case report of chronic abdominal pain with a history of multiple surgeries managed successfully by neuromodulation of the transverse abdominis plane (TAP). The TAP block is a procedure in which local anesthetic is injected into the abdominal fascial plane that carries sensory nerves to the abdominal wall in order to block pain sensation. It has been shown to reduce postoperative pain and analgesic dependence after abdominal and gynecological surgeries. A 60-year-old woman presented to us for chronic abdominal pain for which medications provided little relief. She had an extensive history of abdominal surgeries and was also treated for lower back pain with surgery and less invasive procedures in the past. Under our care, she underwent 2 TAP blocks with almost complete resolution of her abdominal pain. Her pain, however, came back within a few of weeks of the procedures. Since our patient found pain relief from the TAP blocks, we proceeded with neurostimulation of the TAP for long-term pain relief. We placed a dorsal column stimulator 16 contact lead for lower back and leg pain and 8 contact leads placed in the TAP under ultrasound guidance. She has had multiple follow-ups since her TAP lead placement procedure with continued and near complete resolution of her abdominal pain. The TAP lead stimulation was helping her abdominal pain and the dorsal column lead stimulation was helping her back and leg pain.

  11. Abdominal Wall Endometrioma. Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Tahiluma Santana Pedraza


    Full Text Available Abdominal wall endometrioma is a condition rarely seen by surgeons. It represents a diagnostic challenge due to its similarity with other tumors. This entity occurs in fertile women and often appears two to five years after gynecological and obstetric surgical procedures. It must be considered when dealing with a cyclically painful nodule located in a laparotomy scar. The diagnosis is established by histological examination; most imaging tests determine the characteristics of the lesion, concomitant lesions and the intra-abdominal origin or location in the abdominal wall. The cases of two patients treated at the General Surgery Department of the María Eugenia González Comprehensive Diagnostic Center in the Capital District, Venezuela, are presented. Wide excision of the tissue and histological examination were performed, confirming the diagnosis. The postoperative course was uneventful. This case is presented given the rarity of this condition.

  12. Electromyographic analysis of four popular abdominal exercises. (United States)

    Piering, A W; Janowski, A P; Wehrenberg, W B; Moore, M T; Snyder, A C


    This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.

  13. Abdominal Wall Desmoid during Pregnancy: Diagnostic Challenges

    Directory of Open Access Journals (Sweden)

    Johnny Awwad


    Full Text Available Background. Desmoids are benign tumors, with local invasive features and no metastatic potential, which have rarely been described to be pregnancy associated. Case. We described the rapid growth of an anterior abdominal wall mass in a 40-year-old pregnant woman. Due to its close proximity to the enlarged uterus, it was misdiagnosed to be a uterine leiomyoma by ultrasound examination. Final tissue diagnosis and radical resection were done at the time of abdominal delivery. Conclusion. Due to the diagnostic limitations of imaging techniques, desmoids should always be considered when the following manifestations are observed in combination: progressive growth of a solitary abdominal wall mass during pregnancy and well-delineated smooth tumor margins demonstrated by imaging techniques. This case emphasizes the importance of entertaining uncommon medical conditions in the differential diagnosis of seemingly common clinical manifestations.

  14. Decompressive laparotomy for abdominal compartment syndrome (United States)

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.


    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  15. Pressurized Vessel Slurry Pumping

    Energy Technology Data Exchange (ETDEWEB)

    Pound, C.R.


    This report summarizes testing of an alternate ''pressurized vessel slurry pumping'' apparatus. The principle is similar to rural domestic water systems and ''acid eggs'' used in chemical laboratories in that material is extruded by displacement with compressed air.

  16. The Osmotic Pump (United States)

    Levenspiel, Octave; de Nevers, Noel


    Describes the principle involved in an osmotic pump used to extract fresh water from the oceans and in an osmotic power plant used to generate electricity. Although shown to be thermodynamically feasible, the osmotic principle is not likely to be used commerically for these purposes in the near future. (JR)

  17. Microfluidic "blinking" bubble pump

    NARCIS (Netherlands)

    Yin, Zhizhong; Prosperetti, Andrea


    The paper reports data obtained on a simple micropump, suitable for electrolytes, based on the periodic growth and collapse of a single vapor bubble in a microchannel. With a channel diameter of the order of 100 µm, pumping rates of several tens of µl/min and pressure differences of several kPa are

  18. Orbital Liquid Oxygen Pump Project (United States)

    National Aeronautics and Space Administration — This proposed work will develop a pump, which is based on two novel and unique design features. The first feature is a lobed pumping mechanism which operates with...

  19. Optimization of compound gear pump

    Institute of Scientific and Technical Information of China (English)



    This paper introduces the performances of compound gear pump. Based on the target of having the smallest mass per unit volume, the paper established a mathematical model of optimization, and obtained the results of optimization of the pump.

  20. Penetrating abdominal injuries in children in Nigeria. (United States)

    Ameh, E A; Nmadu, P T


    This is a report of a retrospective study of 24 children managed for penetrating abdominal injury over 10 years, and it represents 34% of all abdominal injuries in children in that period. Falls onto sharp objects within and around the home were responsible for ten of the injuries, seven were injured by animal horns and four were sporting injuries. Violence and road traffic accidents were uncommon. Most patients (67%) had evisceration of omentum or intestine, and one of these was found at laparotomy to have a jejuno-jejunal intussusception. Seven children had injury to hollow viscera. There were three deaths, one each from overwhelming sepsis, tetanus and haemorrhage.

  1. Systemic lupus erythematosus : abdominal radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Cheon; Cho, On Koo; Lee, Yong Joo; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Ko, Byung Hee [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)


    Systemic lupus erythematosus(SLE) is a systemic disease of unknown etiology. Its main pathology is vasculitis and serositis, due to deposition of the immune complex or antibodies. Most findings are nonspecific ; abdominal manifestations include enteritis, hepatomegaly, pancreatic enlargement, serositis, lymphadenopathy, splenomegaly, nephritis, interstitial cystitis, and thrombophlebitis. We described radiologic findings of various organ involvement of SLE; digestive system, serosa, reticuloendothelial system, urinary system, and venous system. Diagnosis of SLE was done according to the criteria of American Rheumatism Association. Understanding of the variable imaging findings in SLE may be helpful for the early detection of abdominal involvement and complications.


    Institute of Scientific and Technical Information of China (English)

    向阳; 郎景和; 王友芳; 黄荣丽; 连丽娟


    Twenty-eight cases of abdominal scar endometriosis from Janurary,1989 to December,1993 are reported.Of these patients,twenty-four underwent term cesarean section,and four underwent a midtrimester abortion by abdominal hysterotomy.The majority of patients manifested symptoms 1 year after the operation.The most common was a painful mass of scar tissue that became swollen and tender during menstruation.The pathogenesis,diagnosis and treatment are discussed.In correlation with the pathological findings,the effects of drug therapy are evaluated.It was found that surgical excision is the best method of treatment.

  3. Absorption heat pumps (United States)

    Huhtinen, M.; Heikkilae, M.; Andersson, R.


    The aim of the study was to analyze the technical and economic feasibility of absorption heat pumps in Finland. The work was done as a case study: the technical and economic analyses have been carried out for six different cases, where in each the suitable size and type of the heat pump plant and the auxiliary components and connections were specified. The study also detailed the costs concerning the procurement, installation and test runs of the machinery, as well as the savings in energy costs incurred by the introduction of the plant. Conclusions were drawn of the economic viability of the applications studied. The following cases were analyzed: heat recovery from flue gases and productin of district heat in plants using peat, natural gas, and municipal wastes as a fuel. Heat recovery in the pulp and paper industry for the upgrading of pressure of secondary steam and for the heating of white liquor and combustion and drying the air. Heat recovery in a peat-fulled heat and power plant from flue gases that have been used for the drying of peat. According to the study, the absorption heat pump suits best to the production of district heat, when the heat source is the primary energy is steam produced by the boiler. Included in the flue as condensing is the purification of flue gases. Accordingly, benefit is gained on two levels in thick applications. In heat and power plants the use of absorption heat pumps is less economical, due to the fact that the steam used by the pump reduces the production of electricity, which is rated clearly higher than heat.

  4. Indwelling intrathecal catheter with subcutaneous abdominal reservoir: a viable baclofen delivery system in severely cachectic patients. (United States)

    Waqar, Mueez; Ellenbogen, Jonathan R; Kumar, Ram; Sneade, Christine; Zebian, Bassel; Williams, Dawn; Pettorini, Benedetta L


    Intrathecal baclofen (ITB) is a reversible treatment that reduces muscle tone to ameliorate spasticity and dystonia in patients with cerebral palsy (CP). The resulting decrease in energy expenditure allows patients to gain much-needed weight, albeit temporarily. Modern techniques require sufficient abdominal musculature and subcutaneous fat to permit the implantation of an indwelling pump. In patients with extremely low muscle bulk, visceral pumps may be impractical or impossible, with increased risks of dehiscence and infection. The authors describe a variation of the classical procedure in a young patient with severe cachexia. A 10-year-old boy with spastic-dystonic quadriplegic CP was admitted to the neuromedical unit. Numerous drug trials had failed, and surgical intervention was deemed necessary but was complicated by his cachectic body habitus. The authors inserted a lumbar intrathecal catheter and subcutaneously tunneled it to the anterolateral abdomen, where it was connected to a subcutaneous injection port. Baclofen was continuously infused into the subcutaneous port using a noncoring needle connected to an external pump. The needle and line were changed every 5 days to minimize the risk of sepsis. Although other techniques, such as intraventricular baclofen delivery, have been described, these are largely dependent upon sufficient musculature to support a visceral pump. A subcutaneous injection port system represents an alternative approach that reduces the risk of sepsis and may be better tolerated in cachectic patients.


    Institute of Scientific and Technical Information of China (English)


    Some concepts of virtual product are discussed. The key technologies of virtual fuel-pump development are in detail analysed, which include virtual fuel-pump product modeling, intelligent simulation, distributed design environment, and virtual assembly. The virtual fuel-pump development prototype system considers requirement analysis, concept design, injection preferment analysis, detailed design, and assembly analysis.

  6. Study of a centrifugal blood pump in a mock loop system. (United States)

    Uebelhart, Beatriz; da Silva, Bruno Utiyama; Fonseca, Jeison; Bock, Eduardo; Leme, Juliana; da Silva, Cibele; Leão, Tarcísio; Andrade, Aron


    An implantable centrifugal blood pump (ICBP) is being developed to be used as a ventricular assist device (VAD) in patients with severe cardiovascular diseases. The ICBP system is composed of a centrifugal pump, a motor, a controller, and a power supply. The electricity source provides power to the controller and to a motor that moves the pump's rotor through magnetic coupling. The centrifugal pump is composed of four parts: external conical house, external base, impeller, and impeller base. The rotor is supported by a pivot bearing system, and its impeller base is responsible for sheltering four permanent magnets. A hybrid cardiovascular simulator (HCS) was used to evaluate the ICBP's performance. A heart failure (HF) (when the heart increases beat frequency to compensate for decrease in blood flow) was simulated in the HCS. The main objective of this work is to analyze changes in physiological parameters such as cardiac output, blood pressure, and heart rate in three situations: healthy heart, HF, and HF with left circulatory assistance by ICBP. The results showed that parameters such as aortic pressure and cardiac output affected by the HF situation returned to normal values when the ICBP was connected to the HCS. In conclusion, the test results showed satisfactory performance for the ICBP as a VAD.

  7. Improvement of hemocompatibility for hydrodynamic levitation centrifugal pump by optimizing step bearings. (United States)

    Kosaka, Ryo; Yada, Toru; Nishida, Masahiro; Maruyama, Osamu; Yamane, Takashi


    We have developed a hydrodynamic levitation centrifugal blood pump with a semi-open impeller for a mechanically circulatory assist. The impeller levitated with original hydrodynamic bearings without any complicated control and sensors. However, narrow bearing gap has the potential for causing hemolysis. The purpose of the study is to investigate the geometric configuration of the hydrodynamic step bearing to minimize hemolysis by expansion of the bearing gap. Firstly, we performed the numerical analysis of the step bearing based on Reynolds equation, and measured the actual hydrodynamic force of the step bearing. Secondly, the bearing gap measurement test and the hemolysis test were performed to the blood pumps, whose step length were 0 %, 33 % and 67 % of the vane length respectively. As a result, in the numerical analysis, the hydrodynamic force was the largest, when the step bearing was around 70 %. In the actual evaluation tests, the blood pump having step 67 % obtained the maximum bearing gap, and was able to improve the hemolysis, compared to those having step 0% and 33%. We confirmed that the numerical analysis of the step bearing worked effectively, and the blood pump having step 67 % was suitable configuration to minimize hemolysis, because it realized the largest bearing gap.

  8. Evaluation of erythrocyte flow at a bearing gap in a hydrodynamically levitated centrifugal blood pump. (United States)

    Murashige, Tomotaka; Kosaka, Ryo; Sakota, Daisuke; Nishida, Masahiro; Kawaguchi, Yasuo; Yamane, Takashi; Maruyama, Osamu


    We have developed a hydrodynamically levitated centrifugal blood pump for extracorporeal circulatory support. In the blood pump, a spiral groove bearing was adopted for a thrust bearing. In the spiral groove bearing, separation of erythrocytes and plasma by plasma skimming has been postulated to occur. However, it is not clarified that plasma skimming occurs in a spiral groove bearing. The purpose of this study is to verify whether plasma skimming occurs in the spiral groove bearing of a hydrodynamically levitated centrifugal blood pump. For evaluation of plasma skimming in the spiral groove bearing, an impeller levitation performance test using a laser focus displacement meter and a microscopic visualization test of erythrocyte flow using a high-speed microscope were conducted. Bovine blood diluted with autologous plasma to adjust hematocrit to 1.0% was used as a working fluid. Hematocrit on the ridge region in the spiral groove bearing was estimated using image analysis. As a result, hematocrits on the ridge region with gaps of 45 μm, 31 μm, and 25 μm were calculated as 1.0%, 0.6%, and 0.3%, respectively. Maximum skimming efficiency in this study was calculated as 70% with a gap of 25 μm. We confirmed that separation of erythrocyte and plasma occurred in the spiral groove bearing with decrease in bearing gap in a hydrodynamically levitated centrifugal blood pump.

  9. Improving pumping system efficiency at coal plants

    Energy Technology Data Exchange (ETDEWEB)

    Livoti, W.C.; McCandless, S.; Poltorak, R. [Baldor Electric Co. (United States)


    The industry must employ ultramodern technologies when building or upgrading power plant pumping systems thereby using fuels more efficiently. The article discusses the uses and efficiencies of positive displacement pumps, centrifugal pumps and multiple screw pumps. 1 ref., 4 figs.

  10. Small Scroll Pump for Cryogenic Liquids Project (United States)

    National Aeronautics and Space Administration — The innovation is a compact, reliable, light weight, electrically driven pump capable of pumping cryogenic liquids, based on scroll pump technology. This pump will...

  11. Circulatory shock in horses / Choque circulatório em equinos

    Directory of Open Access Journals (Sweden)

    José Monteira da Silva Filho


    Full Text Available Circulatory shock can be defined as an acute circulatory failure with an inadequate tissue delivery of oxygen and nutritive substrates to the tissues, resulting in generalised cellular hypoxia. Shock can be classified as cardiogenic, obstructive, hypovolaemic, or distributive. The pathophysiologic consequences of inadequate tissue perfusion are directly related to cell ischemia, inadequate O2 delivery, and the production of proinflammatory mediators. If abnormalities of tissue perfusion are allowed to persist, the function of vital organs will be impaired. The subsequent reperfusion will exacerbate organ dysfunction and, in severe cases, may culminate in multiple organ dysfunction syndrome. Early recognition of equine that are shocked and immediate provision of effective circulatory support is therefore essential. In all cases the objective is to restore oxygen delivery to the tissues while correcting the underlying cause. Delays in making the diagnosis and initiating treatment, as well as suboptimal resuscitation, contribute to the development of peripheral vascular failure and irreversible defects in oxygen use which can culminate in vital organ dysfunction.Choque circulatório pode ser definido como uma falha circulatória aguda com liberação inadequada de oxigênio e nutrientes aos tecidos, resultando em hipóxia celular. O choque pode ser classificado como cardiogênico, obstrutivo, hipovolêmico ou distributivo. As consequências fisiopatológicas da perfusão tecidual inadequada estão diretamente relacionadas à isquemia celular, liberação inadequada de O2 e produção de potentes mediadores inflamatórios. Caso as anormalidades de perfusão tecidual se perpetuem, a função de vários órgãos se torna inadequada. A consequente reperfusão poderá exacerbar a disfunção orgânica e, nos casos graves, culminar na síndrome da disfunção orgânica múltipla. O reconhecimento precoce de equinos em choque circulatório e o

  12. [Pathogenetic aspects of intra-abdominal hypertension in patients with abdominal sepsis]. (United States)

    Veliev, N A; Gasanova, D N


    The authors had offered the original estimated system with the points calculation, basing on analysis of the examination and treatment results in 150 patients, suffering abdominal sepsis. The system, alike others, includes not only determination of the inflammation factors and indices of endotoxicosis, but as well as those, concerning intraabdominal pressure, the anterior abdominal wall rigidity and the tissues elasticity. Among the important indices, needed to determine, were considered those, which categorize the syndrome of intraabdominal, intrathoracic and microregional hypertension as well as the mechanisms of endotoxicosis pathogenesis. The authors recommend to use the indices of pathological consequences of this two factors while doing assessment of the abdominal sepsis severity.

  13. Pumping characteristics of roots blower pumps for light element gases

    Energy Technology Data Exchange (ETDEWEB)

    Hiroki, Seiji; Abe, Tetsuya; Tanzawa, Sadamitsu; Nakamura, Jun-ichi; Ohbayashi, Tetsuro [Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment


    The pumping speed and compression ratio of the two-stage roots blower pumping system were measured for light element gases (H{sub 2}, D{sub 2} and He) and for N{sub 2}, in order to assess validity of the ITER torus roughing system as an ITER R and D task (T234). The pumping system of an Edwards EH1200 (nominal pumping speed of 1200 m{sup 3}/s), two EH250s (ibid. 250 m{sup 3}/s) and a backing pump (ibid. 100 m{sup 3}/s) in series connection was tested under PNEUROP standards. The maximum pumping speeds of the two-stage system for D{sub 2} and N{sub 2} were 1200 and 1300 m{sup 3}/h, respectively at 60 Hz, which satisfied the nominal pumping speed. These experimental data support the design validity of the ITER torus roughing system. (author)

  14. SHINE Vacuum Pump Test Verification

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Gregg A; Peters, Brent


    Normetex pumps used world-wide for tritium service are no longer available. DOE and other researchers worldwide have spent significant funds characterizing this pump. Identification of alternate pumps is required for performance and compatibility with tritium gas. Many of the pumps that could be used to meet the functional performance requirements (e.g. pressure and flow conditions) of the Normetex pump have features that include the use of polymers or oils and greases that are not directly compatible with tritium service. This study assembles a test system to determine the flow characteristics for candidate alternate pumps. These tests are critical to the movement of tritium through the SHINE Tritium Purification System (TPS). The purpose of the pump testing is two-fold: (1) obtain baseline vacuum pump characteristics for an alternate (i.e. ''Normetex replacement'') pump intended for use in tritium service; and (2) verify that low pressure hydrogen gas can be transported over distances up to 300 feet by the candidate pumps. Flow rates and nominal system pressures have been identified for the SHINE Mo-99 production process Tritium Purification System (TPS). To minimize the line sizes for the transfer of low pressure tritium from the Neutron Driver Accelerator System (NDAS) to the primary processing systems in the TPS, a ''booster'' pump has been located near the accelerator in the design. A series of pump tests were performed at various configurations using hydrogen gas (no tritium) to ensure that this concept is practical and maintains adequate flow rates and required pressures. This report summarizes the results of the tests that have been performed using various pump configurations. The current design of the Tritium Purification System requires the ''booster'' pump to discharge to or to be backed by another vacuum pump. Since Normetex pumps are no longer manufactured, a commercially available Edwards

  15. 14 CFR 23.991 - Fuel pumps. (United States)


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel pumps. 23.991 Section 23.991... § 23.991 Fuel pumps. (a) Main pumps. For main pumps, the following apply: (1) For reciprocating engine installations having fuel pumps to supply fuel to the engine, at least one pump for each engine must be...

  16. A diagnostic approach to abdominal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Eser Vardareli; Baybora Kircali


    @@ TO THE EDITOR We read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.

  17. Connective tissue alteration in abdominal wall hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Yadete, D H; Sørensen, Lars Tue


    The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdom...

  18. [A young woman with acute abdominal pain

    NARCIS (Netherlands)

    Mooij, R.; Dillen, J. van


    A 17-year-old woman was operated in a Tanzanian hospital because of a suspected ruptured ectopic pregnancy. During laparatomy an interstitial ectopic pregnancy with an intact gestational sac was found. The ectopic pregnancy had ruptured into the abdominal cavity.

  19. Postoperative pleural effusion following upper abdominal surgery

    DEFF Research Database (Denmark)

    Nielsen, P H; Jepsen, S B; Olsen, A D


    Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...

  20. Abdominal sacral colpopexy for massive genital prolapse. (United States)

    Powell; Joseph


    Objective: A retrospective study to determine the success and complications of abdominal sacral colpopexy in correcting massive genital prolapse over an 8-year period between September 1989 and January 1997.Methods: The charts were reviewed for 3 patients with massive procidentia and 15 patients with symptomatic posthysterectomy vaginal vault prolapse, who desired preservation of sexual function and underwent abdominal sacral colpopexy with Marlex mesh at two community teaching hospitals.Results: In 16 of the 18 patients, one or more concurrent procedures were performed at the same time, including three Burch colpocystourethropexies and one Raz bladder neck suspension, which successfully controlled urinary stress incontinence. In three cases, staging procedures were done for ovarian neoplasia. There were no intraoperative complications. One patient developed a superficial abdominal wound infection, one patient had a deep venous thrombosis in her left leg 7 days postoperatively, and one patient experienced a 1 cm area of graft erosion 10 months postoperative requiring partial resection. Duration of follow-up has varied from 8 months to 5 years. One patient died 43 months after surgery of unrelated causes. No patients developed recurrent prolapse.Conclusions: Abdominal sacral colpopexy is a successful operation for the correction of prolapse. Serious complications are infrequent. Photographs of the technique and a review of the literature are presented.

  1. [Albert Einstein and his abdominal aortic aneurysm]. (United States)

    Cervantes Castro, Jorge


    The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

  2. Abdominal muscle function and incisional hernia

    DEFF Research Database (Denmark)

    Jensen, K K; Kjaer, M; Jorgensen, L N


    of life depends largely on abdominal muscle function (AMF), and the present review thus evaluates to what extent AMF is influenced by VIH and surgical repair. METHODS: The PubMed and EMBASE databases were searched for articles following a systematic strategy for inclusion. RESULTS: A total of seven...

  3. Reconstruction of complex abdominal wall defects

    NARCIS (Netherlands)

    Slater, N.J.


    Incisional hernia is by far the most common complication after laparotomies, occurring in 10 – 20%. Its occurrence is secondary to insufficient healing of the postoperative scar, resulting in wound dehiscence and protrusion of abdominal contents through an opening in the musculo-fascial layer of the

  4. Genetics Home Reference: abdominal wall defect (United States)

    ... Aug;6(4):232-6. Citation on PubMed Islam S. Clinical care outcomes in abdominal wall defects. Curr ... Site Map Customer Support Selection Criteria for Links Copyright Privacy Accessibility FOIA Viewers & Players U.S. ...

  5. Pulmonary complications of upper abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Deodhar S


    Full Text Available Pulmonary complications encountered in 67 patients undergoing upper abdominal surgery in our unit in one year period are analysed. Pulmonary function tests and their post-operative reduction, as also the risk factors are discussed. Pathophysiology responsible for pulmonary complications is outlined.

  6. Unusual Differential Diagnosis of Upper Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Lanthaler Monika


    The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.

  7. [Intraabdominal hypertension and abdominal compartment syndrome

    DEFF Research Database (Denmark)

    Sonne, M.; Hilligsø, Jens Georg


    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...

  8. Abdominal manifestations of actinomycosis in IUD users. (United States)

    Asuncion, C M; Cinti, D C; Hawkins, H B


    The use of an intrauterine device (IUD) is associated with the presence of actinomyces in the female genital tract. Since IUD use is currently so prevalent, IUD-related pelvic inflammatory disease occasionally spreads to the rest of the abdomen. Two patients with abdominal actinomycosis in association with an IUD illustrate the problem; we review the general problem.

  9. The Principles of Abdominal Wound Closure

    NARCIS (Netherlands)

    Meijer, E. -T.; Timmermans, L.; Jeekel, J.; Lange, J. F.; Muysoms, F. E.


    Background : Incisional hernia (IH) is a common complication of abdominal surgery. Its incidence has been reported as high as 39.9%. Many factors influence IH rates. Of these, surgical technique is the only factor directly controlled by the surgeon. There is much evidence in the literature on the op

  10. The clinical significance of abdominal right lower paramedian incision inrectal cancer operation

    Institute of Scientific and Technical Information of China (English)

    Chong Shu Wang; Shou Jiang Wei; Jing Dong Li


    AIM The incision in rectal cancer operation is adopted commonly in the left mid-lower abdomen. But thereare some defects for the incision, which is close to the artificial colotomy, readily be contaminated by feces,difficult to treat the lesions in hepatic and cholecystic area at the same time and in the weakened area ofabdominal wall. So, we employed the abdominal right lower paramedian incision to solve these problems.METHODS The abdominal right lower paramedian incision is from publc tubercle upward to 3 cm- 4 cmabove navel. The incision should be extended upward if individual need of performing hepatic and cholecysticoperation, or placing catheter or pump in hepatic artery or portal vein for chemotherapy at the same time.RESULTS One hundred and eighty three cases with rectal cancer were adopted this incision in differentoperation procedure, and out of them 41 patients were taken different operation on hepatic and cholecysticlesions and place a catheter or pump to hepatic artery or portal vein. Operators feel that the incision dose nothinder exploring and operating in all of the patients.CONCLUSION The right lower paramedian incision of abdomen is far away from the artificial colotomy,and it can reduce the feces contamination, lower down the rate of incision hernia and paramedian hernia orfistula. Furthermore, it is easy to treat the complicated hepatic and cholecystic lesion. So, authors suggestthat this incision is useful for the operation of rectal cancer, and it is worth to populize in clinical practice.

  11. Preload-based Starling-like control of rotary blood pumps: An in-vitro evaluation (United States)

    Gregory, Shaun D.; Salamonsen, Robert F.; Lovell, Nigel H.; Stevens, Michael C.; Pauls, Jo P.; Akmeliawati, Rini; Lim, Einly


    Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow (QP¯) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC). The root mean squared hemodynamic deviation (RMSHD) metric was used to assess the clinical acceptability of each controller based on pre-defined hemodynamic limits. We also compared the in-silico results from our previously published paper with our in-vitro outcomes. In the exercise simulation, the SLC increased QP¯ by 37%, compared to only 17% with the CSC. During blood loss, the SLC maintained a better safety margin against left ventricular suction with PLVEDm of 2.7 mmHg compared to -0.1 mmHg for CSC. A transition to reduced LVC resulted in decreased mean arterial pressure (MAP) and QP¯ with CSC, whilst the SLC maintained MAP and QP¯. The results were associated with a much lower RMSHD value with SLC (70.3%) compared to CSC (225.5%), demonstrating improved capacity of the SLC to compensate for the varying cardiac demand during profound circulatory changes. In-vitro and in-silico results demonstrated similar trends to the simulated changes in patient state however the magnitude of hemodynamic changes were different, thus justifying the progression to in-vitro evaluation. PMID:28212401

  12. Advanced heat pump cycle

    Energy Technology Data Exchange (ETDEWEB)

    Groll, E.A.; Radermacher, R.


    The desorption and absorption process of a vapor compression heat pump with a solution circuit (VCHSC) proceeds at gliding temperature intervals, which can be adjusted over a wide range. In case that the gliding temperature intervals in the desorber and the absorber overlap, a modification of the VCHSC employing a desorber/absorber heat exchange (DAHX) can be introduced, which results in an extreme reduction of the pressure ratio. Although the DAHX-cycle has features of a two-stage cycle, it still requires only one solution pump, one separator and one compressor. Such a cycle for the working pair ammonia/water is built in the Energy Laboratory of the Center for Environmental Energy Engineering at the University of Maryland. The experimental results obtained with the research plant are discussed and compared to those calculated with a simulation program. The possible temperature lift between heat source and heat sink depending on the achievable COP are presented.

  13. Wavy tube heat pumping

    Energy Technology Data Exchange (ETDEWEB)

    Haldeman, C. W.


    A PVC conduit about 4'' in diameter and a little more than 40 feet long is adapted for being seated in a hole in the earth and surrounds a coaxial copper tube along its length that carries Freon between a heat pump and a distributor at the bottom. A number of wavy conducting tubes located between the central conducting tube and the wall of the conduit interconnect the distributor with a Freon distributor at the top arranged for connection to the heat pump. The wavy conducting tubing is made by passing straight soft copper tubing between a pair of like opposed meshing gears each having four convex points in space quadrature separated by four convex recesses with the radius of curvature of each point slightly less than that of each concave recess.

  14. Pocket pumped image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kotov, I.V., E-mail: [Brookhaven National Laboratory, Upton, NY 11973 (United States); O' Connor, P. [Brookhaven National Laboratory, Upton, NY 11973 (United States); Murray, N. [Centre for Electronic Imaging, Open University, Milton Keynes, MK7 6AA (United Kingdom)


    The pocket pumping technique is used to detect small electron trap sites. These traps, if present, degrade CCD charge transfer efficiency. To reveal traps in the active area, a CCD is illuminated with a flat field and, before image is read out, accumulated charges are moved back and forth number of times in parallel direction. As charges are moved over a trap, an electron is removed from the original pocket and re-emitted in the following pocket. As process repeats one pocket gets depleted and the neighboring pocket gets excess of charges. As a result a “dipole” signal appears on the otherwise flat background level. The amplitude of the dipole signal depends on the trap pumping efficiency. This paper is focused on trap identification technique and particularly on new methods developed for this purpose. The sensor with bad segments was deliberately chosen for algorithms development and to demonstrate sensitivity and power of new methods in uncovering sensor defects.

  15. Previous Multiple Abdominal Surgeries: A Valid Contraindication to Abdominal Free Flap Breast Reconstruction? (United States)

    Di Candia, Michele; Asfoor, Ahmed Al; Jessop, Zita M.; Kumiponjera, Devor; Hsieh, Frank; Malata, Charles M.


    Presented in part at the following Academic Meetings: 57th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery, September 24-27, 2008, Naples, Italy.45th Congress of the European Society for Surgical Research (ESSR), June 9-12, 2010, Geneva, Switzerland.British Association of Plastic Reconstructive and Aesthetic Surgeons Summer Scientific Meeting, June 30-July 2, 2010, Sheffield Hallam University, Sheffield, UK. Background: Patients with previous multiple abdominal surgeries are often denied abdominal free flap breast reconstruction because of concerns about flap viability and abdominal wall integrity. We therefore studied their flap and donor site outcomes and compared them to patients with no previous abdominal surgery to find out whether this is a valid contraindication to the use of abdominal tissue. Patients and Methods: Twenty patients with multiple previous abdominal operations who underwent abdominal free flap breast reconstruction by a single surgeon (C.M.M., 2000-2009) were identified and retrospectively compared with a cohort of similar patients without previous abdominal surgery (sequential allocation control group, n = 20). Results: The index and control groups were comparable in age, body mass index, comorbidities, previous chemotherapy, and RT exposure. The index patients had a mean age of 54 years (r, 42-63) and an average body mass index of 27.5 kg/m2 (r, 22-38). The main previous surgeries were Caesarean sections (19), hysterectomies (8), and cholecystectomies (6). They underwent immediate (n = 9) or delayed (n = 11) reconstructions either unilaterally (n = 18) or bilaterally (n = 2) and comprising 9 muscle-sparing free transverse rectus abdominis muscle and 13 deep inferior epigastric perforator flaps. All flaps were successful, and there were no significant differences in flap and donor site outcomes between the 2 groups after an average follow up of 26 months (r, 10-36). Conclusion: Multiple previous abdominal

  16. Positive displacement rotary pump (United States)

    Moody, Paul E.


    An eccentric drive rotates inside a ring that is hinged to a plate and an elastomeric curtain is wrapped around the ring and across an articulated plate. The curtain moves along a cylindrical wall inside the pump cavity to move fluid from an inlet to an outlet end of the chamber. Two or more chambers can be coupled in series or in parallel with one another.

  17. Nonazeotropic Heat Pump (United States)

    Ealker, David H.; Deming, Glenn


    Heat pump collects heat from water circulating in heat-rejection loop, raises temperature of collected heat, and transfers collected heat to water in separate pipe. Includes sealed motor/compressor with cooling coils, evaporator, and condenser, all mounted in outer housing. Gradients of temperature in evaporator and condenser increase heat-transfer efficiency of vapor-compression cycle. Intended to recover relatively-low-temperature waste heat and use it to make hot water.

  18. Pioneering Heat Pump Project

    Energy Technology Data Exchange (ETDEWEB)

    Aschliman, Dave [Indiana Inst. of Technology, Inc., Fort Wayne, IN (United States); Lubbehusen, Mike [Indiana Inst. of Technology, Inc., Fort Wayne, IN (United States)


    This project was initiated at a time when ground coupled heat pump systems in this region were limited in size and quantity. There were economic pressures with costs for natural gas and electric utilities that had many organizations considering ground coupled heat pumps; The research has added to the understanding of how ground temperatures fluctuate seasonally and how this affects the performance and operation of the heat pumps. This was done by using a series of temperature sensors buried within the middle of one of the vertical bore fields with sensors located at various depths below grade. Trending of the data showed that there is a lag in ground temperature with respect to air temperatures in the shoulder months, however as full cooling and heating season arrives, the heat rejection and heat extraction from the ground has a significant effect on the ground temps; Additionally it is better understood that while a large community geothermal bore field serving multiple buildings does provide a convenient central plant to use, it introduces complexity of not being able to easily model and predict how each building will contribute to the loads in real time. Additional controllers and programming were added to provide more insight into this real time load profile and allow for intelligent shedding of load via a dry cooler during cool nights in lieu of rejecting to the ground loop. This serves as a means to ‘condition’ the ground loop and mitigate thermal creep of the field, as is typically observed; and It has been observed when compared to traditional heating and cooling equipment, there is still a cost premium to use ground source heat pumps that is driven mostly by the cost for vertical bore holes. Horizontal loop systems are less costly to install, but do not perform as well in this climate zone for heating mode

  19. Hydrodynamics of Pumps


    Brennen, Christopher Earls


    The subject of this monograph is the fluid dynamics of liquid turbomachines, particularly pumps. Rather than attempt a general treatise on turbomachines, we shall focus attention on those special problems and design issues associated with the flow of liquid through a rotating machine. There are two characteristics of a liquid that lead to these special problems, and cause a significantly different set of concerns than would occur in, say, a gas turbine. These are the potential for cavitation ...

  20. Introduction to Pump Rotordynamics (United States)


    RTO-EN-AVT-143 9 - 1 Introduction to Pump Rotordynamics Luis San Andrés Mast-Childs Tribology Professor Turbomachinery Laboratory Texas A... rotordynamics of turbomachinery, excessive vibration and instability. The acceptable performance of a turbomachine depends on the adequate design and operation...on rotordynamics . The basic equations for the modeling of linear rotor-bearing systems are given along with an example for the rotordynamics of a

  1. Diagnostic Accuracy of Secondary Ultrasound Exam in Blunt Abdominal Trauma


    Rajabzadeh Kanafi, Alireza; Giti, Masoumeh; Gharavi, Mohammad Hossein; Alizadeh, Ahmad; Pourghorban, Ramin; Shekarchi, Babak


    Background: In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial. Objectives: To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma. Patients and Methods: We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma p...

  2. Isolated duodenal rupture due to blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Celik Atilla


    Full Text Available Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.

  3. Abdominal fedme og fedmerelaterede sygdomme hos patienter i almen praksis

    DEFF Research Database (Denmark)

    Haugan, Ketil; Rost, Dan; Knudsen, Nils;


    Abdominal obesity is associated with type 2 diabetes, cardiovascular disease, dyslipidemia and hypertension. The prevalence of abdominal obesity and its relationship with these comorbidities have not previously been examined in Danish primary care patients.......Abdominal obesity is associated with type 2 diabetes, cardiovascular disease, dyslipidemia and hypertension. The prevalence of abdominal obesity and its relationship with these comorbidities have not previously been examined in Danish primary care patients....

  4. Abdominal closed trauma in children. Trauma abdominal cerrado en el niño.

    Directory of Open Access Journals (Sweden)

    Rogelio Rodríguez Castillo

    Full Text Available Blunt abdominal trauma constitutes 90% approximately of the abdominal injuries in children. Due to the augmented size of the child trunk in relation to their extremities, the abdominal lesions are extremely frequents. The abdominal trauma is present in 20-30% of the patients with serious trauma. It's the second cause of death for accidents after the cranial traumatism in the pediatric patient. We presented the Good Clinical Practices Guideline for Blunt Abdominal Trauma, approved by consensus in the 2nd National Good Clinical Practices Workshop in Pediatric Surgery (Manzanillo, Cuba, September 31 - October 3, 2002.

    El trauma abdominal cerrado constituye aproximadamente el 90 % de los traumatismos abdominales en niños. Debido al tamaño aumentado del tronco del niño en relación con sus extremidades las lesiones abdominales son extremadamente frecuentes. El trauma abdominal está presente en el 20-30 % de los pacientes con trauma grave. Es la segunda causa de muerte por accidentes, después del traumatismo craneal, en el paciente pediátrico. Se presenta la Guía de Buenas Prácticas Clínicas para trauma abdominal cerrado, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.

  5. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents. (United States)

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław


    Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents.

  6. Circulatory support devices: fundamental aspects and clinical management of bleeding and thrombosis. (United States)

    Susen, S; Rauch, A; Van Belle, E; Vincentelli, A; Lenting, P J


    Circulatory support devices are increasingly being used to overcome cardiac or respiratory failure. Long-term devices are used either as a 'bridge to transplant' to support patients who are unable to wait any longer for a heart transplant, or, more recently, as 'destination therapy' for older patients suffering from end-stage heart failure and who have contraindications to heart transplantation. Short-term support devices for high-risk percutaneous coronary intervention, or as a 'bridge for decision' for patients suffering from refractory cardiogenic shock, have also been developed. The clinical benefit of such assist devices has been demonstrated in several important studies, but, unfortunately, thrombotic and bleeding complications are two major clinical issues in patients requiring these devices. Overcoming these issues is of major importance to allow the safe and broad use of these devices, and to consider them as true alternatives to heart transplantation. The present review focuses on thrombotic and bleeding complications, and describes how the risk of thrombosis and bleeding may vary according to the clinical indication, but also according to the type of device. We describe the current knowledge of the mechanisms underlying the occurrence of these complications, provide some guidance for choosing the most appropriate anticoagulation regimen to prevent their occurrence for each type of device and indication, and provide some recommendations for the management of patients when the complication occurs.

  7. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of)


    The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD) due to adrenal insufficiency (AI) in preterm infants. Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2), early AI (n=5), sepsis (n=1), and patent ductus arteriosus (n=13). Fourteen of 257 infants (5.4%) were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days). The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE) in all 14 patients and germinal matrix hemorrhage (GMH) with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%), grade 1 PVE with newly appearing GMH in three (21%), and increased PVE in three (21%) infants. Five infants (36%) showed new development (n=4) or increased size (n=1) of GMH. Two of three infants (14%) with increased PVE developed cystic periventricular leukomalacia (PVL) and rapid progression to macrocystic encephalomalacia. LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.


    Directory of Open Access Journals (Sweden)

    V. V. Jakusevich


    Full Text Available Aim. To study effects of Ginkgo biloba based drug (Memoplant, Dr Willar Schwabe, Germany on haemorheological and clinical status in elderly patients with circulatory encephalopathy and controlled arterial hypertension.Material and methods. 80 patients (>60 y.o. were involved in the study. Patients were randomized (3:1 on Memoplant (240 mg/daily treatment group and control group. Duration of observation was 16 weeks. The changes of neurological complaints, neuropsychological and life quality test results were estimated during the study. The rheological indicators (blood, plasma and erythrocyte suspension viscosity; aggregative activity and plasticity of erythrocytes also were studied.Results. Reduction (by 50-90% of neurological complaints (headache, giddiness, tinnitus, unsteadiness walking were founded in patients receiving Memoplant. Cognitive abilities according to mental status scale, frontal tests battery, 5 words test, watch drawing test and quality of a life according to QOLI-NS scale improved in patients treated with Memoplant. Decrease of blood viscosity (by 19,3%, р<0,01 , erythrocytes rigidity index (by 15,6%, р<0,05 and erythrocyte aggregation (degree of aggregation by 45,6%; average aggregate size by 25,9%, р<0,05 > <0,05 was observed. Tissue oxygen supply was increased by 23,3% (р<0,05 in comparison with initial state. Changes of haemorheological indicators were not founded in control group.Conclusion. Memoplant increases brain oxygenation due to improvement of microcirculatory blood flow.

  9. Quantitative Circulatory Physiology: an integrative mathematical model of human physiology for medical education. (United States)

    Abram, Sean R; Hodnett, Benjamin L; Summers, Richard L; Coleman, Thomas G; Hester, Robert L


    We have developed Quantitative Circulatory Physiology (QCP), a mathematical model of integrative human physiology containing over 4,000 variables of biological interactions. This model provides a teaching environment that mimics clinical problems encountered in the practice of medicine. The model structure is based on documented physiological responses within peer-reviewed literature and serves as a dynamic compendium of physiological knowledge. The model is solved using a desktop, Windows-based program, allowing students to calculate time-dependent solutions and interactively alter over 750 parameters that modify physiological function. The model can be used to understand proposed mechanisms of physiological function and the interactions among physiological variables that may not be otherwise intuitively evident. In addition to open-ended or unstructured simulations, we have developed 30 physiological simulations, including heart failure, anemia, diabetes, and hemorrhage. Additional stimulations include 29 patients in which students are challenged to diagnose the pathophysiology based on their understanding of integrative physiology. In summary, QCP allows students to examine, integrate, and understand a host of physiological factors without causing harm to patients. This model is available as a free download for Windows computers at

  10. Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

    Directory of Open Access Journals (Sweden)

    Guillermo Delgado


    Full Text Available While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH, there is an initial response to the upright position which is uniquely associated with active standing (AS. We sought to assess this response and to compare it to that seen in young healthy controls (YHC. Method In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr ≤3 the changes in systolic blood pressure (SBP and heart rate that occur in the first 30 seconds (sec of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years. Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p<0.05. Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis.

  11. Cerebral venous circulatory disturbance as an informative prognostic marker for neonatal hemorrhagic stroke (United States)

    Semyachkina-Glushkovskaya, Oxana; Pavlov, Alexey; Navolokin, Nikita; Lychagov, Vladislav; Abdurashitov, Arkady; Zinchenko, Ekaterina; Gekaluk, Artemiy; Zhu, Dan; Shi, Rui; Luo, Qingming; Tuchin, Valery


    Neonatal hemorrhagic stroke (NHS) is a major problem of future generation's health due to the high rate of death and cognitive disability of newborns after NHS. The incidence of NHS in neonates cannot be predicted by standard diagnostic methods. Therefore, the identification of prognostic markers of NHS is crucial. There is evidence that stress-related alterations of cerebral blood flow (CBF) may contribute to NHS. Here, we assessed the stroke-associated CBF abnormalities for high prognosis of NHS using a new model of NHS induced by sound stress in the pre- and post-stroke state. With this aim, we used interdisciplinary methods such as a histological assay of brain tissues, laser speckle contrast imaging and Doppler coherent tomography to monitor cerebral circulation. Our results suggest that the venous stasis with such symptoms as progressive relaxation of cerebral veins, decrease the velocity of blood flow in them are prognostic markers for a risk of NHS and are an informative platform for a future study of corrections of cerebral venous circulatory disturbance related to NHS.

  12. Clinical comparison of radionuclide cisternography and computed tomography in CSF circulatory disturbance

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, M.; Futatsuki, M. (Tazuke Kofukai Medical Research Inst., Osaka (Japan). Kitano Hospital); Tanaka, H.


    Forty-three patients with abnormal cisternograms were classified into (1) NPH, (2) Postmeningitic hydrocephalus, (3) Posttraumatic hydrocephalus, (4) Postoperative hydrocephalus (tumor) (5) Postoperative hydrocephalus (vascular disease), (6) Meningitis, (7) Tumor, (8) Vascular disease, (9) Degenerative disease and (10) Miscellaneous. Cisternography was done by a scinticamera with /sup 111/In-DTPA and all groups were scanned by IInd generation CT scanner. The result of the cisternography was not always compatible with the CT findings. We found a case of anatomically normal but functionally abnormal cisterns and ventricular system. In all classified disorder groups, the cisternography detected functioning cisterns in CSF dynamics but the CT visualized anatomically open cisterns. By the combined use of these two examinations, a local cisternal block was detected. Ten in 20 cases with operated (V-P shunt) hydrocephalus clinically improved. But the result of these techniques, failed to assess the effectiveness of the V-P shunt. V-P shunt was effective in 8 out of 14 cases with persistent ventricular reflux and delayed clearance, and in 9 out of 17 cases with total ventricular dilatation. We concluded that the combined use of the RI cisternography and the computed tomography was better than single examination to detect CSF circulatory disturbance but we were not satisfied with the joint use in the evaluation of the effect of V-P shunt. No adverse reaction was experienced in the 43 patients with /sup 111/In-DTPA.

  13. A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans. (United States)

    Vianna, Lauro C; Fadel, Paul J; Secher, Niels H; Fisher, James P


    A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response of the muscle is relatively small compared with the onset of leg cycling, where a marked increase in muscle blood flow rapidly occurs as a consequence of multiple redundant mechanisms. We recorded blood pressure (BP; brachial artery), stroke volume (pulse contour analysis), cardiac output, and systemic vascular resistance (SVR) in young healthy males, while performing either 20 s of isometric handgrip contraction at 40% maximum voluntary contraction (protocol 1; n = 9) or 20 s of low-intensity leg cycling exercise (protocol 2; n = 8, 42 ± 8 W). Exercise trials were conducted under control (no drug) conditions and following cholinergic blockade (glycopyrrolate). Under control conditions, isometric handgrip elicited an initial increase in BP (+5 ± 2 mmHg at 3 s and +3 ± 1 mmHg at 10 s, P mechanism is important for the BP and SVR responses at the onset of isometric handgrip exercise in humans.

  14. Nursing diagnoses and outcomes related to the circulatory-system terms (ICNP® represented in an ontology

    Directory of Open Access Journals (Sweden)

    Marcia Regina Cubas


    Full Text Available The aim of the present study was to develop titles of Nursing Diagnoses and Outcomes (ND/NO through the relationship between the terms of the Focus axis, limited to the Circulatory System Process, and the terms of other ICNP® axes and to integrate these terms into an ontology. Titles were developed linking 17 terms of the focus axis, which were evaluated by expert nurses in five Brazilian cities. Titles whose use concordance was above 0.80 were included in the ontology. In total, 89 titles for ND/NO were supported in the literature, and 19 were not supported; 37 were assessed as eligible for use in healthcare practice and were included in the ontology. The construction of ND/NO titles based on the ICNP® and using a formal representation of knowledge is a task that requires deepening concepts used for nursing and adequate classification revisions. The elaborated titles will facilitate the composition of diagnostics that are more consistent with practice.

  15. Pearls and pitfalls in short-term mechanical circulatory assist: how to avoid and manage complications. (United States)

    Mohite, Prashant N; Maunz, Olaf; Simon, Andre R


    In today's era, given the worsening risk profiles of patients undergoing cardiac surgery, the increasing number of complex cardiac surgeries, and the increasing number of patients undergoing thoracic organ transplantation, short-term mechanical circulatory assist (MCA) devices are indispensable. MCA devices are capable of supporting heart and lung function and have emerged as potentially lifesaving instruments, but may prove to be as hazardous as helpful due to their inherent tendency toward hemolysis, thromboembolism, and hemorrhage. Although MCA devices are being used regularly at some specialized centers, surgeries involving MCA are not as common as other routine cardiac surgeries, and even though professionals implanting and maintaining short-term MCAs are well acquainted with operating such devices, it is not uncommon to come across complications as a result of minor mistakes committed while dealing with them. Avoiding simple mistakes and taking proper precautions while implanting and maintaining these devices can prevent major catastrophes. We discuss commonly encountered problems and complications during the implantation and maintenance of short-term MCAs and offer reasonable and practical solutions. In addition, crucial issues such as anticoagulation, replacement of the device circuit, and management of the distal perfusion cannula are discussed. Continuous and efficient monitoring of the MCA device and the patient supported on MCA, together with anticipation and avoidance of complications, is key for successful short-term MCA support.

  16. Role of long-term mechanical circulatory support in patients with advanced heart failure. (United States)

    Stokes, M B; Bergin, P; McGiffin, D


    Advanced heart failure represents a small proportion of patients with heart failure that possess high-risk features associated with high hospital readmission rates, significant functional impairment and mortality. Identification of those who have progressed to, or are near a state of advanced heart failure should prompt referral to a service that offers therapies in mechanical circulatory support (MCS) and cardiac transplantation. MCS has grown as a management strategy in the care of these patients, most commonly as a bridge to cardiac transplantation. The predominant utilisation of MCS is implantation of left ventricular assist devices (LVAD), which have evolved significantly in their technology and application over the past 15-20 years. The technology has evolved to such an extent that Destination Therapy is now being utilised as a strategy in management of advanced heart failure in appropriately selected patients. Complication rates have decreased with VAD implantation, but remain a significant consideration in the decision to implant a device, and in the follow up of these patients.

  17. Contribution of prostanoids to gastric circulatory and metabolic actions of solcoseryl. (United States)

    Pawlik, W W; Gustaw, P; Sendur, R; Czarnobilski, K; Konturek, S J


    Solcoseryl, a deproteinized extract of calf blood has been used in the treatment of peptic ulcer, but the mechanisms responsible for its therapeutic properties remain elusive. The present study was designed to determine the effects of solcoseryl on gastric total (GBF) and mucosal (MBF) blood flow, gastric oxygen consumption (GVO2) and mucosal formation of prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) in anesthetized dogs. Soloseryl given iv or ia into the oxyntic gland area of canine stomach caused a dose-dependent increase in the GBF, MBF and GVO2, PGE2 and LTC4 contents in the ethanol-treated gastric mucosa showed a 5-12 fold increase over the values in the intact mucosa. The generation of LTC4, but not PGE2, was significantly diminished by solcoseryl. Pre-treatment with indomethacin completely prevented the effects of solcoseryl on mucosal PGE2, but not LTC4 levels, and significantly reduced its circulatory and metabolic actions on the stomach. The results of these studies indicate that solcoseryl causes dilatation of gastric arterioles and precapillary sphincters thereby improving mucosal blood flow and oxygen supply. The results also suggest that endogenous prostaglandins serve as mediators of the vascular and possibly metabolic effects of the drug on the stomach. The observed reduction by solcoseryl in gastric biosynthesis of LTC4 during mucosal injury may be an important factor in the gastroprotective and anti-ulcer effects of solcoseryl.


    Directory of Open Access Journals (Sweden)

    Mürşet ÇAKMAK


    Full Text Available This study is aimed to investigate effects of teaching “Our Circulatory System”, which is one of the subjects in Science Technology Education curriculum, with concept maps on learning level of students comparing with the traditional methods. The study was carried out in a primary school in Diyarbakır, in 2011, and it is an experimental study with a pre-post test control group. The test group included 80 (N=80 6th year students. Control group was taught using the traditional methods while test-group was trained with the concept maps. Data was collected using achievement test, which has 32 items and of which reliability co-efficient was 0,79. Research period lasted 5 weeks. The data collected was evaluated using SPSS-17. T-test analytical techniques were used to analyse. The significance level was considered as 0.05. As a result, teaching with the concept maps was found to affect students’ academic success at significant level. Some suggestions were made in the light of outcomes.

  19. Acute mechanical circulatory support for fulminant myocarditis complicated by cardiogenic shock. (United States)

    Mody, Kanika P; Takayama, Hiroo; Landes, Elissa; Yuzefpolskaya, Melana; Colombo, Paolo C; Naka, Yoshifumi; Jorde, Ulrich P; Uriel, Nir


    In fulminant myocarditis complicated by cardiogenic shock, early mechanical circulatory support (MCS) may prevent cardiomyopathy and death. We sought to examine the outcomes of patients with fulminant myocarditis supported with MCS. A retrospective review of patients with acute cardiogenic shock treated with MCS from 2007 to 2013 was conducted, and patients with a diagnosis of fulminant myocarditis were included in this series. At our center, 260 patients received MCS for acute cardiogenic shock, and 11 were implanted for fulminant myocarditis. Eight received the Centrimag biventricular assist device (BIVAD), and three received veno-arterial extracorporeal membrane oxygenator (VA ECMO), though 1 VA ECMO-supported patient was transitioned to BIVAD due to refractory shock. The mean acute support time was 14.7 ± 4.4 days. Two patients required long-term left ventricular assist devices and were further supported for 55 and 112 days. Eight patients recovered with a mean ejection fraction of 54 ± 7 %, and one was successfully transplanted. Eight patients survived to discharge (73 %) with mean follow-up: 292.6 ± 306.8 days. All three deaths were due to neurologic complications. MCS should be considered in patients with fulminant myocarditis complicated by shock. With aggressive medical therapy, early utilization of MCS carries promising outcomes.

  20. A Magnetically Coupled Cryogenic Pump (United States)

    Hatfield, Walter; Jumper, Kevin


    Historically, cryogenic pumps used for propellant loading at Kennedy Space Center (KSC) and other NASA Centers have a bellows mechanical seal and oil bath ball bearings, both of which can be problematic and require high maintenance. Because of the extremely low temperatures, the mechanical seals are made of special materials and design, have wearing surfaces, are subject to improper installation, and commonly are a potential leak path. The ball bearings are non-precision bearings [ABEC-1 (Annular Bearing Engineering Council)] and are lubricated using LOX compatible oil. This oil is compatible with the propellant to prevent explosions, but does not have good lubricating properties. Due to the poor lubricity, it has been a goal of the KSC cryogenics community for the last 15 years to develop a magnetically coupled pump, which would eliminate these two potential issues. A number of projects have been attempted, but none of the pumps was a success. An off-the-shelf magnetically coupled pump (typically used with corrosive fluids) was procured that has been used for hypergolic service at KSC. The KSC Cryogenics Test Lab (CTL) operated the pump in cryogenic LN2 as received to determine a baseline for modifications required. The pump bushing, bearings, and thrust rings failed, and the pump would not flow liquid (this is a typical failure mode that was experienced in the previous attempts). Using the knowledge gained over the years designing and building cryogenic pumps, the CTL determined alternative materials that would be suitable for use under the pump design conditions. The CTL procured alternative materials for the bearings (bronze, aluminum bronze, and glass filled PTFE) and machined new bearing bushings, sleeves, and thrust rings. The designed clearances among the bushings, sleeves, thrust rings, case, and case cover were altered once again using experience gained from previous cryogenic pump rebuilds and designs. The alternative material parts were assembled into

  1. Electrocentrifugal pumping; Bombeo electrocentrifugo

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Perez, Guillermo; Medellin Otero, Hector [Instituto Mexicano del Peroleo (Mexico)


    The exploitation of isolated oil deposits, in losing their own energy, enter a phase of secondary recovery. One of the technologies of new development in Mexico is the one of electrocentrifugal pumping , which consists of introducing the motor-pump as an integral part of the production pipe down to the well bottom and pumping directly up to central complexes, from where it is sent inland. In the present paper is intended to explain what this type of secondary recovery consists of. [Spanish] La explotacion de yacimientos aislados de petroleo, al perder su energia propia, entran en una fase de recuperacion secundaria. Una de las tecnologias de nuevo desarrollo en Mexico es la de bombeo electrocentrifugo, la cual consiste en introducir la motobomba como parte integral de la tuberia de produccion hasta el fondo del pozo y bombearlo directamente hasta los complejos centrales, de donde se envia a tierra. En el presente trabajo se pretende explicar en que consiste este tipo de recuperacion secundaria.

  2. A LabVIEW model incorporating an open-loop arterial impedance and a closed-loop circulatory system. (United States)

    Cole, R T; Lucas, C L; Cascio, W E; Johnson, T A


    While numerous computer models exist for the circulatory system, many are limited in scope, contain unwanted features or incorporate complex components specific to unique experimental situations. Our purpose was to develop a basic, yet multifaceted, computer model of the left heart and systemic circulation in LabVIEW having universal appeal without sacrificing crucial physiologic features. The program we developed employs Windkessel-type impedance models in several open-loop configurations and a closed-loop model coupling a lumped impedance and ventricular pressure source. The open-loop impedance models demonstrate afterload effects on arbitrary aortic pressure/flow inputs. The closed-loop model catalogs the major circulatory waveforms with changes in afterload, preload, and left heart properties. Our model provides an avenue for expanding the use of the ventricular equations through closed-loop coupling that includes a basic coronary circuit. Tested values used for the afterload components and the effects of afterload parameter changes on various waveforms are consistent with published data. We conclude that this model offers the ability to alter several circulatory factors and digitally catalog the most salient features of the pressure/flow waveforms employing a user-friendly platform. These features make the model a useful instructional tool for students as well as a simple experimental tool for cardiovascular research.

  3. The efficacy of adhesiolysis on chronic abdominal pain

    DEFF Research Database (Denmark)

    Gerner-Rasmussen, Jonas; Burcharth, Jakob; Gögenur, Ismail


    INTRODUCTION: Abdominal adhesions are a frequent reason for chronic abdominal pain. The purpose of this systematic review was to investigate the evidence of performing laparoscopic adhesiolysis as a treatment for patients with chronic abdominal pain. METHODS: Medline, Embase, and The Cochrane Cen...

  4. Interventional management of abdominal sepsis : when and how

    NARCIS (Netherlands)

    van Goor, H


    Background: To decide "how and when to treat intra-abdominal infection" is one of the most important challenges for surgeons interested in abdominal sepsis. The minimally invasive approach to intra-abdominal infection, both diagnostic and therapeutic, has gained great popularity in recent years: the

  5. Lateral abdominal wall hernia following blunt trauma - a rare case


    Michael Walsh; Antony Pittathankal; Nnamdi Nwaejike


    The presence of superficial bruising, no abnormal signs on abdominal examination and a negative FAST scan of the abdomen may not be enough to rule out intra-abdominal pathology. We report on the usefulness of CT in diagnosing a post-traumatic abdominal wall hernia.

  6. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain (United States)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  7. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises. (United States)

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.


    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  8. Abdominal wall paresis as a complication of laparoscopic surgery

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle); G.J. Kleinrensink (Gert Jan); J.J. Hermans (John); T. Terkivatan (Türkan); J.F. Lange (Johan)


    textabstractPurpose: Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy. Methods: A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patie

  9. Can release of urinary retention trigger abdominal aortic aneurysm rupture? (United States)

    Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad


    Only 50% of abdominal aortic aneurysms present with the classic triad of hypotension, back pain and a pulsatile abdominal mass. This variability in symptoms can delay diagnosis and treatment. We present the case of a patient presenting with a unique combination of symptoms suggesting that decompression of urinary retention can lead to abdominal aortic aneurysm rupture.

  10. 77 FR 66847 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting (United States)


    ... aorta, thus increasing blood flow to the coronary arteries and increasing myocardial oxygen supply... bypass blood pumps (52 FR 17737, May 11, 1987). In 1993, FDA published a proposed rule requiring filing a... external pressure to the lower extremities during diastole to increase coronary perfusion pressure,...

  11. Effect of a bearing gap on hemolytic property in a hydrodynamically levitated centrifugal blood pump with a semi-open impeller. (United States)

    Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu; Yambe, Tomoyuki; Imachi, Kou; Yamane, Takashi


    We have developed a hydrodynamically levitated centrifugal blood pump with a semi-open impeller for long-term circulatory assist. The pump uses hydrodynamic bearings to enhance durability and reliability without additional displacement-sensors or control circuits. However, a narrow bearing gap of the pump has a potential for hemolysis. The purpose of this study is to develop the hydrodynamically levitated centrifugal blood pump with a semi-open impeller, and to evaluate the effect of a bearing gap on hemolytic property. The impeller levitates using a spiral-groove type thrust bearing, and a herringbone-groove type radial bearing. The pump design was improved by adopting a step type thrust bearing and optimizing the pull-up magnetic force. The pump performance was evaluated by a levitation performance test, a hemolysis test and an animal experiment. In these tests, the bearing gap increased from 1 to 63 μm. In addition, the normalized index of hemolysis (NIH) improved from 0.415 to 0.005 g/100 l, corresponding to the expansion of the bearing gap. In the animal experiment for 24 h, the plasma-free hemoglobin remained within normal ranges (pump was improved to the acceptable level by expanding the bearing gap greater than 60 μm.

  12. A new computational fluid dynamics method for in-depth investigation of flow dynamics in roller pump systems. (United States)

    Zhou, Xiaoming; Liang, Xin M; Zhao, Gang; Su, Youchao; Wang, Yang


    Roller pumps are commonly used in circulatory assist devices to deliver blood, but the inherent high mechanical stresses (especially wall shear stress) may cause considerable damage to cells. Conventional experimental approaches to evaluate and reduce device-induced cell damage require considerable effort and resources. In this work, we describe the use of a new computational fluid dynamics method to more effectively study roller pump systems. A generalized parametric model for the fluid field in a typical roller pump system is presented first, and analytical formulations of the moving boundary are then derived. Based on the model and formulations, the dynamic geometry and mesh of the fluid field can be updated automatically according to the time-dependent roller positions. The described method successfully simulated the pulsing flow generated by the pump, offering a convenient way to visualize the inherent flow pattern and to assess shear-induced cell damage. Moreover, the highly reconfigurable model and the semiautomated simulation process extend the usefulness of the presented method to a wider range of applications. Comparison studies were conducted, and valuable indications about the detailed effects of structural parameters and operational conditions on the produced wall shear stress were obtained. Given the good consistency between the simulated results and the existing experimental data, the presented method displays promising potential to more effectively guide the development of improved roller pump systems which produce less mechanical damage to cells.

  13. The Epidemiology of Intra-Abdominal Flora in Critically III Patients with Secondary and Tertiary Abdominal Sepsis

    NARCIS (Netherlands)

    de Ruiter, J.; Weel, J.; Manusama, E.; Kingma, W. P.; van der Voort, P. H. J.


    Background: Different micro-organisms can be cultured from abdominal fluid obtained from patients with intra-abdominal infection resulting from a perforated digestive tract. We evaluated a cohort of patients with abdominal sepsis admitted to the intensive care with the aim of obtaining more insight

  14. A case report of abdominal distention caused by herpes zoster

    Institute of Scientific and Technical Information of China (English)

    Su-Rong Zhou; Chuan-Yu Liu


    Gastrointestinal complications caused by herpes zoster are extremely rare.Here,we described a case of abdominal distention caused by herpes zoster.The patient was a 59-year-old female who suffered from unexplained paroxysmal and a burning pain on the right part of her waist and abdomen,accompanied by abdominal distention.Intestinal pseudo-obstruction was diagnosed by abdominal radiography.Distention of the right abdominal wall was still apparent after one month.In this report,we found that recovery from abdominal distention caused by herpes zoster is difficult and may require surgical intervention.

  15. [Pain originating from the abdominal wall: a forgotten diagnostic option]. (United States)

    Rivero Fernández, Miguel; Moreira Vicente, Víctor; Riesco López, José María; Rodríguez Gandía, Miguel Angel; Garrido Gómez, Elena; Milicua Salamero, José María


    Chronic abdominal pain is a common clinical problem in primary care, and is usually referred to gastroenterologists or general surgeons. Although up to 20% of cases of idiopathic abdominal pain arise in structures of the abdominal wall, this is frequently overlooked as a possible cause. It includes pain arising from structures of the abdominal wall including skin, parietal peritoneum, cellular subcutaneous tissue, aponeuroses, abdominal muscles and somatosensorial innervation from lower dorsal roots. The diagnosis is based on anamnesis and physical examination. Carnett's sign is a simple maneuver that discriminates between parietal and visceral pain. Management with topical anesthesia is effective in a majority of patients and can help to confirm the diagnosis.

  16. Influence of exercise training on the oxidative capacity of rat abdominal muscles (United States)

    Uribe, J. M.; Stump, C. S.; Tipton, C. M.; Fregosi, R. F.


    Our purpose was to determine if endurance exercise training would increase the oxidative capacity of the abdominal expiratory muscles of the rat. Accordingly, 9 male rats were subjected to an endurance training protocol (1 h/day, 6 days/week, 9 weeks) and 9 litter-mates served as controls. Citrate synthase (CS) activity was used as an index of oxidative capacity, and was determined in the following muscles: soleus, plantaris, costal diaphragm, crural diaphragm, and in all four abdominal muscles: rectus abdominis, transversus abdominis, external oblique, and internal oblique. Compared to their non-trained litter-mates, the trained rats had higher peak whole body oxygen consumption rates (+ 16%) and CS activities in plantaris (+34%) and soleus (+36%) muscles. Thus, the training program caused substantial systemic and locomotor muscle adaptations. The CS activity of costal diaphragm was 20% greater in the trained animals, but no difference was observed in crural diaphragm. The CS activity in the abdominal muscles was less than one-half of that in locomotor and diaphragm muscles, and there were no significant changes with training except in the rectus abdominis where a 26% increase was observed. The increase in rectus abdominis CS activity may reflect its role in postural support and/or locomotion, as none of the primary expiratory pumping muscles adapted to the training protocol. The relatively low levels of CS activity in the abdominal muscles suggests that they are not recruited frequently at rest, and the lack of an increase with training indicates that these muscles do not contribute significantly to the increased ventilatory activity accompanying exercise in the rat.

  17. Direct pumping of four levels lasing materials (United States)

    Goldring, Sharone; Lavi, Raphael; Tal, Alon; Jackel, Steven M.; Lebiush, Eyal; Tzuk, Yitshak; Azoulay, Ehud


    Heat generation and laser performance were studied in Nd:YAG oscillators pumped with a Ti:Sapphire laser in two regimes: band pumping at 802nm and direct pumping at 885nm. Slope efficiencies of 52% and 57%, when pumped at 802nm and 885nm, were obtained, respectively. Heat per unit laser output was found to be 27% lower when pumped at 885nm (direct pumping regime) as compared to traditional band pumping around 808nm.

  18. Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Davood Farsi


    Full Text Available Background: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT. Materials and Methods: In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. Results: A total of 104 patients was enrolled in the study. 15 patients (14.4% had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001. On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100, 93.26% (95% CI, 86-96.8, 14.83 (95% CI, 6.84-32.12, and 0, respectively. Conclusion: The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients.

  19. Abdominal leiomyosarcomas: radiologic appearances at various locations

    Energy Technology Data Exchange (ETDEWEB)

    Kurugoglu, Sebuh; Ogut, Gunduz; Mihmanli, Ismail; Korman, Ugur [Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, 34300 Istanbul (Turkey); Durak, Haydar [Department of Pathology, Istanbul University, Cerrahpasa Medical Faculty, 34300 Istanbul (Turkey)


    Leiomyosarcomas are soft tissue tumors that account for approximately 15% of all soft tissue sarcomas. Leiomyosarcomas may be located at almost any part of the abdomen but especially are more common in the retroperitoneum, followed by gastrointestinal tract and genital system. They develop mainly in adult life and are very rare in children. In this article, imaging findings of leiomyosarcomas in various abdominal locations are presented. Radiologic studies are capable of providing useful information on the localization, size, changes in the internal structure of the tumor, its extension and invasion. Leiomyosarcoma should be considered in the differential diagnosis in case of detection of a large, circumscribed, and heterogenous abdominal mass. Histopathologically, diagnosis of malignancy depends particularly on mitotic counts, size, rate of necrosis, and infiltrating margins. (orig.)

  20. Computed Tomography (CT) Perfusion in Abdominal Cancer

    DEFF Research Database (Denmark)

    Hansen, Martin Lundsgaard; Norling, Rikke; Lauridsen, Carsten;


    on the market today based on different perfusion algorithms. However, there is no consensus on which protocol and algorithm to use for specific organs. In this article, the authors give an introduction to CT perfusion in abdominal imaging introducing technical aspects for calculation of perfusion parameters......Computed Tomography (CT) Perfusion is an evolving method to visualize perfusion in organs and tissue. With the introduction of multidetector CT scanners, it is now possible to cover up to 16 cm in one rotation, and thereby making it possible to scan entire organs such as the liver with a fixed...... table position. Advances in reconstruction algorithms make it possible to reduce the radiation dose for each examination to acceptable levels. Regarding abdominal imaging, CT perfusion is still considered a research tool, but several studies have proven it as a reliable non-invasive technique...

  1. [Adrenal injury in blunt abdominal trauma]. (United States)

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G


    10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.

  2. Abdominal pregnancy as a cause of hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Shafi Sheikh


    Full Text Available The coexistence of intrauterine and extrauterine pregnancy, the heterotopic pregnancy, is a rare obstetric phenomenon. The preoperative diagnosis of this condition is very difficult; leading to a higher maternal morbidity and fetal loss. We experienced a case of intrauterine pregnancy and ruptured abdominal pregnancy implanted on the illeocaecal region in a 26-year-old primiparous woman. She was clinically misdiagnosed as a case of ruptured ectopic pregnancy, but ultrasonography showed it to be a case of heterotopic pregnancy. Subsequently, the patient was subjected to laparotomy and the ruptured abdominal pregnancy was evacuated. She continued with the intrauterine pregnancy till term and delivered a healthy female baby. Although this condition is unusual, any general surgeon in the emergency department must be aware of this complication and its management, which is often initially misdiagnosed.

  3. Atrophic coarctation of the abdominal aorta. (United States)

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F


    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  4. [Traumatic and iatrogenic lesions of abdominal vessels]. (United States)

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H


    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  5. Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon

    Institute of Scientific and Technical Information of China (English)

    Jenny N Tannoury; Bassam N Abboud


    Abdominal cocoon,the idiopathic form of sclerosing encapsulating peritonitis,is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane.Preoperative diagnosis re quires a high index of clinical suspicion.The early clinical features are nonspecific,are often not recognized and it is difficult to make a definite pre-operative diagnosis.Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies.The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomography scan.Surgery is important in the management of this disease.Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.

  6. Proper Sizing of Circulation Pumps

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Nørgaard, Jørgen


    , but the results can be applied to Europe in general. Despite the small sample of houses involved in the test, 15 houses, some rather safe conclusions can be drawn from the results, which showed that newly developed pumps with power consumption around 5-8 W, can perform the task of circulating the water......The paper describes the preliminary results from field tests of replacing various types of old pumps used for circulating water in heating systems in single- and double-family houses with new types of pumps. The tests were carried out in Denmark for the Danish Electricity Savings Trust...... sufficiently to keep the houses satisfactorily warm during the heating season of the test. The old replaced pumps used 5-10 times more power. In Europe alone, a gradual replacement of the present vastly oversized pumps with such small but sufficient pumps can save the construction of 17 large power plants...

  7. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)


    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  8. Abdominal compartment syndrome from bleeding duodenal diverticulum

    Directory of Open Access Journals (Sweden)

    Vakhtang Tchantchaleishvili


    Full Text Available Duodenal diverticuli are acquired false diverticuli of unknown etiology. Although mostly asymptomatic, they can occasionally cause upper gastrointestinal hemorrhage, rarely with massive bleeding. In this report, we present (to the best of our knowledge the first reported case of duodenal diverticular bleeding, causing abdominal compartment syndrome. Albeit a rare event, duodenal diverticular bleeding should be included in the differential diagnosis of upper gastrointestinal bleeding. As with our case, a multidisciplinary approach to managing such patients is crucial.

  9. Abdominal manifestations of extranodal lymphoma: pictorial essay* (United States)

    Fajardo, Laís; Ramin, Guilherme de Araujo; Penachim, Thiago José; Martins, Daniel Lahan; Cardia, Patrícia Prando; Prando, Adilson


    In the appropriate clinical setting, certain aspects of extranodal abdominal lymphoma, as revealed by current cross-sectional imaging techniques, should be considered potentially diagnostic and can hasten the diagnosis. In addition, diagnostic imaging in the context of biopsy-proven lymphoma can accurately stage the disease for its appropriate treatment. The purpose of this article was to illustrate the various imaging aspects of extranodal lymphoma in the abdomen. PMID:28057966

  10. Mast Cells in Abdominal Aortic Aneurysms

    DEFF Research Database (Denmark)

    Shi, Guo-Ping; Lindholt, Jes Sanddal


    Mast cells (MCs) are proinflammatory cells that play important roles in allergic responses, tumor growth, obesity, diabetes, atherosclerosis, and abdominal aortic aneurysm (AAA). Although the presence and function of MCs in atherosclerotic lesions have been thoroughly studied in human specimens...... neighboring cells, degrade extracellular matrix proteins, process latent bioactive molecules, promote angiogenesis, recruit additional inflammatory cells, and stimulate vascular cell apoptosis. These activities associate closely with medial elastica breakdown, medial smooth-muscle cell loss and thinning...

  11. Child abdominal tumour in tropical context: Think about schistosomiasis!

    Directory of Open Access Journals (Sweden)

    A. M. Napon


    Full Text Available Schistosomiasis presenting as an abdominal mass with chronic pain in a child is not common. This report presents case of child presenting with schistosomiasis presenting as an abdominal mass with chronic pain. Abdominal ultrasonography did not particularly contribute to definitive pre-operative diagnosis. However, pathological examination of surgical specimen confirmed Schistosoma mansoni eggs in the biospy. A decrease in the mass volume was noticed under medical treatment (Biltricide. The aim of this report was to intimate clinicians on possible abdominal schistosomiasis as differential diagnosis of childhood abdominal mass. This is a clarion call for a high index of suspicion of childhood abdominal schistosomiasis in children presenting with abdominal mass in a tropical setting.

  12. Abdominal tuberculosis in Ahmadi, Kuwait: a clinico-pathological review. (United States)

    Abdul-Ghaffar, N U; Ramadan, T T; Marafie, A A


    For studying abdominal tuberculosis (TB) in Ahmadi, files off all patients admitted to our hospital with abdominal TB over 15 years (1981-1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.

  13. Focal epilepsy with ictal abdominal pain: a case report. (United States)

    Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo


    Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities.

  14. Clinical features of late-onset circulatory dysfunction in premature infants

    Directory of Open Access Journals (Sweden)

    Koyama N


    Full Text Available Norihisa Koyama,1 Masanori Kouwaki,1 Taihei Tanaka,2 Shigeru Ohki,3 Kazuhiro Iwase,4 Shunichi Terasawa,5 Masanao Miyaji,6 Toshimitsu Iwaki,7 Minoru Kokubo,8 Satoru Kobayashi,9 Haruo Mizuno,10 Shinji Fujimoto,10 Hajime Togari10 1Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, 2Department of Pediatrics, Nagoya Daini Red Cross Hospital, Nagoya, 3Department of Pediatrics, Seirei Hamamatsu General Hospital, Hamamatsu, 4Department of Pediatrics, Nagoya City West Medical Center, Nagoya, 5Department of Pediatrics, Ichinomiya Municipal Hospital, Ichinomiya, 6Department of Pediatrics, Shizuoka Saiseikai General Hospital, Shizuoka, 7Department of Pediatrics, Gifu Prefectural Tajimi Hospital, Tajimi, 8Department of Pediatrics, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, 9Department of Pediatrics, Seirei Mikatabara General Hospital, Hamamatsu, 10Department of Pediatrics, Neonatology and Congenital Disorders, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Background: Sudden unpredictable hypotension during the post-transitional period, termed late-onset circulatory dysfunction (LCD of premature infants, has been reported in low birth-weight infants who overcame major problems during the early neonatal period. We investigated the clinical features of LCD and factors associated with the occurrence of LCD. Methods: A multicenter retrospective case-control study. The clinical records of 1,004 children born at less than 32 weeks of gestation were reviewed. Patients with LCD were compared with age-matched non-LCD controls. Results: Of the 1,004 infants, 73 (7.3% were diagnosed with LCD, with the incidence differing significantly among institutions (P<0.0001. The median age of diagnosis was 16 days of age (range: 4–50 days and 29 weeks of postmenstrual age (range: 25–35 weeks. The incidence of LCD was inversely correlated with gestational age at birth, except at 22 and

  15. Centrifugal pumps and allied machinery

    CERN Document Server

    Anderson, HH


    This book will be of vital interest to all engineers and designers concerned with centrifugal pumps and turbines. Including statistical information derived from 20000 pumps and 700 turbines with capacities of 5gpm to 5000000gpm, this book offers the widest range and scope of information currently available. Statistical analyses suggest practical methods of increasing pump performance and provide valuable data for new design aspects.

  16. Research on synchronous gear pump

    Institute of Scientific and Technical Information of China (English)

    LUAN Zhen-hui


    Based on a comprehensive analysis of the structure and existing problems of the gear pump, provided a structure principle of a synchronous gear pump. The discussions focused on the working principle, construction features and finite element analysis of the hydraulic gear. The research indicates that the new pump has such advantages as lower noise, better distributed flow and a high work pressure, and it can be widely used in hydraulic systems.

  17. Risk factors of thrombosis in abdominal veins

    Institute of Scientific and Technical Information of China (English)

    Amit Kumar Durra; Ashok Chacko; Biju George; Joseph Anjilivelil Joseph; Sukesh Chandran Nair; Vikram Mathews


    AIM: To estimate the prevalence of inherited and acquired thrombophilic risk factors in patients with abdominal venous thrombosis and to compare the risk factor profiles between Budd-Chiari syndromes (BCS) and splanchnic vein thrombosis (SVT).METHODS: In this retrospective study, 36 patients with abdominal venous thrombosis were studied.The patients were divided into Budd-Chiari group (hepatic vein, IVC thrombosis) and splanchnic venous thrombosis group (portal, splenic, superior mesenteric veins) based on the veins involved. Hereditary and acquired thrombophilic risk factors were evaluated in all patients.RESULTS: Twenty patients had SVT, 14 had BCS,and 2 had mixed venous thrombosis. Ten patients (28%) had hereditary and 10 patients (28%) acquired thrombophilic risk factors. The acquired risk factors were significantly more common in the SVT group (SVT vs BCS:45% vs 7%,x2=5.7,P=0.02) while hereditary risk factors did not show significant differences between the two groups (SVT vs BCS: 25%vs 36%, x2=0.46,P=0.7). Multiple risk factors were present in one (7%) patient with BCS and in 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and in 45% of patients with SVT.CONCLUSION: Hereditary and acquired risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis. Acquired risk factors are significantly more common in SVT patients while hereditary factors are similar in both groups.

  18. Embarazo ectópico abdominal

    Directory of Open Access Journals (Sweden)

    Karen Luz Torres Rojas


    Full Text Available La incidencia de embarazo ectópico ha aumentado en los últimos años hasta 1:43 recién nacidos. La variedad abdominal es una de las menos frecuentes, su incidencia es de 1:10mil  nacidos vivos. El 1% de los embarazos ectópicos son abdominales y la implantación en el epiplón es una rara entidad. Pueden clasificarse como primarios o secundarios en función de que se originen o no en la cavidad peritoneal. Se presenta un caso de embarazo abdominal primario, localizado en cara posterior del útero y recto, con edad gestacional 16 semanas y feto muerto, en una paciente de 25 años, atendida en el Hospital General “Dr. Ernesto Guevara de la Serna”, con antecedentes de salud, G0 P0 A0, con método anticonceptivo DIU retirado seis meses antes. Se trata de un embarazo abdominal primario, puesto que la anatomía patológica informó ausencia de invasión trofloblástica en la trompa izquierda. El manejo placentario en este caso no permitió realizar la remoción completa de la misma. El seguimiento ecográfico y  control de gonadotropinas evidenció una evolución favorable de la paciente, sin requerir manejo de metotrexate.

  19. [Hereditary angioedema: strange cause of abdominal pain]. (United States)

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio


    Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

  20. Endovascular repair of ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Šarac Momir


    Full Text Available Introduction. Rupture of an abdominal aortic aneurysm (AAA is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR. We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. Case report. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient’s comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80% it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. Endovascular grafting was achieved with aorto-bi-iliac bifurcated excluder endoprosthesis with complete exclusion of the aneurysmal sac, without further enlargment of haemathoma and no contrast leakage. The postoperative course of the patient was eventless, without complications. On recall examination 3 months after, the state of the patient was well. Conclusion. The alternative for open reconstruction of ruptured AAA in haemodynamically stable patients with suitable anatomy and comorbidities could be emergency EVAR in local anesthesia. This technique could provide greater chances for survival with lower intraoperative and postoperative morbidity and mortality, as shown in the presented patient.

  1. Midgut malrotation with chronic abdominal pain

    Directory of Open Access Journals (Sweden)

    Anil K Wanjari


    Full Text Available Abnormalities in midgut rotation occur during the physiological herniation of midgut between the 5 th and 10 th week of gestation. The most significant abnormality is narrow small bowel mesentery which is prone to volvulus. This occurs most frequently in the neonatal period, less commonly midgut malrotation presents in adulthood with either acute volvulus or chronic abdominal symptoms. It is the latter group that represents a diagnostic challenge. We report a case of a 17-year-old male patient who presented with 10-year history of nonspecific gastro-intestinal symptoms. After extensive investigation the patient was diagnosed with midgut malrotation following computed tomography of abdomen. The patient was treated with a laparoscopic Ladd′s procedure and at 3 months he was gaining weight and had stopped vomiting. A laparoscopic Ladd′s procedure is an acceptable alternative to the open technique in treating symptomatic malrotation in adults. Midgut malrotation is a rare congenital anomaly which may present as chronic abdominal pain. Abdominal CT is helpful for diagnosis.

  2. [Abdominal multi-organ transplantation in dogs]. (United States)

    Kumagae, T


    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  3. Sagittal Abdominal Diameter: Application in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Thaís Da Silva-Ferreira


    Full Text Available Excess visceral fat is associated with cardiovascular risk factors. Sagittal abdominal diameter (SAD has recently been highlighted as an indicator of abdominal obesity, and also may be useful in predicting cardiovascular risk. The purpose of the present study was to review the scientific literature on the use of SAD in adult nutritional assessment. A search was conducted for scientific articles in the following electronic databases: SciELO , MEDLINE (PubMed and Virtual Health Library. SAD is more associated with abdominal fat (especially visceral, and with different cardiovascular risk factors, such as, insulin resistance, blood pressure, and serum lipoproteins than the traditional methods of estimating adiposity, such as body mass index and waist-to-hip ratio. SAD can also be used in association with other anthropometric measures. There are still no cut-off limits established to classify SAD as yet. SAD can be an alternative measure to estimate visceral adiposity. However, the few studies on this diameter, and the lack of consensus on the anatomical site to measure SAD, are obstacles to establish cut-off limits to classify it.


    Directory of Open Access Journals (Sweden)

    E. A. Spirina


    Full Text Available Aim of our clinical study was evaluation own initial experience of high-urgency ortotopic heart transplantation (OHT in recipients, who were bridged on peripheral Vena-Arterial Extracorporeal Membrane Oxygenation (VA ECMO. Materials and methods. In this study was included 17 patients (14/3 M/F, age 16–66 (40.1 ± 4.2 yrs who underwent OHT while on peripheral ECMO support. In all cases we used peripheral surgical can- nulation technique via femoral vessels – arterial cannula 15–19 Fr, venous cannula – 21–25 Fr, arterial cannula or vascular catheter 8–10 Fr for anterograde leg’s perfusion. Results. Duration Vena-Arterial Extracorporeal Membrane Oxygenation before OHT was 81 ± 17 h. VA ECMO support was blood flow 4.8 ± 0.6 l/min or 2.63 ± 0/04 l/min/m2, gas flow 4.8 ± 0.6 l/min, FiO2 0.86 ± 0.07. Vena-Arterial Extracorporeal Membrane Oxygenation support was continued in “protective mode” (blood flow 1.9 ± 0.2 l/min 4.3 ± 0.5 days after OHT. Thirteen pa- tients (76.4% were weaned from VA ECMO successfully and survived to be discharged. ICU and hospital LOS after orthotopic heart transplantation was respectively 6.7 ± 0.8 and 32.3 ± 4.6 days in group of survived patients. The reasons of a lethal outcome (n = 4, 23.5% were sepsis and multiorgan failure (n = 3, sudden cardiac arrest (n = 1. Conclusion. Vena-Arterial Extracorporeal Membrane Oxygenation is a favorable short-term method of circulatory support in patients who needed in high-urgency heart transplantation. 

  5. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Directory of Open Access Journals (Sweden)

    Su-Mi Shin


    Full Text Available Purpose: The aim of this study was to characterize the brain ultrasonographic findings of late-onset circulatory dysfunction (LCD due to adrenal insufficiency (AI in preterm infants. Methods: Among the 257 preterm infants born at <33 weeks of gestation between December 2009 and February 2014 at our institution, 35 preterm infants were diagnosed with AI. Brain ultrasonographic findings were retrospectively analyzed before and after LCD in 14 preterm infants, after exclusion of the other 21 infants with AI due to the following causes: death (n=2, early AI (n=5, sepsis (n=1, and patent ductus arteriosus (n=13. Results: Fourteen of 257 infants (5.4% were diagnosed with LCD due to AI. The age at LCD was a median of 18.5 days (range, 9 to 32 days. The last ultrasonographic findings before LCD occurred showed grade 1 periventricular echogenicity (PVE in all 14 patients and germinal matrix hemorrhage (GMH with focal cystic change in one patient. Ultrasonographic findings after LCD demonstrated no significant change in grade 1 PVE and no new lesions in eight (57%, grade 1 PVE with newly appearing GMH in three (21%, and increased PVE in three (21% infants. Five infants (36% showed new development (n=4 or increased size (n=1 of GMH. Two of three infants (14% with increased PVE developed cystic periventricular leukomalacia (PVL and rapid progression to macrocystic encephalomalacia. Conclusion: LCD due to AI may be associated with the late development of GMH, increased PVE after LCD, and cystic PVL with rapid progression to macrocystic encephalomalacia.

  6. End-stage heart failure and mechanical circulatory support: feasibility of discharge from hospital. (United States)

    Oosterom, A; de Jonge, N; Kirkels, J H; Rodermans, B F M; Sukkel, E; Klöpping, C; Ramjankhan, F; Lahpor, J R


    BACKGROUND.: Due to the shortage of donor hearts, mechanical circulatory support is increasingly being used as a bridge to transplantation. In order to allow for more widespread use of ventricular assist devices it is mandatory that patients are not continuously hospitalised. We present the results of our experience with patients with end-stage heart failure, discharged from hospital after implantation of a ventricular assist device and followed in an outpatient setting. METHODS.: After an intensive training and education programme, focusing on the management of the percutaneous driveline and instructions on how to handle in case of an alarm or malfunction of the device, patients were discharged. They were followed in the outpatient department. All regular and unplanned visits were registered, including readmissions. RESULTS.: Twenty-seven patients treated with a ventricular assist device were discharged from hospital. There were 37 extra visits, of these, 27 were device related resulting in 21 readmissions (0.78/patient). We treated eight infectious episodes in four patients, all device related. Furthermore seven thromboembolic episodes occurred in four patients. One patient died because of multiorgan failure seven weeks after he was readmitted with an urosepsis. In our experience of 11.4 patient years at home while on the device, only 5% of the time was spent in hospital for complications. In comparison with patients on an assist device who stayed in hospital until transplantation, there were no more complications. CONCLUSION.: This study demonstrates that patients with end-stage heart failure, treated with a ventricular assist device, can be safely discharged from hospital, with an acceptable rate of readmissions. It results in a fair quality of life, with a high degree of independence of the patient. (Neth Heart J 2007;15:45-50.).

  7. Prevalence of Warfarin Genotype Polymorphisms in Patients with Mechanical Circulatory Support. (United States)

    Awad, Morcos; Czer, Lawrence S C; Soliman, Camelia; Mirocha, James; Ruzza, Andrea; Pinzas, Joshua; Rihbany, Kelsey; Chang, David; Moriguchi, Jaime; Ramzy, Danny; Esmailian, Fardad; Kobashigawa, Jon; Arabia, Francisco


    Polymorphisms for VKORC1 and CYP2C9 are associated with increased warfarin sensitivity. The prevalence of these polymorphisms in patients with mechanical circulatory support (MCS) is unknown. Polymorphisms for VKORC1 and CYP2C9 were determined in 65 patients undergoing MCS surgery. Postoperative warfarin dose, international normalized ratio (INR), and bleeding events were measured until discharge, 6 months, or composite end point (in-hospital MCS recovery, heart transplant, or death). A total of 67.7% (44/65) had at least one polymorphism: VKORC1 (44.6%), CYP2C9*2 (7.7%), CYP2C9*3 (4.6%), CYP2C9*2 and VKORC1 (3.1%), or CYP2C9*3 and VKORC1 (7.7%). At discharge or before composite end point, patients with any polymorphism received a lower mean warfarin dosage than patients having no polymorphism (3.21 ± 1.47 vs. 5.57 ± 3.72 mg, p = 0.015) and achieved a similar mean INR (2.20 ± 0.67 vs. 2.19 ± 0.69, p = 0.96). There was no significant difference in bleeding rates within 6 months or before composite end point (6.13 vs. 8.02 events/patient-year, p = 0.13). One or more polymorphisms for VKORC1 or CYP2C9 (associated with warfarin sensitivity) were found in 67.7% of MCS patients. By using a warfarin genotype-guided approach, MCS patients with polymorphisms received a lower warfarin dosage to achieve a similar INR, with similar bleeding rates, in comparison with no polymorphisms. A warfarin genotype-guided approach avoided excessive anticoagulation and its attendant bleeding risks.

  8. Resolution and outcome of acute circulatory failure does not correlate with hemodynamics (United States)

    Suistomaa, Matti; Uusaro, Ari; Parviainen, Ilkka; Ruokonen, Esko


    Introduction Hemodynamic goals in the treatment of acute circulatory failure (ACF) are controversial. In critical care, organ failures can be assessed using Sequential Organ Failure Assessment and its refinement, total maximal Sequential Organ Failure Assessment (TMS). We studied the associations between resolution of ACF and hemodynamics in the early ( 2 mmol/l and/or base deficit > 4) who had pulmonary artery catheters and stayed for longer than 24 hours in the intensive care unit were included. Hemodynamics, oxygen transport, vasoactive drugs and TMS scores were recorded. Normalisation of hyperlactatemia and metabolic acidosis in less than 24 hours after admission was defined as a positive response to hemodynamic resuscitation. Results Fifty-two patients responded to resuscitation. Nonresponders had higher mortality than responders (52% versus 33%, P = 0.044). Hospital mortality was highest (63%) among nonresponders who received vasoactive drugs. The TMS scores of nonresponders (median [interquartile range], 12 [9-16]) were higher than the scores of responders (10 [7-12], P = 0.019). Late accumulation of TMS scores was associated with increasing mortality, and if the TMS score increase occurred > 5 days after admission then the mortality was 77%. Responders had higher mean arterial pressure at 24 hours, but it was no different between survivors and nonsurvivors. No other hemodynamic and oxygen transport variables were associated with the success of resuscitation or with mortality. Conclusions Except for the mean arterial pressure at 24 hours, invasively derived hemodynamic and oxygen transport variables are not associated with the response to resuscitation or with mortality. Positive response to resuscitation in ACF is associated with less severe organ failures as judged by TMS scores. Late accumulation of the TMS score predicts poor outcome. PMID:12930556

  9. Myocardial Oxidative Metabolism and Protein Synthesis during Mechanical Circulatory Support by Extracorporeal Membrane Oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Priddy, MD, Colleen M.; Kajimoto, Masaki; Ledee, Dolena; Bouchard, Bertrand; Isern, Nancy G.; Olson, Aaron; Des Rosiers, Christine; Portman, Michael A.


    Extracorporeal membrane oxygenation (ECMO) provides mechanical circulatory support essential for survival in infants and children with acute cardiac decompensation. However, ECMO also causes metabolic disturbances, which contribute to total body wasting and protein loss. Cardiac stunning can also occur which prevents ECMO weaning, and contributes to high mortality. The heart may specifically undergo metabolic impairments, which influence functional recovery. We tested the hypothesis that ECMO alters oxidative. We focused on the amino acid leucine, and integration with myocardial protein synthesis. We used a translational immature swine model in which we assessed in heart (i) the fractional contribution of leucine (FcLeucine) and pyruvate (FCpyruvate) to mitochondrial acetyl-CoA formation by nuclear magnetic resonance and (ii) global protein fractional synthesis (FSR) by gas chromatography-mass spectrometry. Immature mixed breed Yorkshire male piglets (n = 22) were divided into four groups based on loading status (8 hours of normal circulation or ECMO) and intracoronary infusion [13C6,15N]-L-leucine (3.7 mM) alone or with [2-13C]-pyruvate (7.4 mM). ECMO decreased pulse pressure and correspondingly lowered myocardial oxygen consumption (~ 40%, n = 5), indicating decreased overall mitochondrial oxidative metabolism. However, FcLeucine was maintained and myocardial protein FSR was marginally increased. Pyruvate addition decreased tissue leucine enrichment, FcLeucine, and Fc for endogenous substrates as well as protein FSR. Conclusion: The heart under ECMO shows reduced oxidative metabolism of substrates, including amino acids, while maintaining (i) metabolic flexibility indicated by ability to respond to pyruvate, and (ii) a normal or increased capacity for global protein synthesis, suggesting an improved protein balance.

  10. Prevention of hypovolemic circulatory collapse by IL-6 activated Stat3.

    Directory of Open Access Journals (Sweden)

    Jeffrey A Alten

    Full Text Available Half of trauma deaths are attributable to hypovolemic circulatory collapse (HCC. We established a model of HCC in rats involving minor trauma plus severe hemorrhagic shock (HS. HCC in this model was accompanied by a 50% reduction in peak acceleration of aortic blood flow and cardiomyocyte apoptosis. HCC and apoptosis increased with increasing duration of hypotension. Apoptosis required resuscitation, which provided an opportunity to intervene therapeutically. Administration of IL-6 completely reversed HCC, prevented cardiac dysfunction and cardiomyocyte apoptosis, reduced mortality 5-fold and activated intracardiac signal transducer and activator of transcription (STAT 3. Pre-treatment of rats with a selective inhibitor of Stat3, T40214, reduced the IL-6-mediated increase in cardiac Stat3 activity, blocked successful resuscitation by IL-6 and reversed IL-6-mediated protection from cardiac apoptosis. The hearts of mice deficient in the naturally occurring dominant negative isoform of Stat3, Stat3beta, were completely resistant to HS-induced apoptosis. Microarray analysis of hearts focusing on apoptosis related genes revealed that expression of 29% of apoptosis related genes was altered in HS vs. sham rats. IL-6 treatment normalized the expression of these genes, while T40214 pretreatment prevented IL-6-mediated normalization. Thus, cardiac dysfunction, cardiomyocyte apoptosis and induction of apoptosis pathway genes are important components of HCC; IL-6 administration prevented HCC by blocking cardiomyocyte apoptosis and induction of apoptosis pathway genes via Stat3 and warrants further study as a resuscitation adjuvant for prevention of HCC and death in trauma patients.

  11. Impact of different treatment of whole-body cryotherapy on circulatory parameters. (United States)

    Bonomi, Felice Giulio; De Nardi, Massimo; Fappani, Aldo; Zani, Viviana; Banfi, Giuseppe


    Cryotherapy is commonly used as a procedure to relieve pain symptoms, particularly in inflammatory diseases, injuries and overuse symptoms. A peculiar form of cold therapy or stimulation was proposed 30 years ago for the treatment of rheumatic diseases. The therapy consists in the exposure to very cold air in special cryochambers. The air is maintained at temperatures between -110 and -160°C. The treatment was named whole-body cryotherapy (WBC). It consists in a brief exposure to extreme cold in a temperature-controlled chamber. It is applied to relieve pain and inflammatory symptoms caused by numerous disorders, particularly those associated with rheumatic conditions, and it is recommended for the treatment of arthritis, fibromyalgia and ankylosing spondylitis. The aim of this study was to investigate the effects of different treatment of WBC on blood pressure (BP) and heart rate (HR) parameters in adult subjects characterized from non-pathological values of BP. Eighty subjects (36 females, 44 males, age range 19-80 years) submitted to 4-17 WBC applications for a total of 816 treatments were recruited. Immediately before and after each WBC application systolic and diastolic BP and HR were measured and recorded. We did not find significant differences in BP and HR (p > 0.05). WBC seems to be safe with respect to unwanted BP and HR alterations for adult patients. An individual monitoring of subjects is recommended over the treatment, but pathological changes of circulatory parameters can be considered rare and occasional.

  12. Inter-observer agreement for abdominal CT in unselected patients with acute abdominal pain

    Energy Technology Data Exchange (ETDEWEB)

    Randen, Adrienne van [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Amsterdam (Netherlands); Lameris, Wytze [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Nio, C.Y.; Spijkerboer, Anje M.; Meier, Mark A.; Tutein Nolthenius, Charlotte; Smithuis, Frank; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Bossuyt, Patrick M. [University of Amsterdam, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Boermeester, Marja A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)


    The level of inter-observer agreement of abdominal computed tomography (CT) in unselected patients presenting with acute abdominal pain at the Emergency Department (ED) was evaluated. Two hundred consecutive patients with acute abdominal pain were prospectively included. Multi-slice CT was performed in all patients with intravenous contrast medium only. Three radiologists independently read all CT examinations. They recorded specific radiological features and a final diagnosis on a case record form. We calculated the proportion of agreement and kappa values, for overall, urgent and frequently occurring diagnoses. The mean age of the evaluated patients was 46 years (range 19-94), of which 54% were women. Overall agreement on diagnoses was good, with a median kappa of 0.66. Kappa values for specific urgent diagnoses were excellent, with median kappa values of 0.84, 0.90 and 0.81, for appendicitis, diverticulitis and bowel obstruction, respectively. Abdominal CT has good inter-observer agreement in unselected patients with acute abdominal pain at the ED, with excellent agreement for specific urgent diagnoses as diverticulitis and appendicitis. (orig.)

  13. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    LENUS (Irish Health Repository)

    Sugrue, Michael


    BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

  14. Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department. (United States)

    He, Lulu; Park, Ellen; Vachhani, Neil; Vogelius, Esben; Thupili, Chakradhar; Udayasankar, Unni


    Diagnostic imaging is often an integral component in the workup of a pediatric patient with acute abdominal pain. The purpose of this study was to compare the diagnostic value of a three-view acute abdominal series (AAS) with that of a single supine view (SSV) in children with acute abdominal pain. All subjects aged ≤18 years that underwent an emergency three-view AAS examination for acute abdominal pain at a single urban hospital system were included. Retrospective evaluation of radiological diagnosis, number of radiological images, further imaging, management, and clinical outcomes was performed. "Positive" AAS studies were compared with corresponding SSV images for direct comparison of diagnostic value. Standard nonparametric statistical evaluation was performed. Five hundred forty-one AAS studies were included in the study. Greater than three radiographs were acquired in 29 % (153/541) of the subjects. Two hundred ninety-nine out of 541 AAS studies included a technically adequate SSV of the abdomen and pelvis. Most AAS examinations were categorized as negative (n = 485; 90 %). Of the 56 examinations initially classified as positive, there was no significant statistical difference between diagnostic accuracy between the AAS and SSV on retrospective evaluation. For pediatric subjects with nontraumatic acute abdominal pain, the yield of conventional radiographic study is exceedingly low. If required, a technically adequate single supine anteroposterior (AP) view of the abdomen and pelvis is sufficient for initial radiographic evaluation while reducing unnecessary radiation exposure to the patient.

  15. Significance of residual abdominal masses in children with abdominal Burkitt's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Karmazyn, B.; Horev, G.; Kornreich, L. [Dept. of Diagnostic Radiology, Schneider Children' s Medical Center of Israel, Petah-Tikva (Israel); Ash, S.; Goshen, Y.; Yaniv, I. [Dept. of Hematology and Oncology, Schneider Children' s Medical Center of Israel, Petah-Tikva (Israel)


    Purpose: To evaluate the natural history of children with abdominal Burkitt's lymphoma who had complete clinical remission and residual abdominal mass after treatment. Material and methods: The charts and imaging findings of all children with abdominal Burkitt's lymphoma treated and followed at our medical center between 1988 and 1999 were reviewed for the presence, management, clinical course, and prognosis of residual mass. Results: Only children who achieved complete clinical remission were included. The study group consisted of 33 children (20 boys and 13 girls) aged 2.6-17.6 years (mean 7.2 years). Of these, seven (20.6 %) were found to have a residual abdominal mass. Two underwent second-look operation with no evidence of viable tumor on histology. The remaining five were followed by imaging studies for 2.2-9.1 years (mean 6.1 years); none relapsed. Conclusion: Residual mass is not uncommon in children with abdominal Burkitt's lymphoma. The presence of residual mass in a child with complete clinical remission does not alter the long-term prognosis. Therefore, in children with Burkitt's lymphoma and residual mass with no other signs of disease activity, expectant watching may be appropriate. (orig.)

  16. Peristaltic Pumping of Blood in micro-vessels of Non-uniform Cross-section

    CERN Document Server

    Misra, J C


    The paper is devoted to a study of the peristaltic motion of blood in the micro-circulatory system. The vessel is considered of non-uniform cross-section. The progressive peristaltic waves are taken to be of sinusoidal nature. The Reynolds number is considered to be small. Blood is considered to be a Herschel-Bulkley fluid. Of particular concern here is to investigate the effects of amplitude ratio, mean pressure gradient, yield stress and the power law index on the velocity distribution, streamline pattern and wall shear stress. Basing upon the study, extensive numerical calculations has been made. The study reveals that peristaltic pumping as well as velocity and wall shear stress are appreciably affected due to the non-uniform geometry of blood vessels. They are also highly sensitive to the magnitude of the amplitude of the amplitude ratio and the value of the fluid index.

  17. Theoretical Prediction of the Pumping Performance of Dry Pumps (Taking the Scroll Pump and the Screw Pump by Way of Example) (United States)

    Sawada, Tadashi; Ohbayashi, Tetsuro

    Since almost all commercially provided dry pumps are of the positive displacement type, the leak flow through clearance between displacement chambers in the pump is a dominant factor which determines pumping performance. Prediction methods for the pumping performance of dry pumps are explained by comparing it to the scroll pump and the screw pump. The scroll pump has long clearances, but the screw pump has relatively short ones, and the volume of the chambers reduces from the inlet toward the outlet in the scroll pump, but that in the screw pump is kept constant throughout the pumping process. Such a structural difference produces a small difference in the way of treating leak flow. These two methods can be applied to the other dry pumps requiring only minor modification.

  18. Radiation-associated circulatory disease mortality in a pooled analysis of 77,275 patients from the Massachusetts and Canadian tuberculosis fluoroscopy cohorts (United States)

    Tran, Van; Zablotska, Lydia B.; Brenner, Alina V.; Little, Mark P.


    High-dose ionising radiation is associated with circulatory disease. Risks associated with lower-dose (Tuberculosis patients in Canada and Massachusetts received multiple diagnostic x-ray fluoroscopic exposures, over a wide range of ages, many at doses <0.5 Gy. We evaluated risks of circulatory-disease mortality associated with <0.5 Gy radiation exposure in a pooled cohort of 63,707 patients in Canada and 13,568 patients in Massachusetts. Under 0.5 Gy there are increasing trends for all circulatory disease (n = 10,209; excess relative risk/Gy = 0.246; 95% CI 0.036, 0.469; p = 0.021) and for ischaemic heart disease (n = 6410; excess relative risk/Gy = 0.267; 95% CI 0.003, 0.552; p = 0.048). All circulatory-disease and ischaemic-heart-disease risk reduces with increasing time since exposure (p < 0.005). Over the entire dose range, there are negative mortality dose trends for all circulatory disease (p = 0.014) and ischaemic heart disease (p = 0.003), possibly due to competing causes of death over this dose interval.These results confirm and extend earlier findings and strengthen the evidence for circulatory-disease mortality radiation risk at doses <0.5 Gy. The limited information on well-known lifestyle/medical risk factors for circulatory disease implies that confounding of the dose trend cannot be entirely excluded. PMID:28287147

  19. The terrestrial silica pump.

    Directory of Open Access Journals (Sweden)

    Joanna C Carey

    Full Text Available Silicon (Si cycling controls atmospheric CO(2 concentrations and thus, the global climate, through three well-recognized means: chemical weathering of mineral silicates, occlusion of carbon (C to soil phytoliths, and the oceanic biological Si pump. In the latter, oceanic diatoms directly sequester 25.8 Gton C yr(-1, accounting for 43% of the total oceanic net primary production (NPP. However, another important link between C and Si cycling remains largely ignored, specifically the role of Si in terrestrial NPP. Here we show that 55% of terrestrial NPP (33 Gton C yr(-1 is due to active Si-accumulating vegetation, on par with the amount of C sequestered annually via marine diatoms. Our results suggest that similar to oceanic diatoms, the biological Si cycle of land plants also controls atmospheric CO(2 levels. In addition, we provide the first estimates of Si fixed in terrestrial vegetation by major global biome type, highlighting the ecosystems of most dynamic Si fixation. Projected global land use change will convert forests to agricultural lands, increasing the fixation of Si by land plants, and the magnitude of the terrestrial Si pump.

  20. Lasers with nuclear pumping

    CERN Document Server

    Melnikov, S P; Sizov, A N; Miley, George H


    This book covers the history of lasers with nuclear pumping (Nuclear Pumped Lasers, NPLs). This book showcases the most important results and stages of NPL development in The Russian Federal Nuclear Center (VNIIEF) as well as other Russian and international laboratories, including laboratories in the United States. The basic science and technology behind NPLs along with potential applications are covered throughout the book. As such, this book: ·         Contains a historical overview of the extensive information developed over the past 40 years of work on NPLs ·         Covers the most important results and stages of NPL development, not just in the Russian Federal Nuclear Center, VNIIEF, but also in other laboratories in Russia, the United States , and some other scattered international laboratories ·         Systematizes the fragmented information accumulated over these years of very active research and development As the first comprehensive discussion of NPLs, students, research...

  1. Diode-pumped laser with improved pumping system (United States)

    Chang, Jim J.


    A laser wherein pump radiation from laser diodes is delivered to a pump chamber and into the lasing medium by quasi-three-dimensional compound parabolic concentrator light channels. The light channels have reflective side walls with a curved surface and reflective end walls with a curved surface. A flow tube between the lasing medium and the light channel has a roughened surface.

  2. Heat-Powered Pump for Liquid Metals (United States)

    Campana, R. J.


    Proposed thermoelectromagnetic pump for liquid metal powered by waste heat; needs no battery, generator, or other external energy source. Pump turns part of heat in liquid metal into pumping energy. In combination with primary pump or on its own, thermoelectric pump circulates coolant between reactor and radiator. As long as there is decay heat to be removed, unit performs function.

  3. 33 CFR 157.126 - Pumps. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Pumps. 157.126 Section 157.126... Washing (COW) System on Tank Vessels Design, Equipment, and Installation § 157.126 Pumps. (a) Crude oil must be supplied to the COW machines by COW system pumps or cargo pumps. (b) The pumps under...

  4. Design of Pumps for Water Hydraulic Systems

    DEFF Research Database (Denmark)

    Klit, Peder; Olsen, Stefan; Bech, Thomas Nørgaard


    This paper considers the development of two pumps for water hydraulic applications. The pumps are based on two different working principles: The Vane-type pump and the Gear-type pump. Emphasis is put on the considerations that should be made to account for water as the hydraulic fluid.......KEYWORDS: water, pump, design, vane, gear....

  5. About Variable Speed Heating and Cooling Pumps


    Cătălin Popovici; Jan Ignat


    The present work has the purpose of underlying the advantages of variable speed heating and cooling pumps use for the perspective of general and particular pumping costs and efficiency. The study approaches comparisons between constant flow pumps and variable flow pumps in different given situations and comparatively analyses the pumping costs.

  6. 46 CFR 119.520 - Bilge pumps. (United States)


    ... 46 Shipping 4 2010-10-01 2010-10-01 false Bilge pumps. 119.520 Section 119.520 Shipping COAST... Ballast Systems § 119.520 Bilge pumps. (a) Each vessel must be provided with bilge pumps in accordance... have a portable hand bilge pump that must be: (1) Capable of pumping water, but not...

  7. 46 CFR 154.1135 - Pumps. (United States)


    ... 46 Shipping 5 2010-10-01 2010-10-01 false Pumps. 154.1135 Section 154.1135 Shipping COAST GUARD... Pumps. (a) Water to the water spray system must be supplied by: (1) A pump that is only for the use of the system; (2) A fire pump; or (3) A pump specially approved by the Commandant (CG-522)....

  8. Pumps in wearable ultrafiltration devices: pumps in wuf devices. (United States)

    Armignacco, Paolo; Garzotto, Francesco; Bellini, Corrado; Neri, Mauro; Lorenzin, Anna; Sartori, Marco; Ronco, Claudio


    The wearable artificial kidney (WAK) is a device that is supposed to operate like a real kidney, which permits prolonged, frequent, and continuous dialysis treatments for patients with end-stage renal disease (ESRD). Its functioning is mainly related to its pumping system, as well as to its dialysate-generating and alarm/shutoff ones. A pump is defined as a device that moves fluids by mechanical action. In such a context, blood pumps pull blood from the access side of the dialysis catheter and return the blood at the same rate of flow. The main aim of this paper is to review the current literature on blood pumps, describing the way they have been functioning thus far and how they are being engineered, giving details about the most important parameters that define their quality, thus allowing the production of a radar comparative graph, and listing ideal pumps' features.

  9. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain]. (United States)

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila


    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  10. Extracorporeal gas exchange with the DeltaStream rotary blood pump in experimental lung injury. (United States)

    Dembinski, Rolf; Kopp, Rüdger; Henzler, Dietrich; Hochhausen, Nadine; Oslender, Nicole; Max, Martin; Rossaint, Rolf; Kuhlen, Ralf


    In most severe cases of the acute respiratory distress syndrome, veno-venous extracorporeal membrane oxygenation (ECMO) can be used to facilitate gas exchange. However, the clinical use is limited due to the size and the concomitant risk of severe adverse events of conventionally-used centrifugal blood pumps with high extracorporeal blood volumes. The DeltaStream blood pump is a small-sized rotary blood pump that may reduce extracorporeal blood volume, foreign surfaces, contact activation of the coagulation system, and blood trauma. The aim of the present study was to test the safety and efficacy of the DeltaStream pump for ECMO in animals with normal lung function and experimental acute lung injury (ALI). Therefore, veno-venous ECMO was performed for 6 hours in mechanically ventilated pigs with normal lung function (n=6) and with ALI induced by repeated lung lavage (n=6) with a blood flow of 30% of the cardiac output. Gas flow with a FiO2 of 1.0 was set to equal blood flow. With a mean activated clotting time of 121 +/- 22 s, no circulatory impairment or thrombus formation was revealed during ECMO. Furthermore, free plasma Hb did not increase. In controls, hemodynamics and gas exchange remained unchanged. In animals with ALI, hemodynamics remained stable and gas transfer across the extracorporeal oxygenators was optimal, but only in 2 animals was a marked increase in PaO2 observed. CO2 removal was efficacious in all animals. We concluded that the DeltaStream blood pump may be used for veno-venous ECMO without major blood damage or hemodynamic impairment.

  11. High Temperature Thermoacoustic Heat Pump

    Energy Technology Data Exchange (ETDEWEB)

    Tijani, H.; Spoelstra, S. [ECN Biomass and Energy Efficiency, Petten (Netherlands)


    Thermoacoustic technology can provide new types of heat pumps that can be deployed in different applications. Thermoacoustic heat pumps can for example be applied in dwellings to generate cooling or heating. Typically, space and water heating makes up about 60% of domestic and office energy consumption. The application of heat pumps can contribute to achieve energy savings and environmental benefits by reducing CO2 and NOx emissions. This paper presents the study of a laboratory scale thermoacoustic-Stirling heat pump operating between 10C and 80C which can be applied in domestics and offices. The heat pump is driven by a thermoacoustic-Stirling engine. The experimental results show that the heat pump pumps 250 W of heat at 60C at a drive ratio of 3.6 % and 200 W at 80C at a drive ratio of 3.5 %. The performance for both cases is about 40% of the Carnot performance. The design, construction, and performance measurements of the heat pump will be presented and discussed.

  12. [Treatment by external insulin pump]. (United States)

    Clavel, Sylvaine


    Since the recent recommendations by the French speaking association for research on diabetes and metabolic illnesses (Alfediam), treatment by insulin pump has found itself in competition with basal-bolus, a procedure using similar injections of insulin which has become a benchmark treatment. The latest Alfediam guidelines focus on defining ways of treating diabetics with an external insulin pump.

  13. Ion-Pumping Microbial Rhodopsins

    Directory of Open Access Journals (Sweden)

    Hideki eKandori


    Full Text Available Rhodopsins are light-sensing proteins used in optogenetics. The word rhodopsin originates from the Greek words rhodo and opsis, indicating rose and sight, respectively. Although the classical meaning of rhodopsin is the red-colored pigment in our eyes, the modern meaning of rhodopsin encompasses photoactive proteins containing a retinal chromophore in animals and microbes. Animal and microbial rhodopsins possess 11-cis and all-trans retinal, respectively, to capture light in seven transmembrane α-helices, and photoisomerizations into all-trans and 13-cis forms, respectively, initiate each function. Ion-transporting proteins can be found in microbial rhodopsins, such as light-gated channels and light-driven pumps, which are the main tools in optogenetics. Light-driven pumps, such as archaeal H+ pump bacteriorhodopsin (BR and Cl- pump halorhodopsin (HR, were discovered in the 1970s, and their mechanism has been extensively studied. On the other hand, different kinds of H+ and Cl- pumps have been found in marine bacteria, such as proteorhodopsin (PR and Fulvimarina pelagi rhodopsin (FR, respectively. In addition, a light-driven Na+ pump was found, Krokinobacter eikastus rhodopsin 2 (KR2. These light-driven ion-pumping microbial rhodopsins are classified as DTD, TSA, DTE, NTQ and NDQ rhodopsins for BR, HR, PR, FR and KR2, respectively. Recent understanding of ion-pumping microbial rhodopsins is reviewed in this paper.

  14. Constant-Pressure Hydraulic Pump (United States)

    Galloway, C. W.


    Constant output pressure in gas-driven hydraulic pump would be assured in new design for gas-to-hydraulic power converter. With a force-multiplying ring attached to gas piston, expanding gas would apply constant force on hydraulic piston even though gas pressure drops. As a result, pressure of hydraulic fluid remains steady, and power output of the pump does not vary.

  15. Mortality due to diseases of the circulatory system among the elderly population in Brazilian Amazon: temporal and spatial analysis

    Directory of Open Access Journals (Sweden)

    Karine Vila Real Nunes


    Full Text Available INTRODUCTION: Circulatory Diseases (CD are the major cause of death among the elderly population in Brazilian Amazon. OBJECTIVE: to analyze standardized mortality rates of diseases of the circulatory system (DCS, according to the main causes of death among the elderly, in microregions of the Brazilian Amazon, in the period of 1998 - 2007. METHODS: ecological study of mortality rates distribution standardized by CD and corrected by deaths from poorly defined causes among the elderly (> 65 years of age who lived in Brazilian Amazon in the period of 1998 - 2007. The analysis were carried out by the linear regression, trend, and spatial distribution of Kernel. RESULTS: We verified an increasing trend in mortality by CD (β1 = 28.34 p = 0.01, due to the increasing trend in the States of Maranhão and Tocantins. The central region of Mato Grosso, Northern Tocantins, Eastern Pará and Southwestern Maranhão present hot spots with the highest mortality rates. Males present higher rates when compared to females all over the region; rates of mortality due to acute myocardial infarction and hypertensive disease present the same spatial standard of the CD group and the rates of cerebrovascular diseases present a different spatial distribution standard. Increment in mortality rates according to age was observed: the greater the age, the higher is mortality by CD. CONCLUSION: The Brazilian Amazon presents an increasing trend with high rates of mortality by the circulatory diseases, and the geographic areas with the highest rates are around the Brazilian Amazon, in the states of Tocantins, Maranhão and Mato Grosso.

  16. A comparison of central venous-arterial and mixed venous-arterial carbon dioxide tension gradient in circulatory failure. (United States)

    Ho, K M; Harding, R; Chamberlain, J


    The arterial and mixed venous carbon dioxide tension gradient has been shown to increase when there is a decrease in cardiac output. Monitoring central venous gases is an attractive alternative to monitoring mixed venous gases in circulatory failure because central venous catheterisation is a less invasive procedure than pulmonary artery catheterisation. This study aims to evaluate the agreement between central venous-arterial carbon dioxide (CVA-CO2) and mixed venous-arterial carbon dioxide (SVA-CO2) tension gradients and assess whether CVA-CO2 tension gradient can be used to predict cardiac output in circulatory failure. Samples of arterial, central venous and mixed venous blood were obtained from 16 patients with circulatory failure at different inspired oxygen concentrations and cardiac indexes within 24 hours of study enrolment. CVA-CO2 and SVA-CO2 tension gradient were not interchangeable numerically (bias = 0.14 mmHg, 95% limits of agreement: -3.0 to 3.2 mmHg). CVA-CO2 (Spearman correlation coefficient r = -0.385) and SVA-CO, (r = -0.578) tension gradient were significantly correlated with the cardiac index but the cardiac index only accounted for 21% and 32% of the variability of CVA-CO, and SVA-CO2 tension gradient, respectively. The ability of CVA-CO2 tension gradient (area under the ROC curve = 0.77, 95% confidence interval [CI]: 0.49-0.99; P = 0.08) to predict a low cardiac output state (cardiac index tension gradient appeared to be limited to their negative predictive value to exclude a low cardiac output state when CVA-CO, or SVA-CO, tension gradient was normal (< or =5 mmHg).

  17. Association of sulfur dioxide exposure with circulatory system deaths in a medium-sized city in Brazil

    Directory of Open Access Journals (Sweden)

    C.T. Amancio


    Full Text Available There is a demonstrable association between exposure to air pollutants and deaths due to cardiovascular diseases. The objective of this study was to estimate the effects of exposure to sulfur dioxide on mortality due to circulatory diseases in individuals 50 years of age or older residing in São José dos Campos, SP. This was a time-series ecological study for the years 2003 to 2007 using information on deaths due to circulatory disease obtained from Datasus reports. Data on daily levels of pollutants, particulate matter, sulfur dioxide (SO2, ozone, temperature, and humidity were obtained from the São Paulo State Environmental Agency. Moving average models for 2 to 7 days were calculated by Poisson regression using the R software. Exposure to SO2 was analyzed using a unipollutant, bipollutant or multipollutant model adjusted for mean temperature and humidity. The relative risks with 95%CI were obtained and the percent decrease in risk was calculated. There were 1928 deaths with a daily mean (± SD of 1.05 ± 1.03 (range: 0-6. Exposure to SO2 was significantly associated with mortality due to circulatory disease: RR = 1.04 (95%CI = 1.01 to 1.06 in the 7-day moving average, after adjusting for ozone. There was an 8.5% decrease in risk in the multipollutant model, proportional to a decrease of SO2 concentrations. The results of this study suggest that residents of medium-sized Brazilian cities with characteristics similar to those of São José dos Campos probably have health problems due to exposure to air pollutants.

  18. Systemic activation of the transient receptor potential vanilloid subtype 4 channel causes endothelial failure and circulatory collapse: Part 2. (United States)

    Willette, Robert N; Bao, Weike; Nerurkar, Sandhya; Yue, Tian-Li; Doe, Chris P; Stankus, Gerald; Turner, Gregory H; Ju, Haisong; Thomas, Heath; Fishman, Cindy E; Sulpizio, Anthony; Behm, David J; Hoffman, Sandra; Lin, Zuojun; Lozinskaya, Irina; Casillas, Linda N; Lin, Min; Trout, Robert E Lee; Votta, Bartholomew J; Thorneloe, Kevin; Lashinger, Erin S R; Figueroa, David J; Marquis, Robert; Xu, Xiaoping


    The transient receptor potential (TRP) vanilloid subtype 4 (V4) is a nonselective cation channel that exhibits polymodal activation and is expressed in the endothelium, where it contributes to intracellular Ca2+ homeostasis and regulation of cell volume. The purpose of the present study was to evaluate the systemic cardiovascular effects of GSK1016790A, a novel TRPV4 activator, and to examine its mechanism of action. In three species (mouse, rat, and dog), the i.v. administration of GSK1016790A induced a dose-dependent reduction in blood pressure, followed by profound circulatory collapse. In contrast, GSK1016790A had no acute cardiovascular effects in the TRPV4-/- null mouse. Hemodynamic analyses in the dog and rat demonstrate a profound reduction in cardiac output. However, GSK1016790A had no effect on rate or contractility in the isolated, buffer-perfused rat heart, and it produced potent endothelial-dependent relaxation of rodent-isolated vascular ring segments that were abolished by nitric-oxide synthase (NOS) inhibition (N-nitro-L-arginine methyl ester; L-NAME), ruthenium red, and endothelial NOS (eNOS) gene deletion. However, the in vivo circulatory collapse was not altered by NOS inhibition (L-NAME) or eNOS gene deletion but was associated with (concentration and time appropriate) profound vascular leakage and tissue hemorrhage in the lung, intestine, and kidney. TRPV4 immunoreactivity was localized in the endothelium and epithelium in the affected organs. GSK1016790A potently induced rapid electrophysiological and morphological changes (retraction/condensation) in cultured endothelial cells. In summary, inappropriate activation of TRPV4 produces acute circulatory collapse associated with endothelial activation/injury and failure of the pulmonary microvascular permeability barrier. It will be important to determine the role of TRPV4 in disorders associated with edema and microvascular congestion.

  19. Structural design of a newly developed pediatric circulatory assist device for Fontan circulation by using shape memory alloy fiber. (United States)

    Shiraishi, Y; Sugai, T K; Tanaka, A; Yoshizawa, M; Yambe, T; Yamada, A; Omran, M H; Shiga, T; Kitano, T; Kamiya, K; Mochizuki, S; Miura, H; Homma, D; Yamagishi, M


    Total cavopulmonary connection (TCPC) is commonly applied for the surgical treatment of congenital heart disease such as single ventricle in pediatric patients. Patients with no ventricle in pulmonary circulation are treated along with Fontan algorithm, in which the systemic venous return is diverted directly to the pulmonary artery without passing through subpulmonary ventricle. In order to promote the pulmonary circulation after Fontan procedure, we developed a newly designed pulmonary circulatory assist device by using shape memory alloy fibers. We developed a pulmonary circulatory assist device as a non-blood contacting mechanical support system in pediatric patients with TCPC. The device has been designed to be installed like a cuff around the ePTFE TCPC conduit, which can contract from outside. We employed a covalent type functional anisotropic shape memory alloy fiber (Biometal, Toki Corporation, Tokyo Japan) as a servo actuator of the pulmonary circulatory assist device. The diameter of this fiber was 100 microns, and its contractile frequency was 2-3 Hz. Heat generation with electric current contracts these fibers and the conduit. The maximum contraction ratio of this fiber is about 7% in length. In order to extend its contractile ratio, we fabricated and installed mechanical structural units to control the length of fibers. In this study, we examined basic contractile functions of the device in the mock system. As a result, the internal pressure of the conduit increased to 63 mmHg by the mechanical contraction under the condition of 400 msec-current supply in the mock examination with the overflow tank of 10 mmHg loading.

  20. Sensitivity Analysis of Median Lifetime on Radiation Risks Estimates for Cancer and Circulatory Disease amongst Never-Smokers (United States)

    Chappell, Lori J.; Cucinotta, Francis A.


    Radiation risks are estimated in a competing risk formalism where age or time after exposure estimates of increased risks for cancer and circulatory diseases are folded with a probability to survive to a given age. The survival function, also called the life-table, changes with calendar year, gender, smoking status and other demographic variables. An outstanding problem in risk estimation is the method of risk transfer between exposed populations and a second population where risks are to be estimated. Approaches used to transfer risks are based on: 1) Multiplicative risk transfer models -proportional to background disease rates. 2) Additive risk transfer model -risks independent of background rates. In addition, a Mixture model is often considered where the multiplicative and additive transfer assumptions are given weighted contributions. We studied the influence of the survival probability on the risk of exposure induced cancer and circulatory disease morbidity and mortality in the Multiplicative transfer model and the Mixture model. Risks for never-smokers (NS) compared to the average U.S. population are estimated to be reduced between 30% and 60% dependent on model assumptions. Lung cancer is the major contributor to the reduction for NS, with additional contributions from circulatory diseases and cancers of the stomach, liver, bladder, oral cavity, esophagus, colon, a portion of the solid cancer remainder, and leukemia. Greater improvements in risk estimates for NS s are possible, and would be dependent on improved understanding of risk transfer models, and elucidating the role of space radiation on the various stages of disease formation (e.g. initiation, promotion, and progression).