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Sample records for abdominal circulatory pump

  1. The abdominal circulatory pump.

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    Andrea Aliverti

    Full Text Available Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs is the difference between changes in trunk and body volume. This is so because both trunk and body volume change identically with breathing and gas expansion or compression. During tidal breathing Vbs was 50-75 ml with an ejection fraction of 4-6% and an output of 750-1500 ml/min. Step increases in abdominal pressure resulted in rapid emptying presumably from the liver with a time constant of 0.61+/-0.1SE sec. followed by slower flow from non-hepatic viscera. The filling time constant was 0.57+/-0.09SE sec. Splanchnic emptying shifted up to 650 ml blood. With emptying, the increased hepatic vein flow increases the blood pressure at its entry into the inferior vena cava (IVC and abolishes the pressure gradient producing flow between the femoral vein and the IVC inducing blood pooling in the legs. The findings are important for exercise because the larger the Vbs the greater the perfusion of locomotor muscles. During asystolic cardiac arrest we calculate that appropriate timing of abdominal compression could produce an output of 6 L/min. so that the abdominal circulatory pump might act as an auxiliary heart.

  2. The Abdominal Circulatory Pump

    OpenAIRE

    Andrea Aliverti; Dario Bovio; Irene Fullin; Dellacà, Raffaele L.; Antonella Lo Mauro; Antonio Pedotti; Macklem, Peter T.

    2009-01-01

    Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs) is the difference between changes in trunk ...

  3. The “Abdominal Circulatory Pump”: An Auxiliary Heart during Exercise?

    OpenAIRE

    Uva, Barbara; Aliverti, Andrea; Bovio, Dario; Kayser, Bengt

    2016-01-01

    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 ± 7 year, 70 ± 11 kg, 1.78 ± 0.1 m, 3 F) performed plantar flexion exercise at ~4 METs. Changes in body volume (ΔVb) and trunk ...

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

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    Barbara eUva

    2016-01-01

    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’.

  5. FEATURES OF LONG-TERM MECHANICAL CIRCULATORY SUPPORT WITH CONTINUOUS-FLOW PUMP

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    G. P. Itkin

    2012-01-01

    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. 

  6. Optimization of Centrifugal Pump Characteristic Dimensions for Mechanical Circulatory Support Devices.

    Science.gov (United States)

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

    2016-01-01

    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.

  7. Optimization of Centrifugal Pump Characteristic Dimensions for Mechanical Circulatory Support Devices.

    Science.gov (United States)

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

    2016-01-01

    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. PMID:27258221

  8. Safety and Feasibility of Laparoscopic Abdominal Surgery in Patients With Mechanical Circulatory Assist Devices.

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    Ashfaq, Awais; Chapital, Alyssa B; Johnson, Daniel J; Staley, Linda L; Arabia, Francisco A; Harold, Kristi L

    2016-10-01

    Objectives Increasing number of mechanical circulatory assist devices (MCADs) are being placed in heart failure patients. Morbidity from device placement is high and the outcome of patients who require noncardiac surgery after, is unclear. As laparoscopic interventions are associated with decreased morbidity, we examined the impact of such procedures in these patients. Methods A retrospective review was conducted on 302 patients who underwent MCAD placement from 2005 to 2012. All laparoscopic abdominal surgeries were included and impact on postoperative morbidity and mortality studied. Results Ten out of 16 procedures were laparoscopic with 1 conversion to open. Seven patients had a HeartMate II, 2 had Total Artificial Hearts, and 1 had CentriMag. Four patients had devices for ischemic cardiomyopathy and 6 cases were emergent. Surgeries included 6 laparoscopic cholecystectomies, 2 exploratory laparoscopies, 1 laparoscopic colostomy takedown, and 1 laparoscopic ventral hernia repair with mesh. Median age of the patients was 63 years (range, 29-79 years). Median operative time was 123 minutes (range, 30-380 minutes). Five of 10 patients were on preoperative anticoagulation with average intraoperative blood loss of 150 mL (range, 20-700 mL). There were 3 postoperative complications; acute respiratory failure, acute kidney injury and multisystem organ failure resulting in death not related to the surgical procedure. Conclusion The need for noncardiac surgery in post-MCAD patients is increasing due to limited donors and due to more durable and longer support from newer generation assist devices. While surgery should be approached with caution in this high-risk group, laparoscopic surgery appears to be a safe and successful treatment option. PMID:26839214

  9. Antithrombogenic properties of a monopivot magnetic suspension centrifugal pump for circulatory assist.

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    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

    2008-06-01

    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.

  10. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices.

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

    2015-08-01

    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.

  11. Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices.

    Science.gov (United States)

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

    2015-08-01

    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. PMID:26234452

  12. 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

    2011-01-01

    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.

  13. A new method of providing pulsatile flow in a centrifugal pump: assessment of pulsatility using a mock circulatory system.

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

    2008-06-01

    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.

  14. Frequency of seal disruption with the sarns centrifugal pump in postcardiotomy circulatory assist.

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

    1994-03-01

    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.

  15. Interaction of an idealized cavopulmonary circulation with mechanical circulatory assist using an intravascular rotary blood pump.

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    Bhavsar, Sonya S; Moskowitz, William B; Throckmorton, Amy L

    2010-10-01

    This study evaluated the performance of an intravascular, percutaneously-inserted, axial flow blood pump in an idealized total cavopulmonary connection (TCPC) model of a Fontan physiology. This blood pump, intended for placement in the inferior vena cava (IVC), is designed to augment pressure and blood flow from the IVC to the pulmonary circulation. Three different computational models were examined: (i) an idealized TCPC without a pump; (ii) an idealized TCPC with an impeller pump; and (iii) an idealized TCPC with an impeller and diffuser pump. Computational fluid dynamics analyses of these models were performed to assess the hydraulic performance of each model under varying physiologic conditions. Pressure-flow characteristics, fluid streamlines, energy augmentation calculations, and blood damage analyses were evaluated. Numerical predictions indicate that the pump with an impeller and diffuser blade set produces pressure generations of 1 to 16 mm Hg for rotational speeds of 2000 to 6000 rpm and flow rates of 1 to 4 L/min. In contrast, for the same flow range, the model with the impeller only in the IVC demonstrated pressure generations of 1 to 9 mm Hg at rotational speeds of 10,000 to 12,000 rpm. Influence of blood viscosity was found to be insignificant at low rotational speeds with minimal performance deviation at higher rotational speeds. Results from the blood damage index analyses indicate a low probability for damage with maximum damage index levels less than 1% and maximum fluid residence times below 0.6 s. The numerical predictions further indicated successful energy augmentation of the TCPC with a pump in the IVC. These results support the continued design and development of this cavopulmonary assist device. PMID:20964699

  16. 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

    2016-01-01

    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.

  17. THE FIRST EXPERIENCE IN CLINICAL APPLICATION OF DOMESTIC CIRCULATORY SUPPORT DEVICE ON BASIS OF IMPLANTABLE AXIAL PUMP FOR TWO STAGE HEART TRANSPLANTATION

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    S. V. Gautier

    2013-01-01

    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. 

  18. Centrifugal pump or pneumatic ventricle for short-term mechanical circulatory support?

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

    1989-05-01

    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.

  19. MedTech Mag-Lev, single-use, extracorporeal magnetically levitated centrifugal blood pump for mid-term circulatory support.

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

    2013-01-01

    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. PMID:23644611

  20. MedTech Mag-Lev, single-use, extracorporeal magnetically levitated centrifugal blood pump for mid-term circulatory support.

    Science.gov (United States)

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

    2013-01-01

    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.

  1. Augmentation of abdominal organ perfusion during cardiopulmonary bypass with a novel intra-aortic pulsatile catheter pump

    NARCIS (Netherlands)

    Gu, YJ; De Kroon, T; Elstrodt, JM; van Oeveren, W; Boonstra, PW; Rakhorst, G

    2005-01-01

    Background: Current pulsatile pumps for cardiopulmonary bypass (CPB) are far from satisfactory because of the poor pulsatility. This study was undertaken to examine the efficiency of a novel pulsatile catheter pump on pulsatility and its effect on abdominal organ perfusion during CPB. Methods: Twelv

  2. 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

    2002-09-01

    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.

  3. 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

    2014-06-01

    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

  4. Transfusion associated circulatory overload

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    Naveen Agnihotri

    2014-01-01

    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.

  5. [Abdominal compartment syndrome].

    Science.gov (United States)

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  6. Mechanical circulatory support for destination therapy.

    Science.gov (United States)

    Tozzi, Piergiorgio; Hullin, Roger

    2016-01-01

    Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical condition, quality of life and life expectancy. This treatment is called destination therapy (DT) and we estimate that in Switzerland more than 120 patients per year could benefit from it. In the last 10 years, design of the devices, implantation techniques and prognoses have changed dramatically. The key to successful therapy with a left ventricular assist device is appropriate patient selection, although we are still working on the definition of reliable inclusion and exclusion criteria and optimal timing for surgical implantation. Devices providing best long-term results are continuous flow, rotary or axial blood pumps implanted using minimally invasive techniques on a beating heart. These new devices (Thoratec HeartMate II and HeartWare HVAD) have only a single moving part, and have improved durability with virtually 10 years freedom from mechanical failure. In selected patients, the overall actuarial survival of DT patients is 75% at 1 year and 62% at 2 years, with a clear improvement in quality of life compared with medical management only. Complications include bleeding and infections; their overall incidence is significantly lower than with previous devices and their management is well defined. DT is evolving into an effective and reasonably cost-effective treatment option for a growing population of patients not eligible for heart transplant, showing encouraging survival rates at 2 years and providing clear improvement in quality of life. The future is bright for people suffering from chronic heart failure. PMID:26945160

  7. The course of circulatory and cerebral recovery after circulatory arrest: influence of pre-arrest, arrest and post-arrest factors.

    Science.gov (United States)

    Jørgensen, E O; Holm, S

    1999-11-01

    We evaluated the influence of pre-arrest, arrest and post-arrest factors on circulatory and neurological recovery for up to 1 year following circulatory arrest of cardio-pulmonary aetiology in 231 patients. Initially, all patients were unconscious and 106 had some cortical activity recorded in the immediate post-resuscitation EEG (Group I), while 125 had no such activity initially (Group II). The following variables were explored: age, sex, medical history, cause and location of arrest, initial cardiac dysrhythmia, duration of life support, metabolic acidosis, pulse-pressure product and heart pump function capacity early after resuscitation. Outcome measures were duration and quality of circulatory survival, cause of death, neurological recovery and ultimate outcome. First year survival was 33% in Group I and 16% in Group II. Severe heart failure and brain death occurred mainly in Group II. Circulatory recovery was negatively influenced by out-of-hospital arrest, metabolic acidosis and pulse-pressure products below 150. Neurological recovery was negatively influenced by initial dysrhythmias other than ventricular fibrillation, pulse-pressure products below 150, post-arrest heart failure and/or pulmonary complications. It seems that circulatory and cerebral outcomes are mainly determined by the global ischaemic insults sustained during the circulatory arrest period. PMID:10625157

  8. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

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

    2016-01-01

    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....

  9. Abdominal Adhesions

    Science.gov (United States)

    ... adhesions? Abdominal adhesions can cause intestinal obstruction and female infertility—the inability to become pregnant after a year of trying. Abdominal adhesions can lead to female infertility by preventing fertilized eggs from reaching the uterus, ...

  10. 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

    Directory of Open Access Journals (Sweden)

    Luiz Fernando KUBRUSLY

    2000-06-01

    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.

  11. [Organ donation after circulatory death].

    Science.gov (United States)

    de Jonge, J; Kalisvaart, M; van der Hoeven, M; Epker, J; de Haan, J; IJzermans, J N M; Grüne, F

    2016-02-01

    Approximately 17 million inhabitants live in the Netherlands. The number of potential organ donors in 1999 was the lowest in Europe with only 10 donors per million inhabitants. Medical associations, public health services, health insurance companies and the government had to find common solutions in order to improve organ allocation, logistics of donations and to increase the number of transplantations. After a prolonged debate on medical ethical issues of organ transplantation, all participants were able to agree on socio-medico-legal regulations for organ donation and transplantation. In addition to improving the procedure for organ donation after brain death (DBD) the most important step was the introduction of organ donation after circulatory death (DCD). Measures such as the introduction of a national organ donor database, improved information to the public, further education on intensive care units (ICU), guidelines for end of life care on the ICU, establishment of transplantation coordinators on site, introduction of autonomous explantation teams and strict procedures on the course of organ donations, answered many practical issues about logistics and responsibilities for DBD and DCD. In 2014 the number of postmortem organ donations rose to 16.4 per million inhabitants. Meanwhile, up to 60 % of organ donations in the Netherlands originate from a DCD procedure compared to approximately 10 % in the USA. This overview article discusses the developments and processes of deceased donation in the Netherlands after 15 years of experience with DCD. PMID:26810404

  12. Abdominal trauma

    International Nuclear Information System (INIS)

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  13. Abdominal sounds

    Science.gov (United States)

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  14. [Circulatory failure in chronic glomerulo- and pyelonephritis].

    Science.gov (United States)

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

    1982-01-01

    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. Abdominal Sepsis.

    Science.gov (United States)

    De Waele, Jan J

    2016-08-01

    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. PMID:27363829

  16. Representations of the Human Circulatory System

    Science.gov (United States)

    Lopez-Manjon, Asuncion; Angon, Yolanda Postigo

    2009-01-01

    There is no agreement about the robustness of intuitive representations of the circulatory system and their susceptibility to change by instruction. In this paper, we analyse to what extent students with varying degrees of biology instruction and different ages (High School Health Science and Social Science students and first and final year…

  17. Abdominal Pain

    Science.gov (United States)

    ... relaxation. Guided imagery for abdominal pain About self-hypnosis and kids See YourChild : Pain and Your Child or Teen for more detail ... how to help your baby cope with the pain of medical procedures, circumcision, and teething. ... Helping Kids YourChild : A Look at Biofeedback YourChild : ...

  18. Pathophysiological roles of peroxynitrite in circulatory shock.

    Science.gov (United States)

    Szabó, Csaba; Módis, Katalin

    2010-09-01

    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.

  19. Haemodynamic and respiratory effects of an abdominal compression binder

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... implications for the risk of deep venous thrombosis formation.......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...... were measured in supine position with venous occlusion plethysmography. In an upright-seated position arterial oxygen saturation was measured by a pulseoxymeter for 1 h before spirometry was performed with a turbine flow measurement device. All the tests were performed in a randomized order...

  20. Haemodynamic and respiratory effects of an abdominal compression binder

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... implications for the risk of deep venous thrombosis formation Udgivelsesdato: 2008/11......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...... were measured in supine position with venous occlusion plethysmography. In an upright-seated position arterial oxygen saturation was measured by a pulseoxymeter for 1 h before spirometry was performed with a turbine flow measurement device. All the tests were performed in a randomized order...

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

    OpenAIRE

    Rodrigo de Lima e Souza; Bruno Tavares Apgaua; João Daniel Milhomens; Francisco Tadeu Motta Albuquerque; Luiz Antônio Carneiro; Márcio Henrique Mendes; Tiago Carvalho Garcia; Clerisson Paiva; Felipe Ladeia; Deiler Célio Jeunon

    2016-01-01

    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 b...

  2. Organ donation after circulatory death: the forgotten donor?

    OpenAIRE

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

    2006-01-01

    Donation after circulatory death (DCD) can be performed on neurologically intact donors who do not fulfill neurologic or brain death criteria before circulatory arrest. This commentary focuses on the most controversial donor-related issues anticipated from mandatory implementation of DCD for imminent or cardiac death in hospitals across the USA. We conducted a nonstructured review of selected publications and websites for data extraction and synthesis. The recommended 5 min of circulatory arr...

  3. THE PUCA PUMP - A LEFT-VENTRICULAR ASSIST DEVICE

    NARCIS (Netherlands)

    VERKERKE, B; DEMUINCK, ED; RAKHORST, G; BLANKSMA, PK

    1993-01-01

    Left ventricular assist devices (LVADs) that are being used clinically still have specific drawbacks. Therefore, a new concept for mechanical circulatory support was developed, the pulsatile catheter (PUCA) pump. It consists of an extracorporeally placed, pneumatically driven membrane pump that is c

  4. Abdominal Aortic Aneurysms: Treatments

    Science.gov (United States)

    ... access catheters Vertebroplasty Women and vascular disease Women's health Social Media Facebook Twitter ... Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists are vascular ...

  5. 77 FR 16038 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-03-19

    ... require the creation of an abdominal pump pocket. The HVAS is indicated for use as a bridge to cardiac transplantation in patients who are at risk of death from refractory, advanced heart failure. On April 26, 2012... shocks as well as bradycardia demand mode cardiac pacing. The study provides data from the treatment...

  6. Risk factors and outcomes in transfusion-associated circulatory overload

    OpenAIRE

    Murphy, EL; Kwaan, N; Looney, MR; Gajic, O; Hubmayr, RD; Gropper, MA; Koenigsberg, M; Wilson, G.; Matthay, M; Bacchetti, P.; Toy, P

    2013-01-01

    Background: Transfusion-associated circulatory overload is characterized by new respiratory distress and hydrostatic pulmonary edema within 6 hours after blood transfusion, but its risk factors and outcomes are poorly characterized. Methods: Using a case control design, we enrolled 83 patients with severe transfusion-associated circulatory overload identified by active surveillance for hypoxemia and 163 transfused controls at the University of California, San Francisco (UCSF) and Mayo Clinic ...

  7. The CIHR Circulatory and Respiratory Health Institute

    Directory of Open Access Journals (Sweden)

    Malcolm King

    2000-01-01

    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.

  8. Anticoagulation for pediatric mechanical circulatory support.

    Science.gov (United States)

    Annich, Gail; Adachi, Iki

    2013-06-01

    Extracorporeal life support applications have evolved considerably in recent years. However, the blood-biomaterial interface remains incompletely understood, and management of the acute inflammatory response and coagulation pathways continues to be challenging. At present, the gold standard for anticoagulation is unfractionated heparin. Since the inception of extracorporeal life support, the mainstay for anticoagulation monitoring has been activated clotting time. However, alongside the technological evolution in extracorporeal life support, the methods for monitoring heparin have also become more sophisticated, adding additional layers of complexity to creating an ideal safe protocol for anticoagulation during extracorporeal life support. To address this, the Extracorporeal Life Support Organization has formed an Anticoagulation Task Force to help direct both a consensus statement and potential guidelines within which the multiple monitoring methods can be customized for extracorporeal life support. One key question that remains in the use of these monitoring methods is whether the objective during extracorporeal life support is to anticoagulate the circuit to prevent thrombus formation within the extracorporeal device or whether it is to systemically anticoagulate the patient. This review details all current monitoring methods and highlights how they can be used during pediatric mechanical circulatory support. PMID:23735984

  9. [Temporary use of centrifugal pump for pump thrombosis in patients with paracorporeal ventricular assist device].

    Science.gov (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

    2015-05-01

    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.

  10. [Temporary use of centrifugal pump for pump thrombosis in patients with paracorporeal ventricular assist device].

    Science.gov (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

    2015-05-01

    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. PMID:25963778

  11. Abdominal Pain or Cramping

    Science.gov (United States)

    ... Body & lifestyle changes > Abdominal pain or cramping Abdominal pain or cramping E-mail to a friend Please ... signs of severe pain. What causes mild belly pain in pregnancy? There are different causes for mild ...

  12. A multiple disk centrifugal pump as a blood flow device.

    Science.gov (United States)

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

    1990-02-01

    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. PMID:2312140

  13. Assessment of left heart and pulmonary circulation flow dynamics by a new pulsed mock circulatory system

    Science.gov (United States)

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

    2010-05-01

    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.

  14. MECHANISMS OF RIGHT VENTRICULAR FAILURE AND BIVENTRICULAR MECHANICAL CIRCULATORY SUPPORT

    Directory of Open Access Journals (Sweden)

    G. P. Itkin

    2013-01-01

    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. 

  15. Abdominal contributions to cardiorenal dysfunction in congestive heart failure.

    Science.gov (United States)

    Verbrugge, Frederik H; Dupont, Matthias; Steels, Paul; Grieten, Lars; Malbrain, Manu; Tang, W H Wilson; Mullens, Wilfried

    2013-08-01

    Current pathophysiological models of congestive heart failure unsatisfactorily explain the detrimental link between congestion and cardiorenal function. Abdominal congestion (i.e., splanchnic venous and interstitial congestion) manifests in a substantial number of patients with advanced congestive heart failure, yet is poorly defined. Compromised capacitance function of the splanchnic vasculature and deficient abdominal lymph flow resulting in interstitial edema might both be implied in the occurrence of increased cardiac filling pressures and renal dysfunction. Indeed, increased intra-abdominal pressure, as an extreme marker of abdominal congestion, is correlated with renal dysfunction in advanced congestive heart failure. Intriguing findings provide preliminary evidence that alterations in the liver and spleen contribute to systemic congestion in heart failure. Finally, gut-derived hormones might influence sodium homeostasis, whereas entrance of bowel toxins into the circulatory system, as a result of impaired intestinal barrier function secondary to congestion, might further depress cardiac as well as renal function. Those toxins are mainly produced by micro-organisms in the gut lumen, with presumably important alterations in advanced heart failure, especially when renal function is depressed. Therefore, in this state-of-the-art review, we explore the crosstalk between the abdomen, heart, and kidneys in congestive heart failure. This might offer new diagnostic opportunities as well as treatment strategies to achieve decongestion in heart failure, especially when abdominal congestion is present. Among those currently under investigation are paracentesis, ultrafiltration, peritoneal dialysis, oral sodium binders, vasodilator therapy, renal sympathetic denervation and agents targeting the gut microbiota. PMID:23747781

  16. [The diseases of circulatory system in employees of railway transport].

    Science.gov (United States)

    Molodtsov, R N; Shemetova, G N

    2013-01-01

    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.

  17. An Integrated Simulation Tool for Modeling the Human Circulatory System

    Science.gov (United States)

    Asami, Ken'ichi; Kitamura, Tadashi

    This paper presents an integrated simulation of the circulatory system in physiological movement. The large circulatory system model includes principal organs and functional units in modules in which comprehensive physiological changes such as nerve reflexes, temperature regulation, acid/base balance, O2/CO2 balance, and exercise are simulated. A beat-by-beat heart model, in which the corresponding electrical circuit problems are solved by a numerical analytic method, enables calculation of pulsatile blood flow to the major organs. The integration of different perspectives on physiological changes makes this simulation model applicable for the microscopic evaluation of blood flow under various conditions in the human body.

  18. Circular pump support of blood circulation in the human body

    Science.gov (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.

    2016-10-01

    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.

  19. A straight path centrifugal blood pump concept in the Capiox centrifugal pump.

    Science.gov (United States)

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

    1993-07-01

    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.

  20. 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)

    2007-11-15

    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.

  1. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

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

    1998-07-01

    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. PMID:9737070

  2. 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

    1996-01-01

    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

  3. Organ donation after circulatory death: the forgotten donor?

    Science.gov (United States)

    Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

    2006-01-01

    Donation after circulatory death (DCD) can be performed on neurologically intact donors who do not fulfill neurologic or brain death criteria before circulatory arrest. This commentary focuses on the most controversial donor-related issues anticipated from mandatory implementation of DCD for imminent or cardiac death in hospitals across the USA. We conducted a nonstructured review of selected publications and websites for data extraction and synthesis. The recommended 5 min of circulatory arrest does not universally fulfill the dead donor rule when applied to otherwise neurologically intact donors. Scientific evidence from extracorporeal perfusion in circulatory arrest suggests that the procurement process itself can be the event causing irreversibility in DCD. Legislative abandonment of the dead donor rule to permit the recovery of transplantable organs is necessary in the absence of an adequate scientific foundation for DCD practice. The designation of organ procurement organizations or affiliates to obtain organ donation consent introduces self-serving bias and conflicts of interest that interfere with true informed consent. It is important that donors and their families are not denied a 'good death', and the impact of DCD on quality of end-of-life care has not been satisfactorily addressed to achieve this. PMID:17020597

  4. The margin of safety in the use of a straight path centrifugal blood pump.

    Science.gov (United States)

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

    1994-09-01

    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.

  5. Physiologic benefits of pulsatile perfusion during mechanical circulatory support for the treatment of acute and chronic heart failure in adults.

    Science.gov (United States)

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

    2010-07-01

    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.

  6. 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.

  7. [Inflammatory abdominal aortic aneurysm].

    Science.gov (United States)

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

    2000-01-01

    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.

  8. Centrifugal pumps

    CERN Document Server

    Anderson, HH

    1981-01-01

    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

  9. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; 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)

    2005-08-01

    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.

  10. Abdominal Pain Syndrome

    Science.gov (United States)

    ... inspection of a drop of urine), and urine culture for bacterial infection. Stools can be analyzed for ... Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity Digestive Health Topics Abdominal Pain Syndrome Belching, Bloating, ...

  11. Abdominal ultrasound (image)

    Science.gov (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 ...

  12. Imaging in Tuberculosis abdominal

    International Nuclear Information System (INIS)

    In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed

  13. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    Science.gov (United States)

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. PMID:26225503

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

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos

    2012-01-01

    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.

  15. Belgian modified classification of Maastricht for donors after circulatory death

    OpenAIRE

    Evrard, Patrick; Belgian Working Group on DCD National Protocol; Lois, Fernande; Darius, Tom; De Pauw, Luc; Hantson, Philippe; Jacquemin, Dominique; Schamps, Geneviève; Van Deynse, Dominique; Rondelet, Benoît; Verschuren, Franck

    2014-01-01

    BACKGROUND: "Non-heart-beating donors," or, in a more recent and international definition, "donors after circulatory death," are a potential and additional group of deceased persons who are able to add organs to the pool. METHODS: A new classification is proposed on the basis of the result of a consensus of experts issued from all Belgian transplant centers. RESULTS: The first level of definition is simple and based on whether the situation is uncontrolled (categories I and II) or contr...

  16. Singular divergence instability thresholds of kinematically constrained circulatory systems

    International Nuclear Information System (INIS)

    Static instability or divergence threshold of both potential and circulatory systems with kinematic constraints depends singularly on the constraints' coefficients. Particularly, the critical buckling load of the kinematically constrained Ziegler's pendulum as a function of two coefficients of the constraint is given by the Plücker conoid of degree n=2. This simple mechanical model exhibits a structural instability similar to that responsible for the Velikhov–Chandrasekhar paradox in the theory of magnetorotational instability.

  17. Effect of Kampo formulations (traditional Chinese medicine) on circulatory parameters.

    Science.gov (United States)

    Xu, F H; Uebaba, K

    1999-01-01

    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

  18. Abdominal emergencies in pediatrics.

    Science.gov (United States)

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

    2016-05-01

    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.

  19. Heat pumps

    CERN Document Server

    Macmichael, DBA

    1988-01-01

    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.

  20. Childhood abdominal cystic lymphangioma

    International Nuclear Information System (INIS)

    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. Conclusions: US

  1. Abdominal Dual Energy Imaging

    Science.gov (United States)

    Sommer, F. Graham; Brody, William R.; Cassel, Douglas M.; Macovski, Albert

    1981-11-01

    Dual energy scanned projection radiography of the abdomen has been performed using an experimental line-scanned radiographic system. Digital images simultaneously obtained at 85 and 135 kVp are combined, using photoelectric/Compton decomposition algorithms to create images from which selected materials are cancelled. Soft tissue cancellation images have proved most useful in various abdominal imaging applications, largely due to the elimination of obscuring high-contrast bowel gas shadows. These techniques have been successfully applied to intravenous pyelography, oral cholecystography, intravenous abdominal arteriog-raphy and the imaging of renal calculi.

  2. 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)

    2002-02-01

    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

  3. Dolor abdominal recurrente

    Directory of Open Access Journals (Sweden)

    Rodrigo De Vivero

    2005-06-01

    Full Text Available Recurrent abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists and surgical specialists. Chronic abdominal pain in children is usually functional-that is, without objective evidence of an underlying organic disorder. The presence of weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea and significant vomiting is associated with a higher prevalence of organic disease. In this article, it examined the diagnostic and therapeutic value of a medical and psychologic history, diagnostic tests, and pharmacological and behavioral therapy.

  4. Heat pumps

    CERN Document Server

    Brodowicz, Kazimierz; Wyszynski, M L; Wyszynski

    2013-01-01

    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

  5. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    Murphy, Kevin P

    2014-06-01

    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.

  6. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

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

    1998-01-01

    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...

  7. Temporary Percutaneous Mechanical Circulatory Support in Advanced Heart Failure.

    Science.gov (United States)

    Brown, Jessica L; Estep, Jerry D

    2016-07-01

    Cardiogenic shock is severe, refractory heart failure caused by significant myocardial dysfunction in the setting of adequate preload that is accompanied by systemic hypoperfusion. Progressive end-organ dysfunction is a hallmark of persistent cardiogenic shock and necessitates intervention to overcome altered hemodynamics and restore end-organ perfusion. Temporary percutaneous mechanical circulatory support is an established modality in the treatment of cardiogenic shock and is increasingly used in patients with cardiogenic shock as a bridge to recovery or further definitive therapy. This article reviews the current devices, their effects on left ventricular hemodynamics, and the evidence supporting their continued use. PMID:27371515

  8. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1997-01-01

    -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...

  9. Bleeding following deep hypothermia and circulatory arrest in children.

    Science.gov (United States)

    Mossad, Emad B; Machado, Sandra; Apostolakis, John

    2007-03-01

    Deep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding. This review examines the impact of DHCA on bleeding and transfusion requirements in children and the pathophysiology of DHCA-induced platelet dysfunction. It also focuses on possible pharmacologic interventions to decrease bleeding following DHCA in children. PMID:17484172

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the abdomen ... limitations of Abdominal Ultrasound Imaging? What is Abdominal Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  11. Development of an in-vitro circulatory system with known resistance and capacitance

    Science.gov (United States)

    Offerdahl, C. D.; Schaub, J. D.; Koenig, S. C.; Swope, R. D.; Ewert, D. L.; Convertino, V. A. (Principal Investigator)

    1996-01-01

    An in-vitro (hydrodynamic) model of the circulatory system was developed. The model consisted of a pump, compliant tubing, and valves for resistance. The model is used to simulate aortic pressure and flow. These parameters were measured using a Konigsburg Pressure transducer and a Triton ART2 flow probe. In addition, venous pressure and flow were measured on the downstream side of the resistance. The system has a known compliance and resistance. Steady and pulsatile flow tests were conducted to determine the resistance of the model. A static compliance test was used to determine the compliance of the system. The aortic pressure and flow obtained from the hydrodynamic model will be used to test the accuracy of parameter estimation models such as the 2-element and 4-element Windkessel models and the 3-element Westkessel model. Verifying analytical models used in determining total peripheral resistance (TPR) and systemic arterial compliance (SAC) is important because it provides insight into hemodynamic parameters that indicate baroreceptor responsiveness to situations such as changes in gravitational acceleration.

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

    CERN Document Server

    Maiti, S

    2013-01-01

    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...

  13. Centrifugal pumps

    CERN Document Server

    Gülich, Johann Friedrich

    2014-01-01

    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...

  14. Ethical controversies in organ donation after circulatory death.

    Science.gov (United States)

    2013-05-01

    The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be required to participate in DCD. Because the preparation for organ recovery in DCD begins before the declaration of death, there are potential conflicts between the donor's and recipient's interests. These conflicts can be managed in a variety of ways, including informed consent and separating the various participants' roles. For example, informed consent should be sought for premortem interventions to improve organ viability, and organ procurement organization personnel and members of the transplant team should not be involved in the discontinuation of life-sustaining treatment or the declaration of death. It is also important to emphasize that potential donors in cases of DCD should receive integrated interdisciplinary palliative care, including sedation and analgesia. PMID:23629612

  15. Computational Hemodynamic Simulation of Human Circulatory System under Altered Gravity

    Science.gov (United States)

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

    2003-01-01

    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. Pumping life

    DEFF Research Database (Denmark)

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

    2012-01-01

    The name PUMPKIN may suggest a research centre focused on American Halloween traditions or the investigation of the growth of vegetables – however this would be misleading. Researchers at PUMPKIN, short for Centre for Membrane Pumps in Cells and Disease, are in fact interested in a large family o......’. Here we illustrate that the pumping of ions means nothing less than the pumping of life....

  17. Component separation in abdominal trauma.

    Science.gov (United States)

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

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

    NARCIS (Netherlands)

    Rafnsson, S.B.; Bhopal, R.S.; Agyemang, C.; Fagot-Campagna, A.; Harding, S.; Hammar, N.; Hedlund, E.; Juel, K.; Primatesta, P.; Rosato, M.; Rey, G.; Wild, S.H.; Mackenbach, J.P.; Stirbu, I.; Kunst, A.E.

    2013-01-01

    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 a

  19. Analysis of circulatory mitochondrial DNA level after cardiac surgery with cardiopulmonary bypass and potential prognostic implications.

    Science.gov (United States)

    Qin, Chaoyi; Gu, Jun; Qian, Hong; Meng, Wei

    2016-01-01

    Our research letter found that circulatory mtDNA level increased after the end of CPB and positive correlations between mtDNA and peak CRP level, peak BNP level, and peak PCT level, which revealed the prognostic role of perioperative circulatory mtDNA level in patients who underwent cardiopulmonary bypass. PMID:27316503

  20. Obesity-Associated Abdominal Elephantiasis

    Directory of Open Access Journals (Sweden)

    Ritesh Kohli

    2013-01-01

    Full Text Available Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.

  1. Abdominal Radical Trachelectomy

    OpenAIRE

    Căpîlna, Mihai Emil; Ioanid, Nicolae; Scripcariu, Viorel; Gavrilescu, Madalina Mihaela; Szabo, Bela

    2014-01-01

    Objective Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. The published results of ART, in comparison with vaginal radical trachelectomy, so far are limited. Materials and Methods This retrospective study comprises all cases of female patients referred to ART with early-stage cervical cancer from 2 gynecologic oncology centers in Romania. Results A total of 29 women were referred for ART, but subsequently, fertility c...

  2. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [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: kimhyejin@amc.seoul.kr [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: jhbyun@amc.seoul.kr [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: aykim@amc.seoul.kr [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: mglee@amc.seoul.kr [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: hkha@amc.seoul.kr [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)

    2011-03-15

    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.

  3. Abdominal aspergillosis: CT findings

    International Nuclear Information System (INIS)

    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. Development of a miniature intraventricular axial flow blood pump.

    Science.gov (United States)

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

    1993-01-01

    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)

  5. Pathophysiology of cerebral circulatory disorders in idiopathic normal pressure hydrocephalus

    International Nuclear Information System (INIS)

    This study was conducted to elucidate the pathologic conditions of cerebral circulatory disorders in idiopathic normal pressure hydrocephalus (iNPH). Among 44 possible iNPH patients, 40 patients underwent shunt surgery based on diagnostic flow charts plotted by the Southern Tohoku method and were evaluated to be shunt-effective at the end of the first post-surgical month. The cerebral blood flow (CBF) was measured by N-isopropyl-(123I)-P-iodo-amphetamine single photon emission computed tomography (mean, mCBF; cortical region, cCBF; thalamus-basal ganglia region, tbCBF on autoradiography [ARG] method) and the perfusion patterns of the cerebral cortex were measured based on three-dimensional stereotactic surface projection (3D-SSP) Z-score images, before and 1 month after the surgery in all 40 subjects. The mCBF rose significantly from 32.1±2.74 ml/100 g/min before surgery to 39.8±3.02 ml/100 g/min after surgery (p<0.03). Investigation of the change of CBF revealed reductions in the cCBF (3 cases), tbCBF (9 cases), and cCBF+tbCBF (28 cases), with the reduced-cCBF group totaling 31 cases and the reduced-tbCBF group totaling 37 cases. Investigation of cerebral cortex hypoperfusion by 3D-SSP Z-score revealed 31 cases with hypoperfusion (frontal lobe type [19 cases], occipitotemporal lobe type [5 cases], mixed type [7 cases]) and nine cases with cortical normoperfusion (N). The pattern of reduction of the cortical blood flow on ARG method was favorably correlated with the pattern of hypoperfusion of the cerebral cortex on 3D-SSP Z-score images before surgery. A reduction of blood flow was found in the thalamus-basal ganglia region of all N type cases. The blood flow improved in 19 of 31 (61.3%) cases of the reduced-cCBF group and in 32 of 37 (86.5%) cases of the reduced-tbCBF group. All of the cases without detectable improvement exhibited increased blood flow in non-reduction areas. Investigation of the hypoperfusion patterns of the cerebral cortex on 3D-SSP Z

  6. Pulmonary Hypertension in the Era of Mechanical Circulatory Support.

    Science.gov (United States)

    Krishnamurthy, Yamini; Cooper, Lauren B; Parikh, Kishan S; Felker, G Michael; Milano, Carmelo A; Rogers, Joseph G; Hernandez, Adrian F; Patel, Chetan B

    2016-01-01

    Left heart disease (LHD) represents the most common cause of pulmonary hypertension (PH), and is associated with worse prognosis compared with LHD without PH. In addition, PH due to LHD may prevent patients from receiving heart transplantation, because of risk of perioperative right ventricular failure. Current literature lacks comprehensive descriptions and management strategies of PH due to LHD. In this review, we summarize the literature that is available to highlight the definition, pathogenesis, and prognosis of PH due to LHD. Furthermore, we discuss the use of mechanical circulatory support (MCS) in this population. Finally, we provide recommendations regarding the management and reassessment of PH due to LHD in the specific context of MCS. PMID:27442856

  7. Deep hypothermic circulatory arrest: real-life suspended animation.

    Science.gov (United States)

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

    2013-01-01

    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.

  8. ICD-11 and SNOMED CT Common Ontology: circulatory system.

    Science.gov (United States)

    Rodrigues, Jean-Marie; Schulz, Stefan; Rector, Alan; Spackman, Kent; Millar, Jane; Campbell, James; Ustün, Bedirhan; Chute, Christopher G; Solbrig, Harold; Della Mea, Vincenzo; Persson, Kristina Brand

    2014-01-01

    The improvement of semantic interoperability between data in electronic health records and aggregated data for health statistics requires efforts to carefully align the two domain terminologies ICD and SNOMED CT. Both represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation, requires a specific resource, named Common Ontology. We present the ICD-11 SNOMED CT Common Ontology building process including: a) the principles proposed for aligning the two systems with the help of a common model of meaning, b) the design of this common ontology, and c) preliminary results of the application to the diseases of the circulatory system. PMID:25160347

  9. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-01

    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. PMID:26331201

  10. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

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

    1994-01-01

    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....

  11. Dolor abdominal recurrente .

    Directory of Open Access Journals (Sweden)

    Rodrigo De Vivero

    2009-11-01

    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.

  12. 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.

    Science.gov (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

    2015-05-19

    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.

  13. 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).

    Science.gov (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

    2015-06-01

    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.

  14. Pump impeller

    International Nuclear Information System (INIS)

    A mixed-flow pump impeller, which may be used, for example, as a primary pump for circulating sodium as the primary coolant in a fast nuclear reactor, is described which comprises an impeller with evenly-spaced blades. Some of the blades, which are symmetrically disposed around the axis of rotation of the impeller, extend beyond the ends of the other blades towards the suction side of the pump to form an inducer. The channels defined between the extensions of the extended blades follow helical paths parallel to the axis of rotation. The leading edges of the unextended blades are interposed between the extended blades in the region of divergence of flow from the axis of rotation. The provision of the inducer reduces the risk of cavitation in the pump, which could cause rapid wear of the impeller. A shroud may be provided for the unextended blades. (author)

  15. Hypnosis for functional abdominal pain.

    Science.gov (United States)

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  17. Comparative hemolysis study of clinically available centrifugal pumps.

    Science.gov (United States)

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

    1996-06-01

    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.

  18. Practical pediatric abdominal CT

    International Nuclear Information System (INIS)

    This course is designed to help the radiologist in a hospital setting successfully approach abdominal CT in the infant and child. Emphasis is placed on techniques necessary for a high-quality examination of the upper abdomen, as applied to common pediatric problems such as trauma, tumor, and infection. Material is presented on technical considerations, including patient sedation, preparation, and potential pitfalls and helpful hints for imaging. An emphasis is placed on dynamic scanning with table incrementation. The section on trauma focuses on an approach to imaging the abdomen in the injured child, typical injuries, patterns of injury in the upper abdomen, and why CT is the best imaging modality for blunt upper abdominal trauma. The discussion of tumor imaging reviews the appearance of typical childhood neoplasia including Wilms tumor, neuroblastoma, non-Hodgkin and Burkitt lymphoma, and disseminated solid tumors such as rhabdomyosarcoma. The authors emphasize what to look for and where, both on initial and on later (for recurrences) examinations. The discussion of infection addresses detection of abscesses and occult infections in children, as well as imaging of abscesses prior to intervention

  19. 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)

    2002-09-01

    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.)

  20. [The Use of Arginine Vasopressin and PhosphodiesteraseIII Inhibitor for Circulatory Shock after the Resection of a Massive Adrenal Pheochromocytoma].

    Science.gov (United States)

    Nagamine, Yusuke; Nishinarita, Reiko; Mizutani, Kenji; Goto, Takahisa

    2016-06-01

    A 72-year-old man developed hypertensive crisis five month previously, and was diagnosed with massive adrenal pheochromocytoma, with a diameter of 14.5 cm. Preoperative echocardiography revealed normal cardiac function. The open abdominal surgery was performed under general anesthesia. During manipulation of the tumor he developed hypertension and tachycardia. Severe hypotension (50/25 mmHg) and mild bradycardia (70 beats x min(-1)) followed the resection of the tumor. In addition to volume replacement noradrenaline and adrenaline were administered, but the systolic blood pressure rose only to 60-70 mmHg. In order to treat vasodilatory shock, we started to administer arginine vasopressin infusion at 0.03 units x min(-1). His systolic blood pressure rose to 90 mmHg. The patient was transferred to the intensive care unit (ICU) postoperatively. The echocardiography revealed diffuse hypokinetic cardiac function. In order to treat cardiogenic shock, we started to administer olprinone (phosphodiesteraseIII inhibitor, infusion of 0.1 μg x kg(-1) x min(-1)). On postoperative day 2, circulatory shock improved and the patient was discharged from the ICU. In conclusion, circulatory shock after the resection of a massive pheochromocytoma was due to the down regulation of α and β adrenergic receptors. The non-adrenergic vasoconstrictor and inotrope were useful for this situation. PMID:27483661

  1. Mean circulatory filling pressure during splanchnic nerve stimulation and whole-body hypoxia in the anaesthetized cat.

    Science.gov (United States)

    Bower, E A; O'Donnell, C P

    1991-01-01

    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.

  2. Effect of parameter variations on the hemodynamic response under rotary blood pump assistance.

    Science.gov (United States)

    Lim, Einly; Dokos, Socrates; Salamonsen, Robert F; Rosenfeldt, Franklin L; Ayre, Peter J; Lovell, Nigel H

    2012-05-01

    Numerical models, able to simulate the response of the human cardiovascular system (CVS) in the presence of an implantable rotary blood pump (IRBP), have been widely used as a predictive tool to investigate the interaction between the CVS and the IRBP under various operating conditions. The present study investigates the effect of alterations in the model parameter values, that is, cardiac contractility, systemic vascular resistance, and total blood volume on the efficiency of rotary pump assistance, using an optimized dynamic heart-pump interaction model previously developed in our laboratory based on animal experimental measurements obtained from five canines. The effect of mean pump speed and the circulatory perturbations on left and right ventricular pressure volume loops, mean aortic pressure, mean cardiac output, pump assistance ratio, and pump flow pulsatility from both the greyhound experiments and model simulations are demonstrated. Furthermore, the applicability of some of the previously proposed control parameters, that is, pulsatility index (PI), gradient of PI with respect to pump speed, pump differential pressure, and aortic pressure are discussed based on our observations from experimental and simulation results. It was found that previously proposed control strategies were not able to perform well under highly varying circulatory conditions. Among these, control algorithms which rely on the left ventricular filling pressure appear to be the most robust as they emulate the Frank-Starling mechanism of the heart. PMID:22489771

  3. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    OpenAIRE

    Su-Mi Shin; Jee Won Chai

    2016-01-01

    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

  4. Mortality from Circulatory System Diseases and Malformations in Children in the State of Rio de Janeiro

    Science.gov (United States)

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

    2016-01-01

    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

  5. Relation between awareness of circulatory disorders and smoking in a general population health examination

    OpenAIRE

    Völzke Henry; Hanke Monika; Meyer Christian; John Ulrich; Schumann Anja

    2006-01-01

    Abstract Background Little is known about proportions of smokers who maintain smoking after they are aware of a circulatory disorder. The goal was to analyze the extent to which the number of circulatory disorders may be related to being a current smoker. Methods Cross-sectional survey study with a probability sample of residents in Germany investigated in health examination centers. Questionnaire data of 3,778 ever smoking participants aged 18 – 79 were used, questions included whether the r...

  6. Endoglin regulates mural cell adhesion in the circulatory system.

    Science.gov (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

    2016-04-01

    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.

  7. Peripheral biomarkers of stroke: Focus on circulatory microRNAs.

    Science.gov (United States)

    Vijayan, Murali; Reddy, P Hemachandra

    2016-10-01

    Stroke is the second leading cause of death in the world. Stroke occurs when blood flow stops, and that stoppage results in reduced oxygen supply to neurons in the brain. The occurrence of stroke increases with age, but anyone at any age can suffer from stroke. Recent research has implicated multiple cellular changes in stroke patients, including oxidative stress and mitochondrial dysfunction, inflammatory responses, and changes in mRNA and proteins. Recent research has also revealed that stroke is associated with modifiable and non-modifiable risk factors. Stroke can be controlled by modifiable risk factors, including diet, cardiovascular, hypertension, smoking, diabetes, obesity, metabolic syndrome, depression and traumatic brain injury. Stroke is the major risk factor for vascular dementia (VaD) and Alzheimer's disease (AD). The purpose of this article is to review the latest developments in research efforts directed at identifying 1) latest developments in identifying biomarkers in peripheral and central nervous system tissues, 2) changes in microRNAs (miRNAs) in patients with stroke, 3) miRNA profile and function in animal brain, and 4) protein biomarkers in ischemic stroke. This article also reviews research investigating circulatory miRNAs as peripheral biomarkers of stroke. PMID:27503360

  8. Blood trauma testing for mechanical circulatory support devices.

    Science.gov (United States)

    Giridharan, Guruprasad A; Sobieski, Michael A; Ising, Mickey; Slaughter, Mark S; Koenig, Steven C

    2011-01-01

    Preclinical hemolysis testing is a critical requirement toward demonstrating device safety for U.S. Food and Drug Administration (FDA) 510(k) approval of mechanical circulatory support devices (MCSD). FDA and ASTM (formerly known as the American Society for Testing and Materials) have published guidelines to assist industry with developing study protocols. However, there can be significant variability in experimental procedures, study design, and reporting of data that makes comparison of test and predicate devices a challenge. To overcome these limitations, we present a hemolysis testing protocol developed to enable standardization of hemolysis testing while adhering to FDA and ASTM guidelines. Static mock flow loops primed with fresh bovine blood (600 mL, Hematocrit = 27±5%, heparin titrated for ACT >300 sec) from a single-source donor were created as a platform for investigating test and predicate devices. MCSD differential pressure and temperature were maintained at 80 mmHg and 25°±2° C. Blood samples (3 ml) were collected at 0, 5, 90, 180, 270, 360 minutes to measure CBC and plasma free hemoglobin. This protocol led to 510(k) approval of two adult MCSD and has been used to test novel cannulae and a pediatric MCSD. Standardization of hemolysis testing procedures and transparency of results may enable better blood trauma characterization of MCS devices to facilitate the FDA 510(k) and PMA submission processes and improve clinical outcomes. PMID:21812617

  9. Insulin pumps.

    Science.gov (United States)

    Pickup, J

    2011-02-01

    The last year has seen a continued uptake of insulin pump therapy in most countries. The USA is still a leader in pump use, with probably some 40% of type 1 diabetic patients on continuous subcutaneous insulin infusion (CSII), but the large variation in usage within Europe remains, with relatively high use (> 15%) in, for example, Norway, Austria, Germany and Sweden and low use (companies or funding from national health services, the availability of sufficient diabetes nurse educators and dietitians trained in pump procedures, and clear referral pathways for the pump candidate from general practitioner or general hospital to specialist pump centre. There are now several comprehensive national guidelines on CSII use (see ATTD Yearbook 2009) but more work needs to be done in unifying uptake and ensuring all those who can benefit do so. Technology developments recently include increasing use of pumps with continuous glucose monitoring (CGM) connectivity (see elsewhere in this volume) and the emergence of numerous manufacturers developing so-called 'patch pumps', often for the type 2 diabetes market. Interestingly, the evidence base for CSII in this group is not well established, and for this reason the selected papers on CSII in this section include several in this area. The use of CSII in diabetic pregnancy is a long-established practice, in spite of the lack of evidence that it is superior to multiple daily injections (MDI), and few randomised controlled trials have been done in recent years. Several papers in this field this year continue the debate about the usefulness of CSII in diabetic pregnancy and are reviewed here. It is pleasing to see more research on the psychosocial aspects of CSII during the year, both from the point of view of how psychological beliefs influence outcomes on CSII (is there a type of patient who does particularly well or poorly on CSII?) and how CSII affects psychological factors like mood, behaviour and quality of life. Quality of

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

    CERN Document Server

    Battista, Nicholas A; Miller, Laura A

    2016-01-01

    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 ...

  11. Penetrating abdominal trauma.

    Science.gov (United States)

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  12. Economics of abdominal wall reconstruction.

    Science.gov (United States)

    Bower, Curtis; Roth, J Scott

    2013-10-01

    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. PMID:24035086

  13. Axial and centrifugal continuous-flow rotary pumps: a translation from pump mechanics to clinical practice.

    Science.gov (United States)

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

    2013-01-01

    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.

  14. Whole blood pumping with a microthrottle pump

    OpenAIRE

    Davies, M J; Johnston, I. D.; Tan, C. K. L.; Tracey, M. C.

    2010-01-01

    We have previously reported that microthrottle pumps (MTPs) display the capacity to pump solid phase suspensions such as polystyrene beads which prove challenging to most microfluidic pumps. In this paper we report employing a linear microthrottle pump (LMTP) to pump whole, undiluted, anticoagulated, human venous blood at 200 μl min−1 with minimal erythrocyte lysis and no observed pump blockage. LMTPs are particularly well suited to particle suspension transport by virtue of their relatively ...

  15. Micromanaging Abdominal Aortic Aneurysms

    Directory of Open Access Journals (Sweden)

    Lars Maegdefessel

    2013-07-01

    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.

  16. Abdominal aortic feminism.

    Science.gov (United States)

    Mortimer, Alice Emily

    2014-01-01

    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.

  17. Using a Breast Pump

    Science.gov (United States)

    ... you can relax and not be disturbed while pumping. If you have an electric pump, find an ... otherwise irritating your nipple or breast tissue. Begin Pumping If your pump is electric or battery-powered, ...

  18. Longterm results of liver transplantation from donation after circulatory death.

    Science.gov (United States)

    Blok, Joris J; Detry, Olivier; Putter, Hein; Rogiers, Xavier; Porte, Robert J; van Hoek, Bart; Pirenne, Jacques; Metselaar, Herold J; Lerut, Jan P; Ysebaert, Dirk K; Lucidi, Valerio; Troisi, Roberto I; Samuel, Undine; den Dulk, A Claire; Ringers, Jan; Braat, Andries E

    2016-08-01

    Donation after circulatory death (DCD) liver transplantation (LT) may imply a risk for decreased graft survival, caused by posttransplantation complications such as primary nonfunction or ischemic-type biliary lesions. However, similar survival rates for DCD and donation after brain death (DBD) LT have been reported. The objective of this study is to determine the longterm outcome of DCD LT in the Eurotransplant region corrected for the Eurotransplant donor risk index (ET-DRI). Transplants performed in Belgium and the Netherlands (January 1, 2003 to December 31, 2007) in adult recipients were included. Graft failure was defined as either the date of recipient death or retransplantation whichever occurred first (death-uncensored graft survival). Mean follow-up was 7.2 years. In total, 126 DCD and 1264 DBD LTs were performed. Kaplan-Meier survival analyses showed different graft survival for DBD and DCD at 1 year (77.7% versus 74.8%, respectively; P = 0.71), 5 years (65.6% versus 54.4%, respectively; P = 0.02), and 10 years (47.3% versus 44.2%, respectively; P = 0.55; log-rank P = 0.038). Although there was an overall significant difference, the survival curves almost reach each other after 10 years, which is most likely caused by other risk factors being less in DCD livers. Patient survival was not significantly different (P = 0.59). Multivariate Cox regression analysis showed a hazard ratio of 1.7 (P end of circulation until aortic cold perfusion, over 25 minutes was associated with a lower graft survival in univariate analysis of all DCD transplants (P = 0.002). In conclusion, DCD LT has an increased risk for diminished graft survival compared to DBD. There was no significant difference in patient survival. DCD allografts with a first WIT > 25 minutes have an increased risk for a decrease in graft survival. Liver Transplantation 22 1107-1114 2016 AASLD. PMID:27028896

  19. 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

    2012-01-01

    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.

  20. [ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR].

    Science.gov (United States)

    Maĭstrenko, D N; Generalov, M I; Tarazov, P G; Zherebtsov, F K; Osovskikh, V V; Ivanov, A S; Oleshchuk, A N; Granov, D A

    2015-01-01

    The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group. PMID:26234059

  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)

    2001-07-01

    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. JAMA Patient Page: Abdominal Hernia

    Science.gov (United States)

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... located within a child's abdomen. A Doppler ultrasound study may be part of a child's abdominal ultrasound ... pain from the procedure. If a Doppler ultrasound study is performed, your child may actually hear pulse- ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... technique that allows the physician to see and evaluate blood flow through arteries and veins in the ... the procedure? Abdominal ultrasound imaging is performed to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas ...

  5. Circulatory disease mortality in a Canadian occupational cohort with low dose exposure to ionizing radiation

    International Nuclear Information System (INIS)

    Exposure to high doses of ionizing radiation, such as those received during radiotherapy, leads to increased risk of circulatory diseases.. Emerging evidence of excess risks of circulatory diseases after exposure to doses well below those considered previously as safe warrants epidemiological studies of populations exposed to low levels of ionizing radiation. The purpose of our study was to evaluate the risk of circulatory disease mortality in a Canadian cohort of 337,397 individuals (169,256 men and 168,141 women) occupationally exposed to ionizing radiation and included in the National Dose Registry (NDR) of Canada. The cohort consists of employees at nuclear power stations (nuclear workers), medical, dental and industrial workers. Mean whole body radiation dose was 8.6 mSv for men and 1.2 mSv for women. During the study period (1951-1995) 3,533 deaths from circulatory diseases (3,018 among men and 515 among women) have been identified. The circulatory disease mortality in the cohort was significantly lower than in the Canadian population at large. The cohort showed a significant dose response both in men and in women. Estimates of circulatory disease mortality risk in the NDR cohort are higher than those of most other occupational cohorts and higher than in the Japanese atomic bomb survivors studies. The major limitation of the study is the absence of information on non-radiation lifestyle-related risk factors for circulatory diseases. Lack of adjustment for these factors or for socio-economic status requires caution in interpretation of the study findings. It was estimated that dose errors related to recording doses below the dosimeter detection limit as zero is unlikely to result in an overestimation of risk by more than 15-20%. (author)

  6. Association between previously diagnosed circulatory conditions and a dietary inflammatory index.

    Science.gov (United States)

    Wirth, Michael D; Shivappa, Nitin; Hurley, Thomas G; Hébert, James R

    2016-03-01

    Inflammation is a key contributor to the development or recurrence of circulatory disorders. Diet is a strong modifier of inflammation. It was hypothesized that more pro-inflammatory diets, as indicated by higher Dietary Inflammatory Index (DII) scores, would be associated with self-reported previously diagnosed circulatory disorders using National Health and Nutrition Examination Survey (NHANES) data. This analysis included NHANES respondents from 2005-2010 (n = 15,693). The DII was calculated from micro and macronutrients derived from a single 24-hour recall. Logistic regression, stratified by sex and adjusted for important covariates, was used to determine the odds of previous circulatory disorder diagnoses by quartile of DII scores. Excluding hypertension, which had a prevalence of 30%, the prevalence of any circulatory disorder was 8%. Those in DII quartile 4 were 1.30 (95%CI = 1.06-1.58) times more likely to have a previous circulatory disorder (excluding hypertension) compared to those in DII quartile 1. Similar findings were observed for specific CVDs including congestive heart failure, stroke, and heart attack. Participants in DII quartile 4 were more likely to have a diagnosis of hypertension compared to those in DII quartile 1 (prevalence odds ratio = 1.19, 95%CI = 1.05-1.34). Results tended to be stronger among females. Individuals with a previous circulatory disorder diagnosis from NHANES appear to have more pro-inflammatory diets compared to those without a previous diagnosis. Because inflammation is an important factor related to recurrence of circulatory disorders, the DII could be used in treatment programs to monitor dietary modulators of inflammation among individuals with these conditions. PMID:26923509

  7. Updates on abdominal desmoid tumors

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    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.

  8. Component separation in abdominal trauma

    OpenAIRE

    Rawstorne, Edward; Smart, Christopher J.; Fallis, Simon A.; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and t...

  9. Imaging of gastrointestinal and abdominal tuberculosis

    NARCIS (Netherlands)

    Vanhoenacker, FM; De Backer, AI; Op de Beeck, B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, AM

    2004-01-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic cha

  10. Left heart bypass support with the Rotaflow Centrifugal Pump® as a bridge to decision and recovery in an adult.

    Science.gov (United States)

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

    2012-06-01

    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.

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

    Science.gov (United States)

    Archer, G. T.

    1974-01-01

    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.

  12. Blood flow/pump rotation ratio as an artificial lung performance monitoring tool during extracorporeal respiratory support using centrifugal pumps

    OpenAIRE

    Park, Marcelo; Mendes, Pedro Vitale; Hirota, Adriana Sayuri; dos Santos, Edzangela Vasconcelos; Costa, Eduardo Leite Vieira; Azevedo, Luciano Cesar Pontes

    2015-01-01

    Objective To analyze the correlations of the blood flow/pump rotation ratio and the transmembrane pressure, CO2 and O2 transfer during the extracorporeal respiratory support. Methods Five animals were instrumented and submitted to extracorporeal membrane oxygenation in a five-step protocol, including abdominal sepsis and lung injury. Results This study showed that blood flow/pump rotations ratio variations are dependent on extracorporeal membrane oxygenation blood flow in a positive logarithm...

  13. Circulatory response to hyperthermia during acute normovolaemic haemodilution

    Science.gov (United States)

    Talwar, Anita; Fahim, M.

    Cats anaesthetized with a mixture of chloralose and urethane were exposed to heat stress in two groups. In the first group (n=10) of control animals, the effect of heat stress on haemodynamic variables was recorded at control haematocrit (HCT) of 42.0+/-1.0%. In a second group, the effect of heat stress was studied after induction of acute normovolaemic haemodilution (HCT of 13.0+/-1.0%). Haemodilution was induced to a maximum of 60% replacement of blood with dextran (mol.wt. 150000). Heat stress was induced by surface heating and core body temperature was raised from 37° C to 42° C. The effect of heat stress and haemodilution on various haemodynamic variables, viz. left ventricular pressure (LVP), left ventricular contractility (LVdP/dtmax), heart rate (HR), cardiac output (CO), arterial blood pressure (ABP), right atrial pressure (RAP), and arterial blood PO2, PCO2 and pH was examined. Haemodilution produced significant (P0.05) changes in ABP, RAP, LVdP/dtmax and total peripherial resistance (TPR). Hyperthermia caused a significant fall (P<0.05) in TPR. However, the percentage fall in TPR was higher in the control group. On exposure to heat stress, there were significant (P<0.05I increases in HR and CO in both the groups; however, HR and CO values were significantly (P<0.05) higher in the haemodiluted group compared to the control. The latter findings could be due either to the higher basal values of these variables with the fall in HCT or to inefficient cardiovascular regulatory mechanisms. The lack of efficient regulatory control under such severe stress conditions makes the cardiovascular system of anaemic animals more vulnerable to heat stress. In conclusion, the results of the present study showed deleterious effects of heat stress in both the groups. The higher values of HR and CO in the haemodiluted group may be responsible for circulatory failure at low HCT values, indicating a higher risk in the haemodiluted group as compared to the control group.

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

    OpenAIRE

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

    1982-01-01

    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.

  15. Development of an in vitro pump: mechanical characterization and surface engineering of elastomeric membranes

    OpenAIRE

    Paik, Isha

    2013-01-01

    In vitro modelling offers the potential of recapitulating human degenerate tissue for physiological studies and pharmacological screening. Yet, few systems have been developed to date, primarily due to the lack of vascularisation in engineered tissue. Here, the development of an in vitro pump is addressed. This will be the first component of a long term strategy to build internal circulatory systems for in vitro engineered tissue. Firstly, mechanical characterisation and surface biocompatibil...

  16. [Clinical experience of mechanical ventricular support with centrifugal pump for severe ventricular failure after open heart surgery].

    Science.gov (United States)

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

    1990-09-01

    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.

  17. A clinical dilemma: abdominal tuberculosis

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

    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

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

    OpenAIRE

    Juvenal da Rocha Torres Neto; Adonai Pinheiro Barreto; Ana Carolina Lisboa Prudente; Allisson Mário dos Santos; Rodrigo Rocha Santiago

    2007-01-01

    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, ...

  19. Abdominal aortic grafting for spontaneous infrarenal abdominal aortic dissection.

    Science.gov (United States)

    Iwasaki, Hiroto; Shibuya, Takashi; Shintani, Takashi; Uenaka, Hisazumi; Suehiro, Shigefumi; Satoh, Hisashi

    2010-02-01

    This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at the median sacral artery, indicating that the false lumen had progressed and compressed the true lumen. A direct approach involving grafting appears to be an effective procedure for resolving mesenteric and lower extremity hypoperfusion due to aortic dissection with a dilated false channel, even during the acute period. PMID:19879731

  20. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  1. Abdominal actinomycosis mimicking acute appendicitis.

    Science.gov (United States)

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

    2015-01-01

    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.

  2. Contemporary imaging in abdominal emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Sivit, Carlos J. [Rainbow Babies and Children' s Hospital, Case Western Reserve School of Medicine, Department of Radiology, Cleveland, OH (United States)

    2008-11-15

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  3. Pump characteristics and applications

    CERN Document Server

    Volk, Michael

    2013-01-01

    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

  4. Secondary abdominal appendicular ectopic pregnancy.

    Science.gov (United States)

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy. PMID:17630175

  5. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

    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.

  6. Blunt abdominal trauma in sports.

    Science.gov (United States)

    Rifat, Sami F; Gilvydis, Rimas P

    2003-04-01

    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.

  7. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W.-K., E-mail: leewk33@hotmail.com [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)

    2012-06-15

    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.

  8. Plain abdominal film and abdominal ultrasound in intestine occlusion

    International Nuclear Information System (INIS)

    Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificy of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecistis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echigenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus

  9. In vitro evaluation of the TandemHeart pediatric centrifugal pump.

    Science.gov (United States)

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

    2007-01-01

    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.

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help ... that is being examined to the transducer (the device used to examine the patient), as well ... is not a medical facility. Please contact your physician with specific medical ...

  11. Economic costs of abdominal obesity

    DEFF Research Database (Denmark)

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

    2008-01-01

    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....

  12. 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

    2008-01-01

    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.

  13. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

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

    2016-01-01

    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 ...

  14. 78 FR 11208 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-02-15

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... three major components: The delivery catheter, the steerable sleeve, and the MitraClip device. The...

  15. 75 FR 7282 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-02-18

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... Warner, Acting Associate Commissioner for Special Medical Programs. BILLING CODE 4160-01-S...

  16. 75 FR 81282 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-12-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice...

  17. 76 FR 56200 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-12

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... and are pre-loaded onto 6 or 7 Fr \\1\\ (diameter of 2 or 2.3 mm) delivery systems. Upon deployment,...

  18. The Persistence of Misconceptions about the Human Blood Circulatory System among Students in Different Grade Levels

    Science.gov (United States)

    Ozgur, Sami

    2013-01-01

    In this paper, it is aimed to investigate the persistence of misconceptions in the topic of the human blood circulatory system among students in different grade levels. For this reason, after discussions with biology educators, two tests consisting of open-ended questions were developed by the researcher and administered to students in four…

  19. 77 FR 25183 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a...

  20. 78 FR 67365 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-11-12

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... percutaneously delivered permanent cardiac implant placed in the left atrial appendage. This device is...

  1. 76 FR 36548 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-06-22

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... vote on information related to the humanitarian device exemption for the Berlin Heart EXCOR...

  2. 76 FR 58019 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-19

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... the Medical Devices Advisory Committee. General Function of the Committee: To provide advice and... Medtronic Ablation Frontiers Cardiac Ablation System is a catheter-based device developed for the...

  3. Hypothermic Oxygenated Machine Perfusion in Porcine Donation After Circulatory Determination of Death Liver Transplant

    NARCIS (Netherlands)

    Fondevila, Constantino; Hessheimer, Amelia J.; Maathuis, Mark-Hugo J.; Munoz, Javier; Taura, Pilar; Calatayud, David; Leuvenink, Henri; Rimola, Antoni; Garcia-Valdecasas, Juan C.; Ploeg, Rutger J.

    2012-01-01

    Background. Livers from donation after circulatory determination-of-death (DCD) donors suffer ischemic injury during a preextraction period of cardiac arrest and are infrequently used for transplantation; they have the potential, however, to considerably expand the donor pool. We aimed to determine

  4. [Heart and vascular surgery interventions with hypothermic circulatory arrest in adults].

    Science.gov (United States)

    Kipfer, B; Leupi, F; Althaus, U

    1990-10-01

    In the period between 1981 and 1988, 51 patients were operated on the thoracic aorta using the hypothermic circulatory arrest technique. 31 patients had a dissection of the thoracic aorta, in 16 cases, an aneurysm was the reason for the intervention. In addition, we used the hypothermic circulatory arrest for a thrombectomy in the aortic arch and two mitral-valve replacements. The following operations were performed: 14 x composite graft, 19 x supracoronar prosthesis (6 x with aortic valve replacement, 3 x with partial replacement of aortic arch), 17 operations were performed either for aortic arch or aorta descendens replacement. In our retrospective study, 7 courses were fata (14%), 3 patients had complications with residuals. Compared with a group of 105 patients operated on the thoracic aorta in the same period without circulatory arrest, we found no difference with regard to the lethality and morbidity. We conclude that the hypothermic circulatory arrest is a safe technique for selected problems in cardiovascular surgery in adults. PMID:2074178

  5. Evaluation of exercise-respiratory system modifications and preliminary respiratory-circulatory system integration scheme

    Science.gov (United States)

    Gallagher, R. R.

    1974-01-01

    The respiratory control system, functioning as an independent system, is presented with modifications of the exercise subroutine. These modifications illustrate an improved control of ventilation rates and arterial and compartmental gas tensions. A very elementary approach to describing the interactions of the respiratory and circulatory system is presented.

  6. 78 FR 49272 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-08-13

    ... HUMAN SERVICES Food and Drug Administration Circulatory System Devices Panel of the Medical Devices... long-term pulmonary support systems, one of the remaining preamendments class III devices regulated... depth of compressions for the duration of CPR. On January 8, 2013 (78 FR 1162), FDA issued a...

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

    Directory of Open Access Journals (Sweden)

    Marek Jarecki

    2003-01-01

    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.

  8. LMFBR with booster pump in pumping loop

    Science.gov (United States)

    Rubinstein, H.J.

    1975-10-14

    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.

  9. Heat pump technology

    CERN Document Server

    Von Cube, Hans Ludwig; Goodall, E G A

    2013-01-01

    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

  10. ADULT ABDOMINAL WALL HERNIA IN IBADAN

    OpenAIRE

    Ayandipo, O.O; Afuwape, O.O.; Irabor, D. O.; Abdurrazzaaq, A.I.

    2015-01-01

    Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate. Aim: To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified hernias Method: The project was a retrospective study of all patients with abdominal wal...

  11. Abdominal shotgun trauma: A case report

    OpenAIRE

    Toutouzas, Konstantinos G; Larentzakis, Andreas; Drimousis, Panagiotis; Riga, Maria; Theodorou, Dimitrios; Katsaragakis, Stylianos

    2008-01-01

    Introduction One of the most lethal mechanisms of injury is shotgun wound and particularly the abdominal one. Case presentation We report a case of a 45 years old male suffering abdominal shotgun trauma, who survived his injuries. Conclusion The management of the abdominal shotgun wounds is mainly dependent on clinical examination and clinical judgment, while requires advanced surgical skills.

  12. 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

    2012-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Little, Mark P., E-mail: mark.little@nih.gov [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)

    2012-12-01

    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.

  14. [Intra-graft balloon pumping--a clinical case report].

    Science.gov (United States)

    Nagata, M; Tashiro, T; Tanaka, K; Haruta, Y; Todo, K

    1991-12-01

    A 29-year-old female underwent tube graft replacement of distal aortic arch and descending aorta for dissecting aneurysm. After 42 minutes of aortic cross-clamping the patient was initially weaned satisfactorily from cardiopulmonary bypass (CPB). However, cardiac arrhythmia and cardiac arrest necessitated reestablishment of CPB. Electro-cardiography showed inferior myocardial infarction. To wean CPB intraaortic balloon pumping (IABP) was mandatory. But because of dissecting aortic aneurysm IABP in conventional method was contra-indicated. Intra graft balloon pumping (IGBP) was initiated while the patient was on full CPB. A low-porosity woven Dacron tube graft (22 mm) was anastomosed end-to-side to ascending aorta. A balloon was inserted into the tube graft to establish IGBP. This IGBP provided effective circulatory assist. The patient was weaned from CPB 1 hours after reestablishment of IGBP. Postoperative course was stable. The patient was returned to the operating room for removal of the balloon 3 days postoperatively. We reported the case for whom IGBP was effective. IGBP was effective circulatory support for the patient when conventional use of IABP was contra-indicated. PMID:1774515

  15. Pharyngeal pumping in Caenorhabditis elegans depends on tonic and phasic signaling from the nervous system

    Science.gov (United States)

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

    2016-01-01

    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

  16. Risk factors of gastroparesis syndrome after abdominal non-gastroduodenal operation and its prevention

    Institute of Scientific and Technical Information of China (English)

    Dong-Dong Yang; Kun He; Xue-Liang Wu; Li-Kun Yang; Shuang-Fa Nie

    2013-01-01

    Objective: To investigate risk factors of gastroparesis syndrome (PGS) after abdominal non-gastroduodenal operation and its prevention. Methods: Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively, and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time. The possible influencing factors of PGS were analyzed by single factor analysis and logistic regression analysis.Results: All 13 selected factors related with PGS, including age, disease category (benign and malignant), operation time, intraoperative blood loss, postoperative analgesic pump, postoperative enteral nutrition time, postoperative parenteral nutrition time, perioperative blood glucose level, perioperative nutrition status (anaemia or lower proteinemia), pylorus obstruction before surgery, intra-abdominal infection after surgery, and spiritual factor were related with PGS. The statistical analysis showed that the difference was statistical significant (P0.05); non-conditional multivariate analysis showed that malignant tumor, perioperative nutrition status, pylorus obstruction, operation time, blood loss, intra-abdominal infection after surgery, and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P <0.05). Conclusions: PGS is a result of multiple factors, and among these factors, malignant tumor, poor nutrition status, pylorus obstruction before surgery, longer operation-time, more blood loss, intra-abdominal infection after surgery, and mental factor are major risk factors of PGS.

  17. Multiple pump housing

    Science.gov (United States)

    Donoho, II, Michael R.; Elliott; Christopher M.

    2010-03-23

    A fluid delivery system includes a first pump having a first drive assembly, a second pump having a second drive assembly, and a pump housing. At least a portion of each of the first and second pumps are located in the housing.

  18. Types of Breast Pumps

    Science.gov (United States)

    ... breast-shield. Some experts discourage the use of bicycle horn pumps because they may be difficult to clean and dry. Battery-Powered and Electric Pumps A powered breast pump uses batteries or a cord plugged into an electrical outlet to power a small motorized pump that ...

  19. Acupuncture Treatment of Abdominal Pain

    Institute of Scientific and Technical Information of China (English)

    胡金生

    2002-01-01

    @@ 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.

  20. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    , constipation, pain, sexuality, quality of life (Short Form-36 questionnaire), hospital contacts, and vaginal bleeding. RESULTS: The questionnaire was answered by 197 of 304 women (64.8%) (subtotal hysterectomy [n = 97] [63.4%]; total hysterectomy [n = 100] [66.2%]). Mean follow-up time was 14 years and mean...... hysterectomy. All women enrolled in the trial from 1996 to 2000 who were still alive and living in Denmark (n = 304) were invited to answer the validated questionnaire used in prior 1 and 5 year follow-ups. Hospital contacts possibly related to hysterectomy from 5 to 14 years postoperatively were registered......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...

  1. [A case of abdominal wall actinomycosis].

    Science.gov (United States)

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  2. Centrifugal pump handbook

    CERN Document Server

    Pumps, Sulzer

    2010-01-01

    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

  3. Acute Abdominal Pain in Children.

    Science.gov (United States)

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  4. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF

    2015-12-01

    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 

  5. Association of physical inactivity with circulatory disease events and hospital treatment costs

    Directory of Open Access Journals (Sweden)

    Davey RC

    2013-04-01

    Full Text Available Rachel C Davey,1 Thomas Cochrane1,21Centre for Research and Action in Public Health, University of Canberra, ACT, Australia; 2Centre for Sport and Exercise Research, Staffordshire University, Stoke on Trent, United KingdomPurpose: Epidemiological studies of chronic disorders need to consider more responsive outcomes, particularly those that manifest themselves across a defined population over a shorter time period, to improve our ability to detect the causes of and intervene in the global epidemics of today. We explore the use of hospital episode statistics as a candidate for this role and estimate the strength of the association of circulatory disease-related events with physical inactivity, considered here as an undesirable health behavior.Settings, patients, and methods: The primary research was set in a mid-sized city in central England. Aggregation was at output area level (comprising ~300 residents; 51 of which were included. A random sample of 761 adults was selected to obtain estimates of the mean level of physical activity within each area. Circulatory disease hospital events were recorded and aggregated by output area over a 2-year period. Hierarchical linear modeling was used to establish the strength of the association between area-level physical activity and circulatory disease events. Sex, age, and reporting quarter were included as additional individual-level explanatory variables.Results: Areas reporting greater activity were less likely (event rate ratio = 0.855; 95% confidence interval [CI]: 0.78–0.94 to have a circulatory disease event, as were females (0.593; 95% CI: 0.47–0.75. Areas with older residents (1.578; 95% CI: 1.5–1.66 and later reporting quarters (1.095; 95% CI: 1.04–1.15 were more likely to report circulatory disease events.Conclusion: This study supports the use of hospital episode statistics as an outcome measure in the epidemiology of circulatory disease and reaffirms the potential importance of

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

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26937963

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

    Science.gov (United States)

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

    2016-01-01

    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.

  8. 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.

  9. Urgent Abdominal Re-Explorations

    Directory of Open Access Journals (Sweden)

    Peskersoy Mustafa

    2006-04-01

    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

  10. 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)

    2006-07-01

    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

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

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Mansur Antonio de Padua

    2001-01-01

    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.

  13. Cerebral perfusion in cardiac surgery : with special reference to circulatory arrest during profound hypothermia

    OpenAIRE

    Astudillo Ley, Rafael

    1998-01-01

    Thirty-nine pediatric and 82 adult patients were studied during cardiac surgery with cardio pulmonary bypass (CPB) performed with moderate hypothermia or with deep hypothermia and circulatory arrest (DHCA) with or-without retrograde cerebral perfusion (RCP). Cerebral blood flow (CBF) was estimated from Doppler measurements of the blood velocity in the middle cerebral artery (MCAv). Arterio-venous (jugular bulb) differences of blood lactate and oxygen were used to study cereb...

  14. A Review of Non-Cancer Effects, Especially Circulatory and Ocular Diseases1

    OpenAIRE

    Little, Mark P.

    2013-01-01

    There is a well-established association between high doses (> 5 Gy) of ionizing radiation exposure and damage to the heart and coronary arteries, although only recently have studies with high quality individual dosimetry been conducted that would enable quantification of this risk adjusting for concomitant chemotherapy. The association between lower dose exposures and late occurring circulatory disease has only recently begun to emerge in the Japanese atomic bomb survivors and in various occu...

  15. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells

    OpenAIRE

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

    2016-01-01

    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 viabili...

  16. Developing Seventh Grade Students’ Systems Thinking Skills in the Context of the Human Circulatory System

    OpenAIRE

    Raved, Lena; Yarden, Anat

    2014-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Canêo

    2015-01-01

    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.

  18. Challenges and advances in optimizing liver allografts from donation after circulatory death donors

    OpenAIRE

    Sutherland, Andrew Ian; Oniscu, Gabriel C.

    2016-01-01

    In recent years, there has been a shift in the donor demographics with an increase in donation after circulatory death (DCD). Livers obtained from DCD donors are known to have poorer outcomes when compared to donors after brainstem death and currently only a small proportion of DCD livers are used. This review outlines the recent technological developments in liver DCD donation, including clinical studies using normothermic regional perfusion and extracorporal machine perfusion of livers from...

  19. Brachiocephalic Artery Cannulation in Proximal Aortic Surgery that Requires Circulatory Arrest

    Science.gov (United States)

    Unal, Mehmet; Akar, Ilker; Ince, Ilker; Aslan, Cemal; Koc, Fatih; Kafali, Haluk

    2014-01-01

    The brachiocephalic artery is an alternative cannulation site in the repair of ascending aortic lesions that require circulatory arrest. We evaluate the effectiveness and safety of this technique. Proximal aortic surgery was performed in 32 patients from 2006 through 2012 via brachiocephalic artery cannulation and circulatory arrest. Twenty-four (75%) of the patients were men. The mean age was 48.69 ± 9.43 years (range, 30–68 yr). Twelve had type I dissection, 2 had type II dissection, and 18 had true aneurysms of the ascending aorta. All operations were performed through a median sternotomy. The arterial cannula was inserted through an 8-mm vascular graft anastomosed to the brachiocephalic artery in an end-to-side fashion. In dissections, the distal anastomosis was performed without clamping the aorta. The patients were cooled to 24 °C, and circulatory arrest was established. The brachiocephalic and left carotid arteries were clamped, and antegrade cerebral perfusion was started at a rate of 10 mL/kg/min. Cardiopulmonary bypass was resumed after completion of the distal anastomosis and the initiation of rewarming. The proximal anastomosis was then performed. None of the patients sustained a major neurologic deficit, but 5 patients experienced transient postoperative agitation (<24 hr). There were 2 early deaths (6.25%), on the 3rd and the 11th postoperative days, both unrelated to the cannulation technique. Brachiocephalic artery cannulation through a graft can be a safe and effective technique in proximal aortic surgical procedures that require circulatory arrest. PMID:25593522

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

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2013-12-01

    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.

  1. A miniature intraventricular axial flow blood pump that is introduced through the left ventricular apex.

    Science.gov (United States)

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

    1992-01-01

    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.

  2. Evaluation of a multiple disk centrifugal pump as an artificial ventricle.

    Science.gov (United States)

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

    1993-07-01

    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. PMID:8338431

  3. Large electromagnetic pumps. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kilman, G.B.

    1976-01-01

    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.

  4. FULL TERM EXTRAUTERINE ABDOMINAL PREGNANCY

    Directory of Open Access Journals (Sweden)

    Neetu

    2014-02-01

    Full Text Available Extrauterine abdominal pregnancy is extremely rare and is frequently missed during antenatal care, despite the routine use of obstetrics ultrasound. A 23 year old primigravida at 39 weeks of gestation was admitted to the department on December 2 , 2012, in routine hour with transverse lie with oligohydramnios. On examination her vitals and laboratory investigation were within normal limits . One of the ultrasonographic scanning done by radiologist at 35 wk. 3 days gestation demonstrated a single live intrauterine fetus of CGA 33 wk. 1 day with transverse lie , fundal gr II placenta and AFI - 10 cm. Ultrasonography done at the department on the day of admission demonstrated single live intrauterine fetus with transverse lie and AFI - 3.8 cm and EFW 2.4 Kg and placenta was right anterior.. She was planned for elective caesarean section on account of transverse lie and oligohydramnios at term. At laparotomy the following findings were made: Secondary abdominal pregnancy arising from right tubal ectopic rupture and making pseudogesta tional sac with meconium stained liquor. Omentum , right tube and ovary were adhered to sac. The uterus and left tube and ovary were healthy and normal . Other abdominal organs were normal. A 1.5 Kg live male baby with good Apgar score and incompletely formed mandible extracted from pseudo gestational sac. There was significant bleeding from pseudogestational sac and patient went in shock during intraoperative period. One unit whole blood transfused during intraoperative period. Placenta was adherent to the pseudogestational sac so Psudogestational sac was removed with placenta in situ and right sided salpingo - o ophrectomy was also done due to their adherence. Hemostasis was secured. The patient and baby progressed well and were discharged on the seventh postoperative day

  5. Peritoneoscopy of the liver after abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Kawaguchi,Kenji

    1983-02-01

    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.

  6. Abdominal manifestations of autoimmune disorders

    International Nuclear Information System (INIS)

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  7. Screening for Abdominal Aortic Aneurysm

    OpenAIRE

    Linné, Anneli

    2014-01-01

    Abdominal Aortic Aneurysm (AAA) is a common disease with a prevalence of 1.5-2.0% in 65-year old men in Sweden. The risk of having AAA is increased with smoking, high age, family history of AAA and cardiovascular disease. Women have a lower prevalence (0.5%) and develop AAA later in life. An AAA seldom gives any symptom prior to rupture. Untreated rupture is associated with 100% mortality, while surgically treated rupture is associated with 25-70% mortality. Prophylactic sur...

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

    Directory of Open Access Journals (Sweden)

    Rodrigo de Lima e Souza

    2016-06-01

    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.

  9. On the abdominal pressure volume relationship

    OpenAIRE

    Mulier, Jan Paul; Dillemans, Bruno; Crombach, Mark; Missant, Carlo; Sels, Annabel

    2009-01-01

    Abstract: During insufflation of the abdomen to create a pneumoperitoneum for laparoscopy, both intra abdominal pressure and insufflated volume can be measured and are used to calculate the abdominal pressure-volume relationship. First, an accurate, linear relationship was identified using a mathematical model with an elastance, E, or its reciprocal the compliance C and with a pressure at zero volume, PV0. This function was stable and could be used to describe the abdominal characteristics of...

  10. [Internationalization and innovation of abdominal acupuncture].

    Science.gov (United States)

    Wang, Yong-Zhou

    2013-09-01

    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.

  11. Abdominal migraine in childhood: a review

    Directory of Open Access Journals (Sweden)

    Scicchitano B

    2014-08-01

    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

  12. 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)

    1994-10-01

    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.)

  13. The Neonate with Abdominal Mass

    Directory of Open Access Journals (Sweden)

    M. Bajoghli

    2008-01-01

    Full Text Available Neonatal abdominal masses have broad spectrum of pathology, ranging from small lesions found incidentally to large masses occupying the entire of peritoneal cavity. These tumors are benign to malignant, and from unilocular cysts to complex solid lesions. Many of these lesions identified and will treat before delivery. Others are discovered during routine examination. These lesions may be life threatening, or cause persistent morbidity. Some of these have no sequel."nDiagnosis began with history. Characteristic of the mass which must be note include location, size, shape, texture, mobility and tenderness. Other findings should be in mind to find out nature of mass, for example hypoplasia of chest wall with oligohydramnios due to GU tract obstruction (potter sequwnce, a bulging hymen due to hydrometrocolpus, skin metastasis due to neuroblastoma. Radiography is the next step that shows organomegaly and calcification. Next step is US which is an excellent screening tool. CT and MRI are occasionally indicated."nThe purpose of this presentation is to review the diagnosis of abdominal masses in neonates.

  14. Proton pump inhibitors

    Science.gov (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 ...

  15. Photovoltaic pump systems

    Science.gov (United States)

    Klockgether, J.; Kiessling, K. P.

    1983-09-01

    Solar pump systems for the irrigation of fields and for water supply in regions with much sunshine are discussed. For surface water and sources with a hoisting depth of 12 m, a system with immersion pumps is used. For deep sources with larger hoisting depths, an underwater motor pump was developed. Both types of pump system meet the requirements of simple installation and manipulation, safe operation, maintenance free, and high efficiency reducing the number of solar cells needed.

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

    Directory of Open Access Journals (Sweden)

    Juvenal da Rocha Torres Neto

    2007-09-01

    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

  17. Pump for Saturated Liquids

    Science.gov (United States)

    Elliott, D. G.

    1986-01-01

    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.

  18. Breast milk - pumping and storing

    Science.gov (United States)

    ... a comfortable chair, sink, and electric pump. If pumping at work is going to be hard, build ... up your milk supply. Wash your hands before pumping. Collect breast milk when pumping. You can use: ...

  19. Actinomycosis mimicking abdominal neoplasm. Case report

    DEFF Research Database (Denmark)

    Waaddegaard, P; Dziegiel, Morten Hanefeld

    1988-01-01

    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...

  20. Abdominal Wall Modification for the Difficult Ostomy

    OpenAIRE

    Beck, David E.

    2008-01-01

    A select group of patients with major stomal problems may benefit from operative modification of the abdominal wall. Options may include a modified abdominoplasty (abdominal wall contouring), localized flaps, or liposuction. Although frequently successful, these techniques have the potential for significant morbidity.

  1. Live secondary abdominal pregnancy- by chance!!

    Directory of Open Access Journals (Sweden)

    Akanksha Sood

    2013-04-01

    Full Text Available Abdominal pregnancy though rare but is a life threatening situation, if not recognized and managed properly. We are hereby presenting a rare successful outcome in a case of ruptured live Secondary Abdominal pregnancy with placental implants over intestines. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 251-253

  2. Hypoxia inhibits abdominal expiratory nerve activity.

    Science.gov (United States)

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  3. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    Science.gov (United States)

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  4. Thoraco-abdominal aortic aneurysm branched repair

    NARCIS (Netherlands)

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

    2010-01-01

    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

  5. Puerperal endometritis after abdominal twin delivery.

    Science.gov (United States)

    Suonio, S; Huttunen, M

    1994-04-01

    The infectious complications of 122 consecutive abdominal twin deliveries over the period 1984-1989 were analyzed in a prospective clinical study, comparing them with 761 singleton abdominal deliveries over the period 1984-1986. The incidence of endometritis was nearly three-fold after twin deliveries and the incidence of abdominal wound infections nearly two-fold compared with singleton abdominal pregnancies (13.1/4.7% and 5.6/3.0%). The risk of amnionitis was increased ten-fold, 6 hours after rupture of the membranes in abdominal twin delivery, but no connection was found between amnionitis and endometritis, as in singleton abdominal deliveries. Multiple regression analysis indicated only two risk factors as regards puerperal endometritis after abdominal twin delivery: age under 25 years (odds ratio 6.9, 95% confidence limits 1.9-24.8), an association also seen in singleton abdominal deliveries, and a period of more than 6 hours from rupture of membranes to delivery (odds ratio 7.8, 95% confidence limits 2.1-28.5). Multiple pregnancy appears to be associated with an increased risk of endometritis. The etiological factors remain unknown, but a large placental bed and/or immunological factors may be implicated. PMID:8160537

  6. Fetal abdominal magnetic resonance imaging

    International Nuclear Information System (INIS)

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages

  7. Acute spontaneous isolated dissection of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Ali Akbar beigi

    2009-09-01

    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.

  8. A fibromatosis case mimicking abdominal aorta aneurysm.

    Science.gov (United States)

    Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

    2013-01-01

    Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

  9. THE INVESTIGATION OF THE INTERACTION OF THE IMPLANTABLE ROTARY BLOOD PUMP AND THE LEFT VENTRICLE ON THE MOCK CIRCULATION SYSTEM

    Directory of Open Access Journals (Sweden)

    E. G. Konysheva

    2010-01-01

    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. 

  10. Repair of ascending aorta pseudoaneurysm without circulatory arrest in redo patient

    Directory of Open Access Journals (Sweden)

    Auriemma Stefano

    2006-03-01

    Full Text Available Abstract A pseudoaneurysm of the ascending aorta is an unusual and potentially fatal complication after aortic surgical operations. TEE and CT scan are the investigations of choice. Surgical treatment is mandatory. We describe the successful management of a pseudoaneurysm of the ascending aorta, with aorto-sternal-cutaneous fistula requiring right axillary and femoral artery cannulation with Remote Access Perfusion® aortic cannula (Estech®, California, USA. Behaving like this we avoid hypotermic circulatory arrest, provide safe reentry and prevent an impending rupture.

  11. 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

    2008-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Hamed-Basir Ghafouri

    2012-10-01

    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.

  13. 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;

    2013-01-01

    and population data from Denmark, England and Wales, France, the Netherlands, Scotland and Sweden. Mortality rate ratios (MRRs) were constructed to examine differences in circulatory, ischaemic heart disease (IHD) and cerebrovascular disease mortality by geographical region/COB in 35-74 years old men and women...... by geographical region/COB within six EU countries. Excess mortality was observed for some migrant populations, less for others. Reliable pan-European data are needed for monitoring and understanding mortality inequalities in Europe's multiethnic populations....

  14. [Long-term mechanical circulatory support in 2014: A real alternative to heart transplantation?].

    Science.gov (United States)

    Flécher, Erwan

    2014-01-01

    Cardiac transplantation remains the gold standard for end stage heart failure however results of long-term mechanical circulatory support have dramatically improved over the last 10years. One should now clearly consider a left ventricular assist device as bridge to transplant or destination therapy in refractory isolated left heart failure. Mechanical biventricular support remains more challenging with lower survival and may be proposed as bridge to transplant. Correct patient's selection and appropriate follow-up are mandatory in such critical patients. PMID:24933679

  15. Abdominal Burkitt lymphoma in children : CT finding

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jae Uoo; Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo; Ahn, Hyo Seop; Shin, Hee Young [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Song, Chi Sung [Seoul City Boramae Hospital Department of Radiology, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the CT findings of Burkitt's lymphoma involving the abdomen in children We retrospectively analyzed the abdominal CT of ten children who presented with abdominal symptom. They were confirmed by operation in two cases and by fine needle aspiration biopsy in eight to be suffering from Burkitt's lymphoma. We also abdominal ultrasonography(USG)(n=10) and carried out small bowel follow-through examination(SBS)(n=5). Analyses focused on features of the abdominal mass : bowel wall thickening, ascites, lymphadenopathy, and the involvement of intra-abdominal solid organ. Abdominal CT at the time of presentation showed a huge conglomerated mass encasing segments of small bowel and also peripherally displacing bowel loops(n=9), bowel wall thickening(n=10), and ascites(n=10). In three of these cases, we were able to see tumor necrosis and cavity formation. Extensive infiltration into mesenteric fat and obliteration of tissue plane made it impossible to identify on CT the margin of the tumor and the presence of mesenteric lymphadenopathy. In four patients, sonography showed enlarged mesenteric lymph nodes(15-20mm), and in three, retroperitoneal lymph nodes(5mm, 10mm, 12mm in long dimension) were detected on CT and USG. Abdominal CT can reveal the characteristic imaging features of Burkitt's lymphoma in children. These are a huge conglomerate mass with or without cavity formation, that encases the small bowel and infiltrates the mesentery, ascites, and the relatively spared retroperitoneal lymph nodes.

  16. 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.

    Science.gov (United States)

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

    2009-09-01

    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.

  17. 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.

    Science.gov (United States)

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

    2009-09-01

    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. PMID:19775262

  18. Pump application and maintenance

    International Nuclear Information System (INIS)

    Nuclear maintenance programs are typically organized by overall application, function, cost impact, and failure histories. Each maintenance program is uniquely tailored for each plant's specific goals and objectives. Most maintenance programs include pump maintenance within an application and/or a function. NMAC provides guidance on maintenance, troubleshooting, and applications of Deep Draft Vertical Centrifugal Pumps, Main Coolant Pump Seals, Feedwater Pumps, and Charging Pumps. Each maintenance guide includes a technical discussion of the design and operating issues which influence pump and component performance, reliability, and availability. The guides also discuss comprehensive inspection and corresponding repair Advisory groups consisting of utility, manufacturer, and regulatory representatives oversee the development of the NMAC guides, and review by utility personnel further augments the development process

  19. Electrokinetic pumps and actuators

    International Nuclear Information System (INIS)

    Flow and ionic transport in porous media are central to electrokinetic pumping as well as to a host of other microfluidic devices. Electrokinetic pumping provides the ability to create high pressures (to over 10,000 psi) and high flow rates (over 1 mL/min) with a device having no moving parts and all liquid seals. The electrokinetic pump (EKP) is ideally suited for applications ranging from a high pressure integrated pump for chip-scale HPLC to a high flow rate integrated pump for forced liquid convection cooling of high-power electronics. Relations for flow rate and current fluxes in porous media are derived that provide a basis for analysis of complex microfluidic systems as well as for optimization of electrokinetic pumps

  20. [Internationalization and innovation of abdominal acupuncture].

    Science.gov (United States)

    Wang, Yong-Zhou

    2013-09-01

    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. PMID:24298780

  1. Combined subcutaneous, intrathoracic and abdominal splenosis.

    Science.gov (United States)

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  2. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    Science.gov (United States)

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  3. The Insulin Pump

    OpenAIRE

    Toews, C. J.

    1985-01-01

    Subcutaneous continuous insulin infusion systems deliver insulin at a basal rate designed to keep blood glucose levels normal in the non-fed state. Additional insulin is delivered at meal time. Pumps can provide near optimal control of blood glucose concentrations in selected, highly motivated patients. The pump provides better diabetic control than once daily insulin injections, although several daily injections can provide comparable control. Optimal control with the pump causes some short-...

  4. Fakir fuel pump

    Science.gov (United States)

    1922-01-01

    In designing the Fakir fuel pump, the fundamental idea was to obtain a simple and reliable method of conveying the fuel from a low tank to the carburetor, with the avoidance of the faults of all former methods and the simultaneous warming of the fuel by means of the heat of compression generated. The principle of the Fakir fuel pump rests on the well-known principle of the diaphragm pump, which must be suitably adapted to the present purpose.

  5. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-08-01

    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.

  6. Initial Acute Animal Experiment Using a New Miniature Axial Flow Pump in Series With the Natural Heart.

    Science.gov (United States)

    Okamoto, Eiji; Yano, Tetsuya; Shiraishi, Yasuyuki; Miura, Hidekazu; Yambe, Tomoyuki; Mitamura, Yoshinori

    2015-08-01

    We have advocated an axial flow blood pump called "valvo pump" that is implanted at the aortic valve position, and we have developed axial flow blood pumps to realize the concept of the valvo pump. The latest model of the axial flow blood pump mainly consists of a stator, a directly driven impeller, and a hydrodynamic bearing. The axial flow blood pump has a diameter of 33 mm and length of 74 mm, and the length of anatomical occupation is 33 mm. The axial flow blood pump is anastomosed to the aorta with polytetrafluoroethylene (PTFE) cuffs worn on the inflow and outflow ports. Dp-Q curves of the axial flow blood pump are flatter than those of ordinary axial flow pumps, and pump outflow of 5 L/min was obtained against a pressure difference of 50 mm Hg at a rotational speed of 9000 rpm in vitro. The axial flow blood pump was installed in a goat by anastomosing with the thoracic descending aorta using PTFE cuffs, and it was rotated at a rotational speed of 8000 rpm. Unlike in case of the ventricular assistance in parallel with the natural heart, pulsatilities of aortic pressure and aortic flow were preserved even when the pump was on, and mean aortic flow was increased by 1.5 L/min with increase in mean aortic pressure of 30 mm Hg. In conclusion, circulatory assistance in series with the natural heart using the axial flow blood pump was able to improve hemodynamic pulsatility, and it would contribute to improvement of end-organ circulation. . PMID:26234449

  7. 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

    2006-01-01

    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.

  8. Circulatory shear flow alters the viability and proliferation of circulating colon cancer cells

    Science.gov (United States)

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

    2016-06-01

    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.

  9. 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

    2003-01-01

    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.

  10. Developing seventh grade students' systems thinking skills in the context of the human circulatory system.

    Science.gov (United States)

    Raved, Lena; Yarden, Anat

    2014-01-01

    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.

  11. The use of VEPs for CNS monitoring during continuous cardiopulmonary bypass and circulatory arrest.

    Science.gov (United States)

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

    1987-07-01

    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.

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

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2015-01-01

    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. 

  13. Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report.

    Science.gov (United States)

    Widjaja, Felix F; Khairan, Paramita; Kamelia, Telly; Hasan, Irsan

    2016-04-01

    Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD. Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of "ascites", "albumin", "colloid", "dextran", "hydroxyethyl starch", "gelatin", and "paracentesis induced circulatory dysfunction". Articles was limited to randomized clinical trial and meta-analysis with clinical question of "In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD". We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters. PMID:27550886

  14. Developing 7th grade students' systems thinking skills in the context of the human circulatory system

    Directory of Open Access Journals (Sweden)

    Lena eRaved

    2014-12-01

    Full Text Available 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 7th 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. [Churg-Strauss abdominal manifestation].

    Science.gov (United States)

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

    2014-01-01

    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.

  16. Champagne Heat Pump

    Science.gov (United States)

    Jones, Jack A.

    2004-01-01

    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.

  17. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-04-01

    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.

  18. Optically pumped atoms

    CERN Document Server

    Happer, William; Walker, Thad

    2010-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    V. I. Klimenko

    2014-02-01

    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

  20. 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;

    2004-01-01

    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...

  1. Component Separation for Complex Abdominal Wall Reconstruction

    Medline Plus

    Full Text Available COMPONENT SEPARATION FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION ALBANY MEDICAL CENTER ALBANY, NY April 30, 2008 00:00: ... Koumanis. The surgery comes to you from Albany Medical Center in Albany, New York. In just moments, ...

  2. An Unusual Case of Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Bobby Desai

    2012-01-01

    Full Text Available Renal calyceal rupture is a usual etiology of abdominal pain in the emergency department. We present a case of unexpected renal calyx rupture in a patient with symptomatology of renal colic. A discussion and review are provided.

  3. Genetics Home Reference: abdominal wall defect

    Science.gov (United States)

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

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

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    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...

  5. Liquid pump for astronaut cooling

    Science.gov (United States)

    Carson, M. A.

    1972-01-01

    The Apollo portable life support system water-recirculation pump used for astronaut cooling is described. The problems associated with an early centrifugal pump and how these problems were overcome by the use of a new diaphragm pump are discussed. Performance comparisons of the two pump designs are given. Developmental problems and flight results with the diaphragm pump are discussed.

  6. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    Science.gov (United States)

    Stagnitti, Franco

    2009-01-01

    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

  7. Recurrent abdominal pain in paediatric patients

    OpenAIRE

    Mak, VWY; Ng, WM; Chan, KL

    1999-01-01

    Recurrent abdominal pain is a common problem in the paediatric population. While functional abdominal pain accounts for the majority of cases, an organic cause for pain may be found in about 5% to 10% of children. Diagnostic evaluation depends on the clinical presentation and the presence of specific findings. Excessive testing should be avoided as this may increase parental anxiety and put the child through unnecessary stress.

  8. Surveillance intervals for small abdominal aortic aneurysms

    DEFF Research Database (Denmark)

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

    2013-01-01

    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....

  9. Using abdominal massage in bowel management.

    Science.gov (United States)

    Connor, Michelle; Hunt, Catherine; Lindley, Alison; Adams, John

    2014-07-15

    This article describes the introduction of abdominal massage techniques by a community team as part of a total bowel management programme for people with learning disabilities. A trust-wide audit of prescribed laxative use by this client group raised concerns, and led to a more systematic approach to managing constipation in people with learning disabilities. An education programme for carers proved to be successful. Some reported that adopting abdominal massage provided further opportunity to develop the therapeutic relationship. PMID:25005415

  10. Asymptomatic torsion of intra-abdominal testis

    OpenAIRE

    M. Amin El-Gohary

    2015-01-01

    We report a case of intra-abdominal testicular torsion, of eight years old boy who presented with asymptomatic left impalpable testis. Diagnostic laparoscopy revealed a twisted small intra-abdominal testis in which the spermatic cord twisted 3 times over a band attached to the internal ring. The cord was long enough to bring the small testis into the scrotal sac. This case highlights the pole of laparoscopy in the management of impalpable testes.

  11. Traumatic pseudoaneurysm of the abdominal aorta.

    Science.gov (United States)

    Barchiche, R; Bové, T; Demanet, H; Goldstein, J P; Deuvaert, F E

    1999-08-01

    A traumatic pseudoaneurysm of the abdominal aorta is a rare entity, occurring as the result of a missed aortic lesion at the time of the initial injury. Therefore, clinical suspicion and careful abdominal exploration at first laparotomy is mandatory to prevent aortic pseudoaneurysm formation and its risk of delayed rupture. We present a case of successful surgical treatment of a suprarenal aortic false aneurysm, presenting 4 weeks after a life-threatening gunshot wound in a 13-year-old child. PMID:10499389

  12. Abdominal integument atrophy after operative procedures

    OpenAIRE

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Lubiński, Jan; Bojko, Stefania; Gałdyńska, Maria; Bernatowicz, Elżbieta

    2012-01-01

    The aim of the study was to analyze clinical material concerning postoperative atrophy of abdominal integument. Material and methods The evaluated group consisted of 29 patients with sonographically revealed atrophy of the abdominal wall. Those changes were observed after various surgical procedures: mainly after long, anterolateral laparotomies or several classical operations. Ultrasound examinations up to the year 2000 were performed with analog apparatus, in the latter years only with digi...

  13. Diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma

    International Nuclear Information System (INIS)

    We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery. (orig.)

  14. Pump element for a tube pump

    DEFF Research Database (Denmark)

    2011-01-01

    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...... 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...

  15. Magnetic heat pump design

    Science.gov (United States)

    Kirol, L. D.; Dacus, M. W.

    1988-03-01

    Heat pumps utilizing the magnetocaloric effect offer a potentially attractive alternative to conventional heat pumps and refrigerators. Many physical configurations of magnetic heat pumps are possible. Major classes include those requiring electrical energy input and those with mechanical energy input. Mechanical energy is used to move magnets, working material, or magnetic shielding. Each type of mechanical magnetic heat pump can be built in a rotary (recuperative) or reciprocal (regenerative) configuration. Machines with electrical energy input utilize modulation of the magnetic field to cause working material to execute the desired thermodynamic cycle, and can also be recuperative or regenerative. Recuperative rotary heat pumps in which working material is moved past stationary magnets is the preferred configuration. Regenerative devices suffer performance degradation from temperature change of regenerator material and mixing and conduction in the regenerator. Field modulated cycles are not practical due to ac losses in superconducting magnets. Development of methods for recuperator fluid pumping is the major challenge in design of rotary recuperative devices. Several pumping options are presented, and the design of a bench scale heat pump described.

  16. Water Treatment Technology - Pumps.

    Science.gov (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…

  17. Normetex Pump Alternatives Study

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Elliot A.

    2013-04-25

    A mainstay pump for tritium systems, the Normetex scroll pump, is currently unavailable because the Normetex company went out of business. This pump was an all-metal scroll pump that served tritium processing facilities very well. Current tritium system operators are evaluating replacement pumps for the Normetex pump and for general used in tritium service. An all-metal equivalent alternative to the Normetex pump has not yet been identified. 1. The ideal replacement tritium pump would be hermetically sealed and contain no polymer components or oils. Polymers and oils degrade over time when they contact ionizing radiation. 2. Halogenated polymers (containing fluorine, chlorine, or both) and oils are commonly found in pumps. These materials have many properties that surpass those of hydrocarbon-based polymers and oils, including thermal stability (higher operating temperature) and better chemical resistance. Unfortunately, they are less resistant to degradation from ionizing radiation than hydrocarbon-based materials (in general). 3. Polymers and oils can form gaseous, condensable (HF, TF), liquid, and solid species when exposed to ionizing radiation. For example, halogenated polymers form HF and HCl, which are extremely corrosive upon reaction with water. If a pump containing polymers or oils must be used in a tritium system, the system must be designed to be able to process the unwanted by-products. Design features to mitigate degradation products include filters and chemical or physical traps (eg. cold traps, oil traps). 4. Polymer components can work in tritium systems, but must be replaced regularly. Polymer components performance should be monitored or be regularly tested, and regular replacement of components should be viewed as an expected normal event. A radioactive waste stream must be established to dispose of used polymer components and oil with an approved disposal plan developed based on the facility location and its regulators. Polymers have varying

  18. DIEP breast reconstruction following multiple abdominal liposuction procedures

    OpenAIRE

    Farid, Mohammed; Nicholson, Simon; Kotwal, Ashutosh; Akali, Augustine

    2014-01-01

    Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Methods: Review of case notes and radiological investigations of two patients, and a PubMed search using the ter...

  19. Evaluation of a physiologic pulsatile pump system for neonate-infant cardiopulmonary bypass support.

    Science.gov (United States)

    Undar, A; Masai, T; Inman, R; Beyer, E A; Mueller, M A; McGarry, M C; Frazier, O H; Fraser, C D

    1999-01-01

    An alternate physiologic pulsatile pump (PPP) system was designed and evaluated to produce sufficient pulsatility during neonate-infant open heart surgery. This hydraulically driven pump system has a unique "dual" pumping chamber mechanism. The first chamber is placed between the venous reservoir and oxygenator and the second chamber between the oxygenator and patient. Each chamber has two unidirectional tricuspid valves. Stroke volume (0.2-10 ml), upstroke rise time (10-350 msec), and pump rate (2-250 beats per minute [bpm]) can be adjusted independently to produce adequate pulsatility. This system has been tested in 3-kg piglets (n = 6), with a pump flow of 150 ml/kg/min, a pump rate of 150 bpm, and a pump ejection time of 110 msec. After initiation of cardiopulmonary bypass (CPB), all animals were subjected to 25 minutes of hypothermia to reduce the rectal temperatures to 18 degrees C, 60 minutes of deep hypothermic circulatory arrest (DHCA), then 10 minutes of cold perfusion with a full pump flow, and 40 minutes of rewarming. During CPB, mean arterial pressures were kept at less than 50 mm Hg. Mean extracorporeal circuit pressure (ECCP), the pressure drop of a 10 French aortic cannula, and the pulse pressure were 67+/-9, 21+/-6, and 16+/-2 mm Hg, respectively. All values are represented as mean+/-SD. No regurgitation or abnormal hemolysis has been detected during these experiments. The oxygenator had no damping effect on the quality of the pulsatility because of the dual chamber pumping mechanism. The ECCP was also significantly lower than any other known pulsatile system. We conclude that this system, with a 10 French aortic cannula and arterial filter, produces adequate pulsatility in 3 kg piglets. PMID:9952008

  20. Apparatus for Pumping a Fluid

    Science.gov (United States)

    Boeyen, Robert Van; Reeh, Jonathan

    2013-01-01

    A fluid pump has been developed for mechanically pumped fluid loops for spacecraft thermal control. Lynntech's technology utilizes a proprietary electrochemically driven pumping mechanism. Conventional rotodynamic and displacement pumps typically do not meet the stringent power and operational reliability requirements of space applications. Lynntech's developmental pump is a highly efficient solid-state pump with essentially no rotating or moving components (apart from metal bellows).

  1. 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.

    2009-01-01

    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

  2. Relations of Cognitive and Motivational Variables with Students' Human Circulatory System Achievement in Traditional and Learning Cycle Classrooms

    Science.gov (United States)

    Sadi, Özlem; Çakiroglu, Jale

    2014-01-01

    This study is aimed at investigating the relationships among students' relevant prior knowledge, meaningful learning orientation, reasoning ability, self-efficacy, locus of control, attitudes toward biology and achievement with the human circulatory system (HCS) using the learning cycle (LC) and the traditional classroom setting. The study…

  3. RETROGRADE CEREBRAL PERFUSION AS METHOD OF BRAIN PROTECTION DURING OPERATIONS ON ASCENDING AND TRANSVERSE AORTA WITH HYPOTHERMIC CIRCULATORY ARREST

    Directory of Open Access Journals (Sweden)

    N. N. Tarabarko

    2011-01-01

    Full Text Available There is no optimal approach to cerebral protection during ascending and transverse aortic arch repairs in our days. This study was designed to analyze experience of using retrograde cerebral perfusion as method of brain protection during operations on ascending and transverse aorta with hypothermic circulatory arrest. 

  4. 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

    2009-01-01

    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

  5. 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

    2013-01-01

    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

  6. Teaching Integrative Physiology Using the Quantitative Circulatory Physiology Model and Case Discussion Method: Evaluation of the Learning Experience

    Science.gov (United States)

    Rodriguez-Barbero, A.; Lopez-Novoa, J. M.

    2008-01-01

    One of the problems that we have found when teaching human physiology in a Spanish medical school is that the degree of understanding by the students of the integration between organs and systems is rather poor. We attempted to remedy this problem by using a case discussion method together with the Quantitative Circulatory Physiology (QCP)…

  7. Effect of particulate matter, atmospheric gases, temperature, and humidity on respiratory and circulatory diseases’ trends in Lisbon, Portugal

    NARCIS (Netherlands)

    Freitas, M.C.; Pacheco, A.M.G.; Verburg, T.G.; Wolterbeek, H.T.

    2009-01-01

    This study addresses the significant effects of both well-known contaminants (particles, gases) and less-studied variables (temperature, humidity) on serious, if relatively common, respiratory and circulatory diseases. The area of study is Lisbon, Portugal, and time series of health outcome (daily a

  8. 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

    2010-01-01

    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

  9. Deep Hypothermic Circulatory Arrest with Lung Perfusion/Ventilation in a Patient with Acute Type A Aortic Dissection

    Directory of Open Access Journals (Sweden)

    Yiliam F. Rodriguez-Blanco

    2012-01-01

    Full Text Available A 50-year-old black male presented with acute type A aortic dissection. Surgical repair was performed under deep hypothermic circulatory arrest (DHCA with lung perfusion/ventilation throughout the procedure. Details of the lung perfusion technique and its potential benefits and drawbacks are discussed.

  10. Deep Hypothermic Circulatory Arrest with Lung Perfusion/Ventilation in a Patient with Acute Type A Aortic Dissection

    OpenAIRE

    Yiliam F Rodriguez-Blanco; Lester Garcia; Tania Brice; Marco Ricci; Salerno, Tomas A.

    2012-01-01

    A 50-year-old black male presented with acute type A aortic dissection. Surgical repair was performed under deep hypothermic circulatory arrest (DHCA) with lung perfusion/ventilation throughout the procedure. Details of the lung perfusion technique and its potential benefits and drawbacks are discussed.

  11. Pumping machinery theory and practice

    CERN Document Server

    Badr, Hassan M

    2014-01-01

    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

  12. New classification of donation after circulatory death donors definitions and terminology.

    Science.gov (United States)

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

    2016-07-01

    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. PMID:26991858

  13. Non-Intrusive Device for Real-Time Circulatory System Assessment with Advanced Signal Processing Capabilities

    Science.gov (United States)

    Pinheiro, E.; Postolache, O.; Girão, P.

    2010-01-01

    This paper presents a device that uses three cardiography signals to characterize several important parameters of a subject's circulatory system. Using electrocardiogram, finger photoplethysmogram, and ballistocardiogram, three heart rate estimates are acquired from beat-to-beat time interval extraction. Furthermore, pre-ejection period, pulse transit time (PTT), and pulse arrival time (PAT) are computed, and their long-term evolution is analyzed. The system estimates heart rate variability (HRV) and blood pressure variability (BPV) from the heart rate and PAT time series, to infer the activity of the cardiac autonomic system. The software component of the device evaluates the frequency content of HRV and BPV, and also their fractal dimension and entropy, thus providing a detailed analysis of the time series' regularity and complexity evolution, to allow personalized subject evaluation.

  14. REMOTE MONITORING OF PATIENTS WITH LONG-TERM MECHATRONIC CIRCULATORY SUPPORT SYSTEM

    Directory of Open Access Journals (Sweden)

    A. V. Adaskin

    2016-01-01

    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. 

  15. No evidence for an increase in circulatory disease mortality in astronauts following space radiation exposures

    Science.gov (United States)

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

    2016-08-01

    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.

  16. [Forming a community at risk for circulatory system diseases among workers engaged into underground mining].

    Science.gov (United States)

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

    2015-01-01

    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.

  17. Liver Transplant From Unexpected Donation After Circulatory Determination of Death Donors: A Challenge in Perioperative Management.

    Science.gov (United States)

    Blasi, A; Hessheimer, A J; Beltrán, J; Pereira, A; Fernández, J; Balust, J; Martínez-Palli, G; Fuster, J; Navasa, M; García-Valdecasas, J C; Taurá, P; Fondevila, C

    2016-06-01

    Unexpected donation after circulatory determination of death (uDCD) liver transplantation is a complex procedure, in particular when it comes to perioperative recipient management. However, very little has been published to date regarding intraoperative and immediate postoperative care in this setting. Herein, we compare perioperative events in uDCD liver recipients with those of a matched group of donation after brain death liver recipients. We demonstrate that the former group of recipients suffers significantly greater hemodynamic instability and derangements in coagulation following graft reperfusion. Based on our experience, we recommend a proactive recipient management strategy in uDCD liver transplantation that involves early use of vasopressor support; maintaining adequate intraoperative levels of red cells, platelets, and fibrinogen; and routinely administering tranexamic acid before graft reperfusion. PMID:26601629

  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.

    2016-01-01

    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

  19. 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

    2014-01-01

    . 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...

  20. 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

    2014-01-01

    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.

  1. Numerical Models of Human Circulatory System under Altered Gravity: Brain Circulation

    Science.gov (United States)

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

    2003-01-01

    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

  2. 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.

  3. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

    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.

  4. Abdominal tuberculosis, clinical-radiological revision

    International Nuclear Information System (INIS)

    We retrospectively evaluated the clinical charts and diagnostic images of hospitalised patients with histological or bacteriologic demonstration of abdominal tuberculosis (TB) including those with probable abdominal TB, who had pulmonary TB and radiologic findings highly suggestive of abdominal TB with favourable response to treatment. Cases with genitourinary TB were excluded. We found 24 patients with an average age of 25 yrs. In some cases this entity was not suspected on the imaging studies, and diagnosis was made on surgery. The most frequent symptoms were: abdominal pain, diarrhoea, fever, vomiting, weight loss and abdominal mass. Active pulmonary TB was demonstrated on 8 cases (33%) Peritoneal presentation was the most frequent (54%) with septated or simple ascites, cystic ascites or pseudocysts within bowel loops. Mesenteric involvement (21 %) showed adenopathy or masses identified with CT. Intestinal forms (17%) showed pseudo-polyps on terminal ileum and ulcers on ileum, cecum and colon. We found one case with diffuse ulcerative involvement of the colon. Two cases showed hepatic involvement, one with an abscess and a tuberculosis Cole cystitis, with pyloric syndrome due to fibrosis

  5. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Association with Ruptured Abdominal Aortic Aneurysm in the Endovascular Era: Vigilance Remains Critical

    Directory of Open Access Journals (Sweden)

    Matthew C. Bozeman

    2012-01-01

    In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events.

  6. The Murine Angiotensin II-Induced Abdominal Aortic Aneurysm Model: Rupture Risk and Inflammatory Progression Patterns

    OpenAIRE

    TimothySt. Amand

    2010-01-01

    An abdominal aortic aneurysm (AAA) is an enlargement of the greatest artery in the body defined as an increase in diameter of 1.5-fold. AAAs are common in the elderly population and thousands die each year from their complications. The most commonly used mouse model to study the pathogenesis of AAA is the angiotensin II (Ang II) infusion method delivered via osmotic mini-pump for 28 days. Here, we studied the site-specificity and onset of aortic rupture, characterized three-dimensional (3D) i...

  7. Regenerative Hydride Heat Pump

    Science.gov (United States)

    Jones, Jack A.

    1992-01-01

    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.

  8. Advanced heat pump

    Science.gov (United States)

    Ashley, Joseph L.; Matthews, John D.

    1989-09-01

    This patent application discloses a heat pump which includes a first packed bed of liquid desiccant for removing moisture from outside air in the heating mode of operation, and a pump for transferring the moisture laden desiccant to a second packed bed which humidifies condenser heated inside air by adding water vapor to the air. The first packed bed, by removing moisture from the outside air before it passes through the heat pump's evaporator coils, prevents frost from forming on the coils. In the cooling mode of operation the second packed bed of liquid desiccant removes water vapor from the air inside of the building. The moisture laden desiccant is then transferred to the first packed bed by a second pump where condenser heat transfers the moisture from the desiccant to outside air.

  9. High Voltage Charge Pump

    KAUST Repository

    Emira, Ahmed A.

    2014-10-09

    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.

  10. Nuclear-pumped lasers

    CERN Document Server

    Prelas, Mark

    2016-01-01

    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. Keeping Hearts Pumping

    Science.gov (United States)

    2002-01-01

    A collaboration between NASA, Dr. Michael DeBakey, Dr. George Noon, and MicroMed Technology, Inc., resulted in a life-saving heart pump for patients awaiting heart transplants. The MicroMed DeBakey VAD functions as a "bridge to heart transplant" by pumping blood throughout the body to keep critically ill patients alive until a donor heart is available. Weighing less than 4 ounces and measuring 1 inch by 3 inches, the pump is approximately one-tenth the size of other currently marketed pulsatile VADs. This makes it less invasive and ideal for smaller adults and children. Because of the pump's small size, less than 5 percent of the patients implanted developed device-related infections. It can operate up to 8 hours on batteries, giving patients the mobility to do normal, everyday activities.The MicroMed DeBakey VAD is a registered trademark of MicroMed Technology, Inc.

  12. Thoracic and abdominal blastomycosis in a horse.

    Science.gov (United States)

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  13. Psychosocial factors and childhood recurrent abdominal pain.

    Science.gov (United States)

    Boey, Christopher Chiong-Meng; Goh, Khean-Lee

    2002-12-01

    Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms. PMID:12423267

  14. [Pediatric Abdominal Pain – Harmless or Harmful?].

    Science.gov (United States)

    Furlano, Raoul Ivano

    2016-04-27

    Abdominal pain is a very common pediatric complaint. In the majority of cases there is no life-threatening pathology behind this symptom, but a functional disease. However, all-day activities of children and adolescents are often limited, frequent absences from school, and general physician/ pediatrician office visits with often unnecessary diagnostic and therapies are registered. Once an organic etiology of the abdominal pain is excluded by a thoroughly medical history taking and physical examination, the first steps for a successful alleviation of the pain is the reassurance of the patients and their family that there is no life-threatening pathology. There is evidence that cognitive-behavioral therapy may be useful in improving pain and disability outcome in the short term. There is no evidence for pharmacological, dietetic, or complementary intervention in the treatment of chronic functional abdominal pain. PMID:27120211

  15. Enhancement of hemocompatibility of the MERA monopivot centrifugal pump: toward medium-term use.

    Science.gov (United States)

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

    2013-02-01

    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.

  16. Optimization of a miniature Maglev ventricular assist device for pediatric circulatory support.

    Science.gov (United States)

    Zhang, Juntao; Koert, Andrew; Gellman, Barry; Gempp, Thomas M; Dasse, Kurt A; Gilbert, Richard J; Griffith, Bartley P; Wu, Zhongjun J

    2007-01-01

    A miniature Maglev blood pump based on magnetically levitated bearingless technology is being developed and optimized for pediatric patients. We performed impeller optimization by characterizing the hemodynamic and hemocompatibility performances using a combined computational and experimental approach. Both three-dimensional flow features and hemolytic characteristics were analyzed using computational fluid dynamics (CFD) modeling. Hydraulic pump performances and hemolysis levels of three different impeller designs were quantified and compared numerically. Two pump prototypes were constructed from the two impeller designs and experimentally tested. Comparison of CFD predictions with experimental results showed good agreement. The optimized impeller remarkably increased overall pump hydraulic output by more than 50% over the initial design. The CFD simulation demonstrated a clean and streamlined flow field in the main flow path. The numerical results by hemolysis model indicated no significant high shear stress regions. Through the use of CFD analysis and bench-top testing, the small pediatric pump was optimized to achieve a low level of blood damage and improved hydraulic performance and efficiency. The Maglev pediatric blood pump is innovative due to its small size, very low priming volume, excellent hemodynamic and hematologic performance, and elimination of seal-related and bearing-related failures due to adoption of magnetically levitated bearingless motor technology, making it ideal for pediatric applications. PMID:17237645

  17. Tokamak pump limiters

    International Nuclear Information System (INIS)

    Recent experiments with a scoop limiter without active internal pumping have been carried out in the PDX tokamak with up to 6MW of auxiliary neutral beam heating. Experiments have also been done with a rotating head pump limiter in the PLT tokamak in conjunction with RF plasma heating. Extensive experiments have been done in the ISX-B tokamak and first experiments have been completed with the ALT-I limiter in TEXTOR. The pump limiter modules in these latter two machines have internal getter pumping. Experiments in ISX-B are with ohmic and auxiliary neutral beam heating. The results in ISX-B and TEXTOR show that active density control and particle removal is achieved with pump limiters. In ISX-B, the boundary layer (or scape-off layer) plasma partially screens the core plasma from gas injection. In both ISX-B and TEXTOR, the pressure internal to the module scales linearly with plasma density but in ISX-B, with neutral beam injection, a nonlinear increase is observed at the highest densities studied. Plasma plugging is the suspected cause. Results from PDX suggest that a region may exist in which core plasma energy confinement improves using a pump limiter during neutral beam injection. Asymmetric radial profiles and an increased edge electron temperature are observed in discharges with improved confinement. The injection of small amounts of neon into ISX-B has more clearly shown an improved electron core energy confinement during neutral beam injection. While carried out with a regular limiter, this Z-mode of operation is ideal for use with pump limiters and should be a way to achieve energy confinement times similar to values for H-mode tokamak plasmas. The implication of all these results for the design of a reactor pump limiter is described

  18. Lunar Base Heat Pump

    Science.gov (United States)

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

    1996-01-01

    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.

  19. Rotary blood pump

    Science.gov (United States)

    Benkowski, Robert J. (Inventor); Kiris, Cetin (Inventor); Kwak, Dochan (Inventor); Rosenbaum, Bernard J. (Inventor); Bacak, James W. (Inventor); DeBakey, Michael E. (Inventor)

    1999-01-01

    A blood pump that comprises a pump housing having a blood flow path therethrough, a blood inlet, and a blood outlet; a stator mounted to the pump housing, the stator having a stator field winding for producing a stator magnetic field; a flow straightener located within the pump housing, and comprising a flow straightener hub and at least one flow straightener blade attached to the flow straightener hub; a rotor mounted within the pump housing for rotation in response to the stator magnetic field, the rotor comprising an inducer and an impeller; the inducer being located downstream of the flow straightener, and comprising an inducer hub and at least one inducer blade attached to the inducer hub; the impeller being located downstream of the inducer, and comprising an impeller hub and at least one impeller blade attached to the impeller hub; and preferably also comprising a diffuser downstream of the impeller, the diffuser comprising a diffuser hub and at least one diffuser blade. Blood flow stagnation and clot formation within the pump are minimized by, among other things, providing the inducer hub with a diameter greater than the diameter of the flow straightener hub; by optimizing the axial spacing between the flow straightener hub and the inducer hub, and between the impeller hub and the diffuser hub; by optimizing the inlet angle of the diffuser blades; and by providing fillets or curved transitions between the upstream end of the inducer hub and the shaft mounted therein, and between the impeller hub and the shaft mounted therein.

  20. BIOMATERIALS FOR ROTARY BLOOD PUMPS

    NARCIS (Netherlands)

    VANOEVEREN, W

    1995-01-01

    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

  1. 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.

    Science.gov (United States)

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

    2016-04-01

    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

  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.

    Science.gov (United States)

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

    2016-04-01

    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. Indium 111 leucocyte scintigraphy in abdominal sepsis

    International Nuclear Information System (INIS)

    We have studied the clinical utility of indium 111 autologous leucocyte scintigraphy retrospectively in 45 patients presenting with suspected intra-abdominal sepsis. The sensitivity was 95% (21/22) and the specificity was 91% (21/23). Some 34 of the studies (17 positive and 17 negative) were considered helpful in furthering patient management (76%) and 8, unhelpful (18%). In 3, the study results were misleading and led to inappropriate treatment. Indium 111 scintigraphy, whether positive or negative, provides information in patients with suspected intra-abdominal sepsis upon which therapeutic decisions can be based. (orig.)

  4. Damage control resuscitation for abdominal war injury

    Directory of Open Access Journals (Sweden)

    Wei-wei DING

    2014-03-01

    Full Text Available In recent years, the concept of comprehensive treatment for military trauma has been comprehensively updated. The application of damage control surgery has significantly improved the clinical outcome of severe abdominal injury. With appropriate surgical intervention, post-trauma fluid resuscitation plays an increasingly important role in the treatment of abdominal injury. The damage control resuscitation strategy addresses the importance of permissive hypotension and haemostatic resuscitation for patients with severe trauma, under the guidance of damage control surgical principle. DOI: 10.11855/j.issn.0577-7402.2014.03.02

  5. Penetrating abdominal injuries in children in Nigeria.

    Science.gov (United States)

    Ameh, E A; Nmadu, P T

    1999-09-01

    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.

  6. Aggressive malignant abdominal mesothelioma: Clinical report

    International Nuclear Information System (INIS)

    A 32-year-old Filipino female, working as an x-ray technician, presented to the Emergency Room (ER) with acute abdominal pain for one day. The pain was mainly on the left side and left hypochondrium. She had recurring abdominal pain before but not significant to worry her. She also complained of abdominal distension, which she noticed one week ago. Abdominal examination revealed fullness in the left hypochondrium with marked tenderness but negative rebound. Abdominal ultrasound (US) showed a huge mass mainly in the left hypochondrium. The origin of the mass cannot be identified by US. A computerized tomography scan showed a mass in the left side of the abdomen crossing the midline with a necrotic centre. The hospital course of the patient runs smoothly, and she was discharged after 7-days and referred to an Oncology Center. Abdominal mesothelioma is a neoplasm arising from the mesothelial surface lining the abdominal cavity. It is less frequent than that of the pleura. It is a rapidly growing and fatal malignancy with a median survival of less than 1-year. The relation between pleural malignant mesothelioma and asbestos is well recognized since it was described in 19602 but implication of asbestos exposure in the etiology of the peritoneal type is less obvious. This patient history is giving no obvious exposure to asbestos but as she is working in the Radiology Department as an x-ray technician she is well exposed to x-ray, but the effect of radioactivity on induction of mesothelioma is still disputed.4 There are several reports linking malignant mesothelioma to radioactivity due to radiation therapy.The fibrous mesothelioma (sarcomatous), as in this case, which is difficult to diagnose microscopically, looks like a fibroma, unless helped by tissue culture. The treatment options of malignant mesothelioma include surgery, intraperitoneal chemotherapy and whole abdominal radiation or multimodality therapy, which were suggested that might prolong the survival in

  7. [Penetrating abdominal wounds. Apropos of 330 cases].

    Science.gov (United States)

    Nejjar, M; Bennani, S; Zerouali, O N

    1991-01-01

    Penetrating abdominal wounds are frequent and serious. 330 cases have been treated in the Department of Emergencies and visceral Surgery at Averroes Hospital of Casablanca from 1980 to 1990. The predominance of male sex is noted, and these wounds are always the result of aggression by white arm. All patients have been operated, the white laparotomy rate is of 36%. The classic interventionist attitude is still recommended in spite of this high rate, because our present conditions can't permit us a rigorous watching. According to abdominal lesions, the different interventions are reviewed, and their indications are detailed.

  8. An unusual cause of abdominal pain.

    Science.gov (United States)

    Terneu, S; Verhelst, D; Thys, F; Ketelslegers, E; Hantson, P; Wittebole, X

    2003-01-01

    A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K. PMID:14635532

  9. ABDOMINAL SCAR ENDOMETRIOSIS: REPORT OF 28 CASES

    Institute of Scientific and Technical Information of China (English)

    向阳; 郎景和; 王友芳; 黄荣丽; 连丽娟

    1995-01-01

    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.

  10. 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)

    1999-06-01

    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.

  11. Thermally Actuated Hydraulic Pumps

    Science.gov (United States)

    Jones, Jack; Ross, Ronald; Chao, Yi

    2008-01-01

    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

  12. 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

    2006-01-01

    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.

  13. A diagnostic approach to abdominal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Eser Vardareli; Baybora Kircali

    2005-01-01

    @@ 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.

  14. Unusual Differential Diagnosis of Upper Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Lanthaler Monika

    2009-01-01

    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.

  15. [Albert Einstein and his abdominal aortic aneurysm].

    Science.gov (United States)

    Cervantes Castro, Jorge

    2011-01-01

    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.

  16. CT features of abdominal plasma cell neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Monill, J.; Pernas, J.; Montserrat, E.; Perez, C.; Clavero, J.; Martinez-Noguera, A.; Guerrero, R.; Torrubia, S. [Universitat Autonoma de Barcelona, Hospital de Sant Pau, Barcelona (Spain)

    2005-08-01

    The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11). (orig.)

  17. Abdominal CT in acute arterial pathology

    International Nuclear Information System (INIS)

    The abdominal arterial pathology as studied by CT imagings is reviewed. The illustrated morphology of aortic aneurysms complications (arterial embolism, dissection and arteriosclerotic ulcer ) are studied. The signs that lead to diagnosis are assessed and the major points on which to base a correct radiological study are reviewed

  18. CT features of abdominal plasma cell neoplasms

    International Nuclear Information System (INIS)

    The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11). (orig.)

  19. Connective tissue alteration in abdominal wall hernia

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...

  20. Case series of abdominal sacral colpopexy

    Directory of Open Access Journals (Sweden)

    Vandana Dhama

    2016-06-01

    Conclusions: Abdominal sacral colpopexy with polypropylene mesh is a safe, effective treatment in patients having post hysterectomy vaginal vault proplase. When done by experienced gynecologist, major post-operative complications seem to be very few in patients having normal BMI and no major systemic illnesses. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1992-1995

  1. Intra-abdominal tumors in children

    International Nuclear Information System (INIS)

    Objective: The objective of the present study was to observe the histopathological pattern of intra-abdominal tumors in children less than 16 years. Place and Duration of Study: The study was carried out at the Department of Histopathology, Children's Hospital and the Institute of Child Health and King Edward Medical College, Lahore, over a period of 5 years, from January 1997 to December 2002. Subjects and Methods: The histopathological and demographic data of 264 intra-abdominal tumors of both the sexes under 16 years of age was collected and analyzed to determine the various morphological types of intra- abdominal tumors in relation to age and sex. Results: Neuroblastoma was the most common tumor constituting 29.6% of all cases, followed by Wilms' tumor (25.1%). Others were non-Hodgkins Iymphomas (15.5%), germ cell tumors and hepatoblastoma (9%) each, rhabdomyosarcoma (4.4%), hepatocellular carcinoma (1.4%) and miscellaneous (6%). Majority of the patients (77.2%) were under 5 years of age. The male to female ratio was 1.1 :0.9. Conclusion: Intra-abdominal tumors are more common in males. Most of the tumors were noted in children less than 5 years of age. (author)

  2. The Principles of Abdominal Wound Closure

    NARCIS (Netherlands)

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

    2013-01-01

    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

  3. Splenic trauma during abdominal wall liposuction: a case report

    OpenAIRE

    Harnett, Paul; Koak, Yashwant; Baker, Daryl

    2008-01-01

    A 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery.

  4. Mechanical circulatory support in treatment of children with refractory heart failure%辅助循环在婴幼儿难治性心力衰竭治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    史珍英; 周燕萍; 徐卓明; 蔡及明; 朱丽敏; 李志浩; 傅惟定

    2011-01-01

    Objective To summarize the intensive care experience of extracorporeal membrane oxygenation (ECMO) and left ventricular assist device ( LYAD) in children with refractory heart failure. Methods Thirteen children having undergone operation for complicated congenital heart disease and I child with fulminant myocarditis received mechanical circulatory support due to refractory heart failure. There were 8 children in ECMO group and 6 children in LVAD group. The mean arterial pressure, central venous pressure, pressure of right atrium, pressure of left atrium, serum lactate concentration and oxygen saturation of mixed venous blood were monitored during mechanical circulatory support. The dosage of inotropic medicine was adjusted, the activated coagulation time was maintained between 150 s and 180 s, hematocrit between 30% and 35%, and platelet count >80 000/mm3. The mechanical circulatory support was weaned off when blood pressure was stable, pulse pressure was no lower than 20 mmHg, and left ventricular ejection fraction reached 50%. Results The mean time of mechanical circulatory support was (147 ± 152) h in ECMO group and LVAD group. During the mechanical circulatory support, the blood pressure increased from (48. 1 ±5.2) mmHg to (60.2 ±7. 8) mmHg (P <0. 05), while the serum lactate concentration decreased from (5. 1 ±0. 8) tnmol/L to (3.6 ±0.5) mraol/L (P <0.05). The survival rate of weaning off was 57. 1% (8/14), and the survival rate of hospital discharge was 42. 9% (6/14). The major complication was severe bleeding in thoracic and abdominal cavity (63.7%). Four children had indifferent mind (23.6%), and 8 had multiple organ dysfunction (57.1 %). During the follow up of 4 to 26 months, the left ventricular ejection fraction was no less than 50%, the cardiac function was class II, the growth of children was significantly improved, and mild to moderate neural sequela was found in 2 children- Conclusion Mechanical circulatory support plays an effective role in

  5. Evaluation of abdominal CT in the initial treatment of abdominal trauma

    International Nuclear Information System (INIS)

    During the last four years 102 patients with abdominal trauma were examined by CT for preoperative evaluation in our hospital. In 35 patients (34 %), the CT scans revealed no abnormal findings. They were all managed conservatively except for one case of perforated small bowel. In 67 patients (66 %) CT revealed evidences of substantial abdominal or retroperitoneal trauma. In 30 of them CT findings were confirmed by surgery. Hepatic injury is usually easily recognized by CT. CT is also useful for the detection of renal or splenic injuries. The majority of those parenchymatous organ injuries were successfully managed with conservative therapy, despite apparent traumatic lesions revealed by CT. Repeat CT scans is proved to be very useful to follow the changes of these traumatic lesions. In conclusion, application of abdominal CT is extremely useful for the initial decision making in treatment of patients with abdominal trauma and for the follow-up observation of injured lesions. (author)

  6. Underground pumped hydroelectric storage

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-07-01

    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-leveling requirements of a greater metropolitan area with population of 1 million or more. The technical feasibility of UPHS depends upon excavation of a subterranean powerhouse cavern and reservoir caverns within a competent, impervious rock formation, and upon selection of reliable and efficient turbomachinery - pump-turbines and motor-generators - all remotely operable.

  7. Heat driven pulse pump

    Science.gov (United States)

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

    2000-01-01

    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. Scandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure

    DEFF Research Database (Denmark)

    Perner, A; Junttila, E; Haney, M;

    2015-01-01

    recommendations for general intensive care unit (ICU) patients and those with sepsis, trauma and burn injury. RESULTS: For general ICU patients and those with sepsis, we recommend using crystalloids for resuscitation rather than hydroxyethyl starch and we suggest using crystalloids rather than gelatin and albumin....... For patients with trauma we recommend to use crystalloids for resuscitation rather than colloid solutions. For patients with burn injury we provide no recommendations as there are very limited data from randomised trials on fluid resuscitation in this patient population. CONCLUSIONS: We recommend using......BACKGROUND: The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure...

  9. Isolated duodenal rupture due to blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Celik Atilla

    2006-01-01

    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.

  10. Abdominal fedme og fedmerelaterede sygdomme hos patienter i almen praksis

    DEFF Research Database (Denmark)

    Haugan, Ketil; Rost, Dan; Knudsen, Nils;

    2010-01-01

    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....

  11. 小儿罗叶泵的研制%Development of Pediatric Luo-Ye Pump

    Institute of Scientific and Technical Information of China (English)

    黄焕雷; 肖学钧; 刘鹏; 成安衡; 吴岳恒; 庄建

    2012-01-01

    Objective To investigate the manufacture method of 20 mL pediatric Luo-Ye pump, and conduct a test about its fatigue resistance to observe impulse performance of the pump. Methods Luo-Ye pump is composed of five parts: pump body, diaphragm, diaphragm fixed ring, inlet and outlet of prosthetic valve. The injection forming technique is adopted to manufacture Luo-Ye pump body of auxiliary pump, and diaphragm fixed ring; the methods of cold forming and thermal fixing are adopted to make diaphragm of pump; inlet and outlet of pump are made by medical Tc-4 titanium; valves adopt 17# CL-I(standard form) domestic, artificial, mechanical valves. A Luo-Ye pump assembled undertakes fatigue test on analogue circulatory device. Results Pediatric Luo-Ye pump of 20 mL is manufactured by taking the method of injection moulding, in which the surface is smooth. The pump body is totally transparent. It is tested on analogue circulatory device. And no deformities and leakage are found around the pump body, diaphragm, inlet and outlet. Conclusion Adoption of injection moulding technique could successfully manufacture pediatric Luo-Ye pump, which has stable quality and realizes batch production. Pediatric Luo-Ye pump has satisfactory durability.%目的 探讨20 mL小儿罗叶泵的制作方法,并对其行耐疲劳实验,观察罗叶泵的搏动性能.方法 罗叶泵由泵体、隔膜、隔膜固定圈、泵接口、出入口和人工瓣膜等组成.模具制作,采用注塑成形工艺制作辅助泵泵体和隔膜固定圈;采用冷成形热固定的方法制作罗叶泵隔膜;泵的出、入接口采用Tc-4医用钛金属制作;瓣膜采用17#CL-Ⅰ(标准型)国产人工机械心脏瓣膜.对组装好的罗叶泵在模拟循环台上行耐疲劳实验.结果 采用模具注塑成形的方法制作20 mL小儿罗叶泵,泵内表面光滑,泵体透明.在模拟循环台上进行测试,泵体、隔膜及接口无变形和渗漏.结论 采用模具注塑成形技术可成功制

  12. Skipping Breakfast and Risk of Mortality from Cancer, Circulatory Diseases and All Causes: Findings from the Japan Collaborative Cohort Study

    OpenAIRE

    Yokoyama, Yae; Onishi, Kazunari; Hosoda, Takenobu; Amano, Hiroki; Otani, Shinji; KUROZAWA, Youichi; Tamakoshi, Akiko

    2016-01-01

    Background Breakfast eating habits are a dietary pattern marker and appear to be a useful predictor of a healthy lifestyle. Many studies have reported the unhealthy effects of skipping breakfast. However, there are few studies on the association between skipping breakfast and mortality. In the present study, we examined the association between skipping breakfast and mortality from cancer, circulatory diseases and all causes using data from a large-scale cohort study, the Japan Collaborative C...

  13. Skipping Breakfast and Risk of Mortality from Cancer, Circulatory Diseases and All Causes: Findings from the Japan Collaborative Cohort Study

    Science.gov (United States)

    Yokoyama, Yae; Onishi, Kazunari; Hosoda, Takenobu; Amano, Hiroki; Otani, Shinji; Kurozawa, Youichi; Tamakoshi, Akiko

    2016-01-01

    Background Breakfast eating habits are a dietary pattern marker and appear to be a useful predictor of a healthy lifestyle. Many studies have reported the unhealthy effects of skipping breakfast. However, there are few studies on the association between skipping breakfast and mortality. In the present study, we examined the association between skipping breakfast and mortality from cancer, circulatory diseases and all causes using data from a large-scale cohort study, the Japan Collaborative Cohort Study (JACC) Study. Methods A cohort study of 34,128 men and 49,282 women aged 40–79 years was conducted, to explore the association between lifestyle and cancer in Japan. Participants completed a baseline survey during 1988 to 1990 and were followed until the end of 2009. We classified participants into two groups according to dietary habits with respect to eating or skipping breakfast and carried out intergroup comparisons of lifestyle. Multivariate analysis was performed using the Cox proportional hazard regression model. Results There were 5,768 deaths from cancer and 5,133 cases of death owing to circulatory diseases and 17,112 cases for all causes of mortality during the median 19.4 years follow-up. Skipping breakfast was related to unhealthy lifestyle habits. After adjusting for confounding factors, skipping breakfast significantly increased the risk of mortality from circulatory diseases [hazard ratio (HR) = 1.42] and all causes (HR = 1.43) in men and all causes mortality (HR = 1.34) in women. Conclusion Our findings showed that skipping breakfast is associated with increasing risk of mortality from circulatory diseases and all causes among men and all causes mortality among women in Japan. PMID:27046951

  14. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    Science.gov (United States)

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

    2012-12-15

    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 (P<0.05) and male (P<0.05) values, and returned to initial perioperative readings four hours after surgery. Tomcats and pregnant females (P<0.05) showed an increase in MAP and APP immediately after surgery decreasing back to initial perioperative values four hours later. A significant decrease in RT was appreciated immediately after laparotomy in both pregnant and non-pregnant queens. IAP was affected by abdominal surgery in this study, due likely to factors, such as postoperative pain and hypothermia. Pregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy. PMID:23118052

  15. 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)

    2009-01-01

    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

  16. 2013 WSES guidelines for management of intra-abdominal infections

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2013-01-01

    Full Text Available Abstract Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections.

  17. Primary abdominal pregnancy following intra-uterine insemination

    OpenAIRE

    Sujata Kar

    2011-01-01

    Primary abdominal pregnancy is an extremely rare type of extrauterine pregnancy. It has been reported from many unusual intra-abdominal sites. We report a case of primary abdominal pregnancy following intra-uterine insemination (not reported earlier to our knowledge). Implanted on the anterior surface of the uterus possibly related to an endometriotic foci. Early diagnosis enabled laparoscopic management of this case.

  18. Can release of urinary retention trigger abdominal aortic aneurysm rupture?

    Science.gov (United States)

    Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad

    2013-04-04

    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.

  19. Fluid pumping apparatus

    Science.gov (United States)

    West, Phillip B.

    2006-01-17

    A method and apparatus suitable for coupling seismic or other downhole sensors to a borehole wall in high temperature and pressure environments. In one embodiment, one or more metal bellows mounted to a sensor module are inflated to clamp the sensor module within the borehole and couple an associated seismic sensor to a borehole wall. Once the sensing operation is complete, the bellows are deflated and the sensor module is unclamped by deflation of the metal bellows. In a further embodiment, a magnetic drive pump in a pump module is used to supply fluid pressure for inflating the metal bellows using borehole fluid or fluid from a reservoir. The pump includes a magnetic drive motor configured with a rotor assembly to be exposed to borehole fluid pressure including a rotatable armature for driving an impeller and an associated coil under control of electronics isolated from borehole pressure.

  20. Pearls and pitfalls in short-term mechanical circulatory assist: how to avoid and manage complications.

    Science.gov (United States)

    Mohite, Prashant N; Maunz, Olaf; Simon, Andre R

    2014-10-01

    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.

  1. [Improvements in implantable mechanical circulatory support systems : literature overview and update].

    Science.gov (United States)

    Krabatsch, T; Schweiger, M; Stepanenko, A; Drews, T; Potapov, E; Pasic, M; Weng, Y; Huebler, M; Hetzer, R

    2011-10-01

    In recent years, ventricular assist devices (VAD) supporting the left (LVAD), the right (RVAD) or both ventricles (BVAD) have rapidly emerged as the standard of care for advanced heart failure patients. Both the numbers and ages of patients in which they are used are rising worldwide, especially when used as a permanent support (bridge to destination, BTD). Due to the continuing lack of donor organs, these devices now represent a viable alternative to bridge patients to transplantation (BTT), with a 1-year survival rate of 86%. BTD, especially in long-term support, might be a valid, and the sole, option for those patients in whom heart transplantation is contraindicated. Patient selection, pre- and intra-operative preparation, as well as the timing of VAD implantation are important factors critical to successful circulatory support. While BTT remains the goal in the majority of patients, the number of permanent VADs (i. e. BTD) is rising significantly. Although explantation of a VAD system as a bridge to recovery (BTR) can be considered in only a small number of patients, it represents a very special part of this therapy modality. PMID:21912911

  2. Cerebral venous circulatory disturbance as an informative prognostic marker for neonatal hemorrhagic stroke

    Science.gov (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

    2016-04-01

    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.

  3. Nursing diagnoses and outcomes related to the circulatory-system terms (ICNP® represented in an ontology

    Directory of Open Access Journals (Sweden)

    Marcia Regina Cubas

    2013-10-01

    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.

  4. 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.

    1980-12-01

    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.

  5. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Science.gov (United States)

    2016-01-01

    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 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. PMID:27156563

  6. Mechanical circulatory assist devices: a primer for critical care and emergency physicians.

    Science.gov (United States)

    Sen, Ayan; Larson, Joel S; Kashani, Kianoush B; Libricz, Stacy L; Patel, Bhavesh M; Guru, Pramod K; Alwardt, Cory M; Pajaro, Octavio; Farmer, J Christopher

    2016-01-01

    Mechanical circulatory assist devices are now commonly used in the treatment of severe heart failure as bridges to cardiac transplant, as destination therapy for patients who are not transplant candidates, and as bridges to recovery and "decision-making". These devices, which can be used to support the left or right ventricles or both, restore circulation to the tissues, thereby improving organ function. Left ventricular assist devices (LVADs) are the most common support devices. To care for patients with these devices, health care providers in emergency departments (EDs) and intensive care units (ICUs) need to understand the physiology of the devices, the vocabulary of mechanical support, the types of complications patients may have, diagnostic techniques, and decision-making regarding treatment. Patients with LVADs who come to the ED or are admitted to the ICU usually have nonspecific clinical symptoms, most commonly shortness of breath, hypotension, anemia, chest pain, syncope, hemoptysis, gastrointestinal bleeding, jaundice, fever, oliguria and hematuria, altered mental status, headache, seizure, and back pain. Other patients are seen for cardiac arrest, psychiatric issues, sequelae of noncardiac surgery, and trauma. Although most patients have LVADs, some may have biventricular support devices or total artificial hearts. Involving a team of cardiac surgeons, perfusion experts, and heart-failure physicians, as well as ED and ICU physicians and nurses, is critical for managing treatment for these patients and for successful outcomes. This review is designed for critical care providers who may be the first to see these patients in the ED or ICU. PMID:27342573

  7. Circulatory support devices: fundamental aspects and clinical management of bleeding and thrombosis.

    Science.gov (United States)

    Susen, S; Rauch, A; Van Belle, E; Vincentelli, A; Lenting, P J

    2015-10-01

    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.

  8. Episodic high irrigation pressure during surgical neuroendoscopy may cause intermittent intracranial circulatory insufficiency.

    Science.gov (United States)

    Fàbregas, N; Valero, R; Carrero, E; Tercero, J; Caral, L; Zavala, E; Ferrer, E

    2001-04-01

    Intermittent high peak pressure values inside the endoscope during neuroendoscopic surgical procedures are associated with postoperative morbidity. Unexpected delay in awakening is the complication most frequently observed by the anesthesiologist as a result of high peak pressure values inside the endoscope. During eight neuroendoscopic procedures the authors continuously monitored cerebral hemodynamic function, using a transcranial doppler (TCD) probe fixed on patients' temporal window. We observed that episodes of high peak pressure values inside the endoscope during neuroendoscopic navigation rinsing periods resulted in changes in the TCD wave profile consistent with "near intracranial circulatory arrestlike" wave. No systemic hemodynamic warning signs accompanied these intermittent episodes of severe decrease in cerebral perfusion pressure. When the rinsing liquid was allowed to escape, the pressure inside the endoscope decreased and the TCD wave immediately returned to its previous value. Neuroendoscopic procedures, although classified as minimally invasive surgery, warrant special monitoring that could alert us to a decrease in cerebral perfusion pressure. Middle cerebral artery TCD recording is a reliable and accurate tool for this purpose. PMID:11294458

  9. Programmed death 1 protects from fatal circulatory failure during systemic virus infection of mice.

    Science.gov (United States)

    Frebel, Helge; Nindl, Veronika; Schuepbach, Reto A; Braunschweiler, Thomas; Richter, Kirsten; Vogel, Johannes; Wagner, Carsten A; Loffing-Cueni, Dominique; Kurrer, Michael; Ludewig, Burkhard; Oxenius, Annette

    2012-12-17

    The inhibitory programmed death 1 (PD-1)-programmed death ligand 1 (PD-L1) pathway contributes to the functional down-regulation of T cell responses during persistent systemic and local virus infections. The blockade of PD-1-PD-L1-mediated inhibition is considered as a therapeutic approach to reinvigorate antiviral T cell responses. Yet previous studies reported that PD-L1-deficient mice develop fatal pathology during early systemic lymphocytic choriomeningitis virus (LCMV) infection, suggesting a host protective role of T cell down-regulation. As the exact mechanisms of pathology development remained unclear, we set out to delineate in detail the underlying pathogenesis. Mice deficient in PD-1-PD-L1 signaling or lacking PD-1 signaling in CD8 T cells succumbed to fatal CD8 T cell-mediated immunopathology early after systemic LCMV infection. In the absence of regulation via PD-1, CD8 T cells killed infected vascular endothelial cells via perforin-mediated cytolysis, thereby severely compromising vascular integrity. This resulted in systemic vascular leakage and a consequential collapse of the circulatory system. Our results indicate that the PD-1-PD-L1 pathway protects the vascular system from severe CD8 T cell-mediated damage during early systemic LCMV infection, highlighting a pivotal physiological role of T cell down-regulation and suggesting the potential development of immunopathological side effects when interfering with the PD-1-PD-L1 pathway during systemic virus infections. PMID:23230000

  10. Acute mechanical circulatory support for fulminant myocarditis complicated by cardiogenic shock.

    Science.gov (United States)

    Mody, Kanika P; Takayama, Hiroo; Landes, Elissa; Yuzefpolskaya, Melana; Colombo, Paolo C; Naka, Yoshifumi; Jorde, Ulrich P; Uriel, Nir

    2014-03-01

    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.

  11. THE IMPACT OF THE CONCEPT MAPS USED FOR OUR CIRCULATORY SYSTEM ON STUDENTS ACADEMIC SUCCESS

    Directory of Open Access Journals (Sweden)

    Mürşet ÇAKMAK

    2012-06-01

    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.

  12. Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

    Directory of Open Access Journals (Sweden)

    Guillermo Delgado

    2014-03-01

    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.

  13. Single and combined effects of air pollutants on circulatory and respiratory system-related mortality in Belgrade, Serbia.

    Science.gov (United States)

    Stojić, Svetlana Stanišić; Stanišić, Nemanja; Stojić, Andreja; Šoštarić, Andrej

    2016-01-01

    The aim of this study was to investigate the association between short- and long-term exposure to particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and soot and mortality attributed to circulatory and respiratory diseases in Belgrade area (Serbia). The analyzed data set comprised results of regular pollutant monitoring and corresponding administrative records on frequency of daily mortality in the period 2009-2014. Nonlinear exposure-response dependencies and delayed effects of temperature were examined by means of distributed lag nonlinear models. The air pollutant loadings and circulatory system-related death rates in Belgrade area are among the highest in Europe. Data demonstrated that excess risk of death with short-term exposure to elevated concentrations of PM10, SO2, and soot was not significant, whereas marked effect size estimates for exposure over 90 d preceding mortality were found. The influence of chronic exposure was shown to be greater for respiratory than circulatory system-related mortality. When stratified by age and gender, higher risk was noted for male individuals below the age of 65 years. PMID:26699658

  14. Air-Operated Sump Pump

    Science.gov (United States)

    Nolt, Gary D.

    1988-01-01

    Pump removes liquid seepage from small, restricted area and against large pressure head. Developed for moving small amounts of water and oil from sump pit 85 ft (25.91 m) deep. Fits in space only 6 1/2 in. (16.5 cm) in diameter and 18 in. (45.7 cm) long. In discharge part of pumping cycle, air forces liquid out of pump chamber through pipe. During filling part of pumping cycle, water enters pump chamber from sump pit. Float in chamber next to pump chamber controls pressurization through timer and solenoid valve.

  15. Noise through Quantum Pumps

    OpenAIRE

    Polianski, M. L.; Vavilov, M. G.; Brouwer, P.W.

    2002-01-01

    We study the current noise through an unbiased quantum electron pump and its mesoscopic fluctuations for arbitrary temperatures and beyond the bilinear response. In the bilinear regime, we find the full distributions of the noise power and the current-to-noise ratio for a chaotic quantum dots with single-channel and many-channel ballistic point contacts. For a dot with many-channel point contacts we also calculate the ensemble-averaged noise at arbitrary temperature and pumping strength. In t...

  16. Reactor coolant pump flywheel

    Science.gov (United States)

    Finegan, John Raymond; Kreke, Francis Joseph; Casamassa, John Joseph

    2013-11-26

    A flywheel for a pump, and in particular a flywheel having a number of high density segments for use in a nuclear reactor coolant pump. The flywheel includes an inner member and an outer member. A number of high density segments are provided between the inner and outer members. The high density segments may be formed from a tungsten based alloy. A preselected gap is provided between each of the number of high density segments. The gap accommodates thermal expansion of each of the number of segments and resists the hoop stress effect/keystoning of the segments.

  17. Heat pump planning handbook

    CERN Document Server

    Bonin, Jürgen

    2015-01-01

    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

  18. Regenerative adsorbent heat pump

    Science.gov (United States)

    Jones, Jack A. (Inventor)

    1991-01-01

    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.

  19. Aquaflo pump vs FMS 4 pump for shoulder arthroscopic surgery.

    OpenAIRE

    Ampat, G.; Bruguera, J.; Copeland, S A

    1997-01-01

    A prospective controlled trial was carried out to compare two different fluid delivery systems used for shoulder arthroscopy. One an advanced pump system that controls both pressure and flow of fluid delivered, the other an air-driven diaphragm pump that only controls fluid pressure. Blood loss, presence of bleeding vessels and visual clarity were parameters used to assess the pump systems. There was no difference between the pumps in straightforward shoulder procedures. However, complicated ...

  20. 77 FR 66847 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-11-07

    ... 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,...

  1. Evaluation of erythrocyte flow at a bearing gap in a hydrodynamically levitated centrifugal blood pump.

    Science.gov (United States)

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

    2015-01-01

    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.

  2. Study of a centrifugal blood pump in a mock loop system.

    Science.gov (United States)

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

    2013-11-01

    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.

  3. Improvement of hemocompatibility for hydrodynamic levitation centrifugal pump by optimizing step bearings.

    Science.gov (United States)

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

    2011-01-01

    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.

  4. Computational design and in vitro characterization of an integrated maglev pump-oxygenator.

    Science.gov (United States)

    Zhang, Juntao; Taskin, M Ertan; Koert, Andrew; Zhang, Tao; Gellman, Barry; Dasse, Kurt A; Gilbert, Richard J; Griffith, Bartley P; Wu, Zhongjun J

    2009-10-01

    For the need for respiratory support for patients with acute or chronic lung diseases to be addressed, a novel integrated maglev pump-oxygenator (IMPO) is being developed as a respiratory assist device. IMPO was conceptualized to combine a magnetically levitated pump/rotor with uniquely configured hollow fiber membranes to create an assembly-free, ultracompact system. IMPO is a self-contained blood pump and oxygenator assembly to enable rapid deployment for patients requiring respiratory support or circulatory support. In this study, computational fluid dynamics (CFD) and computer-aided design were conducted to design and optimize the hemodynamics, gas transfer, and hemocompatibility performances of this novel device. In parallel, in vitro experiments including hydrodynamic, gas transfer, and hemolysis measurements were conducted to evaluate the performance of IMPO. Computational results from CFD analysis were compared with experimental data collected from in vitro evaluation of the IMPO. The CFD simulation demonstrated a well-behaved and streamlined flow field in the main components of this device. The results of hydrodynamic performance, oxygen transfer, and hemolysis predicted by computational simulation, along with the in vitro experimental data, indicate that this pump-lung device can provide the total respiratory need of an adult with lung failure, with a low hemolysis rate at the targeted operating condition. These detailed CFD designs and analyses can provide valuable guidance for further optimization of this IMPO for long-term use. PMID:19681842

  5. Evaluation of erythrocyte flow at a bearing gap in a hydrodynamically levitated centrifugal blood pump.

    Science.gov (United States)

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

    2015-01-01

    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. PMID:26736252

  6. Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Davood Farsi

    2014-01-01

    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.

  7. Piston for rod pumping

    Energy Technology Data Exchange (ETDEWEB)

    Pastushenko, G.I.

    1965-06-22

    A piston, or plunger, for rod pumping, is made up of a cylindrical housing with labryinthal seals, a nose piece, and a scraper. In order to remove paraffin from the inside surface of the production pipe, the housing is made in telescopic form. The scraper consists of an arrangement of springs installed on the outer surface of the housing.

  8. Pump Flow Analysis

    Science.gov (United States)

    1981-01-01

    Ingersoll-Rand Research, Inc.'s use of COSMIC's computer program MERIDL permits designers to evaluate performance and efficiency characteristics to be expected from the pump's impeller. It also provides information that enables a trained hydraulic engineer to make design improvements. Company was able to avoid the cost of developing new software and to improve some product design features.

  9. Microfluidic "blinking" bubble pump

    NARCIS (Netherlands)

    Yin, Zhizhong; Prosperetti, Andrea

    2005-01-01

    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

  10. Optimization of compound gear pump

    Institute of Scientific and Technical Information of China (English)

    栾振辉

    2002-01-01

    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.

  11. Orbital Liquid Oxygen Pump Project

    Data.gov (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...

  12. Fuel Pumping System And Method

    Science.gov (United States)

    Shafer, Scott F.; Wang, Lifeng

    2005-12-13

    A fuel pumping system that includes a pump drive is provided. A first pumping element is operatively connected to the pump drive and is operable to generate a first flow of pressurized fuel. A second pumping element is operatively connected to the pump drive and is operable to generate a second flow of pressurized fuel. A first solenoid is operatively connected to the first pumping element and is operable to vary at least one of a fuel pressure and a fuel flow rate of the first flow of pressurized fuel. A second solenoid is operatively connected to the second pumping element and is operable to vary at least one of a fuel pressure and a fuel flow rate of the second flow of pressurized fuel.

  13. Atrophic coarctation of the abdominal aorta.

    Science.gov (United States)

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    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

  14. [Traumatic and iatrogenic lesions of abdominal vessels].

    Science.gov (United States)

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H

    1997-01-01

    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.

  15. Drug Therapy for Small Abdominal Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Ramachandran Meenakshisundaram

    2010-03-01

    Full Text Available Abdominal aortic aneurysm is often asymptomatic, less recognized, and causes considerable mortalityand morbidity, if missed. The incidence varies from country to country and the occurrence is influencedby modifiable (smoking, coronary heart disease, hypertension, dyslipidemia, and prolonged steroid therapyand non-modifiable risk factors (increasing age, male gender, and positive family history. Most ofthe patients with such aneurysm do not exhibit symptoms and the diagnosis is made accidentally duringroutine medical investigations, abdominal ultrasonography, or by an astute surgeon during an abdominalprocedure. Sometimes the diagnosis is made in an emergency room, if the attending resident/doctor isaware of it. Despite good diagnosis and effective management, the outcomes of complicated cases arepoor and the treatment cost is prohibitive. Hence, we reviewed the literature to find out the pathogenesisof such aneurysms and the usefulness of available drugs in its prevention.

  16. Abdominal pregnancy as a cause of hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Shafi Sheikh

    2009-01-01

    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.

  17. 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)

    2002-12-01

    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.)

  18. Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon

    Institute of Scientific and Technical Information of China (English)

    Jenny N Tannoury; Bassam N Abboud

    2012-01-01

    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.

  19. [Adrenal injury in blunt abdominal trauma].

    Science.gov (United States)

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G

    2009-01-01

    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.

  20. Child abdominal tumour in tropical context: Think about schistosomiasis!

    Directory of Open Access Journals (Sweden)

    A. M. Napon

    2014-01-01

    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.

  1. [Surgical criteria for reoperation in abdominal surgery].

    Science.gov (United States)

    Bricot, R

    1975-07-01

    Analysis of the surgical criteria for reintervention in Abdominal Surgery led to the accentuation of a certain number of pictures of occlusion, general infectious syndromes, postoperative peritonitis, gastro-intestinal fistula and hemorrhagic syndrome. In all cases, the clinical examination can be misleading in particular in the case of peritonitis, and the history and non-surgical criteria must be strongly borne in mind. PMID:2036

  2. Malignant peritoneal mesothelioma after remote abdominal radiation

    International Nuclear Information System (INIS)

    Peritoneal mesothelioma in a 61-year-old man, occurred 26 years after abdominal radiotherapy for a testicular seminoma. The patient had no history of asbestos exposure. After asbestos, radiation is the second most frequent defined cause of mesothelioma in North America, but the number of well-documented cases is small; this case represents only the fifth example of peritoneal mesothelioma after therapeutic irradiation of the abdomen. 16 references

  3. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    OpenAIRE

    Al Soub, Hussam; Al-Maslamani, Eman; Al-Maslamani, Mona

    2008-01-01

    We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably r...

  4. Computed tomography of pediatric abdominal masses

    Energy Technology Data Exchange (ETDEWEB)

    Kook, Shin Ho; Ko, Eun Joo; Chung, Eun Chul; Suh, Jung Soo; Rhee, Chung Sik [College of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    1988-02-15

    Ultrasonography is a very useful diagnostic modality for evaluation of the pediatric abdominal masses, due to faster, cheaper, and no radiation hazard than CT. But CT has more advantages in assessing precise anatomic location, and extent of the pathologic process, and also has particular value in defining the size, relation of the mass to surrounding organs and detection of lymphadenopathy. We analyzed CT features of 35 cases of pathologically proven pediatric abdominal masses for recent 2 years at Ewha Woman's University Hospital. The results were as follows: 1.The most common originating site was kidney (20 cases, 57.1%); followed by gastrointestinal (5 cases, 14.3%), nonrenal retroperitoneal (4 cases, 11.4%), hepatobiliary (3 cases, 8.6%), and genital (3 cases, 8.6%) in order of frequency. 2.The most common mass was hydronephrosis (11 cases, 31.4%), Wilms' tumor (7 cases, 20.0%), neuroblastoma, choledochal cyst, periappendiceal abscess (3 cases, 8.6%, respectively), ovarian cyst (2 cases, 5.7%) were next in order of frequency. 3.Male to female ratio was 4:5 and choledochal cyst and ovarian cyst were found only in females. The most prevalent age group was 1-3 year old (12 cases, 34.3%). 4.With CT, the diagnosis of hydronephrosis was easy in all cases and could evaluate of its severity, renal function and obstruction site with high accuracy. 5.Wilms' tumor and neuroblastoma were relatively well differentiated by their characteristic CT features; such as location, shape, margin, middle cross, calyceal appearance and calcification, etc. 6.Ovarian and mensentric cysts had similar CT appearance. 7.In other pediatric abdominal masses, CT provided excellent information about anatomic detail, precise extent of tumor and differential diagnostic findings. So, CT is useful imaging modality for the demonstration and diagnosis of abdominal mass lesions in pediatric patients.

  5. Abdominal pregnancy as a cause of hemoperitoneum

    OpenAIRE

    Shafi Sheikh; Malla Misbha; Salaam Parvaiz; Kirmani Omer

    2009-01-01

    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 ...

  6. Reconstruction of chest, abdominal walls and perineum

    OpenAIRE

    Vijaykumar D; Vijayaraghavan Sundeep

    2007-01-01

    The structural integrity of the chest and abdominal walls and perineum is frequently altered by cancer extirpation. Advances in reconstructive surgery and the availability of innovative techniques have helped the cancer surgeon to proceed with radical excisions with minimum morbidity. The ability to harvest flaps from distant sites and the availability of good prosthetic materials have now become part of the routine armamentarium of the plastic surgeon engaged in reconstructive surgery of the...

  7. Blood Pump Bearing System

    Science.gov (United States)

    Aber, Gregory S. (Inventor)

    2000-01-01

    An apparatus is provided for a blood pump bearing system within a pump housing to support long-term highspeed rotation of a rotor with an impeller blade having a plurality of individual magnets disposed thereon to provide a small radial air gap between the magnets and a stator of less than 0.025 inches. The bearing system may be mounted within a flow straightener, diffuser, or other pump element to support the shaft of a pump rotor. The bearing system includes a zirconia shaft having a radiused end. The radiused end has a first radius selected to be about three times greater than the radius of the zirconia shaft. The radiused end of the zirconia shaft engages a flat sapphire endstone. Due to the relative hardness of these materials a flat is quickly produced during break-in on the zirconia radiused end of precisely the size necessary to support thrust loads whereupon wear substantially ceases. Due to the selection of the first radius, the change in shaft end-play during pump break-in is limited to a total desired end-play of less than about 0.010 inches. Radial loads are supported by an olive hole ring jewel that makes near line contact around the circumference of the Ir shaft to support big speed rotation with little friction. The width of olive hole ring jewel is small to allow heat to conduct through to thereby prevent heat build-up in the bearing. A void defined by the bearing elements may fill with blood that then coagulates within the void. The coagulated blood is then conformed to the shape of the bearing surfaces.

  8. Absorption heat pumps

    Science.gov (United States)

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

    1987-03-01

    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.

  9. Influence of exercise training on the oxidative capacity of rat abdominal muscles

    Science.gov (United States)

    Uribe, J. M.; Stump, C. S.; Tipton, C. M.; Fregosi, R. F.

    1992-01-01

    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.

  10. Sagittal Abdominal Diameter: Application in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Thaís Da Silva-Ferreira

    2014-05-01

    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.

  11. Endovascular repair of abdominal aortic aneurysms.

    Science.gov (United States)

    Arnaoutakis, Dean J; Zammert, Martin; Karthikesalingam, Alan; Belkin, Michael

    2016-09-01

    Endovascular repair of abdominal aortic aneurysms is an important technique in the vascular surgeon's armamentarium, which has created a seismic shift in the management of aortic pathology over the past two decades. In comparison to traditional open repair, the endovascular approach is associated with significantly improved perioperative morbidity and mortality. The early survival benefit of endovascular abdominal aortic aneurysm repair is sustained up to 3 years postoperatively, but longer-term life expectancy remains poor regardless of operative modality. Nonetheless, most abdominal aortic aneurysms are now repaired using endovascular stent grafts. The technology is not perfect as several postoperative complications, namely endoleak, stent-graft migration, and graft limb thrombosis, can develop and therefore lifelong imaging surveillance is required. In addition, a postoperative inflammatory response has been documented after endovascular repair of aortic aneurysms; the clinical significance of this finding has yet to be determined. Subsequently, the safety and applicability of endovascular stent grafts are likely to improve and expand with the introduction of newer-generation devices and with the simplification of fenestrated systems. PMID:27650343

  12. Endovascular repair of ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Šarac Momir

    2014-01-01

    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.

  13. Multidetector CT of blunt abdominal trauma.

    Science.gov (United States)

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  14. [Hereditary angioedema: strange cause of abdominal pain].

    Science.gov (United States)

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio

    2014-01-01

    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.

  15. 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

    2008-01-01

    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.

  16. Quantification of abdominal aortic deformation after EVAR

    Science.gov (United States)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  17. [Abdominal aortic aneurysm: an uncommon presentation].

    Science.gov (United States)

    Taborda, Lúcia; Pereira, Laurinda; Amona, Eurides; Pinto, Erique Guedes; Rodrigues, Joaquim

    2011-01-01

    Most abdominal aortic aneurysms are asymptomatic, being accidentally found on physical examination or in routinely performed imaging studies. They only require surveillance (which is variable according to the aneurism size) and medical therapy in order to achieve risk factor reduction. However, in certain situations, according to the risk of aneurism rupture, elective surgery or endovascular procedure may be necessary. About 80% of the cases of aneurism rupture occur into the retroperitoneal space, with a high mortality rate. There are uncommon presentations of aneurism rupture as the aorto-caval fistula, which also require fast diagnosis and intervention. The authors present the case of a 71-year-old man, with the previous diagnosis of hypertension, acute myocardial infarction 2 months earlier (undergone primary Percutaneous Coronary Intervention) and tabagism, who was admitted at the emergency department with intense 24-hour-evolution epigastric pain. On physical examination, the Blood Pressure values measured at the lower limbs were about half the ones measured at the upper limbs and there was an abdominal pulsatile mass, with a high-intensity murmur. As the authors suspected aortic dissection, aneurysm, coarctation or thrombosis, it was done a Computed Tomography scanning with intravenous contrast, which revealed a ruptured abdominal aorta aneurysm with a mural thrombus. The doppler ultrasound confirmed the presence of a high debit aorto-caval fistula. The patient was immediately transferred to the Vascular Surgery. However he died 2 hours later, during surgery. PMID:22525642

  18. [Abdominal multi-organ transplantation in dogs].

    Science.gov (United States)

    Kumagae, T

    1988-07-01

    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.

  19. Getting Pumped About Heart Failure

    OpenAIRE

    Mann, Douglas L.

    2014-01-01

    Heart failure is a clinical syndrome caused by dysregulated calcium handling and abnormal cardiac pumping capacity. Whalquist et al. (2014) show that upregulation of micro-RNA25 impairs calcium handling leading to pump dysfunction, and that targeting micro-RNA25 using antisense oligonucleotides reverses pump dysfunction and improves survival in mice with heart failure.

  20. VIRTUAL FUEL-PUMP DESIGN

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    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.

  1. Clinical features of late-onset circulatory dysfunction in premature infants

    Directory of Open Access Journals (Sweden)

    Koyama N

    2014-07-01

    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

  2. Significance of residual abdominal masses in children with abdominal Burkitt's lymphoma

    International Nuclear Information System (INIS)

    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.)

  3. 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)

    2001-11-01

    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.)

  4. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2012-01-31

    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.

  5. Small Scroll Pump for Cryogenic Liquids Project

    Data.gov (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...

  6. Improving pumping system efficiency at coal plants

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

    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.

  7. PERIPHERAL VENO-ARTERIAL ECMO AS MECHANICAL CIRCULATORY SUPPORT BEFORE HEART TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    E. A. Spirina

    2013-01-01

    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. 

  8. Brain ultrasonographic findings of late-onset circulatory dysfunction due to adrenal insufficiency in preterm infants

    Directory of Open Access Journals (Sweden)

    Su-Mi Shin

    2016-07-01

    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.

  9. Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

    International Nuclear Information System (INIS)

    Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care. (author)

  10. 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.

    2013-02-01

    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.

  11. Resolution and outcome of acute circulatory failure does not correlate with hemodynamics

    Science.gov (United States)

    Suistomaa, Matti; Uusaro, Ari; Parviainen, Ilkka; Ruokonen, Esko

    2003-01-01

    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

  12. Behaviour at eight years in children with surgically corrected transposition: The Boston Circulatory Arrest Trial*

    Science.gov (United States)

    Bellinger, David C.; Newburger, Jane W.; Wypij, David; Kuban, Karl C. K.; duPlesssis, Adre J.; Rappaport, Leonard A.

    2016-01-01

    Uncertainty exists regarding the degree to which infants with congenitally malformed hearts are at risk of behavioural disorders in childhood. Data was collected as part of a randomized clinical trial involving 155 children with surgically corrected transposition (concordant atrioventricular and ventriculo-arterial connections or alignments). As infants, they underwent the arterial switch operation, involving deep hypothermia with predominantly total circulatory arrest or predominantly low-flow continuous cardiopulmonary bypass as the method of providing support to the vital organs. Parents completed the Child Behavior Checklist when the patients were aged 4 and 8 years, and the Connors’ Parent Rating Scale at the age of 8 years. When the children were aged 8, teachers completed the Teacher’s Report Form and the Connors’ Teacher Rating Scale. In the cohort as a whole, the frequencies of behavioural problems identified by both parents and teachers were elevated, particularly on the scales for competence of the Child Behavior Checklist, and the Adaptive scales of the Teacher’s Report Form. Approximately 1 in 5 patients had scores for Total Problem Behavior in the range of clinical concern on both the Child Behavior Checklist and the Teacher’s Report Form. Few differences were found, however, according to the method of operative treatment. Postoperative seizures were associated with social and attention problems. Children experiencing academic problems at the age of 8 showed a larger increase in behavioural problems between the ages of 4 and 8 than did children making adequate academic progress. Children with congenitally malformed hearts who underwent reparative surgery in infancy using a strategy of severe haemodilution and alpha stat are at increased risk of behavioural problems in middle childhood. PMID:19079812

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

    International Nuclear Information System (INIS)

    The pumping speed and compression ratio of the two-stage roots blower pumping system were measured for light element gases (H2, D2 and He) and for N2, 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 m3/s), two EH250s (ibid. 250 m3/s) and a backing pump (ibid. 100 m3/s) in series connection was tested under PNEUROP standards. The maximum pumping speeds of the two-stage system for D2 and N2 were 1200 and 1300 m3/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

    2013-09-30

    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. VIBRATION ANALYSIS IN OVERHUNG PUMP

    OpenAIRE

    Neelendra Pratap Singh*, Prateek Gupta, Siddharth Agnihotri

    2016-01-01

    In the present scenario, Energy demand is increasing day by day. To meet that demand, the production or extraction of crude oil, natural gas and other energy resources is done with the help of various pumps. Pumps are the second largest used machinery in world and plays a vital role. In this paper, we have done analysis on centrifugal pump categorised as overhung pump (OH2). It is commonly known that vibration problems on centrifugal pumps can result from multitude of possible parameters whic...

  16. Linear tubular switched reluctance motor for heart assistance circulatory: Analytical and finite element modeling

    OpenAIRE

    LLIBRE, Jean-François; Martinez, Nicolas; Nogarède, Bertrand; Leprince, Pascal

    2011-01-01

    A linear tubular switched reluctance motor is presented. This actuator is devoted to be used as a left ventricular assist device (LVAD). In order to avoid thrombosis, this actuator includes pump and valve functions. By using a St. Jude Medical mechanical valve inside the tubular mover, a pulsatile flow is created in the descending aorta. A linear model of a basic pattern of the actuator based on a reluctance network is developed. Then, a two dimensions finite element method analysis is per...

  17. Functional and biocompatibility performances of an integrated Maglev pump-oxygenator.

    Science.gov (United States)

    Zhang, Tao; Cheng, Guangming; Koert, Andrew; Zhang, Juntao; Gellman, Barry; Yankey, G Kwame; Satpute, Aditee; Dasse, Kurt A; Gilbert, Richard J; Griffith, Bartley P; Wu, Zhongjun J

    2009-01-01

    To provide respiratory support for patients with lung failure, a novel compact integrated pump-oxygenator is being developed. The functional and biocompatibility performances of this device are presented. The pump-oxygenator is designed by combining a magnetically levitated pump/rotor with a uniquely configured hollow fiber membrane bundle to create an assembly free, ultracompact, all-in-one system. The hemodynamics, gas transfer and biocompatibility performances of this novel device were investigated both in vitro in a circulatory flow loop and in vivo in an ovine animal model. The in vitro results showed that the device was able to pump blood flow from 2 to 8 L/min against a wide range of pressures and to deliver an oxygen transfer rate more than 300 mL/min at a blood flow of 6 L/min. Blood damage tests demonstrated low hemolysis (normalized index of hemolysis [NIH] approximately 0.04) at a flow rate of 5 L/min against a 100-mm Hg afterload. The data from five animal experiments (4 h to 7 days) demonstrated that the device could bring the venous blood to near fully oxygen-saturated condition (98.6% +/- 1.3%). The highest oxygen transfer rate reached 386 mL/min. The gas transfer performance was stable over the study duration for three 7-day animals. There was no indication of blood damage. The plasma free hemoglobin and platelet count were within the normal ranges. No gross thrombus is found on the explanted pump components and fiber surfaces. Both in vitro and in vivo results demonstrated that the newly developed pump-oxygenator can achieve sufficient blood flow and oxygen transfer with excellent biocompatibility. PMID:19178439

  18. Evaluation of Forty-Nine Patients with Abdominal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Murat Kilic

    2014-12-01

    Full Text Available Aim: Abdominal tuberculosis is an uncommon form of extrapulmonary infection. In this study, we aimed to highlight the nonspecific clinical presentations and diagnostic difficulties of abdominal tuberculosis. Material and Method: Clinical features, diagnostic methods, and the therapeutic outcomes of 49 patients diagnosed as abdominal tuberculosis between 2003 and 2014 were retrospectively analyzed. Results: The patients were classified into four subgroups including peritoneal (28, nodal (14, intestinal (5, and solid organ tuberculosis (2. The most frequent symptoms were abdominal pain, abdominal distention and fatique. Ascites appeared to be the most frequent clinical finding. Ascites and enlarged abdominal lymph nodes were the most frequent findings on ultrasonography and tomography. Diagnosis of abdominal tuberculosis was mainly depended on histopathology of ascitic fluid and biopsies from peritoneum, abdominal lymph nodes or colonoscopic materials. Forty patients healed with standart 6-month therapy while extended treatment for 9-12 months was needed in 8 whom had discontinued drug therapy and had persistent symptoms and signs. One patient died within the treatment period due to disseminated infection. Discussion: The diagnosis of abdominal tuberculosis is often difficult due to diverse clinical presentations. The presence of ascites, personal/familial/contact history of tuberculosis, and coexisting active extraabdominal tuberculosis are the most significant marks in diagnosis. Diagnostic laparoscopy and tissue sampling seem to be the best diagnostic approach for abdominal tuberculosis.

  19. Remote revascularization of abdominal wall transplants using the forearm.

    Science.gov (United States)

    Giele, H; Bendon, C; Reddy, S; Ramcharan, R; Sinha, S; Friend, P; Vaidya, A

    2014-06-01

    Primary abdominal wall closure following small bowel transplantation is frequently impossible due to contraction of the abdominal domain. Although abdominal wall transplantation was reported 10 years ago this, technique has not been widely adopted, partly due to its complexity, but largely because of concerns that storing the abdominal allograft until the end of a prolonged intestinal transplant procedure would cause severe ischemia-reperfusion injury. We report six cases of combined small bowel and abdominal wall transplantation where the ischemic time was minimized by remotely revascularizing the abdominal wall on the forearm vessels, synchronous to the intestinal procedure. When the visceral transplant was complete, the abdominal wall was removed from the forearm and revascularized on the abdomen (n = 4), or used to close the abdomen while still vascularized on the forearm (n = 2). Primary abdominal wall closure was achieved in all. Mean cold ischemia was 305 min (300-330 min), and revascularization on the arm was 50 min (30-60 min). Three patients had proven abdominal wall rejection, all treated successfully. Immediate revascularization of the abdominal wall allograft substantially reduces cold ischemia without imposing constraints on the intestinal transplant. Reducing storage time may also have benefits with respect to ischemia-reperfusion-related graft immunogenicity. PMID:24797611

  20. Advanced heat pump cycle

    Energy Technology Data Exchange (ETDEWEB)

    Groll, E.A.; Radermacher, R.

    1993-07-01

    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.

  1. Solar-powered pump

    Science.gov (United States)

    Kirsten, C. C. (Inventor)

    1976-01-01

    A solar powered pump particularly suited for intermittently delivering a stream of water is reported. The pump is characterized by a housing adapted to be seated in a source of water having a water discharge port disposed above the water line of the source, a sump including a valved inlet port through which water is introduced to the sump, disposed beneath the water line, a displacer supported for vertical reciprocation in said housing, an air passageway extended between the vertically spaced faces of the displacer, and a tipple disposed adjacent to the water discharge port adapted to be filled in response to a discharge of water from the housing. Air above a displacer is expanded in response to solar energy impinging on the housing and transferred into pressurizing relation with the sump for forcing water from the sump.

  2. Water displacement mercury pump

    Science.gov (United States)

    Nielsen, Marshall G.

    1985-01-01

    A water displacement mercury pump has a fluid inlet conduit and diffuser, a valve, a pressure cannister, and a fluid outlet conduit. The valve has a valve head which seats in an opening in the cannister. The entire assembly is readily insertable into a process vessel which produces mercury as a product. As the mercury settles, it flows into the opening in the cannister displacing lighter material. When the valve is in a closed position, the pressure cannister is sealed except for the fluid inlet conduit and the fluid outlet conduit. Introduction of a lighter fluid into the cannister will act to displace a heavier fluid from the cannister via the fluid outlet conduit. The entire pump assembly penetrates only a top wall of the process vessel, and not the sides or the bottom wall of the process vessel. This insures a leak-proof environment and is especially suitable for processing of hazardous materials.

  3. Sucker rod pump

    Energy Technology Data Exchange (ETDEWEB)

    Brewer, J.R.

    1992-04-14

    This patent describes a subsurface well pump, it comprises: a working barrel; a plunger which reciprocates along the vertical axis within the working barrel between an upper and lower position; a rod connected to the plunger and extending to a means for providing reciprocating force; a well string extending from the top of the working barrel to the surface; an outlet check valve which permits flow to exit the working barrel into the well string and does not permit flow to exit the well string into the working barrel; and an inlet check valve which permits flow into the working barrel from outside of the subsurface pump, the inlet check valve being above the top position of the plunger, the inlet check valve having a cross sectional flow area about equal to or greater than the horizontal cross sectional area of the working barrel, and the inlet check valve being a hinged flapper valve.

  4. Pocket pumped image analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kotov, I.V., E-mail: kotov@bnl.gov [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)

    2015-07-01

    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.

  5. Effect of a bearing gap on hemolytic property in a hydrodynamically levitated centrifugal blood pump with a semi-open impeller.

    Science.gov (United States)

    Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu; Yambe, Tomoyuki; Imachi, Kou; Yamane, Takashi

    2013-01-01

    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.

  6. Nonazeotropic Heat Pump

    Science.gov (United States)

    Ealker, David H.; Deming, Glenn

    1991-01-01

    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.

  7. Stirling Engine Heat Pump

    Science.gov (United States)

    Kagawa, Noboru

    Recent advances in the feasibility studies related to the Stirling engines and Stirling engine heat pumps which have been considered attractive due to their promising role in helping to solve the global environmental and energy problems,are reviewed. This article begins to describe the brief history of the Stirling engines and theoretical thermodynamic analysis of the Stirling cycle in order to understand several advantages on the Stirling engine. Furthermore,they could throw light on our question why the dream engines had not been promoted to practical applications during two hundred years. The present review shows that the Stirling engines with several unique advantages including 30 to 40% thermal efficiency and preferable exhaust characteristics,had been designed and constructed by recent tackling for the development of the advanced automobile and other applications using them. Based on the current state of art,it is being provided to push the Stirling engines combined with heat pumps based on the reversed Rankine cycle to the market. At present,however, many problems, especially for the durability, cost, and delicate engine parts must be enforced to solve. In addition,there are some possibilities which can increase the attractiveness of the Stirling engines and heat pumps. The review closes with suggestions for further research.

  8. Electrocentrifugal pumping; Bombeo electrocentrifugo

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Perez, Guillermo; Medellin Otero, Hector [Instituto Mexicano del Peroleo (Mexico)

    1996-07-01

    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.

  9. Pumping potential wells

    Science.gov (United States)

    Hershkowitz, N.; Forest, C.; Wang, E. Y.; Intrator, T.

    1987-01-01

    Nonmonotonic plasma potential structures are a common feature of many double layers and sheaths. Steady state plasma potential wells separating regions having different plasma potentials are often found in laboratory experiments. In order to exist, such structures all must find a solution to a common problem. Ions created by charge exchange or ionization in the region of the potential well are electrostatically confined and tend to accumulate and fill up the potential well. The increase in positive charge should eliminate the well. Nevertheless, steady state structures are found in which the wells do not fill up. This means that it is important to take into account processes which 'pump' ions from the well. As examples of ion pumping of plasma wells, potential dips in front of a positively biased electro collecting anode in a relatively cold, low density multidipole plasma is considered. Pumping is provided by ion leaks from the edges of the potential dip or by oscillating the applied potential. In the former case the two dimensional character of the problem is shown to be important.

  10. A Magnetically Coupled Cryogenic Pump

    Science.gov (United States)

    Hatfield, Walter; Jumper, Kevin

    2011-01-01

    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

  11. A new computational fluid dynamics method for in-depth investigation of flow dynamics in roller pump systems.

    Science.gov (United States)

    Zhou, Xiaoming; Liang, Xin M; Zhao, Gang; Su, Youchao; Wang, Yang

    2014-07-01

    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.

  12. [THE CHARACTERISTIC OF SOMATOTYPE AND FUNCTIONAL STATE OF CIRCULATORY SYSTEM OF STUDENT YOUTH OF THE NORTHEAST OF RUSSIA].

    Science.gov (United States)

    Timofeieva, A V; Klimova, T M; Mikhailova, A E; Zakharova, R N; Vinokurova, S P; Timofeiev, L F

    2015-01-01

    The article considers results of single-step study in random sampling of female students of the M.K. Ammosov north-east federal university (n=456). The study was carried out to investigate somatotype and functional state of circulatory system. The standard technique was applied to measure height, body mass, chest circumference, level of arterial pressure and rate of heart beats. The type of somatotype was established using Pignet index. The tone of vegetative system was determined using Kérdö index. The adaptation potential of circulatory system was determined using functional changes index. The results of study established that in 61% of examined female students the type of constitution corresponds to normosthenic one. The percentage of persons with asthenic and hypersthenic type of constitution amounted to 27% and 12% correspondingly. The signs of increasing oftone ofsympathetic nervous system are observed in 89% of girls. The functional condition of circulatory system is evaluated as "tension of adaptation mechanisms" that is apparently related to period of adaptation to new conditions. The prolonged preservation of such states results in exhaustion offunctional resources of organism and can promote development of diseases. In conditions of impacting of unfavorable ecological factors the deconditionning disorders can significantly contribute to health disturbances and decreasing of life quality. To preserve youth's health during period of education the comprehensive strategy is to be implemented such components as dynamic monitoring of health, organization of adequate diet, explanation of necessity of observance of sleep and rest pattern, development of conditions for active aerobic physical exertion and activities on correction of risk factors of development of diseases are to be included. PMID:26987173

  13. Association of sulfur dioxide exposure with circulatory system deaths in a medium-sized city in Brazil

    International Nuclear Information System (INIS)

    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

  14. 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

    2013-12-01

    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.

  15. Sensitivity Analysis of Median Lifetime on Radiation Risks Estimates for Cancer and Circulatory Disease amongst Never-Smokers

    Science.gov (United States)

    Chappell, Lori J.; Cucinotta, Francis A.

    2011-01-01

    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).

  16. 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

    2012-11-01

    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.

  17. Abdominal irradiation modulates 5-Fluorouracil pharmacokinetics

    Directory of Open Access Journals (Sweden)

    Shueng Pei-Wei

    2010-03-01

    Full Text Available Abstract Background Concurrent chemoradiation with 5-fluorouracil (5-FU is widely accepted for treatment of abdominal malignancy. Nonetheless, the interactions between radiation and 5-FU remain unclear. We evaluated the influence of abdominal irradiation on the pharmacokinetics of 5-FU in rats. Methods The radiation dose distributions of cholangiocarcinoma patients were determined for the low dose areas, which are generously deposited around the intrahepatic target volume. Then, corresponding single-fraction radiation was delivered to the whole abdomen of Sprague-Dawley rats from a linear accelerator after computerized tomography-based planning. 5-FU at 100 mg/kg was intravenously infused 24 hours after radiation. A high-performance liquid chromatography system equipped with a UV detector was used to measure 5-FU in the blood. Ultrafiltration was used to measure protein-unbound 5-FU. Results Radiation at 2 Gy, simulating the daily human treatment dose, reduced the area under the plasma concentration vs. time curve (AUC of 5-FU by 31.7% compared to non-irradiated controls. This was accompanied by a reduction in mean residence time and incremental total plasma clearance values, and volume of distribution at steady state. Intriguingly, low dose radiation at 0.5 Gy, representing a dose deposited in the generous, off-target area in clinical practice, resulted in a similar pharmacokinetic profile, with a 21.4% reduction in the AUC. This effect was independent of protein binding capacity. Conclusions Abdominal irradiation appears to significantly modulate the systemic pharmacokinetics of 5-FU at both the dose level for target treatment and off-target areas. This unexpected and unwanted influence is worthy of further investigation and might need to be considered in clinical practice.

  18. Emerging roles of calcium-activated K channels and TRPV4 channels in lung oedema and pulmonary circulatory collapse

    DEFF Research Database (Denmark)

    Simonsen, Ulf; Wandall-Frostholm, Christine; Oliván-Viguera, Aida;

    2016-01-01

    endothelial/epithelial barrier functions and vascular integrity, while KCa3.1 channels provide the driving force required for Cl(-) and water transport in some cells and most secretory epithelia. The three conditions, increased pulmonary venous pressure caused by left heart disease, high inflation pressure......, fluid extravasation, hemorrhage, pulmonary circulatory collapse, and cardiac arrest in vivo. These data identify KCa3.1 channels as crucial molecular components in downstream TRPV4-signal transduction and as a potential target for the prevention of undesired fluid extravasation, vasodilatation...

  19. Functional Abdominal Pain: "Get" the Function, Loose the Pain.

    Science.gov (United States)

    Draeger-Muenke, Reinhild

    2015-07-01

    Functional abdominal pain is a mind-body, psychosocial, and self-reinforcing experience with significant consequences for the sufferer and the surrounding support network. The occurrence of unpredictable symptoms and their severity add an element of dread and feeling out-of-control to daily life and often reduce overall functioning in a downward spiral. Two clinical presentations of functional abdominal pain are offered in this article (composites to protect confidentiality) dealing with abdominal pain syndrome and abdominal migraines. The treatment demonstrates the use of hypnotic principles for self-regulation, exploration, and meaning-making. Hypnosis treatment is conducted in combination with mindfulness-based interventions and Traditional Chinese Medicine's (TCM) teachings regarding abdominal health and illness. The clinical examples illustrate medical findings that suggest children with early life stress and an early onset of gastrointestinal somatization may not simply outgrow their functional abdominal pain but may suffer into adulthood. PMID:26046716

  20. A Rare Cause of Abdominal Pain; Celiac Truncus Aneurysm

    Directory of Open Access Journals (Sweden)

    Zulfu Birkan

    2016-01-01

    In this case we presented a patient who were admitted to surgery department with complaints of abdominal pain and nausea. There were no pathological findings on physical examination, direct abdominal x-ray, chest radiograph and biochemical parameters. At proximal of the celiac trunk, it was shown approximately 3x2 cm in size fusiform aneurysmal dilatation on the patient%u2019s abdominal ultrasonography and turbulence, arterial flow on the patient%u2019s abdominal doppler ultrasonography subsequently. In abdominal computed tomography we detected dense calcifications, dilatation and hypodensities that may belong to a thrombus in the lumen superior mesenteric vein (SMV. At the same time, approximately 3.5 cm segment of trunk celiak we observed aneurysm dilatation which reaching 2 cm at the widest point. Celiac trunk aneurysm is a rare cause of abdominal pain and often noticed after the complicated, thus it must always be kept in mind in the differential diagnosis.

  1. Simulation-Based Abdominal Ultrasound Training

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Ewertsen, C; Konge, L;

    2016-01-01

    PURPOSE: The aim is to provide a complete overview of the different simulation-based training options for abdominal ultrasound and to explore the evidence of their effect. MATERIALS AND METHODS: This systematic review was performed according to the PRISMA guidelines and Medline, Embase, Web....... CONCLUSION: The included studies were heterogeneous in the choice of simulator, study design, participants, and outcome measures, and the level of evidence for effect was inadequate. In all studies simulation training was equally or more beneficial than other instructions or no instructions. Study designs...

  2. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Directory of Open Access Journals (Sweden)

    Al Soub Hussam

    2008-01-01

    Full Text Available We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. Combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

  3. Chylous complications after abdominal aortic surgery.

    Science.gov (United States)

    Haug, E S; Saether, O D; Odegaard, A; Johnsen, G; Myhre, H O

    1998-12-01

    Two patients developed chylous complications following abdominal aortic aneurysm repair. One patient had chylous ascitis and was successfully treated by a peritoneo-caval shunt. The other patient developed a lymph cyst, which gradually resorbed after puncture. Chylous complications following aortic surgery are rare. Patients in bad a general condition should be treated by initial paracentesis and total parenteral nutrition, supplemented by medium-chain triglyceride and low-fat diet. If no improvement is observed on this regimen, the next step should be implementation of a peritoneo-venous shunt, whereas direct ligation of the leak should be reserved for those who are not responding to this treatment. PMID:10204656

  4. Exercise-related transient abdominal pain (ETAP).

    Science.gov (United States)

    Morton, Darren; Callister, Robin

    2015-01-01

    Exercise-related transient abdominal pain (ETAP), commonly referred to as 'stitch', is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours

  5. PUMPED LASER SYSTEM USING FEEDBACK TO PUMP MEANS

    DEFF Research Database (Denmark)

    2008-01-01

    A laser system according to the invention comprises pump generating means (xO2, xO3) for generating at least a first and a second, preferably focused, pump beam, and lasing means (xO6, xO7) for emitting radiation by being appropriately pumped. The lasing means (xO6, xO7) is disposed in a first...... resonator so as to receive the first pump beam in order to generate a first beam (x21) having a first frequency, and the lasing means (xO6, xO7) is disposed in a second resonator so as to receive the second pump beam in order to generate a second beam (x22) having a second frequency. At least one Q...... fed back to a regulation system (x14), said regulation system (x14) controlling said pump generating means (xO2, xO3)....

  6. Donor preoperative oxygen delivery and post-extubation hypoxia impact donation after circulatory death hypoxic cholangiopathy

    Science.gov (United States)

    Chirichella, Thomas J; Dunham, C Michael; Zimmerman, Michael A; Phelan, Elise M; Mandell, M Susan; Conzen, Kendra D; Kelley, Stephen E; Nydam, Trevor L; Bak, Thomas E; Kam, Igal; Wachs, Michael E

    2016-01-01

    AIM: To evaluate donation after circulatory death (DCD) orthotopic liver transplant outcomes [hypoxic cholangiopathy (HC) and patient/graft survival] and donor risk-conditions. METHODS: From 2003-2013, 45 DCD donor transplants were performed. Predonation physiologic data from UNOS DonorNet included preoperative systolic and diastolic blood pressure, heart rate, pH, SpO2, PaO2, FiO2, and hemoglobin. Mean arterial blood pressure was computed from the systolic and diastolic blood pressures. Donor preoperative arterial O2 content was computed as [hemoglobin (gm/dL) × 1.37 (mL O2/gm) × SpO2%) + (0.003 × PaO2)]. The amount of preoperative donor red blood cell transfusions given and vasopressor use during the intensive care unit stay were documented. Donors who were transfused ≥ 1 unit of red-cells or received ≥ 2 vasopressors in the preoperative period were categorized as the red-cell/multi-pressor group. Following withdrawal of life support, donor ischemia time was computed as the number-of-minutes from onset of diastolic blood pressure 2.0 (69.6% vs 25.0%, P = 0.006), and increased preoperative mean arterial pressure (92.7 ± 16.2 mmHg vs 83.8 ± 18.5 mmHg, P = 0.10). HC was independently associated with age, multi-pressor/red-cell transfusion status, arterial oxygen content, hypoxia score, and mean arterial pressure (r2 = 0.6197). The transplantation rate was greater for the later period with more liberal donor selection [era 2 (7.1/year)], compared to our early experience [era 1 (2.5/year)]. HC occurred in 63.0% during era 2 and in 29.4% during era 1 (P = 0.03). Era 2 donors had longer times for extubation-to-asystole (14.4 ± 4.7 m vs 9.3 ± 4.5 m, P = 0.001), ischemia (13.9 ± 5.9 m vs 9.7 ± 5.6 m, P = 0.03), and hypoxemia (16.0 ± 5.1 m vs 11.1 ± 6.7 m, P = 0.013) and a higher hypoxia score > 2.0 rate (73.1% vs 28.6%, P = 0.006). CONCLUSION: Easily measured donor indices, including a hypoxia score, provide an objective measure of DCD liver transplantation

  7. Experimental Study on Series Operation of Sliding Vane Pump and Centrifugal Pump

    OpenAIRE

    Tao Li; Weiming Zhang; Ming Jiang; Zhengyang Li

    2013-01-01

    A platform for sliding vane pump and centrifugal pump tests is installed to study the series operation of them under different characteristics of pipeline. Firstly, the sliding vane pump and the centrifugal pump work independently, and the performance is recorded. Then, the two types of pumps are combined together, with the sliding vane pump acting as the feeding pump. Comparison is made between the performance of the independently working pump and the performance of series operation pump. Re...

  8. Supercritical waste oxidation pump investigation

    International Nuclear Information System (INIS)

    This report investigates the pumping techniques and pumping equipment that would be appropriate for a 5,000 gallon per day supercritical water oxidation waste disposal facility. The pumps must boost water, waste, and additives from atmospheric pressure to approximately 27.6 MPa (4,000 psia). The required flow ranges from 10 gpm to less than 0.1 gpm. For the higher flows, many commercial piston pumps are available. These pumps have packing and check-valves that will require periodic maintenance; probably at 2 to 6 month intervals. Several commercial diaphragm pumps were also discovered that could pump the higher flow rates. Diaphragm pumps have the advantage of not requiring dynamic seals. For the lower flows associated with the waste and additive materials, commercial diaphragm pumps. are available. Difficult to pump materials that are sticky, radioactive, or contain solids, could be injected with an accumulator using an inert gas as the driving mechanism. The information presented in this report serves as a spring board for trade studies and the development of equipment specifications

  9. Supercritical waste oxidation pump investigation

    Energy Technology Data Exchange (ETDEWEB)

    Thurston, G.; Garcia, K.

    1993-02-01

    This report investigates the pumping techniques and pumping equipment that would be appropriate for a 5,000 gallon per day supercritical water oxidation waste disposal facility. The pumps must boost water, waste, and additives from atmospheric pressure to approximately 27.6 MPa (4,000 psia). The required flow ranges from 10 gpm to less than 0.1 gpm. For the higher flows, many commercial piston pumps are available. These pumps have packing and check-valves that will require periodic maintenance; probably at 2 to 6 month intervals. Several commercial diaphragm pumps were also discovered that could pump the higher flow rates. Diaphragm pumps have the advantage of not requiring dynamic seals. For the lower flows associated with the waste and additive materials, commercial diaphragm pumps. are available. Difficult to pump materials that are sticky, radioactive, or contain solids, could be injected with an accumulator using an inert gas as the driving mechanism. The information presented in this report serves as a spring board for trade studies and the development of equipment specifications.

  10. Report of a Case of Primary Abdominal Pregnancy

    OpenAIRE

    Sh Beigi

    2006-01-01

    Ectopic pregnancy (EP) is a potentially life-threatening condition in which the embryo implants outside the uterine endometrial cavity. Abdominal pregnancy is an atypical site wherein the product of conception lies totally outside the reproductive tract. Primary abdominal pregnancy is a very rare condition with a high mortality rate. Diagnosis is often late or misdiagnosed. The aim of introducing this case report is to present a new case of early primary abdominal pregnancy. Despite regular m...

  11. A large abdominal desmoid tumour associated with pregnancy and puerperium

    OpenAIRE

    Setu Rathod; Sunil Kumar Samal; Purna Chandra Mahapatra

    2014-01-01

    We report a rare case of huge abdominal desmoid tumour first detected during pregnancy. The patient delivered vaginally and the size of the tumour increased during puerperium for which resection was done. Most of these tumours occur in the abdominal muscles particularly right rectus abdominis, perhaps related to trauma from abdominal stretching and movement. These tumours are known to regress spontaneously after delivery which was not in our case. Subsequent pregnancies do not appear to resul...

  12. A prospective study on geriatric abdominal surgical emergencies

    OpenAIRE

    Deepak R. Chavan; Shailesh Kannur; B. B. Metan; Girish Kullolli

    2014-01-01

    Background: Geriatric population is a special subgroup of population undergoing emergency abdominal surgeries. Both higher age group and emergency surgical procedure are considered as high risk factors. In this study, we study the most common cause for geriatric population to undergo an emergency abdominal surgery and the therapeutic outcomes. Methods: All the patients aged more than 60 years coming to surgical department, BLDEU's hospital with acute abdominal conditions. Study period was ...

  13. Abdominal Computed Tomography Findings of Malaria Infection with Plasmodium vivax

    OpenAIRE

    Kim, Eun Mi; Cho, Hyeon Je; Cho, Chong Rae; Kwak, Yee Gyung; Kim, Mi Young; Cho, Yun Ku

    2010-01-01

    Abdominal computed tomography (CT) findings of malaria are not well-known even though malaria is a serious infectious disease. To identify abdominal CT findings, we selected 34 of 405 patients who had a positive peripheral blood smear for Plasmodium vivax and had underwent abdominal CT as the malaria group. We also selected 80 patients who had fever and a negative peripheral blood smear as the control group and 120 healthy people as the normal group. We reviewed and analyzed their medical rec...

  14. Primary abdominal pregnancy following intra-uterine insemination

    Directory of Open Access Journals (Sweden)

    Sujata Kar

    2011-01-01

    Full Text Available Primary abdominal pregnancy is an extremely rare type of extrauterine pregnancy. It has been reported from many unusual intra-abdominal sites. We report a case of primary abdominal pregnancy following intra-uterine insemination (not reported earlier to our knowledge. Implanted on the anterior surface of the uterus possibly related to an endometriotic foci. Early diagnosis enabled laparoscopic management of this case.

  15. Endovascular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience

    Energy Technology Data Exchange (ETDEWEB)

    Choi, You Ri; Chang, Nam Kyu [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Shin, Hyo Hyun; Oh, Hyun Jun; Kim, Jae Kyu; Choi, Soo Jin Na; Chung, Sang Young [Chonnam National University Hospital, Gwangju (Korea, Republic of); Yim, Nam Yeol [Armed Forces Yangju Hospital, Yangju (Korea, Republic of)

    2010-08-15

    To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy. The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively. Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted. Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy

  16. Prevalence of abdominal migraine and recurrent abdominal pain in a Japanese clinic.

    Science.gov (United States)

    Hikita, Toshiyuki

    2016-07-01

    Prevalence of abdominal migraine (AM) and recurrent abdominal pain (RAP) was evaluated in patients who visited Hikita Pediatric Clinic between May 2010 and April 2015. Patient data were collected prospectively using a questionnaire. Out of a total of 3611 cases, observed prevalence was 2.44% for repeated abdominal pain over a period of ≥3 months, 1.47% for RAP, and 0.19% for AM. Duration of abdominal pain was longer for AM than for non-AM RAP. Certain clinical features were significantly different between AM and non-AM RAP. No correlations were found among age at onset, frequency of attack, and duration of attack for various types of RAP. It was difficult to determine useful diagnostic criteria for distinguishing between AM and non-AM RAP. They did not appear to be separate disease entities but, instead, lie on a disease spectrum. The present prevalence of AM (0.19%) was lower than that in many previous studies from countries other than Japan. PMID:27460403

  17. RP-200: Design of PD pump for pumping of molasses

    OpenAIRE

    Skåtun, Kim

    2008-01-01

    Abstract Motivation There is, at the present time, no submerged molasses pump on the market that is designed specifically for cargo tankers. Due to this I, find it interesting to look into the possibilities of installing a molasses pump in cargo tankers to transport molasses instead of transporting molasses in containers as it is done today. It is challenging to come up with a new product, and the motivation of actual be able to release a pump for the international marked is indescribable...

  18. Peristaltic Pumping of Blood in micro-vessels of Non-uniform Cross-section

    CERN Document Server

    Misra, J C

    2010-01-01

    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.

  19. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tania Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanes, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mario Flores, E-mail: marlivermelho@globo.com [Instituto de Infectologia Emilio Ribas (IIER), Sao Paulo, SP (Brazil)

    2015-03-15

    Objective: to evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and methods: retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results: abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion: computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. (author)

  20. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings

    International Nuclear Information System (INIS)

    Objective: to evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and methods: retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results: abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion: computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. (author)